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Surugiu R, Iancu MA, Vintilescu ȘB, Stepan MD, Burdusel D, Genunche-Dumitrescu AV, Dogaru CA, Dumitra GG. Molecular Mechanisms of Healthy Aging: The Role of Caloric Restriction, Intermittent Fasting, Mediterranean Diet, and Ketogenic Diet-A Scoping Review. Nutrients 2024; 16:2878. [PMID: 39275194 PMCID: PMC11397047 DOI: 10.3390/nu16172878] [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: 08/07/2024] [Revised: 08/21/2024] [Accepted: 08/23/2024] [Indexed: 09/16/2024] Open
Abstract
As the population ages, promoting healthy aging through targeted interventions becomes increasingly crucial. Growing evidence suggests that dietary interventions can significantly impact this process by modulating fundamental molecular pathways. This review focuses on the potential of targeted dietary strategies in promoting healthy aging and the mechanisms by which specific nutrients and dietary patterns influence key pathways involved in cellular repair, inflammation, and metabolic regulation. Caloric restriction, intermittent fasting, the Mediterranean diet, as well as the ketogenic diet showed promising effects on promoting healthy aging, possibly by modulating mTORC1 AMPK, an insulin signaling pathway. By understanding the intricate interplay between diet and molecular pathways, we can develop personalized dietary strategies that not only prevent age-related diseases, but also promote overall health and well-being throughout the aging process.
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Affiliation(s)
- Roxana Surugiu
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, St. Petru Rares, No. 2-4, 200433 Craiova, Romania
| | - Mihaela Adela Iancu
- Department of Internal Medicine (Cardiology, Gastroenterology, Hepatology, Rheumatology, Geriatrics), Family Medicine, Labor Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Ștefănița Bianca Vintilescu
- Department of Infant Care-Pediatrics-Neonatology, University of Medicine and Pharmacy of Craiova, St. Petru Rares, No. 2-4, 200433 Craiova, Romania
| | - Mioara Desdemona Stepan
- Department of Infant Care-Pediatrics-Neonatology, University of Medicine and Pharmacy of Craiova, St. Petru Rares, No. 2-4, 200433 Craiova, Romania
| | - Daiana Burdusel
- Department of Biochemistry, University of Medicine and Pharmacy of Craiova, St. Petru Rares, No. 2-4, 200433 Craiova, Romania
| | | | - Carmen-Adriana Dogaru
- Department of Family Medicine, University of Medicine and Pharmacy of Craiova, St. Petru Rareș, No. 2-4, 200349 Craiova, Romania
| | - Gheorghe Gindrovel Dumitra
- Department of Family Medicine, University of Medicine and Pharmacy of Craiova, St. Petru Rareș, No. 2-4, 200349 Craiova, Romania
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Bergeron-Boucher MP, Callaway J, Strozza C, Oeppen J. Inequalities in lifespan and mortality risk in the US, 2015-2019: a cross-sectional analysis of subpopulations by social determinants of health. BMJ Open 2024; 14:e079534. [PMID: 39106997 DOI: 10.1136/bmjopen-2023-079534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2024] Open
Abstract
OBJECTIVE To quantify inequalities in lifespan across multiple social determinants of health, how they act in tandem with one another, and to create a scoring system that can accurately identify subgroups of the population at high risk of mortality. DESIGN Comparison of life tables across 54 subpopulations defined by combinations of four social determinants of health: sex, marital status, education and race, using data from the Multiple Cause of Death dataset and the American Community Survey. SETTING United States, 2015-2019. MAIN OUTCOME MEASURES We compared the partial life expectancies (PLEs) between age 30 and 90 years of all subpopulations. We also developed a scoring system to identify subgroups at high risk of mortality. RESULTS There is an 18.0-year difference between the subpopulations with the lowest and highest PLE. Differences in PLE between subpopulations are not significant in most pairwise comparisons. We visually illustrate how the PLE changes across social determinants of health. There is a complex interaction among social determinants of health, with no single determinant fully explaining the observed variation in lifespan. The proposed scoring system adds clarification to this interaction by yielding a single score that can be used to identify subgroups that might be at high risk of mortality. A similar scoring system by cause of death was also created to identify which subgroups could be considered at high risk of mortality from specific causes. Even if subgroups have similar mortality levels, they are often subject to different cause-specific mortality risks. CONCLUSIONS Having one characteristic associated with higher mortality is often not sufficient to be considered at high risk of mortality, but the risk increases with the number of such characteristics. Reducing inequalities is vital for societies, and better identifying individuals and subgroups at high risk of mortality is necessary for public health policy.
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Affiliation(s)
| | - Julia Callaway
- Interdisciplinary Centre on Population Dynamics, Syddansk Universitet, Odense, Denmark
| | - Cosmo Strozza
- Interdisciplinary Centre on Population Dynamics, Syddansk Universitet, Odense, Denmark
| | - Jim Oeppen
- Interdisciplinary Centre on Population Dynamics, Syddansk Universitet, Odense, Denmark
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Romero-Cristóbal M, Díaz-Fontenla F, Fernández-Yunquera A, Caballero-Marcos A, Conthe A, Velasco E, Pérez-Peña J, López-Baena JÁ, Rincón D, Bañares R, Salcedo M. Demographic Trends in Liver Transplant Survivors After 3 Decades of Program Implementation: The Impact of Cohort and Period Effects on Life Expectancy. Transplant Direct 2024; 10:e1684. [PMID: 39081590 PMCID: PMC11288611 DOI: 10.1097/txd.0000000000001684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 05/27/2024] [Indexed: 08/02/2024] Open
Abstract
Background Demographic analyses may reveal current patterns of change in the outcomes of rapidly developing medical procedures because they incorporate the period perspective. Methods We analyzed the changes in size, age structure, and hospitalizations in the population of liver transplantation (LT) survivors in our center during the last 30 y (n = 1114 patients) and generated projections, including life expectancy (LE), considering cohort and period effects. Life tables were used to project the complete LE (overall 1990-2020 experience), the cohort LE (according to the decade of surgery: 1990-2000, 2000-2010, and 2010-2020), and the period LE (current 2015-2020 experience). Results The population of LT recipients in follow-up continued to experience progressive growth and aging since 1990 (492 patients [41.9% >65 y] in 2020), and the magnitude of these phenomena may double in the next 30 y. However, the number of admissions and days of admission has been decreasing. The complete LE at LT was 12.4 y, whereas the period LE was 15.8 y. The cohort LE (limited to 10 y) was 5.3, 6.3, and 7.3 y for the 1990-2000, 2000-2010, and 2010-2020 cohorts, respectively. Conclusions The target population of our medical care after LT is growing and aging. The prevalence of both of these phenomena is expected to increase in the coming years and is associated with a current improvement in LE. However, the hospitalization burden associated with LT survivors is declining. The period effect should be considered for generating up-to-date information on these current trends, which are crucial when designing health policies for LT survivors.
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Affiliation(s)
- Mario Romero-Cristóbal
- Liver Unit, Digestive Department, H.G.U. Gregorio Marañón, Madrid. Spain
- CIBEREHD. Instituto de Salud Carlos III, Madrid, Spain
| | - Fernando Díaz-Fontenla
- Liver Unit, Digestive Department, H.G.U. Gregorio Marañón, Madrid. Spain
- CIBEREHD. Instituto de Salud Carlos III, Madrid, Spain
| | - Ainhoa Fernández-Yunquera
- Liver Unit, Digestive Department, H.G.U. Gregorio Marañón, Madrid. Spain
- CIBEREHD. Instituto de Salud Carlos III, Madrid, Spain
| | - Aranzazu Caballero-Marcos
- Liver Unit, Digestive Department, H.G.U. Gregorio Marañón, Madrid. Spain
- CIBEREHD. Instituto de Salud Carlos III, Madrid, Spain
| | - Andrés Conthe
- Liver Unit, Digestive Department, H.G.U. Gregorio Marañón, Madrid. Spain
- CIBEREHD. Instituto de Salud Carlos III, Madrid, Spain
| | - Enrique Velasco
- Liver Transplant and Hepatobiliary Surgery Unit, H.G.U. Gregorio Marañón, Madrid. Spain
| | - José Pérez-Peña
- Department of Anesthesiology, H.G.U. Gregorio Marañón, Madrid
| | | | - Diego Rincón
- Liver Unit, Digestive Department, H.G.U. Gregorio Marañón, Madrid. Spain
- CIBEREHD. Instituto de Salud Carlos III, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid. Spain
| | - Rafael Bañares
- Liver Unit, Digestive Department, H.G.U. Gregorio Marañón, Madrid. Spain
- CIBEREHD. Instituto de Salud Carlos III, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid. Spain
| | - Magdalena Salcedo
- Liver Unit, Digestive Department, H.G.U. Gregorio Marañón, Madrid. Spain
- CIBEREHD. Instituto de Salud Carlos III, Madrid, Spain
- School of Medicine, Universidad Complutense, Madrid. Spain
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Rousson V, Locatelli I. Years of Life Lost to COVID-19 and Related Mortality Indicators: An Illustration in 30 Countries. Biom J 2024; 66:e202300386. [PMID: 39001703 DOI: 10.1002/bimj.202300386] [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: 12/15/2023] [Revised: 06/07/2024] [Accepted: 06/21/2024] [Indexed: 07/15/2024]
Abstract
The concept of (potential) years of life lost is a measure of premature mortality that can be used to compare the impacts of different specific causes of death. However, interpreting a given number of years of life lost at face value is more problematic because of the lack of a sensible reference value. In this paper, we propose three denominators to divide an excess years of life lost, thus obtaining three indicators, called average life lost, increase of life lost, and proportion of life lost, which should facilitate interpretation and comparisons. We study the links between these three indicators and classical mortality indicators, such as life expectancy and standardized mortality rate, introduce the concept of weighted standardized mortality rate, and calculate them in 30 countries to assess the impact of COVID-19 on mortality in the year 2020. Using any of the three indicators, a significant excess loss is found for both genders in 18 of the 30 countries.
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Affiliation(s)
- Valentin Rousson
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Isabella Locatelli
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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Dai B, Amarteifio ENA, Kyere F, Kwasi Sampene A. Examining the dynamics between economic development, tourism, renewable energy and life expectancy in the Nordic economies. ENVIRONMENTAL RESEARCH 2024; 252:118900. [PMID: 38642635 DOI: 10.1016/j.envres.2024.118900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 03/22/2024] [Accepted: 04/07/2024] [Indexed: 04/22/2024]
Abstract
As the world struggles with pressing issues like climate change and sustainable development, affecting health outcomes and environmental quality, the Nordic regionsare at the forefront of major global challenges. This paper investigates the role of human capital, renewable energy use, tourism, natural resources, and economic growth in shaping life in the Nordic region i.e., Denmark, Norway, Sweden, Finland, and Iceland).Utilizing panel data spanning from 1990 to 2020, the Driscoll and Kraay standard error (DSK) technique is employed to analyze this intricate interplay. The study reveals that in the Nordic context, sustainable economic growth, bolstered by investments in human capital and the widespread acceptance of renewable energy sources, has been positively associated with increased life expectancies. Furthermore, prudent management of natural resources has helped mitigate adverse health effects related to depletion, maintaining environmental and public health standards. The thriving tourism industry has also been shown to influence lifespan in this region positively. On the contrary, the empirical finding contended that an adverse correlation exists between carbon emissions and LEX. This research underscores the importance of a comprehensive and balanced approach that considers economic development, sustainable development, and public health in pursuing longer and healthier lives, providing valuable insights for policymakers and regions seeking to replicate these positive outcomes.The findings of this study are both conceptually reliable and empirically robust, providing important insights for the formulation of environmental and health policy.
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Affiliation(s)
- Baozhen Dai
- Department of Labor and Social Security, School of Public Health, Southeast University, 87 Dingjiaqiao, Nanjing, Jiangsu province, 210009, China.
| | - Edwina Naa Amerley Amarteifio
- Department of Health Policy and Management, Jiangsu University, School of Management, 301 Xuefu Road, Zhenjiang, Jiangsu Province, China.
| | - Francis Kyere
- School of Management Science and Engineering, Jiangsu University, No. 301 Xuefu Road, Zhenjiang, 212013, China.
| | - Agyemang Kwasi Sampene
- School of Management Science and Engineering, Jiangsu University, No. 301 Xuefu Road, Zhenjiang, 212013, China.
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Neilan AM, Ufio OL, Brenner IR, Flanagan CF, Shebl FM, Hyle EP, Freedberg KA, Ciaranello AL, Patel K. Projected Life Expectancy for Adolescents With HIV in the US. JAMA HEALTH FORUM 2024; 5:e240816. [PMID: 38728022 PMCID: PMC11087843 DOI: 10.1001/jamahealthforum.2024.0816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 02/25/2024] [Indexed: 05/12/2024] Open
Abstract
Importance Life expectancy is a key measure of overall population health. Life expectancy estimates for youth with HIV in the US are needed in the current HIV care and treatment context to guide health policies and resource allocation. Objective To compare life expectancy between 18-year-old youth with perinatally acquired HIV (PHIV), youth with nonperinatally acquired HIV (NPHIV), and youth without HIV. Design, Setting, and Participants Using a US-focused adolescent-specific Monte Carlo state-transition HIV model, we simulated individuals from age 18 years until death. We estimated probabilities of HIV treatment and care engagement, HIV progression, clinical events, and mortality from observational cohorts and clinical trials for model input parameters. The simulated individuals were 18-year-old race and ethnicity-matched youth with PHIV, youth with NPHIV, and youth without HIV; 47%, 85%, and 50% were assigned male sex at birth, respectively. Individuals were categorized by US Centers for Disease Control and Prevention-defined HIV acquisition risk: men who have sex with men, people who ever injected drugs, heterosexually active individuals at increased risk for HIV infection, or average risk for HIV infection. Distributions were 3%, 2%, 12%, and 83% for youth with PHIV and youth without HIV, and 80%, 6%, 14%, and 0% for youth with NPHIV, respectively. Among the simulated youth in this analysis, individuals were 61% Black, 24% Hispanic, and 15% White, respectively. Exposures HIV status by timing of acquisition. Main Outcomes Life expectancy loss for youth with PHIV and youth with NPHIV: difference between mean projected life expectancy under current and ideal HIV care scenarios compared with youth without HIV. Uncertainty intervals reflect varying adolescent HIV-related mortality inputs (95% CIs). Results Compared with youth without HIV (life expectancy: male, 76.3 years; female, 81.7 years), male youth with PHIV and youth with NPHIV had projected life expectancy losses of 10.4 years (95% CI, 5.5-18.1) and 15.0 years (95% CI, 9.3-26.8); female youth with PHIV and youth with NPHIV had projected life expectancy losses of 11.8 years (95% CI, 6.4-20.2) and 19.5 years (95% CI, 13.8-31.6), respectively. When receiving ideal HIV care, life expectancy losses were projected to improve for youth with PHIV (male: 0.5 years [95% CI, 0.3-1.8]: female: 0.6 years [95% CI, 0.4-2.1]) but were projected to persist for youth with NPHIV (male: 6.0 years [95% CI, 5.0-9.1]; female: 10.4 years [95% CI, 9.4-13.6]). Conclusions This adolescent-focused microsimulation modeling analysis projected that youth with HIV would have shorter life expectancy than youth without HIV. Projected differences were larger for youth with NPHIV compared with youth with PHIV. Differences in mortality by sex at birth, sexual behavior, and injection drug use contributed to lower projected life expectancy among youth with NPHIV. Interventions focused on HIV care and social factors are needed to improve life expectancy for youth with HIV in the US.
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Affiliation(s)
- Anne M. Neilan
- Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital, Boston
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - Ogochukwu L. Ufio
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston
| | - Isaac Ravi Brenner
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston
| | - Clare F. Flanagan
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston
| | - Fatma M. Shebl
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
| | - Emily P. Hyle
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
- Harvard University Center for AIDS Research, Cambridge, Massachusetts
| | - Kenneth A. Freedberg
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
- Harvard University Center for AIDS Research, Cambridge, Massachusetts
- Division of General Internal Medicine, Massachusetts General Hospital, Boston
| | - Andrea L. Ciaranello
- Medical Practice Evaluation Center, Massachusetts General Hospital, Boston
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, Massachusetts
- Harvard University Center for AIDS Research, Cambridge, Massachusetts
| | - Kunjal Patel
- Department of Epidemiology, Center for Biostatistics in AIDS Research, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
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Luy M. [Healthy life expectancy: a critical look at the benefits and potential of the demographic health indicator]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2024; 67:538-545. [PMID: 38656349 PMCID: PMC11093867 DOI: 10.1007/s00103-024-03874-w] [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: 02/18/2024] [Accepted: 03/25/2024] [Indexed: 04/26/2024]
Abstract
Demographic ageing yields many societal consequences that depend strongly on the health status of the population. Special indicators have been developed for tracking and assessing population health, which are referred to with the overarching term healthy life expectancy (HLE). The derivation of HLE is intuitive and easily comprehensible. However, an overly simplistic interpretation hides the extreme complexity inherent in adding the health dimension to the life table. This makes HLE compared to classic life expectancy (LE) extremely sensitive to certain conceptual and methodological features. In the article, this is presented in more detail for three aspects: the underlying definition of health, the choice of survey data as a basis for estimating health status, and the reporting behavior of survey participants. It is shown that the impact on HLE can be enormous, leading to considerable bias in the interpretation of levels and trends, but also in the analysis of differences between populations. Nevertheless, the extension of classical LE to HLE is an important achievement that must not be abandoned. Therefore, the article also discusses ways in which the HLE indicator could be made more robust and reliable. Until this is achieved, however, the high methodological sensitivity of HLE must not be ignored if it is used to assess the health status of populations and as a basis for health policy measures.
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Affiliation(s)
- Marc Luy
- Vienna Institute of Demography, Österreichische Akademie der Wissenschaften, Dominikanerbastei 16, 1010, Wien, Österreich.
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Tetzlaff F, Sauerberg M, Grigoriev P, Tetzlaff J, Mühlichen M, Baumert J, Michalski N, Wengler A, Nowossadeck E, Hoebel J. Age-specific and cause-specific mortality contributions to the socioeconomic gap in life expectancy in Germany, 2003-21: an ecological study. Lancet Public Health 2024; 9:e295-e305. [PMID: 38702094 DOI: 10.1016/s2468-2667(24)00049-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/01/2024] [Accepted: 03/05/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND Earlier death among people in socioeconomically deprived circumstances has been found internationally and for various causes of death, resulting in a considerable life-expectancy gap between socioeconomic groups. We examined how age-specific and cause-specific mortality contributions to the socioeconomic gap in life expectancy have changed at the area level in Germany over time. METHODS In this ecological study, official German population and cause-of-death statistics provided by the Federal Statistical Office of Germany for the period Jan 1, 2003, to Dec 31, 2021, were linked to district-level data of the German Index of Socioeconomic Deprivation. Life-table and decomposition methods were applied to calculate life expectancy by area-level deprivation quintile and decompose the life-expectancy gap between the most and least deprived quintiles into age-specific and cause-specific mortality contributions. FINDINGS Over the study period, population numbers varied between 80 million and 83 million people per year, with the number of deaths ranging from 818 000 to 1 024 000, covering the entire German population. Between Jan 1, 2003, and Dec 31, 2019, the gap in life expectancy between the most and least deprived quintiles of districts increased by 0·7 years among females (from 1·1 to 1·8 years) and by 0·1 years among males (from 3·0 to 3·1 years). Thereafter, during the COVID-19 pandemic, the gap increased more rapidly to 2·2 years in females and 3·5 years in males in 2021. Between 2003 and 2021, the causes of death that contributed the most to the life-expectancy gap were cardiovascular diseases and cancer, with declining contributions of cardiovascular disease deaths among those aged 70 years and older and increasing contributions of cancer deaths among those aged 40-74 years over this period. COVID-19 mortality among individuals aged 45 years and older was the strongest contributor to the increase in life-expectancy gap after 2019. INTERPRETATION To reduce the socioeconomic gap in life expectancy, effective efforts are needed to prevent early deaths from cardiovascular disease and cancer in socioeconomically deprived populations, with cancer prevention and control becoming an increasingly important field of action in this respect. FUNDING German Cancer Aid and European Research Council.
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Affiliation(s)
- Fabian Tetzlaff
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | - Markus Sauerberg
- Research Area of Ageing, Mortality and Population Dynamics, Federal Institute for Population Research (BiB), Wiesbaden, Germany
| | - Pavel Grigoriev
- Research Area of Ageing, Mortality and Population Dynamics, Federal Institute for Population Research (BiB), Wiesbaden, Germany
| | - Juliane Tetzlaff
- Medical Sociology Unit, Hannover Medical School, Hannover, Germany
| | | | - Jens Baumert
- Division of Physical Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Niels Michalski
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Annelene Wengler
- Division of Health Reporting, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Enno Nowossadeck
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Jens Hoebel
- Division of Social Determinants of Health, Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Poucineau J, Khlat M, Lapidus N, Espagnacq M, Chouaïd C, Delory T, Le Coeur S. Impact of the COVID-19 Pandemic on COPD Patient Mortality: A Nationwide Study in France. Int J Public Health 2024; 69:1606617. [PMID: 38362309 PMCID: PMC10868525 DOI: 10.3389/ijph.2024.1606617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/12/2024] [Indexed: 02/17/2024] Open
Abstract
Objectives: We investigated the mortality patterns of chronic obstructive pulmonary disease (COPD) patients in France relative to a control population, comparing year 2020 to pre-pandemic years 2017-2019. Methods: COPD patient and sex, age and residence matched control cohorts were created from the French National Health Data System. Survival was analyzed using Cox regressions and standardized rates. Results: All-cause mortality increased in 2020 compared to 2019 in the COPD population (+4%), but to a lesser extent than in the control population (+10%). Non-COVID-19 mortality decreased to a greater extent in COPD patients (-5%) than in the controls (-2%). Death rate from COVID-19 was twice as high in the COPD population relative to the control population (547 vs. 279 per 100,000 person-years). Conclusion: The direct impact of the pandemic in terms of deaths from COVID-19 was much greater in the COPD population than in the control population. However, the larger decline in non-COVID-19 mortality in COPD patients could reflect a specific protective effect of the containment measures on this population, counterbalancing the direct impact they had been experiencing.
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Affiliation(s)
- Jonas Poucineau
- Institut National d’Études Démographiques (INED), Paris, France
- Institut de Recherche et Documentation en Économie de la Santé (IRDES), Paris, France
| | - Myriam Khlat
- Institut National d’Études Démographiques (INED), Paris, France
| | - Nathanaël Lapidus
- Faculté de Santé, Sorbonne Université, Paris, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1136 Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
- Hôpital Saint-Antoine, Paris, France
| | - Maude Espagnacq
- Institut de Recherche et Documentation en Économie de la Santé (IRDES), Paris, France
| | - Christos Chouaïd
- Institut National de la Santé et de la Recherche Médicale (INSERM) U955 Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
- Hospital Center Intercommunal De Créteil, Créteil, France
| | - Tristan Delory
- Institut National d’Études Démographiques (INED), Paris, France
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1136 Institut Pierre Louis d’Epidémiologie et de Santé Publique, Paris, France
- Centre Hospitalier Annecy Genevois (CH Annecy), Metz-Tessy, France
| | - Sophie Le Coeur
- Institut National d’Études Démographiques (INED), Paris, France
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Soriano J, Prebil LA, Hannah H, Mhatre P, Santora L, Willis M. Life Expectancy and Causes of Premature Death by Subgroup for Community-Based Action in Marin County, California, 2017-2021. Cureus 2023; 15:e51300. [PMID: 38288212 PMCID: PMC10822772 DOI: 10.7759/cureus.51300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2023] [Indexed: 01/31/2024] Open
Abstract
INTRODUCTION Marin is a medium-sized county in California's San Francisco Bay Area. Despite its historically higher-than-average life expectancy and socioeconomic level, known economic and health disparities by race, ethnicity, and geography became more visible during the COVID-19 pandemic. Methods: We calculated life expectancy, measured years of potential life lost (YPLLs), and described premature mortality for the five years of 2017-2021 by race, ethnicity, census tract, and resource level (as measured by Healthy Places Index [HPI]) to provide data on inequities to guide community-centered action to reduce premature mortality. Results: Life expectancy for the county was 85.2 years. The non-Hispanic African American/Black population experienced the lowest life expectancy of 77.1 years, 11.6 years lower than the non-Hispanic Asian population which had the highest life expectancy (88.7 years). There was a 14.9-year difference in life expectancy between the census tracts with the lowest (77.1 years) and highest (92.0 years) estimates. We found a moderate, positive association between census tract resource level (HPI) and life expectancy (r=0.58, p<0.01). The leading causes of premature death were cancer, diseases of the circulatory system, and accidental overdoses, with variation by subgroup. Conclusion: These data highlight health disparities that persist in Marin County and can inform data-driven public health strategies to narrow gaps in longevity between communities.
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Affiliation(s)
- Jasmine Soriano
- Epidemiology and Public Health, Marin County Department of Health & Human Services, San Rafael, USA
| | - Lee Ann Prebil
- Epidemiology and Public Health, Marin County Department of Health & Human Services, San Rafael, USA
| | - Haylea Hannah
- Epidemiology and Public Health, Marin County Department of Health & Human Services, San Rafael, USA
| | - Pooja Mhatre
- Epidemiology and Public Health, Marin County Department of Health & Human Services, San Rafael, USA
| | - Lisa Santora
- Epidemiology and Public Health, Marin County Department of Health & Human Services, San Rafael, USA
| | - Matthew Willis
- Epidemiology and Public Health, Marin County Department of Health & Human Services, San Rafael, USA
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Wang Z, Liu W, Ren Y, Zhang C, Yang J, Wang L, Zhou M, Yin P, Hao J, Ma Q. Loss of life expectancy due to stroke and its subtypes in urban and rural areas in China, 2005-2020. Stroke Vasc Neurol 2023; 8:349-357. [PMID: 36878612 PMCID: PMC10647878 DOI: 10.1136/svn-2022-001968] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/21/2023] [Indexed: 03/08/2023] Open
Abstract
Stroke is characterised by high mortality and disability rate in China. This study aimed to explore the temporal trends in years of life lost (YLL) and loss of life expectancy due to stroke and its subtypes in urban and rural areas in China during 2005-2020. Data were obtained from China National Mortality Surveillance System. Abbreviated life and stroke-eliminated life tables were generated to calculate loss of life expectancy. The YLL and loss of life expectancy due to stroke in urban and rural areas at both national and provincial level during 2005-2020 were estimated. In China, the age-standardised YLL rate due to stroke and its subtypes were higher in rural areas than in urban areas. The YLL rate due to stroke showed a downward trend in both urban and rural residents from 2005 to 2020, decreased by 39.9% and 21.5%, respectively. Loss of life expectancy caused by stroke decreased from 1.75 years to 1.70 years from 2005 to 2020. During which, loss of life expectancy due to intracerebral haemorrhage (ICH) decreased from 0.94 years to 0.65 years, while that of ischaemic stroke (IS) increased from 0.62 years to 0.86 years. A slightly upward trend was observed in loss of life expectancy caused by subarachnoid haemorrhage (SAH), from 0.05 years to 0.06 years. Loss of life expectancy due to ICH and SAH was always higher in rural areas than in urban areas, whereas that of IS was higher in urban areas than in rural areas. Rural males suffered the greatest loss of life expectancy due to ICH and SAH, while the highest loss of life expectancy caused by IS was found in urban females. Furthermore, Heilongjiang (2.25 years), Tibet (2.17 years) and Jilin (2.16 years) were found to have the highest loss of life expectancy caused by stroke in 2020. Loss of life expectancy caused by ICH and SAH was higher in western China, while the disease burden of IS was heavier in northeast China. Stroke remains a major public health problem in China, although the age-standardised YLL rate and loss of life expectancy due to stroke decreased. Evidence-based strategies should be conducted to reduce the premature death burden caused by stroke and prolong life expectancy in Chinese population.
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Affiliation(s)
- Zixin Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Center for Neurological Disorders, Beijing, China
| | - Wei Liu
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yi Ren
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Center for Neurological Disorders, Beijing, China
| | - Chen Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Center for Neurological Disorders, Beijing, China
| | - Jia Yang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Center for Neurological Disorders, Beijing, China
| | - Lijun Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Yin
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Junwei Hao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Center for Neurological Disorders, Beijing, China
| | - Qingfeng Ma
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
- National Center for Neurological Disorders, Beijing, China
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12
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Trias-Llimós S, Spijker JJ, Blanes A, Permanyer I. Age and cause-of-death contributions to educational inequalities in life expectancy and lifespan variation in a low-mortality country: A cross-sectional study of 1.67 million deaths in Spain (2016-19). SSM Popul Health 2023; 23:101461. [PMID: 37554668 PMCID: PMC10404554 DOI: 10.1016/j.ssmph.2023.101461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND We aim to assess the age- and cause-specific contributions to differences in life expectancy and lifespan variation between the high- and low-educated groups in Spain. METHODS We use sex-, age-, education- and cause-specific mortality and population data for individuals aged 30 and over for 2016-19 in Spain. We estimated life expectancies, and standard deviations of the age-at-death distribution (lifespan variation), and we disentangled the contribution of age-causes of death to educational differences in both indicators. FINDINGS Life expectancy at age 30 was higher for high-educated groups compared to low-educated groups, 5.5 years for males and 3.0 years for females. Lifespan variation was higher for low-educated groups compared to high-educated groups, 2.9 years for males and 2.2 years for females. The main contributors to the life expectancy gaps in males were lung cancer (0.58 years) and ischaemic heart diseases (0.42 years), and in females were other cardiovascular causes (0.26 years), and ischaemic heart diseases (0.22 years). The main contributors to the lifespan variation gaps were in males lung cancer (-0.25 years) and ischaemic heart diseases (-0.22 years), while in females were other neoplasms and other diseases of the nervous system. INTERPRETATION Whereas behavioural causes are more important in explaining educational inequalities in mortality among men, ageing-related causes of death seem more important among women. Attempts at narrowing socioeconomic gaps in mortality may benefit from applying gender-specific preventive policy measures.
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Affiliation(s)
- Sergi Trias-Llimós
- Centre d’Estudis Demogràfics, Centres de Recerca de Catalunya (CERCA), Carrer de Ca n’Altayó, Edifici E2, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Jeroen J.A. Spijker
- Centre d’Estudis Demogràfics, Centres de Recerca de Catalunya (CERCA), Carrer de Ca n’Altayó, Edifici E2, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Amand Blanes
- Centre d’Estudis Demogràfics, Centres de Recerca de Catalunya (CERCA), Carrer de Ca n’Altayó, Edifici E2, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
| | - Iñaki Permanyer
- Centre d’Estudis Demogràfics, Centres de Recerca de Catalunya (CERCA), Carrer de Ca n’Altayó, Edifici E2, Universitat Autònoma de Barcelona, 08193 Bellaterra, Spain
- ICREA, Passeig Lluís Companys 23, 08010, Barcelona, Spain
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13
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Cases L, Vela E, Santaeugènia Gonzàlez SJ, Contel JC, Carot-Sans G, Coca M, Pastor M, Carrasco I, Barbeta C, Vila A, Amil P, Plaza A, Pontes C, Piera-Jiménez J, Amblàs J. Excess mortality among older adults institutionalized in long-term care facilities during the COVID-19 pandemic: a population-based analysis in Catalonia. Front Public Health 2023; 11:1208184. [PMID: 37732085 PMCID: PMC10507684 DOI: 10.3389/fpubh.2023.1208184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/15/2023] [Indexed: 09/22/2023] Open
Abstract
Objectives To assess excess mortality among older adults institutionalized in nursing homes within the successive waves of the COVID-19 pandemic in Catalonia (north-east Spain). Design Observational, retrospective analysis of population-based central healthcare registries. Setting and participants Individuals aged >65 years admitted in any nursing home in Catalonia between January 1, 2015, and April 1, 2022. Methods Deaths reported during the pre-pandemic period (2015-2019) were used to build a reference model for mortality trends (a Poisson model, due to the event counting nature of the variable "mortality"), adjusted by age, sex, and clinical complexity, defined according to the adjusted morbidity groups. Excess mortality was estimated by comparing the observed and model-based expected mortality during the pandemic period (2020-2022). Besides the crude excess mortality, we estimated the standardized mortality rate (SMR) as the ratio of weekly deaths' number observed to the expected deaths' number over the same period. Results The analysis included 175,497 older adults institutionalized (mean 262 days, SD 132), yielding a total of 394,134 person-years: 288,948 person-years within the reference period (2015-2019) and 105,186 within the COVID-19 period (2020-2022). Excess number of deaths in this population was 5,403 in the first wave and 1,313, 111, -182, 498, and 329 in the successive waves. The first wave on March 2020 showed the highest SMR (2.50; 95% CI 2.45-2.56). The corresponding SMR for the 2nd to 6th waves were 1.31 (1.27-1.34), 1.03 (1.00-1.07), 0.93 (0.89-0.97), 1.13 (1.10-1.17), and 1.07 (1.04-1.09). The number of excess deaths following the first wave ranged from 1,313 (2nd wave) to -182 (4th wave). Excess mortality showed similar trends for men and women. Older adults and those with higher comorbidity burden account for higher number of deaths, albeit lower SMRs. Conclusion Excess mortality analysis suggest a higher death toll of the COVID-19 crisis in nursing homes than in other settings. Although crude mortality rates were far higher among older adults and those at higher health risk, younger individuals showed persistently higher SMR, indicating an important death toll of the COVID-19 in these groups of people.
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Affiliation(s)
- Laia Cases
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic—Central University of Catalonia (UVIC-UCC), Barcelona, Spain
- Sub-Directorate General of Surveillance and Response to Public Health Emergencies, Public Health Agency of Catalonia, Generalitat of Catalonia, Barcelona, Spain
| | - Emili Vela
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3), IDIBELL, Barcelona, Spain
| | - Sebastià J. Santaeugènia Gonzàlez
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic—Central University of Catalonia (UVIC-UCC), Barcelona, Spain
- General Directorate of Health and Research Planning, Department of Health, Generalitat de Catalunya, Barcelona, Spain
| | - Joan Carles Contel
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic—Central University of Catalonia (UVIC-UCC), Barcelona, Spain
- General Directorate of Health and Research Planning, Department of Health, Generalitat de Catalunya, Barcelona, Spain
- Integrated Social and Health Care Program, Generalitat de Catalunya, Barcelona, Spain
| | - Gerard Carot-Sans
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3), IDIBELL, Barcelona, Spain
| | - Marc Coca
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3), IDIBELL, Barcelona, Spain
| | - Marta Pastor
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3), IDIBELL, Barcelona, Spain
| | - Ignasi Carrasco
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic—Central University of Catalonia (UVIC-UCC), Barcelona, Spain
- Catalan Health Service, Barcelona, Spain
| | - Conxita Barbeta
- Integrated Social and Health Care Program, Generalitat de Catalunya, Barcelona, Spain
- Department of Social Welfare, Generalitat de Catalunya, Barcelona, Spain
| | - Anna Vila
- Integrated Social and Health Care Program, Generalitat de Catalunya, Barcelona, Spain
- Department of Social Welfare, Generalitat de Catalunya, Barcelona, Spain
| | - Paloma Amil
- General Directorate of Health and Research Planning, Department of Health, Generalitat de Catalunya, Barcelona, Spain
- Integrated Social and Health Care Program, Generalitat de Catalunya, Barcelona, Spain
| | - Aina Plaza
- General Directorate of Health and Research Planning, Department of Health, Generalitat de Catalunya, Barcelona, Spain
- Integrated Social and Health Care Program, Generalitat de Catalunya, Barcelona, Spain
| | - Caridad Pontes
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3), IDIBELL, Barcelona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Piera-Jiménez
- Catalan Health Service, Barcelona, Spain
- Digitalization for the Sustainability of the Healthcare System (DS3), IDIBELL, Barcelona, Spain
- Faculty of Informatics, Multimedia and Telecommunications, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Jordi Amblàs
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), University of Vic—Central University of Catalonia (UVIC-UCC), Barcelona, Spain
- General Directorate of Health and Research Planning, Department of Health, Generalitat de Catalunya, Barcelona, Spain
- Integrated Social and Health Care Program, Generalitat de Catalunya, Barcelona, Spain
- Faculty of Medicine, University of Vic-Central University of Catalonia, Vic, Spain
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14
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Locatelli I, Rousson V. Two complementary approaches to estimate an excess of mortality: The case of Switzerland 2022. PLoS One 2023; 18:e0290160. [PMID: 37582109 PMCID: PMC10426989 DOI: 10.1371/journal.pone.0290160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 07/26/2023] [Indexed: 08/17/2023] Open
Abstract
OBJECTIVE During the COVID-19 pandemic, excess mortality has generally been estimated comparing overall mortality in a given year with either past mortality levels or past mortality trends, with different results. Our objective was to illustrate and compare the two approaches using mortality data for Switzerland in 2022, the third year of the COVID-19 pandemic. METHODS Using data from the Swiss Federal Statistical Office, standardized mortality rates and life expectancies in 2022 were compared with those of the last pre-pandemic year 2019 (first approach), as well as with those that would be expected if the pre-pandemic downward trend in mortality had continued during the pandemic (second approach). The pre-pandemic trend was estimated via a Poisson log-linear model on age-specific mortality over the period 2010-19. RESULTS Using the first approach, we estimated in Switzerland in 2022 an excess mortality of 2.6% (95%CI: 1.0%-4.1%) for men and 2.5% (95%CI: 1.0%-4.0%) for women, while the excess mortality rose to 8.4% (95%CI: 6.9%-9.9%) for men and 6.0% (95%CI: 4.6%-7.5%) for women using the second approach. Age classes over 80 were the main responsible for the excess mortality in 2022 for both sexes using the first approach, although a significant excess mortality was also found in most age classes above 30 using the second approach. Life expectancy in 2022 has been reduced by 2.7 months for men and 2.4 months for women according to the first approach, whereas it was reduced by respectively 8.8 and 6.0 months according to the second approach. CONCLUSIONS The excess mortality and loss of life expectancy in Switzerland in 2022 are around three times greater if the pre-pandemic trend is taken into account than if we simply compare 2022 with 2019. These two different approaches, one being more speculative and the other more factual, can also be applied simultaneously and provide complementary results. In Switzerland, such a dual-approach strategy has shown that the pre-pandemic downward trend in mortality is currently halted, while pre-pandemic mortality levels have largely been recovered by 2022.
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Affiliation(s)
- Isabella Locatelli
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
| | - Valentin Rousson
- Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland
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15
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Lloyd SJ, Quijal-Zamorano M, Achebak H, Hajat S, Muttarak R, Striessnig E, Ballester J. The Direct and Indirect Influences of Interrelated Regional-Level Sociodemographic Factors on Heat-Attributable Mortality in Europe: Insights for Adaptation Strategies. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:87013. [PMID: 37606292 PMCID: PMC10443201 DOI: 10.1289/ehp11766] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/06/2023] [Accepted: 07/19/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND Heat is a significant cause of mortality, but impact patterns are heterogenous. Previous studies assessing such heterogeneity focused exclusively on risk rather than heat-attributable mortality burdens and assume predictors are independent. OBJECTIVES We assessed how four interrelated regional-level sociodemographic predictors-education, life expectancy, the ratio of older to younger people (aging index), and relative income-influence heterogeneity in heat-attributable mortality burdens in Europe and then derived insights into adaptation strategies. METHODS We extracted four outcomes from a temperature-mortality study covering 16 European countries: the rate of increase in mortality risk at moderate and extreme temperatures (moderate and extreme slope, respectively), the minimum mortality temperature percentile (MMTP), and the underlying mortality rate. We used structural equation modeling with country-level random effects to quantify the direct and indirect influences of the predictors on the outcomes. RESULTS Higher levels of education were directly associated with lower heat-related mortality at moderate and extreme temperatures via lower slopes and higher MMTPs. A one standard deviation increase in education was associated with a - 0.46 ± 0.14 , - 0.41 ± 0.12 , and 0.41 ± 0.12 standard deviation (± standard error ) change in the moderate slope, extreme slope, and MMTP, respectively. However, education had mixed indirect influences via associations with life expectancy, the aging index, and relative income. Higher life expectancy had mixed relations with heat-related mortality, being associated with higher risk at moderate temperatures (0.33 ± 0.11 for the moderate slope; - 0.19 ± 0.097 for the MMTP) but lower underlying mortality rates (- 0.72 ± 0.097 ). A higher aging index was associated with higher burdens through higher risk at extreme temperatures (0.13 ± 0.072 for the extreme slope) and higher underlying mortality rates (0.93 ± 0.055 ). Relative income had relatively small, mixed influences. DISCUSSION Our novel approach provided insights into actions for reducing the health impacts of heat. First, the results show the interrelations between possible vulnerability-generating mechanisms and suggest future research directions. Second, the findings point to the need for a dual approach to adaptation, with actions that explicitly target heat exposure reduction and actions focused explicitly on the root causes of vulnerability. For the latter, the climate crisis may be leveraged to accelerate ongoing general public health programs. https://doi.org/10.1289/EHP11766.
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Affiliation(s)
- Simon J Lloyd
- Climate and Health Programme, ISGlobal, Barcelona, Spain
| | - Marcos Quijal-Zamorano
- Climate and Health Programme, ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Hicham Achebak
- Climate and Health Programme, ISGlobal, Barcelona, Spain
| | - Shakoor Hajat
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Raya Muttarak
- Department of Statistical Sciences "Paolo Fortunati", University of Bologna, Bologna, Italy
| | | | - Joan Ballester
- Climate and Health Programme, ISGlobal, Barcelona, Spain
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16
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Wirayuda AAB, Al-Mahrezi A, Chan MF. Comparing Life Expectancy Determinants between Saudi Arabia and United Arab Emirates from 1980-2020. Eur J Investig Health Psychol Educ 2023; 13:1293-1305. [PMID: 37504486 PMCID: PMC10378486 DOI: 10.3390/ejihpe13070095] [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: 06/19/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023] Open
Abstract
Despite marked advancements, life expectancy (LE) growth in Saudi Arabia and the United Arab Emirates (UAE) has remained stagnant compared to other developed nations. This study aims to investigate the significant correlation between macroeconomic (ME), sociodemographic (SD), and health status and resources (HSR) factors and LE to formulate an explanatory model for Saudi Arabia and the UAE-a previously unexplored area. Utilizing an ecological, retrospective, time-series study design, we delved into secondary data on SD, ME, and HSR factors and LE of the populations of the UAE and Saudi Arabia spanning three decades (1980-2020). We employed partial least squares-structural equation modeling for statistical analysis. Our analysis revealed significant direct impacts of HSR factors on LE for Saudi Arabia (β = 0.958, p < 0.001) and the UAE (β = 0.716, p < 0.001). Furthermore, we discerned a notable indirect influence of ME factors on LE, mediated through SD and HSR factors for Saudi Arabia (β = 0.507, p < 0.001) and the UAE (β = 0.509, p < 0.001), along with a considerable indirect effect of SD factors on LE through HSR (Saudi: β = 0.529, p < 0.001; UAE: β = 0.711, p < 0.001). This study underscores the mediating role of a nexus of ME-SD-HSR factors on LE in Saudi Arabia and the UAE. Consequently, these findings signal an imperative need for holistic policy interventions addressing ME, SD, and HSR factors, aiming to alter health behaviors and improve LE projections for Saudi Arabia and the UAE in the long run.
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Affiliation(s)
- Anak Agung Bagus Wirayuda
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman
| | - Abdulaziz Al-Mahrezi
- Director General of Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat 123, Oman
| | - Moon Fai Chan
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Oman
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17
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Lim WH, Chen JHC, Minas K, Johnson DW, Ladhani M, Ooi E, Boudville N, Hawley C, Viecelli AK, Roberts M, Wyburn K, Walker R, Borlace M, Pilmore H, Davies CE, Lok CE, Teixeira-Pinto A, Wong G. Sex Disparity in Cause-Specific and All-Cause Mortality Among Incident Dialysis Patients. Am J Kidney Dis 2023; 81:156-167.e1. [PMID: 36029966 DOI: 10.1053/j.ajkd.2022.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/14/2022] [Indexed: 01/25/2023]
Abstract
RATIONALE & OBJECTIVE Early mortality rates of female patients receiving dialysis have been, at times, observed to be higher than rates among male patients. The differences in cause-specific mortality between male and female incident dialysis patients with kidney failure are not well understood and were the focus of this study. STUDY DESIGN Retrospective cohort study. SETTING & PARTICIPANTS Incident patients who had initiated dialysis in Australia and New Zealand in 1998-2018. EXPOSURE Sex. OUTCOMES Cause-specific and all-cause mortality while receiving dialysis, censored for kidney transplant. ANALYTICAL APPROACH Adjusted cause-specific proportional hazards models, focusing on the first 5 years following initiation of dialysis. RESULTS Among 53,414 patients (20,876 [39%] female) followed for a median period of 2.8 (IQR, 1.3-5.2) years, 27,137 (51%) died, with the predominant cause of death attributed to cardiovascular disease (18%), followed by dialysis withdrawal (16%). Compared with male patients, female patients were more likely to die in the first 5 years after dialysis initiation (adjusted hazard ratio [AHR], 1.08 [95% CI, 1.05-1.11]). Even though female patients experienced a lower risk of cardiovascular disease-related mortality (AHR, 0.93 [95% CI, 0.89-0.98]) than male patients, they experienced a greater risk of infection-related (AHR, 1.20 [95% CI, 1.10-1.32]) and dialysis withdrawal-related (AHR, 1.19 [95% CI, 1.13-1.26]) mortality. LIMITATIONS Possibility of residual and unmeasured confounders. CONCLUSIONS Compared with male patients, female patients had a higher risk of all-cause mortality in the first 5 years after dialysis initiation, a difference driven by higher rates of mortality from infections and dialysis withdrawals. These findings may inform the study of sex differences in mortality in other geographic settings.
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Affiliation(s)
- Wai H Lim
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia; Internal Medicine, University of Western Australia Medical School, Perth, Western Australia.
| | - Jenny H C Chen
- School of Medicine, University of New South Wales, Sydney, New South Wales; Department of Renal Medicine, Wollongong Hospital, Wollongong, New South Wales
| | - Kimberley Minas
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia
| | - David W Johnson
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland; Australasian Kidney Trials Network, University of Queensland, Woolloongabba, Queensland; Translational Research Institute, Woolloongabba, Queensland
| | - Maleeka Ladhani
- Faculty of Health and Medical Science, Adelaide University Medical School, Adelaide, South Australia; Central and Northern Adelaide Renal and Transplantation Services, Lyell McEwin Hospital, Elizabeth Vale, South Australia
| | - Esther Ooi
- School of Biomedical Sciences, University of Western Australia, Perth, Western Australia
| | - Neil Boudville
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia; Internal Medicine, University of Western Australia Medical School, Perth, Western Australia
| | - Carmel Hawley
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland; Australasian Kidney Trials Network, University of Queensland, Woolloongabba, Queensland; Translational Research Institute, Woolloongabba, Queensland
| | - Andrea K Viecelli
- Department of Nephrology, Princess Alexandra Hospital, Woolloongabba, Queensland; Australasian Kidney Trials Network, University of Queensland, Woolloongabba, Queensland
| | - Matthew Roberts
- Eastern Health Integrated Renal Service and Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Kate Wyburn
- Department of Renal Medicine, Royal Prince Alfred Hospital, Camperdown, New South Wales; Charles Perkins Centre Kidney Node, University of Sydney, Camperdown, New South Wales
| | | | - Monique Borlace
- Central and Northern Adelaide Renal and Transplantation Services, Lyell McEwin Hospital, Elizabeth Vale, South Australia
| | - Helen Pilmore
- Department of Renal Medicine, Auckland City Hospital, Auckland, New Zealand; Department of Medicine, Auckland University, Auckland, New Zealand
| | - Christopher E Davies
- Faculty of Health and Medical Science, Adelaide University Medical School, Adelaide, South Australia; Australia and New Zealand Dialysis and Transplant Registry, South Australian Health and Medical Research Institute, Adelaide, South Australia
| | - Charmaine E Lok
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Department of Medicine, University Health Network-Toronto General Hospital, Toronto, Ontario, Canada
| | - Armando Teixeira-Pinto
- School of Public Health, Faculty of Medicine and Health, Sydney University, Sydney, New South Wales
| | - Germaine Wong
- School of Public Health, Faculty of Medicine and Health, Sydney University, Sydney, New South Wales; Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, New South Wales; Department of Renal Medicine and National Pancreas Transplant Unit, Westmead Hospital, Sydney, New South Wales
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18
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Pinho-Gomes AC, Peters SAE, Woodward M. Gender equality related to gender differences in life expectancy across the globe gender equality and life expectancy. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001214. [PMID: 36963039 PMCID: PMC10021358 DOI: 10.1371/journal.pgph.0001214] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/13/2023] [Indexed: 03/08/2023]
Abstract
Life expectancy (LE) depends on the wider determinants of health, many of which have gendered effects worldwide. Therefore, this study aimed to investigate whether gender equality was associated with LE for women and men and the gender gap in LE across the globe. Gender equality in 156 countries was estimated using a modified global gender gap index (mGGGI), based on the index developed by the World Economic Forum between 2010 and 2021. Linear regression was used to investigate the association between the mGGGI and its economic, political, and education subindices and the gender gap in LE and women and men's LE. Overall, the mGGGI increased from 58% in 2010 to 62% in 2021. Globally, changes in the mGGGI and its economic and political subindexes were not associated with changes in the gender gap in LE or with LE for women and men between 2010 and 2020. Improvements in gender equality in education were associated with a longer LE for women and men and widening of the gender gap in LE. In 2021, each 10% increase in the mGGGI was associated with a 4.3-month increase in women's LE and a 3.5-month increase in men's LE, and thus with an 8-month wider gender gap. However, the direction and magnitude of these associations varied between regions. Each 10% increase in the mGGGI was associated with a 6-month narrower gender gap in high-income countries, and a 13- and 16-month wider gender gap in South and Southeast Asia and Oceania, and in Sub-Saharan Africa, respectively. Globally, greater gender equality is associated with longer LE for both women and men and a widening of the gender gap in LE. The variation in this association across world regions suggests that gender equality may change as countries progress towards socioeconomic development and gender equality.
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Affiliation(s)
- Ana-Catarina Pinho-Gomes
- The George Institute for Global Health, Imperial College London, London, United Kingdom
- School of Population Health & Environmental Sciences, Faculty of Life Sciences & Medicine, King's College London, London, United Kingdom
| | - Sanne A E Peters
- The George Institute for Global Health, Imperial College London, London, United Kingdom
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Mark Woodward
- The George Institute for Global Health, Imperial College London, London, United Kingdom
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
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Minton J, Hiam L, McKee M, Dorling D. Slowing down or returning to normal? Life expectancy improvements in Britain compared to five large European countries before the COVID-19 pandemic. Br Med Bull 2022; 145:6-16. [PMID: 36579968 DOI: 10.1093/bmb/ldac036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION OR BACKGROUND Life expectancy is an important summary measure of population health. In the absence of a significant event like war or disease outbreak, trends should, and historically have, increase over time, albeit with some fluctuations. SOURCES OF DATA Data were extracted from the human mortality database for life expectancy at birth and age 65 years from 1980 to the latest available year for England & Wales, Scotland (Great Britain), France, Spain, Italy, the Netherlands and Germany. AREAS OF AGREEMENT It is well established that life expectancy improvements in Great Britain have stalled in recent years, and that a similar stalling was seen in other high-income countries during the mid-2010s. AREAS OF CONTROVERSY The significance and causes of the slowdown in improvement in life expectancy in Britain are disputed. First, was Britain's slowdown in progress in life expectancy in the 2010s a deviation 'from' earlier sustained improvements or simply returning to normal (slower) improvement rates following faster gains in the 2000s? Second, did other European countries have slowdowns comparable to that in Britain? GROWING POINTS Life expectancy, as a summary measure, conceals inequalities. Other measures, such as lifespan disparity, complement it in understanding changing trends. While annual fluctuations in life expectancy are expected, continued stalls should raise concern. The three British nations examined were the only ones among these European countries to experience stalling of life expectancy gains in both sexes. AREAS TIMELY FOR DEVELOPING RESEARCH While it is clear that Britain is making less progress in health than similar countries, more research is needed to explain why.
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Affiliation(s)
- Jon Minton
- College of Social Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Lucinda Hiam
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK.,School of Geography and the Environment, University of Oxford, South Parks Road, Oxford OX1 3QY, UK
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - Danny Dorling
- School of Geography and the Environment, University of Oxford, South Parks Road, Oxford OX1 3QY, UK
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Arnold L, Kellermann L, Fischer F, Gepp S, Hommes F, Jung L, Mohsenpour A, Starke D, Stratil JM. What Factors Influence the Interest in Working in the Public Health Service in Germany? Part I of the OeGD-Studisurvey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811838. [PMID: 36142111 PMCID: PMC9517554 DOI: 10.3390/ijerph191811838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 05/11/2023]
Abstract
As in many European countries, the Public Health Service (PHS) in Germany has had considerable difficulties in attracting well-qualified personnel for decades. Despite ongoing political and societal debate, limited empirical research on possible causes and explanations is available. To identify areas of action, we explored reasons for the (lack of) interest in working in the PHS by conducting two cross-sectional surveys among 3019 medical students (MS), public health students, and students from other PHS-relevant fields (PH&ONM) in Germany right before (wave 1, 2019/2020) and during the COVID-19 pandemic (wave 2, 2021). While interest in working in the PHS among MS was low, it was considerably higher among PH&ONM. The prevalent underestimation of the importance of public health and low levels of knowledge about the PHS were identified as potential barriers. Although core activities of the PHS were often considered attractive, they were repeatedly not attributed to the PHS. A negative perception of the PHS (e.g., it being too bureaucratic) was prevalent among students with and without PHS interest, indicating that both a negative image and potentially structural deficits need to be overcome to increase attractiveness. Based on the findings, we propose approaches on how to sustainably attract and retain qualified personnel.
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Affiliation(s)
- Laura Arnold
- Academy of Public Health Services, 40472 Duesseldorf, Germany
- Department of International Health, Care and Public Health Research Institute—CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, 6211 Maastricht, The Netherlands
- German Network of Young Professionals in Public Health, 80539 Munich, Germany
- Correspondence:
| | - Lisa Kellermann
- German Network of Young Professionals in Public Health, 80539 Munich, Germany
| | - Florian Fischer
- German Network of Young Professionals in Public Health, 80539 Munich, Germany
- Institute of Public Health, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany
- Bavarian Research Center for Digital Health and Social Care, Kempten University of Applied Sciences, 87437 Kempten, Germany
| | - Sophie Gepp
- German Network of Young Professionals in Public Health, 80539 Munich, Germany
- Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Franziska Hommes
- German Network of Young Professionals in Public Health, 80539 Munich, Germany
| | - Laura Jung
- German Network of Young Professionals in Public Health, 80539 Munich, Germany
- Division of Infectious Diseases and Tropical Medicine, Medical Faculty, Leipzig University, 04103 Leipzig, Germany
| | - Amir Mohsenpour
- German Network of Young Professionals in Public Health, 80539 Munich, Germany
- Department of Population Medicine and Health Services Research, Bielefeld University, 33615 Bielefeld, Germany
- Department for Psychiatry, Psychotherapy and Psychosomatic Medicine, Vitos Kurhessen, 34308 Kassel, Germany
| | - Dagmar Starke
- Academy of Public Health Services, 40472 Duesseldorf, Germany
| | - Jan M. Stratil
- German Network of Young Professionals in Public Health, 80539 Munich, Germany
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Ni Y, Zhang J, Zhang M, Bai Y, Zeng Q. The life expectancy benefits on respiratory diseases gained by reducing the daily concentration of particulate matter to attain different air quality standard targets: findings from a 5-year time-series study in Tianjin, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:68870-68880. [PMID: 35554809 DOI: 10.1007/s11356-022-20610-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 04/30/2022] [Indexed: 06/15/2023]
Abstract
The short-term effects of particulate matter (PM) on years of life lost (YLL) have been confirmed by several studies; however, little attention has been paid to the effects of PM on life expectancy from respiratory diseases (RD), especially at the city level. A generalized additive model (GAM) was used to assess the associations between daily PM and YLL of the RD and chronic obstructive pulmonary diseases (COPD) in Tianjin from 2015 to 2019. Then the daily avoidable YLL, attributable fraction, and potential life expectancy benefits (PLEB) of RD and COPD by reducing the daily concentration of PM2.5 and PM10 to attain the Chinese and World Health Organization (WHO) air quality standard targets were estimated during 2015-2019. The stratified analyses by gender were also conducted. A total of 18279 RD and 7767 COPD deaths were included in this study. Per 10 μg/m3 increments in PM2.5 and PM10 at lag1 were significantly associated with 0.83(95%CI: 0.11, 1.55) years and 0.57(95%CI: 0.06, 1.08) years increasing in YLL of total RD and 0.48 (95%CI: 0.07, 0.90) years and 0.30 (95%CI: 0.01, 0.60) years increasing in YLL of total COPD. If the daily PM2.5 and PM10 concentrations decreased to attain the Chinese and WHO air quality standard targets, 0.06-0.39 years PLEB due to total RD and 0.08-0.53 years PLEB due to COPD could be gained. And more PLEB on RD could be gained by decreasing the daily PM concentrations to attain the WHO air quality standard targets than that of attaining the Chinese air quality standard targets. These evidence-based findings emphasize the importance of the Chinese PM-related guideline updating and may have implications for PM-related policy-making.
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Affiliation(s)
- Yang Ni
- Tianjin Centers for Disease Control and Prevention, Tianjin, 300011, People's Republic of China
| | - Jimian Zhang
- Tianjin Centers for Disease Control and Prevention, Tianjin, 300011, People's Republic of China
| | - Mengnan Zhang
- Tianjin Centers for Disease Control and Prevention, Tianjin, 300011, People's Republic of China
- School of Public Health, Tianjin Medical University, Tianjin, 300070, People's Republic of China
| | - Yu Bai
- Tianjin Centers for Disease Control and Prevention, Tianjin, 300011, People's Republic of China
- School of Public Health, Tianjin Medical University, Tianjin, 300070, People's Republic of China
| | - Qiang Zeng
- Tianjin Centers for Disease Control and Prevention, Tianjin, 300011, People's Republic of China.
- School of Public Health, Tianjin Medical University, Tianjin, 300070, People's Republic of China.
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Piñeiro B, Trias-Llimós S, Spijker JJA, Blanes Llorens A, Permanyer I. Estimation of smoking-related mortality and its contribution to educational inequalities in life expectancy in Spain: an observational study, 2016-2019. BMJ Open 2022; 12:e059370. [PMID: 35948385 PMCID: PMC9379492 DOI: 10.1136/bmjopen-2021-059370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To estimate smoking-related mortality and its contribution to educational inequalities in life expectancy in Spain. DESIGN Nationwide, observational study from 2016 to 2019. Population-attributable fractions were used to estimate age, sex and education-specific cause-of-death smoking-attributable mortality. Life table techniques and decomposition methods were used to estimate potential gains in life expectancy at age 35 and the cause-specific contributions of smoking-related mortality to life expectancy differences across educational groups. SETTING Spain. PARTICIPANTS We use cause-specific mortality data from population registers and smoking prevalence from the National and the European Health Survey for Spain from 2017 and 2019/2020, respectively. RESULTS We estimated 219 086 smoking-related deaths during 2016-2019, equalling 13% of all deaths, 83.7% of those in men. In the absence of smoking, potential gains in male life expectancy were higher among the low-educated than the high-educated (3.1 vs 2.1 years). For women, educational differences were less and also in the opposite direction (0.6 vs 0.9 years). The contribution of smoking to life expectancy differences between high-educated and low-educated groups accounted for 1.5 years among men, and -0.2 years among women. For men, the contribution of smoking to these differences was mostly driven by cancer in middle age, cardiometabolic diseases at younger ages and respiratory diseases at older ages. For women, the contribution to this gap, although negligible, was driven by cancer at older ages among the higher educated. CONCLUSIONS Smoking remains a relevant preventable risk factor of premature mortality in Spain, disproportionately affecting life expectancy of low-educated men.
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Affiliation(s)
- Bárbara Piñeiro
- Centre d'Estudis Demogràfics, Centres de Recerca de Catalunya (CERCA), Universitat Autònoma de Barcelona, Bellaterra-Barcelona, Catalonia, Spain
| | - Sergi Trias-Llimós
- Centre d'Estudis Demogràfics, Centres de Recerca de Catalunya (CERCA), Universitat Autònoma de Barcelona, Bellaterra-Barcelona, Catalonia, Spain
| | - Jeroen J A Spijker
- Centre d'Estudis Demogràfics, Centres de Recerca de Catalunya (CERCA), Universitat Autònoma de Barcelona, Bellaterra-Barcelona, Catalonia, Spain
| | - Amand Blanes Llorens
- Centre d'Estudis Demogràfics, Centres de Recerca de Catalunya (CERCA), Universitat Autònoma de Barcelona, Bellaterra-Barcelona, Catalonia, Spain
| | - Iñaki Permanyer
- Centre d'Estudis Demogràfics, Centres de Recerca de Catalunya (CERCA), Universitat Autònoma de Barcelona, Bellaterra-Barcelona, Catalonia, Spain
- ICREA, Passeig de Lluís Companys 23, Barcelona, Spain
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Chen L, Wang L, Qian Y, Chen H. Changes and Trend Disparities in Life Expectancy and Health-Adjusted Life Expectancy Attributed to Disability and Mortality From 1990 to 2019 in China. Front Public Health 2022; 10:925114. [PMID: 35923968 PMCID: PMC9339800 DOI: 10.3389/fpubh.2022.925114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Objective This study aims to investigate sex, age, and cause-specific contributions to changes and trend disparities in life expectancy (LE) and health-adjusted life expectancy (HALE) attributed to disability and mortality from 1990 to 2019 in China, which provides insight into policy-making, health systems planning, and resource allocation. Methods Contributions of disability and mortality to changes and trend disparities in LE and HALE were estimated with standard abridged life table, Sullivan's method, and decomposition method, using retrospective demographic analysis based on mortality and years lived with disability (YLD) rates extracted from Global Burden of Disease Study 2019 (GBD 2019). Results From 1990 to 2019, LE and HALE increased by 10.49 and 8.71 years for both sexes, mainly due to noncommunicable diseases (NCDs) (5.83 years, 55.58% for LE and 6.28 years, 72.10% for HALE). However, HIV/AIDS and sexually transmitted infections had negative effects on changes in LE (−0.03 years, −0.29%) and HALE (−0.05 years, −0.57%). Lung cancer and ischemic heart disease caused the biggest reduction in LE (−0.14 years, −1.33%) and HALE (−0.42 years, −4.82%). Also, cardiovascular diseases (−0.08 years, −0.92%), neurological disorders (−0.08 years, −0.92%), diabetes and kidney diseases (−0.06 years, −0.69%), and transport injuries (−0.06 years, −0.69%) had main negative disability effects in HALE. Moreover, life expectancy lived with disability (LED) increased by 1.78 years, mainly attributed to respiratory infections and tuberculosis (1.04 years, 58.43%) and maternal and neonatal disorders (0.78 years, 43.82%). Conclusion The LE and HALE in China have grown rapidly over the past few decades, mainly attributed to NCDs. It is necessary to further reduce the negative mortality effect of HIV/AIDS, lung cancer, colon and rectum cancer, pancreatic cancer, and ischemic heart disease and the negative disability effect of stroke, diabetes mellitus, and road injuries. In addition, the signs of disparities in mortality and disability of different sexes and ages call for targeted and precise interventions for key groups such as males and the elderly. According to the decomposition results, we may better determine the key objects of health policies that take into account substantial cause-specific variations to facilitate the realization of “healthy China 2030” plan.
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Are Measures of Health Status for the Total Population Good Proxies for the Health of the Older Population in International Comparison Studies? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137559. [PMID: 35805218 PMCID: PMC9265627 DOI: 10.3390/ijerph19137559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 02/04/2023]
Abstract
In the face of population aging, the health of older people is becoming especially important, impacting various areas of life, societies and countries’ economies. To provide the basis for effective decisions to achieve better health, comparative analyses can be used to find best practices to follow. The aim of the research was to check whether drawing conclusions about the older population’s health based on the health status of the total population is justified in international comparison analyses. An analysis was conducted for six population health indicators for European countries from 2010–2019. Rankings were created for the total population and the older subpopulation, and then ranks for these two populations were compared using statistical methods. The statistical analyses indicate that there is a strong, statistically significant relationship between the ranks for the total and the older population. However, looking at the descriptive analysis and visual presentation of data, differences in international rankings of indicator values for these two populations can be observed. As older people comprise a specific group of the population that is growing ever bigger and increasingly significant, it would be advisable to present the results of international comparisons not only for the total, but separately for the older population as well.
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25
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Geng H, Wang Q, Cui J, Gu Q, Long J. Management and organization construction status and development suggestions of aged-friendly medical institutions in mainland China. Aging Med (Milton) 2022; 5:113-119. [PMID: 35783112 PMCID: PMC9245169 DOI: 10.1002/agm2.12209] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/18/2022] [Accepted: 04/19/2022] [Indexed: 11/26/2022] Open
Abstract
The increasing number of regions have begun to construct age-friendly medical institutions to further promote the "successful aging" of the elderly in mainland China. This study deeply analyzes the development status of age-friendly medical institutions abroad and describes the policies, research, evaluation, and certification of different countries. This study focuses on the current construction status of age-friendly medical institutions in mainland China. With the issuing of several national policies, mainland China has established a top-down system for the construction of age-friendly medical institutions, which has been gradually implemented in the actions of medical institutions. On the whole, the goal and evaluation standard are clear and the action is rapid. However, it also faces many challenges and problems. This study puts forward various suggestions for the construction of age-friendly medical institutions, such as increasing manpower and financial investment and carrying out evidence-based research. In particular, we should pay attention to promoting a bottom-up construction system, understand the actual needs of the elderly, pay attention to the personal experience of the elderly, and fully mobilize the active and full participation of the whole society.
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Affiliation(s)
- Hongli Geng
- Department of RehabilitationThe First Affiliated Hospital of Shenzhen UniversityShenzhenGuangdongChina
| | - Qiuyun Wang
- Yunnan Medical Health CollegeKunmingYunnanChina
| | - Jinlong Cui
- Xiangya Boai Rehabilitation HospitalChangshaHunanChina
| | - Qiuyan Gu
- Affiliated Maternal and Child Health of Nantong UniversityNantongJiangsuChina
| | - Jianjun Long
- Department of RehabilitationThe First Affiliated Hospital of Shenzhen UniversityShenzhenGuangdongChina
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Schlüter BS, Masquelier B, Camarda CG. Heterogeneity in subnational mortality in the context of the COVID-19 pandemic: the case of Belgian districts in 2020. Arch Public Health 2022; 80:130. [PMID: 35524287 PMCID: PMC9073828 DOI: 10.1186/s13690-022-00874-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 03/26/2022] [Indexed: 03/29/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to major shocks in mortality trends in many countries. Yet few studies have evaluated the heterogeneity of the mortality shocks at the sub-national level, rigorously accounting for the different sources of uncertainty. METHODS Using death registration data from Belgium, we first assess change in the heterogeneity of districts' standardized mortality ratios in 2020, when compared to previous years. We then measure the shock effect of the pandemic using district-level values of life expectancy, comparing districts' observed and projected life expectancy, accounting for all sources of uncertainty (stemming from life-table construction at district level and from projection methods at country and district levels). Bayesian modelling makes it easy to combine the different sources of uncertainty in the assessment of the shock. This is of particular interest at a finer geographical scale characterized by high stochastic variation in annual death counts. RESULTS The heterogeneity in the impact of the pandemic on all-cause mortality across districts is substantial: while some districts barely show any impact, the Bruxelles-Capitale and Mons districts experienced a decrease in life expectancy at birth of 2.24 (95% CI:1.33-3.05) and 2.10 (95% CI:0.86-3.30) years, respectively. The year 2020 was associated with an increase in the heterogeneity of mortality levels at a subnational scale in comparison to past years, measured in terms of both standardized mortality ratios and life expectancies at birth. Decisions on uncertainty thresholds have a large bearing on the interpretation of the results. CONCLUSION Developing sub-national mortality estimates taking careful account of uncertainty is key to identifying which areas have been disproportionately affected.
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Affiliation(s)
| | - Bruno Masquelier
- IACCHOS (DEMO), Catholic University of Louvain (UCLouvain), Louvain-la-Neuve, Belgium
| | - Carlo Giovanni Camarda
- Mortality, Health and Epidemiology, Institut National d’Etudes Démographiques (INED), Paris, France
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Changes in socioeconomic differentials in old age life expectancy in four Nordic countries: the impact of educational expansion and education-specific mortality. Eur J Ageing 2022; 19:161-173. [PMID: 35663915 PMCID: PMC9156635 DOI: 10.1007/s10433-022-00698-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2022] [Indexed: 01/25/2023] Open
Abstract
Overall progress in life expectancy (LE) depends increasingly on survival in older ages. The birth cohorts now reaching old age have experienced considerable educational expansion, which is a driving force for the social change and social inequality. Thus, this study examines changes in old age LE by educational attainment in the Nordic countries and aims to find out to what extent the change in national LEs is attributable to education-specific mortality and the shifting educational composition. We used national register data comprising total 65 + populations in Denmark, Finland, Norway and Sweden to create period life tables stratified by five-year age groups (65-90 +), sex and educational attainment. Difference in LE between 2001 and 2015 was decomposed into the contributions of mortality changes within each educational group and changes in educational composition. Increasing LE at all ages and in all educational groups coincided with persistent and growing educational inequalities in all countries. Most of the gains in LE at age 65 could be attributed to decreased mortality (63-90%), especially among those with low education, the largest educational group in most countries. The proportion of the increase in LE attributable to improved education was 10-37%, with the highest contributions recorded for women in Norway and Sweden. The rising educational levels in the Nordic countries still carry potential for further gains in national LEs. However, the educational expansion has contributed to uneven gains in LE between education groups, which poses a risk for the future increase of inequalities in LE. Supplementary Information The online version contains supplementary material available at 10.1007/s10433-022-00698-y.
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Shapkina MY, Mazdorova EV, Avdeeva EM, Shcherbakova LV, Ryabikov AN, Hubachek JA, Bobak M, Malyutina SK. Changes in the prevalence of atrial fibrillation in the Russian population over a 13-year follow-up. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aim. To study the prevalence of atrial fibrillation (AF) in the Russian urban population cohort aged 45-69 years and its changes over 13-year follow-up during aging.Material and methods. This cross-sectional long-term prospective study included random population sample of men and women 45-69 years (n=9360, HAPIEE project, Novosibirsk), which was examined in 2003-2005 and was re-examined twice and followed up for about 13±1,00 years in men and 13,1±2,17 years in women. The incidence of AF was assessed for individuals without AF or cardiovascular disease (CVD) at the baseline examination. Statistical analysis was performed using the SPSS software package (v.13.0).Results. In a population sample over a 13-year follow-up, AF prevalence increased from 1,6% (1,1% among women and 2,1% among men) at the age of 45-69 years to 4,2% (3,0% among women and 6,1% among men) aged 55-84 years according to screening rest ECG examinations. The prevalence of new AF cases over a 13-year followup in the cohort of 45-69 years old without previous CVD and AF was 5,6%, of which 40% were paroxysmal. The mean age at the time of first registered AF was 69±6,93 years, and was 2 years higher in women (70,0±6,83) than in men (68±6,93). The average period before the AF onset among people aged 45-69 years without baseline CVD and AF was 7,5±3,83 years for men and 8,1±4,02 years for women. The total prevalence of AF in the population sample was 8,3%. The highest AF prevalence was registered at the age of 65-69 years (11,4%) for men and 5 years later for women (12,0%) (p80 years decreased and amounted to 4,1% among men and 5,7% among women.Conclusion. In the Russian population sample (Novosibirsk) aged 45-69, the AF prevalence increased from 1,6 to 8,3% over 13 years of follow-up. In addition, 473 new AF cases were identified, ~40% of which were paroxysmal AF. The prevalence of AF in the Siberian population sample for the 45-60 years age group is comparable with the large Russian and North American studies, but higher for persons aged 60-74 years and lower for older age group, for both men and women.
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Affiliation(s)
- M. Yu. Shapkina
- Research Institute of Internal and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics
| | - E. V. Mazdorova
- Research Institute of Internal and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics
| | - E. M. Avdeeva
- Research Institute of Internal and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics
| | - L. V. Shcherbakova
- Research Institute of Internal and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics
| | - A. N. Ryabikov
- Research Institute of Internal and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics
| | | | | | - S. K. Malyutina
- Research Institute of Internal and Preventive Medicine — branch of the Federal Research Center Institute of Cytology and Genetics
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Aburto JM, Schöley J, Kashnitsky I, Zhang L, Rahal C, Missov TI, Mills MC, Dowd JB, Kashyap R. Quantifying impacts of the COVID-19 pandemic through life-expectancy losses: a population-level study of 29 countries. Int J Epidemiol 2022; 51:63-74. [PMID: 34564730 PMCID: PMC8500096 DOI: 10.1093/ije/dyab207] [Citation(s) in RCA: 146] [Impact Index Per Article: 73.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Variations in the age patterns and magnitudes of excess deaths, as well as differences in population sizes and age structures, make cross-national comparisons of the cumulative mortality impacts of the COVID-19 pandemic challenging. Life expectancy is a widely used indicator that provides a clear and cross-nationally comparable picture of the population-level impacts of the pandemic on mortality. METHODS Life tables by sex were calculated for 29 countries, including most European countries, Chile and the USA, for 2015-2020. Life expectancy at birth and at age 60 years for 2020 were contextualized against recent trends between 2015 and 2019. Using decomposition techniques, we examined which specific age groups contributed to reductions in life expectancy in 2020 and to what extent reductions were attributable to official COVID-19 deaths. RESULTS Life expectancy at birth declined from 2019 to 2020 in 27 out of 29 countries. Males in the USA and Lithuania experienced the largest losses in life expectancy at birth during 2020 (2.2 and 1.7 years, respectively), but reductions of more than an entire year were documented in 11 countries for males and 8 among females. Reductions were mostly attributable to increased mortality above age 60 years and to official COVID-19 deaths. CONCLUSIONS The COVID-19 pandemic triggered significant mortality increases in 2020 of a magnitude not witnessed since World War II in Western Europe or the breakup of the Soviet Union in Eastern Europe. Females from 15 countries and males from 10 ended up with lower life expectancy at birth in 2020 than in 2015.
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Affiliation(s)
- José Manuel Aburto
- Leverhulme Centre for Demographic Science and Department of Sociology, University of Oxford, Oxford, UK
- Nuffield College, Oxford, UK
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
- Laboratory of Population Health, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Jonas Schöley
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
- Laboratory of Population Health, Max Planck Institute for Demographic Research, Rostock, Germany
| | - Ilya Kashnitsky
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Luyin Zhang
- Leverhulme Centre for Demographic Science and Department of Sociology, University of Oxford, Oxford, UK
- St Cross College, Oxford, UK
| | - Charles Rahal
- Leverhulme Centre for Demographic Science and Department of Sociology, University of Oxford, Oxford, UK
- Nuffield College, Oxford, UK
| | - Trifon I Missov
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Melinda C Mills
- Leverhulme Centre for Demographic Science and Department of Sociology, University of Oxford, Oxford, UK
- Nuffield College, Oxford, UK
| | - Jennifer B Dowd
- Leverhulme Centre for Demographic Science and Department of Sociology, University of Oxford, Oxford, UK
- Nuffield College, Oxford, UK
| | - Ridhi Kashyap
- Leverhulme Centre for Demographic Science and Department of Sociology, University of Oxford, Oxford, UK
- Nuffield College, Oxford, UK
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Siegel A, Schug JF, Rieger MA. Social Determinants of Remaining Life Expectancy at Age 60: A District-Level Analysis in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1530. [PMID: 35162553 PMCID: PMC8835464 DOI: 10.3390/ijerph19031530] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/21/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023]
Abstract
Remaining life expectancy at age 60 (in short: RLE) is an important indicator of the health status of a population's elders. Until now, RLE has not been thoroughly investigated at the district level in Germany. In this study we analyzed, based on recent publicly available data (2015-2017), and for men and women separately, how large the RLE differences were in Germany across the 401 districts. Furthermore, we examined a wide range of potential social determinants in terms of their bivariate and multivariate (i.e., partial) impact on men's and women's RLE. Men's district-level RLE ranged between 19.89 and 24.32 years, women's district-level RLE between 23.67 and 27.16 years. The best single predictor both for men's and women's RLE at district level was 'proportion of employees with academic degree' with standardized partial regression coefficients of 0.42 (men) and 0.51 (women). Second and third in rank were classic economic predictors, such as 'household income' (men), 'proportion of elder with financial elder support' (women), and 'unemployment' (men and women). Indicators expressing the availability of medical services and staffing levels of nursing homes and services had at best a marginal partial impact. This study contributes to the growing body of evidence that a population's educational level is a decisive determinant of population health resp. life expectancy in contemporary industrialized societies.
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Affiliation(s)
- Achim Siegel
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany
| | - Jonas F Schug
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany
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Hecking M, Tu C, Zee J, Bieber B, Hödlmoser S, Reichel H, Sesso R, Port FK, Robinson BM, Carrero JJ, Tong A, Combe C, Stengel B, Pecoits-Filho R. Sex-Specific Differences in Mortality and Incident Dialysis in the Chronic Kidney Disease Outcomes and Practice Patterns Study. Kidney Int Rep 2021; 7:410-423. [PMID: 35257054 PMCID: PMC8897674 DOI: 10.1016/j.ekir.2021.11.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/18/2021] [Accepted: 11/15/2021] [Indexed: 11/20/2022] Open
Abstract
Introduction More men than women start kidney replacement therapy (KRT) although the prevalence of chronic kidney disease (CKD) is higher in women than men. We therefore aimed at analyzing sex-specific differences in clinical outcomes among 8237 individuals with CKD in stages 3 to 5 from Brazil, France, Germany, and the United States participating in the Chronic Kidney Disease Outcomes and Practice Patterns Study (CKDopps). Methods Fine and Gray models, evaluating the effect of sex on time to events, were adjusted for age, Black race (model A); plus diabetes, cardiovascular disease, albuminuria (model B); plus estimated glomerular filtration rate (eGFR) slope during the first 12 months after enrollment and first eGFR after enrollment (model C). Results There were more men than women at baseline (58% vs. 42%), men were younger than women, and men had higher eGFR (28.9 ± 11.5 vs. 27.0 ± 10.8 ml/min per 1.73 m2). Over a median follow-up of 2.7 and 2.5 years for men and women, respectively, the crude dialysis initiation and pre-emptive transplantation rates were higher in men whereas that of pre-KRT death was more similar. The adjusted subdistribution hazard ratios (SHRs) between men versus women for dialysis were 1.51 (1.27–1.80) (model A), 1.32 (1.10–1.59) (model B), and 1.50 (1.25–1.80) (model C); for pre-KRT death, were 1.25 (1.02–1.54) (model A), 1.14 (0.92–1.40) (model B), and 1.15 (0.93–1.42) (model C); for transplantation, were 1.31 (0.73–2.36) (model A), 1.44 (0.76–2.74) (model B), and 1.53 (0.79–2.94) (model C). Conclusion Men had a higher probability of commencing dialysis before death, unexplained by CKD progression alone. Although the causal mechanisms are uncertain, this finding helps interpret the preponderance of men in the dialysis population.
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Décarie Y, Michaud PC. Counting the Dead: COVID-19 and Mortality in Quebec and British Columbia During the First Wave. CANADIAN STUDIES IN POPULATION 2021; 48:139-164. [PMID: 34548750 PMCID: PMC8446740 DOI: 10.1007/s42650-021-00053-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 08/09/2021] [Indexed: 01/18/2023]
Abstract
The first wave of the COVID-19 pandemic has led to excess mortality across the globe, and Canada has been no exception. Nonetheless, the pandemic experience has been very different across provinces, and the objective of this paper is to investigate these differences focusing on two extreme cases. We contrast the mortality experience of British Columbia with that of Québec to understand how large differences in mortality during the first wave of the pandemic emerged across these two provinces. We find that most of the differences can be found in excess mortality in institutions (nursing homes) and that travel restrictions, differences in how deaths are recorded, differences in the seasonality of the flu, or differences in how the pandemic spread across different economic segments of the population are unlikely explain these large differences. We document that the reported death toll from COVID-19 is about 30% larger than excess mortality in Quebec due to lower mortality from other causes of death, in particular malignant tumors, heart disease, and respiratory problems. We do not find evidence of an income gradient (measured by postal code level income) in relative excess death for the first wave.
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Affiliation(s)
- Yann Décarie
- HEC Montreal, 3000 chemin Cote-Ste-Catherine, Montreal, H3T 2A7 Canada
| | - Pierre-Carl Michaud
- HEC Montreal, 3000 chemin Cote-Ste-Catherine, Montreal, H3T 2A7 Canada
- CIRANO, Montreal, Canada
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Le Bourg E. Epidemics and Forecasts of Life Expectancy. Gerontology 2021; 68:453-455. [PMID: 34350860 DOI: 10.1159/000517947] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/15/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Eric Le Bourg
- Centre de Recherches sur la Cognition Animale, Centre de Biologie Intégrative, Université de Toulouse, CNRS, UPS, Toulouse, France
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Premature Aging in Chronic Kidney Disease: The Outcome of Persistent Inflammation beyond the Bounds. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158044. [PMID: 34360333 PMCID: PMC8345753 DOI: 10.3390/ijerph18158044] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/22/2021] [Accepted: 07/26/2021] [Indexed: 01/08/2023]
Abstract
Over the last hundred years, life expectancy in developed countries has increased because of healthier living habits and the treatment of chronic pathologies causing premature aging. Aging is an inexorable, time-dependent, multifactorial process characterized by a series of progressive and irreversible physiological changes associated with loss of functional, psychological, and social capabilities. Numerous factors, such as oxidative stress, inflammation, and cellular senescence, and an irreversible geriatric syndrome known as frailty, contribute to human body deterioration in aging. The speed of aging may differ between individuals depending on the presence or absence of multiple factors (genetic and/or environment) and the subsequent misbalance of homeostasis, together with the increase of frailty, which also plays a key role in developing chronic diseases. In addition, pathological circumstances have been reported to precipitate or accelerate the aging process. This review investigated the mechanisms involved in the developing pathologies, particularly chronic kidney disease, associated with aging.
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Alaimo C, Campana E, Stoppelli MR, Gobbi E, Baglio F, Rossetto F, Binetti G, Zanetti O, Manenti R, Cotelli M. Cognitive Tele-Enhancement in Healthy Older Adults and Subjects With Subjective Memory Complaints: A Review. Front Neurol 2021; 12:650553. [PMID: 34290660 PMCID: PMC8287022 DOI: 10.3389/fneur.2021.650553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background: In recent years, emphasis has been placed on cognitive enhancement to stimulate cognitive abilities and prevent functional decline. Considering that traditional face-to-face interventions can be very expensive and are not accessible to all individuals, the need to transfer care from the clinic to the patient's home is evident. In this regard, cognitive tele-enhancement interventions have received increased attention. Aim: The aim of this review was to provide an overview of protocols that apply remotely controlled cognitive training with individualized feedback on performance by the therapist in healthy older adults or participants with subjective memory complaints. Methods: Out of 35 articles assessed for eligibility, eight studies were identified. Of the selected studies, five included cognitively healthy older adults, while three included participants with subjective memory complaints. Results: Most of the reviewed studies showed beneficial effects of cognitive tele-enhancement interventions, reporting improvements in memory, sustained attention, working memory, executive functions, and language abilities. Moreover, reductions in anxiety and depression symptomatology levels, as well as in subjective memory difficulties, were described in some of the studies. Conclusions: Cognitive tele-enhancement treatment could be a good alternative to face-to-face intervention. This literature review highlights the importance of applying preventive cognitive interventions to subjects with initial subjective memory complaints. Remote modalities seem to facilitate the application of such interventions.
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Affiliation(s)
- Cristina Alaimo
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Campana
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Maria Rachele Stoppelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | | | - Giuliano Binetti
- Macroattività Ambulatoriale Complessa (MAC) Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Orazio Zanetti
- Alzheimer's Research Unit, Macroattività Ambulatoriale Complessa (MAC) Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Sauerberg M. The impact of population's educational composition on Healthy Life Years: An empirical illustration of 16 European countries. SSM Popul Health 2021; 15:100857. [PMID: 34258376 PMCID: PMC8255240 DOI: 10.1016/j.ssmph.2021.100857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/24/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022] Open
Abstract
Healthy Life Years (HLY) is a prominent summary indicator for evaluating and comparing the levels of population health status across Europe. Variations in HLY, however, do not necessarily reflect underlying differences in health and mortality levels among countries and the indicator is particularly sensitive when broken down by subpopulations. For instance, despite European countries showing large HLY inequalities by educational level, these countries are also heterogenous regarding their population composition by educational attainment, which most likely affects their HLY levels. We demonstrate how this compositional effect shapes HLY levels by providing estimates for HLY by educational attainment and gender for 16 European countries using the Sullivan method. We use prevalence data about limitations in daily activities from the European Union Statistics on Income and Living Conditions (EU-SILC) and mortality data from the Eurostat database. Finally, we adjust for compositional effects by means of standardization. The education-adjusted HLY estimates do not differ much from conventional HLY. Yet, we find that in some countries HLY levels are indeed affected by the population composition by educational attainment. For example, low-, medium-, and high educated individuals in Portugal show more HLY than their counterparts in Poland. Still, Poland's total HLY value slightly exceeds that of Portugal, indicating favorable health and mortality conditions in Poland. It is Poland's lower relative number of low educated individuals in its population that is responsible for producing this higher total HLY value. We conclude that differentials in HLY due to differences in the relative size of educational subpopulations are generally small in HLY across Europe but they can play an important role for countries that experienced large differences in their educational expansion.
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Affiliation(s)
- Markus Sauerberg
- Vienna Institute of Demography (OeAW), Wittgenstein Centre for Demography and Global Human Capital (IIASA, OeAW, University of Vienna), Vordere Zollamtsstrasse 3, 1030, Vienna, Austria
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Sauerberg M, Guillot M, Luy M. The cross-sectional average length of healthy life (HCAL): a measure that summarizes the history of cohort health and mortality. Popul Health Metr 2020; 18:21. [PMID: 32867786 PMCID: PMC7457804 DOI: 10.1186/s12963-020-00220-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 07/30/2020] [Indexed: 11/10/2022] Open
Abstract
Background Healthy life years have superseded life expectancy (LE) as the most important indicator for population health. The most common approach to separate the total number of life years into those spent in good and poor health is the Sullivan method which incorporates the health dimension to the classic period life table, thus transforming the LE indicator into the health expectancy (HE) indicator. However, life years derived from a period life table and health prevalence derived from survey data are based on different conceptual frameworks. Method We modify the Sullivan method by combining the health prevalence data with the conceptually better fitting cross-sectional average length of life (CAL). We refer to this alternative HE indicator as the “cross-sectional average length of healthy life” (HCAL). We compare results from this alternative indicator with the conventional Sullivan approach for nine European countries. The analyses are based on EU-SILC data in three empirical applications, including the absolute and relative level of healthy life years, changes between 2008 and 2014, and the extent of the gender gap. Results HCAL and conventional HE differ in each of these empirical applications. In general, HCAL provides larger gains in healthy life years in recent years, but at the same time greater declines in the proportion of healthy life years. Regarding the gender gap, HCAL provides a more favourable picture for women compared to conventional HE. Nonetheless, the extent of these differences between the indicators is only of minor extent. Conclusions Albeit the differences between HE and HCAL are small, we found some empirical examples in which the two indicators led to different conclusions. It is important to note, however, that the measurement of health and the data quality are much more important for the healthy life years indicator than the choice of the variant of the Sullivan method. Nonetheless, we suggest to use HCAL in addition to HE whenever possible because it widens the spectrum of empirical analyses and serves for verification of results based on the highly sensitive HE indicator.
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Affiliation(s)
- Markus Sauerberg
- Vienna Institute of Demography, Austrian Academy of Sciences, Vienna, Austria. .,Wittgenstein Centre for Demography and Global Human Capital (IIASA, OeAW, University of Vienna), Vienna, Austria.
| | - Michel Guillot
- Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA.,French Institute for Demographic Studies (INED), Paris, France
| | - Marc Luy
- Vienna Institute of Demography, Austrian Academy of Sciences, Vienna, Austria.,Wittgenstein Centre for Demography and Global Human Capital (IIASA, OeAW, University of Vienna), Vienna, Austria
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McCartney G, Fenton L, Minton J, Fischbacher C, Taulbut M, Little K, Humphreys C, Cumbers A, Popham F, McMaster R. Is austerity responsible for the recent change in mortality trends across high-income nations? A protocol for an observational study. BMJ Open 2020; 10:e034832. [PMID: 31980513 PMCID: PMC7044814 DOI: 10.1136/bmjopen-2019-034832] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Mortality rates in many high-income countries have changed from their long-term trends since around 2011. This paper sets out a protocol for testing the extent to which economic austerity can explain the variance in recent mortality trends across high-income countries. METHODS AND ANALYSIS This is an ecological natural experiment study, which will use regression adjustment to account for differences in exposure, outcomes and confounding. All high-income countries with available data will be included in the sample. The timing of any changes in the trends for four measures of austerity (the Alesina-Ardagna Fiscal Index, real per capita government expenditure, public social spending and the cyclically adjusted primary balance) will be identified and the cumulative difference in exposure to these measures thereafter will be calculated. These will be regressed against the difference in the mean annual change in life expectancy, mortality rates and lifespan variation compared with the previous trends, with an initial lag of 2 years after the identified change point in the exposure measure. The role of underemployment and individual incomes as outcomes in their own right and as mediating any relationship between austerity and mortality will also be considered. Sensitivity analyses varying the lag period to 0 and 5 years, and adjusting for recession, will be undertaken. ETHICS AND DISSEMINATION All of the data used for this study are publicly available, aggregated datasets with no individuals identifiable. There is, therefore, no requirement for ethical committee approval for the study. The study will be lodged within the National Health Service research governance system. All results of the study will be published following sharing with partner agencies. No new datasets will be created as part of this work for deposition or curation.
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Affiliation(s)
- Gerry McCartney
- Public Health Observatory, NHS Health Scotland, Glasgow, Scotland, UK
| | - Lynda Fenton
- Public Health Observatory, NHS Health Scotland, Glasgow, Scotland, UK
- Public Health, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - Jon Minton
- Public Health Observatory, NHS Health Scotland, Glasgow, Scotland, UK
| | - Colin Fischbacher
- Information Services Division, NHS National Services Scotland, Edinburgh, Scotland, UK
| | - Martin Taulbut
- Public Health Observatory, NHS Health Scotland, Glasgow, Scotland, UK
| | | | | | - Andrew Cumbers
- Adam Smith Business School, University of Glasgow, Glasgow, UK
| | - Frank Popham
- CSO/MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland, UK
| | - Robert McMaster
- Adam Smith Business School, University of Glasgow, Glasgow, UK
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