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Jasso Vargas R. [Decrease in Mexico's life expectancy due to multiple homicides: the murder of women adjacent to the homicide of one or more men]. Salud Colect 2023; 19:e4247. [PMID: 37311137 DOI: 10.18294/sc.2023.4247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 01/18/2023] [Indexed: 06/15/2023] Open
Abstract
The objective is to analyze the effect of multiple homicides on male and female life expectancy and to provide empirical evidence of the temporal and spatial associations between male and female homicide rates by age group during the period 2002-2020. Using data from the National Institute of Statistics and Geography (INEGI) and population projections from the National Population Council (CONAPO), mortality rates due to homicide from 2002-2020 were estimated for both men and women, and the adjacency of homicides of men and women was analyzed, along with the spatial proximity between multiple homicides of men and women, along with changes in life expectancy due to homicide. Individual homicides have caused the greatest decrease in life expectancy for both men and women. The negative impact of multiple homicides on both female and male life expectancy began to draw attention in 2008. By analyzing the murders of women adjacent to the homicides of one or more men questions are raised about whether these crimes are primarily the result of criminal violence, and to a lesser extent the role of gender.
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Affiliation(s)
- Rosalba Jasso Vargas
- Doctora en Estudios de Población. Investigadora asociada C, Centro de Investigaciones Multidisciplinarias sobre Chiapas y la Frontera Sur, Universidad Nacional Autónoma México, Chiapas, México
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Solovei A, Rovira P, Anderson P, Jané-Llopis E, Natera Rey G, Arroyo M, Medina P, Mercken L, Rehm J, de Vries H, Manthey J. Improving alcohol management in primary health care in Mexico: A return-on-investment analysis. Drug Alcohol Rev 2023; 42:680-690. [PMID: 36646970 DOI: 10.1111/dar.13598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 10/13/2022] [Accepted: 12/07/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Alcohol screening, brief advice and referral to treatment (SBIRT) in primary health care is an effective strategy to decrease alcohol consumption at population level. However, there is relatively scarce evidence regarding its economic returns in non-high-income countries. The current paper aims to estimate the return-on-investment of implementing a SBIRT program in Mexican primary health-care settings. METHODS Empirical data was collected in a quasi-experimental study, from 17 primary health-care centres in Mexico City regarding alcohol screening delivered by 145 health-care providers. This data was combined with data from a simulation study for a period of 10 years (2008 to 2017). Economic investments were calculated from a public sector health-care perspective as clinical consultation costs (salary and material costs) and program costs (set-up, adaptation, implementation strategies). Economic return was calculated as monetary gains in the public sector health-care, estimated via simulated reductions in alcohol consumption, dependent on population coverage of alcohol interventions delivered to primary health-care patients. RESULTS Results showed that scaling up a SBIRT program in Mexico over a 10-year period would lead to positive return-on-investment values ranging between 21% in scenario 4 (confidence interval -8.6%, 79.5%) and 110% in scenario 5 (confidence interval 51.5%, 239.8%). Moreover, over the 10-year period, up to 16,000 alcohol-related deaths could be avoided as a result of implementing the program. DISCUSSION AND CONCLUSIONS SBIRT implemented at national level in Mexico may lead to substantial financial gains from a public sector health-care perspective.
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Affiliation(s)
- Adriana Solovei
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Communication Science, Amsterdam School of Communication Research/ASCoR, University of Amsterdam, Amsterdam, The Netherlands
| | - Pol Rovira
- Program on Substance Abuse, Public Health Agency of Catalonia, Barcelona, Spain
| | - Peter Anderson
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Eva Jané-Llopis
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- ESADE, University Ramon Llull, Barcelona, Spain
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | | | - Miriam Arroyo
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Perla Medina
- Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Liesbeth Mercken
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Health Psychology, Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Department of International Health Projects, Institute for Leadership and Health Management, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Hein de Vries
- Department of Health Promotion, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Jakob Manthey
- Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
- Center for Interdisciplinary Addiction Research, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry, Medical Faculty, University of Leipzig, Leipzig, Germany
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Aburto JM, Tilstra AM, Floridi G, Dowd JB. Significant impacts of the COVID-19 pandemic on race/ethnic differences in US mortality. Proc Natl Acad Sci U S A 2022; 119:e2205813119. [PMID: 35998219 PMCID: PMC9436308 DOI: 10.1073/pnas.2205813119] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022] Open
Abstract
The coronavirus 2019 (COVID-19) pandemic triggered global declines in life expectancy. The United States was hit particularly hard among high-income countries. Early data from the United States showed that these losses varied greatly by race/ethnicity in 2020, with Hispanic and Black Americans suffering much larger losses in life expectancy compared with White people. We add to this research by examining trends in lifespan inequality, average years of life lost, and the contribution of specific causes of death and ages to race/ethnic life-expectancy disparities in the United States from 2010 to 2020. We find that life expectancy in 2020 fell more for Hispanic and Black males (4.5 and 3.6 y, respectively) compared with White males (1.5 y). These drops nearly eliminated the previous life-expectancy advantage for the Hispanic compared with the White population, while dramatically increasing the already large gap in life expectancy between Black and White people. While the drops in life expectancy for the Hispanic population were largely attributable to official COVID-19 deaths, Black Americans saw increases in cardiovascular diseases and "deaths of despair" over this period. In 2020, lifespan inequality increased slightly for Hispanic and White populations but decreased for Black people, reflecting the younger age pattern of COVID-19 deaths for Hispanic people. Overall, the mortality burden of the COVID-19 pandemic hit race/ethnic minorities particularly hard in the United States, underscoring the importance of the social determinants of health during a public health crisis.
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Affiliation(s)
- José Manuel Aburto
- Leverhulme Centre for Demographic Science, Department of Sociology, and Nuffield College, University of Oxford, Oxford, OX1 1JD, United Kingdom
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, United Kingdom
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark; Odense 5000, Denmark
| | - Andrea M. Tilstra
- Leverhulme Centre for Demographic Science, Department of Sociology, and Nuffield College, University of Oxford, Oxford, OX1 1JD, United Kingdom
- University of Colorado Population Center, Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO 80302
| | - Ginevra Floridi
- Leverhulme Centre for Demographic Science, Department of Sociology, and Nuffield College, University of Oxford, Oxford, OX1 1JD, United Kingdom
| | - Jennifer Beam Dowd
- Leverhulme Centre for Demographic Science, Department of Sociology, and Nuffield College, University of Oxford, Oxford, OX1 1JD, United Kingdom
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Prevalence, incidence and years of life adjusted for disability due to depressive disorders in Mexico: Results of the Global Burden of Disease Study 2019. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Lima EEC, Vilela EA, Peralta A, Rocha M, Queiroz BL, Gonzaga MR, Piscoya-Díaz M, Martinez-Folgar K, García-Guerrero VM, Freire FHMA. Investigating regional excess mortality during 2020 COVID-19 pandemic in selected Latin American countries. GENUS 2021; 77:30. [PMID: 34744175 PMCID: PMC8564791 DOI: 10.1186/s41118-021-00139-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 10/11/2021] [Indexed: 11/10/2022] Open
Abstract
In this paper, we measure the effect of the 2020 COVID-19 pandemic wave at the national and subnational levels in selected Latin American countries that were most affected: Brazil, Chile, Ecuador, Guatemala, Mexico, and Peru. We used publicly available monthly mortality data to measure the impacts of the pandemic using excess mortality for each country and its regions. We compare the mortality, at national and regional levels, in 2020 to the mortality levels of recent trends and provide estimates of the impact of mortality on life expectancy at birth. Our findings indicate that from April 2020 on, mortality exceeded its usual monthly levels in multiple areas of each country. In Mexico and Peru, excess mortality was spreading through many areas by the end of the second half of 2020. To a lesser extent, we observed a similar pattern in Brazil, Chile, and Ecuador. We also found that as the pandemic progressed, excess mortality became more visible in areas with poorer socioeconomic and sanitary conditions. This excess mortality has reduced life expectancy across these countries by 2-10 years. Despite the lack of reliable information on COVID-19 mortality, excess mortality is a useful indicator for measuring the effects of the coronavirus pandemic, especially in the context of Latin American countries, where there is still a lack of good information on causes of death in their vital registration systems. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1186/s41118-021-00139-1.
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Affiliation(s)
| | | | - Andrés Peralta
- Public Health Institute, Pontifical Catholic University of Ecuador (PUCE) – Ecuador, Quito, Ecuador
| | | | | | - Marcos R. Gonzaga
- Departamento de Demografia e Ciências Atuariais, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | | | - Kevin Martinez-Folgar
- Urban Health Collaborative & Department of Epidemiology and Biostatistics, Dornsife School of Public
Health, Drexel University, Philadelphia, PA USA
| | | | - Flávio H. M. A. Freire
- Departamento de Demografia e Ciências Atuariais, Universidade Federal do Rio Grande do Norte, Natal, Brazil
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García-Guerrero VM, Beltrán-Sánchez H. Heterogeneity in Excess Mortality and Its Impact on Loss of Life Expectancy due to COVID-19: Evidence from Mexico. CANADIAN STUDIES IN POPULATION 2021; 48:165-200. [PMID: 34667369 PMCID: PMC8516578 DOI: 10.1007/s42650-021-00051-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 10/31/2022]
Abstract
The new coronavirus (COVID-19) is having a major impact on mortality and survival in most countries of the world, with Mexico being one of the countries most heavily impacted by the pandemic. In this paper, we study the impact of COVID-19 deaths on period life expectancy at birth in Mexico by sex and state. We focus on the loss of life expectancy at different ages as a geographically comparable measure of the pandemic's impact on the population in 2020. Results show that males have been affected more than women since they have lost more years of life expectancy at birth due to COVID-19, and they have also experienced a high variation of life expectancy loss across states. The biggest life expectancy loss concentrates in the Northeastern, Central, and Southeastern (Yucatan peninsula) states. Considering the likely undercount associated with COVID-19 deaths, sensitivity analysis suggests that the new coronavirus is having a much larger impact on life expectancy in Mexico than the official government data appears to indicate. Continuos assessment of the pandemic will help state governments quantify the effect of current and new public health measures.
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Affiliation(s)
- Víctor M García-Guerrero
- Center for Demographic, Urban and Environmental Studies, El Colegio de México A.C, Mexico City, Mexico
| | - Hiram Beltrán-Sánchez
- Department of Community Health Sciences, Fielding School of Public Health, Center for Population Research, University of California At Los Angeles (UCLA), Los Angeles, USA
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Nikoloski Z, Albala S, Montero AM, Mossialos E. The impact of primary health care and specialist physician supply on amenable mortality in Mexico (2000-2015): Panel data analysis using system-Generalized Method of Moments. Soc Sci Med 2021; 278:113937. [PMID: 33932691 DOI: 10.1016/j.socscimed.2021.113937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/04/2021] [Accepted: 04/11/2021] [Indexed: 11/17/2022]
Abstract
The study had a three-fold objective: (i) to estimate the amenable mortality rates and trends at a national and state level between 2000 and 2015 in Mexico; (ii) to estimate the contribution and trends of various causes of death to overall amenable mortality; and (iii) to determine the association between health system inputs and amenable mortality for the period 2000-2015. We used a panel dataset for the period 2000-2015. The following health care inputs were used in the analysis: density of general practitioners, specialists and nurses, as well as density of hospital beds. We find that amenable mortality fell from 136 per 100,000 in 2000, to 124.1 per 100,000 in 2015 nationally, with significant heterogeneity in the trends across states. Mortality due to infectious diseases, diseases of childhood, and cardiovascular diseases decreased, while deaths due to other non-communicable diseases, such as diabetes, increased. There was a significant negative association between the density of general practitioners and specialist physicians, and amenable mortality. Our results indicate that reducing the burden of non-communicable diseases must be a health system priority. Improvements in primary health care could lead to improved disease detection and earlier diagnosis which could further reduce amenable mortality in Mexico.
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Affiliation(s)
- Zlatko Nikoloski
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom.
| | - Sarah Albala
- University College London, London, United Kingdom
| | | | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
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Aburto JM, Calazans J, Lanza Queiroz B, Luhar S, Canudas-Romo V. Uneven state distribution of homicides in Brazil and their effect on life expectancy, 2000-2015: a cross-sectional mortality study. BMJ Open 2021; 11:e044706. [PMID: 33589464 PMCID: PMC7887357 DOI: 10.1136/bmjopen-2020-044706] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 01/08/2021] [Accepted: 01/28/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To determine cause-specific and age-specific contributions to life expectancy changes between 2000 and 2015, separately by state and sex in Brazil, with a focus on homicides. DESIGN Retrospective cross-sectional demographic analysis of mortality. SETTING AND POPULATION Brazilian population by age, sex and state from 2000 to 2015. MAIN OUTCOME MEASURE Using mortality data from the Brazilian Mortality Information System and population estimates from the National Statistics Office, we used death distribution methods and the linear integral decomposition model to estimate levels and changes in life expectancy. We also examine how multiple causes of death, including those attributable to homicides and amenable/avoidable mortality, contributed to these changes from 2000 to 2015. RESULTS Between 2000 and 2015, life expectancy in Brazil increased from 71.5 to 75.1 years. Despite state-level variation in gains, life expectancy increased in almost all states over this period. However across Brazil, homicide mortality contributed, to varying degrees, to either attenuated or decreased male life expectancy gains. In Alagoas in 2000-2007 and Sergipe in 2007-2015, homicides contributed to a reduction in life expectancy of 1.5 years, offsetting gains achieved through improvements due to medically amenable causes. In the period 2007-2015, male life expectancy could have been improved by more than half a year in 12 of Brazil's states if homicide mortality had remained at the levels of 2007. CONCLUSIONS Homicide mortality appears to offset life expectancy gains made through recent improvements to mortality amenable to medical services and public health interventions, with considerable subnational heterogeneity in the extent of this phenomenon. Efforts combating the causes of homicides can increase life expectancy beyond what has been achieved in recent decades.
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Affiliation(s)
- José Manuel Aburto
- Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford, UK
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Julia Calazans
- CEDEPLAR, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Shammi Luhar
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Vladimir Canudas-Romo
- School of Demography, Australian National University, Canberra, Australian Capital Territory, Australia
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García J, Aburto JM. The impact of violence on Venezuelan life expectancy and lifespan inequality. Int J Epidemiol 2020; 48:1593-1601. [PMID: 31006034 PMCID: PMC6857745 DOI: 10.1093/ije/dyz072] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Venezuela is one of the most violent countries in the world. According to the United Nations, homicide rates in the country increased from 32.9 to 61.9 per 100 000 people between 2000 and 2014. This upsurge coincided with a slowdown in life expectancy improvements. We estimate mortality trends and quantify the impact of violence-related deaths and other causes of death on life expectancy and lifespan inequality in Venezuela. METHODS Life tables were computed with corrected age-specific mortality rates from 1996 to 2013. From these, changes in life expectancy and lifespan inequality were decomposed by age and cause of death using a continuous-change model. Lifespan inequality, or variation in age at death, is measured by the standard deviation of the age-at-death distribution. RESULTS From 1996 to 2013 in Venezuela, female life expectancy rose 3.57 [95% confidence interval (CI): 3.08-4.09] years [from 75.79 (75.98-76.10) to 79.36 (78.97-79.68)], and lifespan inequality fell 1.03 (-2.96 to 1.26) years [from 18.44 (18.01-19.00) to 17.41 (17.30-18.27)]. Male life expectancy increased 1.64 (1.09-2.25) years [from 69.36 (68.89-59.70) to 71.00 (70.53-71.39)], but lifespan inequality increased 0.95 (-0.80 to 2.89) years [from 20.70 (20.24-21.08) to 21.65 (21.34-22.12)]. If violence-related death rates had not risen over this period, male life expectancy would have increased an additional 1.55 years, and lifespan inequality would have declined slightly (-0.31 years). CONCLUSIONS As increases in violence-related deaths among young men (ages 15-39) have slowed gains in male life expectancy and increased lifespan inequality, Venezuelan males face more uncertainty about their age at death. There is an urgent need for more accurate mortality estimates in Venezuela.
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Affiliation(s)
- Jenny García
- French Institute for Demographic Studies (INED), Université Paris 1 Panthéon Sorbonne, Paris, France
| | - José Manuel Aburto
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark.,Max Planck Institute for Demographic Research, Rostock, Germany
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Calderón-Garcidueñas L, Torres-Jardón R, Kulesza RJ, Mansour Y, González-González LO, Gónzalez-Maciel A, Reynoso-Robles R, Mukherjee PS. Alzheimer disease starts in childhood in polluted Metropolitan Mexico City. A major health crisis in progress. ENVIRONMENTAL RESEARCH 2020; 183:109137. [PMID: 32006765 DOI: 10.1016/j.envres.2020.109137] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 05/20/2023]
Abstract
Exposures to fine particulate matter (PM2.5) and ozone (O3) above USEPA standards are associated with Alzheimer's disease (AD) risk. Metropolitan Mexico City (MMC) youth have life time exposures to PM2.5 and O3 above standards. We focused on MMC residents ≤30 years and reviewed 134 consecutive autopsies of subjects age 20.03 ± 6.38 y (range 11 months to 30 y), the staging of Htau and ß amyloid, the lifetime cumulative PM2.5 (CPM 2.5) and the impact of the Apolipoprotein E (APOE) 4 allele, the most prevalent genetic risk for AD. We also reviewed the results of the Montreal Cognitive Assessment (MoCA) and the brainstem auditory evoked potentials (BAEPs) in clinically healthy young cohorts. Mobile sources, particularly from non-regulated diesel vehicles dominate the MMC pollutant emissions exposing the population to PM2.5 concentrations above WHO and EPA standards. Iron-rich,magnetic, highly oxidative, combustion and friction-derived nanoparticles (CFDNPs) are measured in the brain of every MMC resident. Progressive development of Alzheimer starts in childhood and in 99.25% of 134 consecutive autopsies ≤30 years we can stage the disease and its progression; 66% of ≤30 years urbanites have cognitive impairment and involvement of the brainstem is reflected by auditory central dysfunction in every subject studied. The average age for dementia using MoCA is 20.6 ± 3.4 y. APOE4 vs 3 carriers have 1.26 higher odds of committing suicide. PM2.5 and CFDNPs play a key role in the development of neuroinflammation and neurodegeneration in young urbanites. A serious health crisis is in progress with social, educational, judicial, economic and overall negative health impact for 25 million residents. Understanding the neural circuitry associated with the earliest cognitive and behavioral manifestations of AD is needed. Air pollution control should be prioritised-including the regulation of diesel vehicles- and the first two decades of life ought to be targeted for neuroprotective interventions. Defining paediatric environmental, nutritional, metabolic and genetic risk factor interactions is a multidisciplinary task of paramount importance to prevent Alzheimer's disease. Current and future generations are at risk.
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Affiliation(s)
| | - Ricardo Torres-Jardón
- Centro de Ciencias de la Atmósfera, Universidad Nacional Autónoma de México, 04310, Ciudad de México, Mexico
| | - Randy J Kulesza
- Auditory Research Center, Lake Erie College of Osteopathic Medicine, Erie, PA, 16509, USA
| | - Yusra Mansour
- Auditory Research Center, Lake Erie College of Osteopathic Medicine, Erie, PA, 16509, USA
| | | | | | | | - Partha S Mukherjee
- Interdisciplinary Statistical Research Unit, Indian Statistical Institute, 700108, Kolkata, India
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12
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Calazans JA, Queiroz BL. The adult mortality profile by cause of death in 10 Latin American countries (2000-2016). Rev Panam Salud Publica 2020; 44:e1. [PMID: 31966038 PMCID: PMC6966090 DOI: 10.26633/rpsp.2020.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 10/03/2019] [Indexed: 11/24/2022] Open
Abstract
Objective To investigate the adult mortality profile from eight causes of death in 10 Latin American countries (Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Mexico, Paraguay, Peru, and Uruguay) from 2000 to 2016. Methods The cause of death effect in adult mortality was calculated as the hypothetical gain in the average number of years lived in adulthood (15 to 60 years old), in a cause-deleted life table. Mortality information by cause, sex, and age group came from the World Health Organization. Results Although the adult mortality levels are very different among the 10 countries, the pattern of mortality by cause of death is very similar. All the countries are in the intermediate stages of the epidemiological transition, with chronic degenerative diseases being predominant. Among males, circulatory system diseases and external causes are the most important causes of death in terms of the average number of years lived in adulthood. Among females, the leading causes are circulatory system diseases and neoplasms. Conclusions Some studies have pointed out that Latin America exhibits severe difficulties in moving through some epidemiological transition phases, given the continuing high mortality from chronic diseases and violent deaths. However, between 2000 and 2016, there was a convergence among the 10 analyzed countries around the theoretical limit in the average number of years lived in adulthood. Countries that include Brazil, Colombia, Ecuador, Mexico, Paraguay, and Peru are still further away from this limit, but they have an enormous potential to increase the number of years lived in adulthood in the future.
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Affiliation(s)
- Júlia Almeida Calazans
- Universidade Federal de Minas Gerais Belo Horizonte Belo HorizonteMinas Gerais Brazil Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Bernardo Lanza Queiroz
- Universidade Federal de Minas Gerais Belo Horizonte Belo HorizonteMinas Gerais Brazil Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Payne CF, Wong R. Expansion of disability across successive Mexican birth cohorts: a longitudinal modelling analysis of birth cohorts born 10 years apart. J Epidemiol Community Health 2019; 73:900-905. [PMID: 31326892 PMCID: PMC6817695 DOI: 10.1136/jech-2019-212245] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 05/30/2019] [Accepted: 06/19/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND Life expectancy (LE) in Mexico has risen rapidly since the 1950s. In high-income contexts, these increases have coincided with a compression of disability to later ages. However, little evidence on trends in disability-free LE (DFLE) exist from Mexico or elsewhere in Latin America. METHODS Using data from the Mexican Health and Aging Study, we compare changes in LE and DFLE in ages 50-59, 60-69 and 70-79 using birth-cohort-specific multistate lifetable models across successive 10-year birth cohorts. Disability was measured using the Katz activities of daily living (ADL) index, and limitation was measured using a seven-item questionnaire on physical functioning. RESULTS Overall, Mexican adults born in 1953-1962 lived 0.87 (p<0.001) fewer active years between ages 50 and 59 than individuals born in 1942-1951, a difference comprised of a 0.54-year (p<0.001) increase in physically limited LE and a 0.27-year (p<0.001) increase in ADL-disabled LE. Active LE declined by 1.13 (p<0.001) years in ages 60-69, and by 0.93 (p<0.001) years in ages 70-79, across successive 10-year birth cohorts. No substantial changes in total LE were seen in any age group, and the magnitude of the expansion of disability was larger in females than in males. CONCLUSIONS Our results indicate that more recently born cohorts of Mexican adults are spending more years of life with physical limitations and disabilities. These results foreshadow a need to closely monitor adult health in middle-income contexts, as the epidemiological conditions under which disability has expanded in Mexico are similar to those seen in many other countries.
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Affiliation(s)
- Collin F Payne
- School of Demography, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Rebeca Wong
- Department of Preventive Medicine and Community Health, The University of Texas Medical Branch, Galveston, Texas, USA.,WHO/PAHO Collaborating Center on Aging and Health, Galveston, Texas, United States
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Alvarez JA, Aburto JM, Canudas-Romo V. Latin American convergence and divergence towards the mortality profiles of developed countries. POPULATION STUDIES 2019; 74:75-92. [PMID: 31179848 DOI: 10.1080/00324728.2019.1614651] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
It is uncertain whether Latin America and Caribbean (LAC) countries are approaching a single mortality regime. Over the last three decades, LAC has experienced major public health interventions and the highest number of homicides in the world. However, these interventions and homicide rates are not evenly shared across countries. This study documents trends in life expectancy and lifespan variability for 20 LAC countries, 2000-14. By extending a previous method, we decompose differences in lifespan variability between LAC and a developed world benchmark into cause-specific effects. For both sexes, dispersion of amenable diseases through the age span makes the largest contribution to the gap between LAC and the benchmark. Additionally, for males, the concentration of homicides, accidents, and suicides in mid-life further impedes mortality convergence. Great disparity exists in the region: while some countries are rapidly approaching the developed regime, others remain far behind and suffer a clear disadvantage in population health.
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Affiliation(s)
| | - José Manuel Aburto
- University of Southern Denmark.,Max Planck Institute for Demographic Research
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Canudas-Romo V, Aburto JM. Youth lost to homicides: disparities in survival in Latin America and the Caribbean. BMJ Glob Health 2019; 4:e001275. [PMID: 31139444 PMCID: PMC6509612 DOI: 10.1136/bmjgh-2018-001275] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/23/2019] [Accepted: 01/25/2019] [Indexed: 11/04/2022] Open
Abstract
Introduction The homicide rates among young men in Latin America and the Caribbean (LAC) are the highest in the world. It is not clear how this has impacted the life expectancy in these countries. This research has two purposes: (1) to quantify the impact of homicides on the mortality gap between LAC and high-income countries over recent years and (2) to assess the changes in homicide impact in overall survival over time. Methods Causes of death data were extracted for 23 countries in the LAC and 15 European countries (average European union-15 [EU-15]), using UN, UNODC, WHO, HMD and IHME databases for the period 2005-2014. The contribution by homicide deaths to the change in life expectancy, over time and as a difference between two populations, was quantified using decomposition methods. Results The contribution by homicide mortality to changes in life expectancy levels differed widely across the examined LAC countries. In Honduras, homicide mortality accounted for 1.75 (95% CI 1.64 to 1.86) and 6.30 (95% CI 6.07 to 6.53) years lower life expectancy than in the EU-15 countries for women and men, respectively. Contrary to this, homicide was just accountable for less than a couple of months of life expectancy differences between Chile and EU-15. Jamaica had the largest reduction in homicides and its impact increased life expectancy over time by almost half a year for men. However, Mexican men and Honduran women have experienced increases in mortality by homicide, which decreased their life expectancy by more than a quarter of a year between 2005 and 2014. Conclusions Excess mortality related to homicides in young people accounted for major changes in life expectancy in the LAC region. Furthermore, reducing excess mortality due to homicides is a crucial goal to further increase longevity towards levels of low-mortality countries. These reductions might prevent homicides spreading to other parts of Latin America. Decision and policy-makers in LAC need to address this immediately, and investing in the young population needs to be given a high priority.
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Affiliation(s)
- Vladimir Canudas-Romo
- School of Demography, College of Arts and Social Sciences, Australian National University, Canberra, Australian Capital Territory, Australia
| | - José Manuel Aburto
- Interdisciplinary Centre on Population Dynamics (CPop), University of Southern Denmark, Odense, Denmark.,Max Planck Institute for Demographic Research, Rostock, Germany
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Aburto JM, Beltrán-Sánchez H. Upsurge of Homicides and Its Impact on Life Expectancy and Life Span Inequality in Mexico, 2005-2015. Am J Public Health 2019; 109:483-489. [PMID: 30676788 DOI: 10.2105/ajph.2018.304878] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES To quantify the effect of the upsurge of violence on life expectancy and life span inequality in Mexico after 2005. METHODS We calculated age- and cause-specific contributions to changes in life expectancy and life span inequality conditional on surviving to age 15 years between 1995 and 2015. We analyzed homicides, medically amenable conditions, diabetes, ischemic heart diseases, and traffic accidents by state and sex. RESULTS Male life expectancy at age 15 years increased by more than twice in 1995 to 2005 (1.17 years) than in 2005 to 2015 (0.55 years). Life span inequality decreased by more than half a year for males in 1995 to 2005, whereas in 2005 to 2015 the reduction was about 4 times smaller. Homicides for those aged between 15 and 49 years had the largest effect in slowing down male life expectancy and life span inequality. Between 2005 and 2015, three states in the north experienced life expectancy losses while 5 states experienced increased life span inequality. CONCLUSIONS Ten years into the upsurge of violence, Mexico has not been able to reduce the homicide levels to those before 2005. Life expectancy and life span inequality stagnated since 2005 for young men at the national level. In some states, males live shorter lives than in 2005, on average, and experience higher uncertainty in their eventual death.
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Affiliation(s)
- José Manuel Aburto
- José Manuel Aburto is a PhD candidate with the Interdisciplinary Center on Population Dynamics, University of Southern Denmark, Odense, Denmark, and the Lifespan Inequalities research group at Max-Planck Institute for Demographic Research, Rostock, Germany. Hiram Beltrán-Sánchez is with the Department of Community Health Sciences at the Fielding School of Public Health and California Center for Population Research, University of California-Los Angeles (UCLA)
| | - Hiram Beltrán-Sánchez
- José Manuel Aburto is a PhD candidate with the Interdisciplinary Center on Population Dynamics, University of Southern Denmark, Odense, Denmark, and the Lifespan Inequalities research group at Max-Planck Institute for Demographic Research, Rostock, Germany. Hiram Beltrán-Sánchez is with the Department of Community Health Sciences at the Fielding School of Public Health and California Center for Population Research, University of California-Los Angeles (UCLA)
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Carvajal SC, Huang S, Bell ML, Denman C, Guernsey de Zapien J, Cornejo E, Chang J, Staten LK, Rosales C. Behavioral and subjective health changes in US and Mexico border residing participants in two promotora-led chronic disease preventive interventions. HEALTH EDUCATION RESEARCH 2018; 33:522-534. [PMID: 30358830 PMCID: PMC6293312 DOI: 10.1093/her/cyy037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 09/25/2018] [Indexed: 06/08/2023]
Abstract
Chronic diseases are the primary health burden among Mexican-origin populations and health promotion efforts have not been able to change negative population trends. This research presents behavioral and subjective health impacts of two related community health worker (CHW) interventions conducted in the US-Mexico border region. Pasos Adelante (United States) and Meta Salud (Mexico) are 12-13 week CHW-led preventive interventions implemented with Mexico-origin adults. Curricula include active learning modules to promote healthy dietary changes and increasing physical activity; they also incorporate strategies to promote social support, empowerment and group exercise components responsive to their communities. Questionnaire data at baseline (N = 347 for Pasos; 171 for Meta Salud), program completion and 3-month follow-up were analyzed. Results showed statistically significant improvements in multiple reported dietary, physical activity and subjective health indicators. Furthermore, at follow-up across both cohorts there were ≥10% improvements in participants' meeting recommended physical activity guidelines, consumption of whole milk, days of poor mental health and self-rated health. While this study identifies some robust health improvements and contributes to the evidence base for these interventions current dissemination, the lack of change observed for some targeted behaviors (e.g. time sitting) suggests they may have stronger overall impacts with curricula refinement.
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Affiliation(s)
- S C Carvajal
- Mel and Enid Zuckerman College of Public Health, Health Promotion Sciences & Arizona Prevention Research Center
| | - S Huang
- Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, Tucson, AZ, USA
| | - M L Bell
- Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, Tucson, AZ, USA
| | - C Denman
- Centro de Estudios en Salud & Sociedad, El Colegio de Sonora, Hermosillo, Sonora, Mexico
| | - J Guernsey de Zapien
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, Tucson, AZ, USA
| | - E Cornejo
- Centro de Estudios en Salud & Sociedad, El Colegio de Sonora, Hermosillo, Sonora, Mexico
| | - J Chang
- Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave, Tucson, AZ, USA
| | - L K Staten
- Social and Behavioral Sciences, Richard M. Fairbanks School of Public Health, Indiana University, 1050 Wishard Blvd, RG, Indianapolis, IN, USA
| | - C Rosales
- Division of Public Health Practice & Translational Research, Mel and Enid Zuckerman College of Public Health, University of Arizona, 714 E. Van Buren Street, Building 4 – UA Phoenix Plaza 119G, Phoenix, AZ, USA
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Aburto JM, Riffe T, Canudas-Romo V. Trends in avoidable mortality over the life course in Mexico, 1990-2015: a cross-sectional demographic analysis. BMJ Open 2018; 8:e022350. [PMID: 30068622 PMCID: PMC6074636 DOI: 10.1136/bmjopen-2018-022350] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To analyse average lifespan and quantify the effect of avoidable/amenable mortality on the difference between state-specific mortality and a low-mortality benchmark in Mexico during 1990-2015. DESIGN Retrospective cross-sectional demographic analysis using aggregated data. SETTING Vital statistics from the Mexican civil registration system. PARTICIPANTS Aggregated national data (from 91.2 million people in 1995 to 119.9 in 2015) grouped in 64 populations (32 Mexican states (including Mexico City) by sex) with cause-of-death data. MAIN OUTCOME MEASURES Cause-specific contributions to the gap in life expectancy with a low-mortality benchmark in three age groups (0-14, 15-49 and 50-84 years). RESULTS Infants and children under the age of 15 years show improvements towards maximal survival in all states. However, adult males aged 15 to 49 years show deterioration after 2006 in almost every state due to increasing homicides, and a slow recovery thereafter. Out of 35 potential years, females and males live on average 34.57 (34.48 to 34.67) and 33.80 (33.34 to 34.27), respectively. Adults aged 50 to 84 years show an unexpected decrease in the low mortality benchmark, indicating nationwide deterioration among older adults. Females and males in this age group show an average survival of 28.59 (27.43 to 29.75) and 26.52 (25.33 to 27.73) out of 35 potential years, respectively. State gaps from the benchmark were mainly caused by ischaemic heart diseases, diabetes, cirrhosis and homicides. We find large health disparities between states, particularly for the adult population after 2005. CONCLUSIONS Mexico has succeeded in reducing mortality and between-state inequalities in children. However, adults are becoming vulnerable as they have not been able to reduce the burden of violence and conditions amenable to health services and behaviours, such as diabetes, ischaemic heart diseases and cirrhosis. These trends have led to large health disparities between Mexican states in the last 25 years.
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Affiliation(s)
- José Manuel Aburto
- Center on Population Dynamics (CPop) and Department of Public Health, University of Southern Denmark, Odense, Denmark
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Tim Riffe
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Vladimir Canudas-Romo
- School of Demography, Australian National University, Canberra, Australian Capital Territory, Australia
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Dávila-Cervantes C, Agudelo-Botero M. Changes in life expectancy due to avoidable and non-avoidable deaths in Argentina, Chile, Colombia and Mexico, 2000-2011. CAD SAUDE PUBLICA 2018; 34:e00093417. [PMID: 29947656 DOI: 10.1590/0102-311x00093417] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 12/04/2017] [Indexed: 02/08/2023] Open
Abstract
The objective of this study was to analyze the level and trend of avoidable deaths and non-avoidable deaths and their contribution to the change in life expectancy in Latin America by studying the situations in Argentina, Chile, Colombia and Mexico between the years 2000 and 2011, stratified by sex and 5-year age groups. The information source used in this study was the mortality vital statistics, and the population data were obtained from censuses or estimates. The proposal by Nolte & McKee (2012) was used to calculate the standardized mortality rates and the influence from avoidable and non-avoidable causes in the change in life expectancy between 0 and 74 years. In Argentina, Chile and Colombia, all the rates declined between the years 2000 and 2011, whereas in Mexico, the avoidable deaths and non-avoidable deaths rates increased slightly for men and decreased for women. In all the countries, the non-avoidable death rates were higher than the avoidable death rates, and the rates were higher for men. The largest contributions to changes in life expectancy were explained by the non-avoidable deaths for men in all countries and for women in Argentina; in contrast, in Chile, Colombia and Mexico, the gains in years of life expectancy for women were mainly a result of avoidable causes. The results suggest there have been reductions in mortality from these causes that have resulted in gains in years of life expectancy in the region. Despite these achievements, differences between countries, sex and age groups are still present, without any noticeable progress in the reduction of these inequalities until now.
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Affiliation(s)
| | - Marcela Agudelo-Botero
- Centro de Investigación en Políticas, Población y Salud, Universidad Nacional Autónoma de México, Ciudad de México, México
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20
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[Analysis of the trend and impact of mortality due to external causes: Mexico, 2000-2013]. Salud Colect 2018; 12:251-264. [PMID: 28414841 DOI: 10.18294/sc.2016.743] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 04/04/2016] [Indexed: 02/05/2023] Open
Abstract
The objective of this study was to analyze mortality due to the main external causes of death (traffic accidents, other accidents, homicides and suicides) in Mexico, calculating the years of life lost between 0 and 100 years of age and their contribution to the change in life expectancy between 2000 and 2013, at the national level, by sex and age group. Data came from mortality vital statistics of the Instituto Nacional de Estadística y Geografía (INEGI) [National Institute of Statistics and Geography]. The biggest impact in mortality due to external causes occurred in adolescent and adult males 15-49 years of age; mortality due to these causes remained constant in males and slightly decreased in females. Mortality due to traffic accidents and other accidents decreased, with a positive contribution to life expectancy, but this effect was canceled out by the increase in mortality due to homicides and suicides. Mortality due to external causes can be avoided through interventions, programs and prevention strategies as well as timely treatment. It is necessary to develop multidisciplinary studies on the dynamics of the factors associated with mortality due to these causes.
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Erlangsen A, Andersen PK, Toender A, Laursen TM, Nordentoft M, Canudas-Romo V. Cause-specific life-years lost in people with mental disorders: a nationwide, register-based cohort study. Lancet Psychiatry 2017; 4:937-945. [PMID: 29122573 DOI: 10.1016/s2215-0366(17)30429-7] [Citation(s) in RCA: 94] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/05/2017] [Accepted: 10/06/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND People with mental disorders have higher mortality rates than the general population and more detailed estimates of mortality differences are needed to address this public health issue. We aimed to assess whether differences in cause-specific mortality between people with and without mental disorders have changed between 1995 and 2014 by quantifying life-years lost and assessing differences over time. METHODS Using a cohort design, we linked nationwide population data from the Danish Civil Registration System to information about hospital contacts from the Psychiatric Central Research Register and deaths from the Danish Cause of Death register. All linked data sources contained longitudinal information covering all individuals aged 15-94 years living in Denmark between 1995 and 2014. We assessed cause-specific mortality differences using rate ratios and average life-years lost. FINDINGS Between 1995 and 2014, 6 107 234 individuals (3 026 132 men and 3 081 102 women) aged 15-94 years were living in Denmark. The study population was observed over 89 216 177 person-years (men: 43 914 948; women 45 301 229). Cause-specific mortality rates were higher for people with mental disorders than those without (total mortality rate per 1000 person-years in men 27·1 vs 11·4, respectively, and in women 21·2 vs 11·0). When compared with individuals without mental disorders, men and women with mental disorders had 10·20 and 7·34 excess life-years lost, respectively. The largest cause-specific differences between those with and without mental disorders in terms of excess life-years lost were for respiratory diseases (men: 0·9; women: 1·4) and alcohol misuse (men: 2·8; women: 1·2). Between 1995 and 2014, we noted an increase in excess life-years lost for neoplasms (men: 0·7; women: 0·4), heart diseases (men: 1·2; women: 0·3), and respiratory diseases (men: 0·3; women: 0·2), and a decrease for suicide (men: -0·7; women: -0·5) and accidents (men: -0·9; women: -0·5). INTERPRETATION By applying a novel approach, more precise estimates of life-years lost were obtained. The increase in excess mortality due to medical diseases and disorders among people with mental disorders emphasises the need for future interventions to address these aspects as well as the continued high shares of excess mortality due to alcohol misuse, suicide, and accidents. FUNDING The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH).
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Affiliation(s)
- Annette Erlangsen
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark; Institute of Regional Health Research, University of Copenhagen, Copenhagen, Denmark.
| | | | - Anita Toender
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark; Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Denmark; National Centre for Register-Based Research, Aarhus University, Denmark
| | - Thomas Munk Laursen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark; Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Denmark; National Centre for Register-Based Research, Aarhus University, Denmark
| | - Merete Nordentoft
- Danish Research Institute for Suicide Prevention, Mental Health Centre Copenhagen, Copenhagen, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; Research Unit, Mental Health Centre Copenhagen, Copenhagen, Denmark
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Aguinaco A, Barra A. Cannabis for personal use in the Supreme Court of Mexico: Legal case and potential for policy change. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 50:9-10. [PMID: 28957741 DOI: 10.1016/j.drugpo.2017.07.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 06/29/2017] [Accepted: 07/26/2017] [Indexed: 11/19/2022]
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Gamlin JB, Hawkes SJ. Masculinities on the Continuum of Structural Violence: The Case of Mexico's Homicide Epidemic. SOCIAL POLITICS 2017; 25:50-71. [PMID: 31198401 PMCID: PMC6565429 DOI: 10.1093/sp/jxx010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Through the theoretical lens of a "violence continuum" we explore how, in many of the most marginalized areas of Mexico, global and regional historical and contemporary structures have shaped and constrained men's ability to achieve the hegemonic masculinity of neoliberal Mexico. An analysis of statistics and local research studies on male homicide is used to understand how impoverishment and extreme inequality can undermine men's capacity to access a dignified standard of living and exercise their masculinity, in the process of which many draw on interpersonal violence as a resource for respect and manhood.
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Aburto JM, Beltrán-Sánchez H, García-Guerrero VM, Canudas-Romo V. Homicides In Mexico Reversed Life Expectancy Gains For Men And Slowed Them For Women, 2000-10. Health Aff (Millwood) 2017; 35:88-95. [PMID: 26733705 DOI: 10.1377/hlthaff.2015.0068] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Life expectancy in Mexico increased for more than six decades but then stagnated in the period 2000-10. This decade was characterized by the enactment of a major health care reform-the implementation of the Seguro Popular de Salud (Popular Health Insurance), which was intended to provide coverage to the entire Mexican population-and by an unexpected increase in homicide mortality. We assessed the impact on life expectancy of conditions amenable to medical service-those sensitive to public health policies and changes in behaviors, homicide, and diabetes-by analyzing mortality trends at the state level. We found that life expectancy among males deteriorated from 2005 to 2010, compared to increases from 2000 to 2005. Females in most states experienced small gains in life expectancy between 2000 and 2010. The unprecedented rise in homicides after 2005 led to a reversal in life expectancy increases among males and a slowdown among females in most states in the first decade of the twenty-first century.
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Affiliation(s)
- José Manuel Aburto
- José Manuel Aburto is a Max Planck Institute for Demographic Research fellow at the European Doctoral School of Demography, Sapienza University, in Rome, Italy
| | - Hiram Beltrán-Sánchez
- Hiram Beltrán-Sánchez is an assistant professor in the Department of Community Health Sciences and at the California Center for Population Research, both at the University of California, Los Angeles
| | - Victor Manuel García-Guerrero
- Victor Manuel García-Guerrero is a professor at the Center of Demographic, Urban, and Environmental Studies, El Colegio de México, in Mexico City
| | - Vladimir Canudas-Romo
- Vladimir Canudas-Romo is an associate professor at the Max-Planck Odense Center on Biodemography of Aging, University of Southern Denmark, in Odense
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Palmer MJ, Clarke L, Ploubidis GB, Mercer CH, Gibson LJ, Johnson AM, Copas AJ, Wellings K. Is "Sexual Competence" at First Heterosexual Intercourse Associated With Subsequent Sexual Health Status? JOURNAL OF SEX RESEARCH 2017; 54:91-104. [PMID: 26891245 PMCID: PMC5214675 DOI: 10.1080/00224499.2015.1134424] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The timing of first sexual intercourse is often defined in terms of chronological age, with particular focus on "early" first sex. Arguments can be made for a more nuanced concept of readiness and appropriateness of timing of first intercourse. Using data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), conducted in 2010-2012, this study examined whether a context-based measure of first intercourse-termed sexual competence-was associated with subsequent sexual health in a population-based sample of 17-to 24-year-olds residing in Britain (n = 2,784). Participants were classified as "sexually competent" at first intercourse if they reported the following four criteria: contraceptive protection, autonomy of decision (not due to external influences), that both partners were "equally willing," and that it happened at the "right time." A lack of sexual competence at first intercourse was independently associated with testing positive for human papillomavirus (HPV) at interview; low sexual function in the past year; and among women only, reported sexually transmitted infection (STI) diagnosis ever; unplanned pregnancy in the past year; and having ever experienced nonvolitional sex. These findings provide empirical support for defining the nature of first intercourse with reference to contextual aspects of the experience, as opposed to a sole focus on chronological age at occurrence.
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Affiliation(s)
- Melissa J. Palmer
- Department of Population Health, London School of Hygiene and Tropical Medicine
| | - Lynda Clarke
- Department of Population Health, London School of Hygiene and Tropical Medicine
| | - George B. Ploubidis
- Department of Social Science, Institute of Education, University College London
| | - Catherine H. Mercer
- Research Department of Infection and Population Health, University College London
| | - Lorna J. Gibson
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine
| | - Anne M. Johnson
- Research Department of Infection and Population Health, University College London
| | - Andrew J. Copas
- Research Department of Infection and Population Health, University College London
| | - Kaye Wellings
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine
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Canudas-Romo V, Aburto JM, García-Guerrero VM, Beltrán-Sánchez H. Mexico's epidemic of violence and its public health significance on average length of life. J Epidemiol Community Health 2016; 71:188-193. [PMID: 27451436 PMCID: PMC5284477 DOI: 10.1136/jech-2015-207015] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 05/30/2016] [Accepted: 07/04/2016] [Indexed: 11/18/2022]
Abstract
Objectives A disproportionate number of homicides have caused Mexican life expectancy to stagnate during the new millennium. No efforts currently exist to quantify the harm of violent acts on the lives of the general population. We quantified the impact of perceived vulnerability on life expectancy. Methods Three Mexican national surveys on perceptions of public safety, life tables, and crime and vital statistics (2000–2014) were used. Prevalence rates of vulnerability/safety by age and sex were obtained from surveys at 2 different levels: federal state and home. The Sullivan method was used to estimate life expectancy lived with and without vulnerability for Mexican women and men. Results Overall life expectancy at age 20 stagnated between 2005 and 2014 for females and males; yet, there was an increase of 40% and 70% in average number of years lived with vulnerability at the state and home levels, respectively. In 2014, female life expectancy at age 20 was 59.5 years (95% CI 59.0 to 60.1); 71% of these years (42.3 years, 41.6 to 43.0) were spent with perceived vulnerability of violence taking place in the state and 26% at the home (15.3 years, 15 to 15.8). For males, life expectancy at age 20 was 54.5 years (53.7 to 55.1); 64% of these years (34.6 years, 34.0 to 35.4) were lived with perceived vulnerability of violence at the state and 20% at the home (11.1 years, 10.8 to 11.5). Conclusions The number of years lived with perceived vulnerability among Mexicans has increased by 30.5 million person-years over the last 10 years. If perceived vulnerability remains at its 2014 level, the average Mexican adults would be expected to live a large fraction of his/her life with perceived vulnerability of violence. Acts of violence continue to rise in the country and they should be addressed as a major public health issue before they become endemic.
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Affiliation(s)
- Vladimir Canudas-Romo
- Max-Planck Odense Center on the Biodemography of Aging, University of Southern Denmark, Odense C, Denmark.,Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Max Planck Institute for Demographic Research, Rostock, Germany
| | - José Manuel Aburto
- Max-Planck Odense Center on the Biodemography of Aging, University of Southern Denmark, Odense C, Denmark.,Max Planck Institute for Demographic Research, Rostock, Germany
| | | | - Hiram Beltrán-Sánchez
- Department of Community Health Sciences at the Fielding School of Public Health and California Center for Population Research, Center for Health Sciences, Los Angeles, California, USA
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Csete J, Kamarulzaman A, Kazatchkine M, Altice F, Balicki M, Buxton J, Cepeda J, Comfort M, Goosby E, Goulão J, Hart C, Kerr T, Lajous AM, Lewis S, Martin N, Mejía D, Camacho A, Mathieson D, Obot I, Ogunrombi A, Sherman S, Stone J, Vallath N, Vickerman P, Zábranský T, Beyrer C. Public health and international drug policy. Lancet 2016; 387:1427-1480. [PMID: 27021149 PMCID: PMC5042332 DOI: 10.1016/s0140-6736(16)00619-x] [Citation(s) in RCA: 305] [Impact Index Per Article: 38.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In September 2015, the member states of the United Nations endorsed sustainable development goals (SDG) for 2030 that aspire to human rights-centered approaches to ensuring the health and well-being of all people. The SDGs embody both the UN Charter values of rights and justice for all and the responsibility of states to rely on the best scientific evidence as they seek to better humankind. In April 2016, these same states will consider control of illicit drugs, an area of social policy that has been fraught with controversy, seen as inconsistent with human rights norms, and for which scientific evidence and public health approaches have arguably played too limited a role. The previous UN General Assembly Special Session (UNGASS) on drugs in 1998 – convened under the theme “a drug-free world, we can do it!” – endorsed drug control policies based on the goal of prohibiting all use, possession, production, and trafficking of illicit drugs. This goal is enshrined in national law in many countries. In pronouncing drugs a “grave threat to the health and well-being of all mankind,” the 1998 UNGASS echoed the foundational 1961 convention of the international drug control regime, which justified eliminating the “evil” of drugs in the name of “the health and welfare of mankind.” But neither of these international agreements refers to the ways in which pursuing drug prohibition itself might affect public health. The “war on drugs” and “zero-tolerance” policies that grew out of the prohibitionist consensus are now being challenged on multiple fronts, including their health, human rights, and development impact. The Johns Hopkins – Lancet Commission on Drug Policy and Health has sought to examine the emerging scientific evidence on public health issues arising from drug control policy and to inform and encourage a central focus on public health evidence and outcomes in drug policy debates, such as the important deliberations of the 2016 UNGASS on drugs. The Johns Hopkins-Lancet Commission is concerned that drug policies are often colored by ideas about drug use and drug dependence that are not scientifically grounded. The 1998 UNGASS declaration, for example, like the UN drug conventions and many national drug laws, does not distinguish between drug use and drug abuse. A 2015 report by the UN High Commissioner for Human Rights, by contrast, found it important to emphasize that “[d]rug use is neither a medical condition nor does it necessarily lead to drug dependence.” The idea that all drug use is dangerous and evil has led to enforcement-heavy policies and has made it difficult to see potentially dangerous drugs in the same light as potentially dangerous foods, tobacco, alcohol for which the goal of social policy is to reduce potential harms.
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Affiliation(s)
| | | | - Michel Kazatchkine
- UN Special Envoy, HIV in Eastern Europe and Central Asia, Geneva, Switzerland
| | | | | | | | - Javier Cepeda
- Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Eric Goosby
- University of California, San Francisco, San Francisco, CA, USA
| | | | - Carl Hart
- Columbia University, New York City, NY, USA
| | - Thomas Kerr
- University of British Columbia, Center of Excellence in HIV/AIDS, Vancouver, BC, Canada
| | | | | | | | | | | | | | | | | | - Susan Sherman
- Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Nandini Vallath
- Trivandrum Institute of Palliative Sciences, Trivandrum, India
| | | | | | - Chris Beyrer
- Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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