Years of Potential Life Lost from Cardiovascular Disease Among Hispanics

Objective

To quantify the impact of cardiovascular disease and its subtypes on the premature mortality of Hispanics in the United States.

Methods

We used national death records to identify deaths for the three largest Hispanic subgroups (Mexicans, Puerto Ricans, and Cubans) in the United States from 2003 to 2012 (N = 832,550). We identified all deaths from cardiovascular disease and by subtype (ie, ischemic, cerebrovascular, hypertensive and heart failure) using the underlying cause of death via ICD-10 codes. Years of potential life lost (YPLL) was calculated by age categories standardizing with the 2000 US Census population. Population estimates were calculated using linear interpolation from 2000 and 2010 US Census data.

Results

After standardization, Puerto Ricans experienced the highest YPLL for all types of cardiovascular disease compared with Mexicans and Cubans (1,139 years per 100,000 compared with 868 and 841, respectively), a disparity that remained consistent over the course of a decade. Among different subcategories of cardiovascular disease, Puerto Ricans had the highest YPLL for ischemic and hypertensive heart disease, while Mexicans had the highest YPLL from cerebrovascular disease.

Conclusions

In conclusion, disaggregation of Hispanic subgroups revealed marked heterogeneity in premature cardiovascular mortality. These findings suggest that measures to improve the cardiovascular health of Hispanics should incorporate subgroup status as a key part of public health strategy.

Exercise Is Medicine: Primary Care Counseling on Aerobic Fitness and Muscle Strengthening

Patient counseling on physical fitness remains underutilized in primary care, despite its clinical and cost effectiveness. Most counseling interventions have focused on aerobic activity and neglected another vital component of physical fitness, muscle strengthening, which has recently been shown to be independently protective against cardiometabolic diseases and premature mortality. This article reviews the latest scientific evidence and makes recommendations toward a more comprehensive approach for promoting physical fitness in primary care. Given the high prevalence and wide-ranging health impacts of physical inactivity, counseling on physical fitness should be a standard part of wellness promotion and disease prevention and treatment for all patients. Interventions that include muscle strengthening will have a significantly greater impact on health outcomes than those focused on aerobic fitness alone. Counseling to promote both aerobic fitness and muscle strengthening is indicated for all patients, irrespective of body weight, and should begin early in life and continue across the life course.

Projecting productivity losses for cancer-related mortality 2011 - 2030

Background

When individuals stop working due to cancer this represents a loss to society – the loss of productivity. The aim of this analysis was to estimate productivity losses associated with premature mortality from all adult cancers and from the 20 highest mortality adult cancers in Ireland in 2011, and project these losses until 2030.

Methods

An incidence-based method was used to estimate the cost of cancer deaths between 2011 and 2030 using the Human Capital Approach. National data were used for cancer, population and economic inputs. Both paid work and unpaid household activities were included. Sensitivity analyses estimated the impact of assumptions around future cancer mortality rates, retirement ages, value of unpaid work, wage growth and discounting.

Results

The 233,000 projected deaths from all invasive cancers in Ireland between 2011 and 2030 will result in lost productivity valued at €73 billion; €13 billion in paid work and €60 billion in household activities. These losses represent approximately 1.4 % of Ireland’s GDP annually. The most costly cancers are lung (€14.4 billion), colorectal and breast cancer (€8.3 billion each). However, when viewed as productivity losses per cancer death, testis (€364,000 per death), cervix (€155,000 per death) and brain cancer (€136,000 per death) are most costly because they affect working age individuals. An annual 1 % reduction in mortality reduces productivity losses due to all invasive cancers by €8.5 billion over 20 years.

Conclusions

Society incurs substantial losses in productivity as a result of cancer-related mortality, particularly when household production is included. These estimates provide valuable evidence to inform resource allocation decisions in cancer prevention and control.

Productivity costs and years of potential life lost associated with five leading causes of death: Evidence from Iran (2006-2010)

Background: Economic burden due to premature mortalities is significant both on health system and on the society as a whole. This study aimed to determine the productivity costs and years of potential life lost associated with five leading causes of death in Iran from 2006 to 2010. Methods: Data on mortality by sex and age-groups due to five main leading causes of death (myocardial infarction (MI), cerebral vascular diseases (CVD), transport accidents (TA), hypertensive heart disease (HHD) and gastric cancer (GC)) were obtained from the Ministry of Health and Medical Education from 2006 to 2010 for 29 providences of Iran (data on Tehran province was not available). Three measures including years of potential life lost (YPLL), years of potential productive life lost (YPPLL) and the cost of productivity loss (CPL) due to premature mortality were used. To estimate the CPL and YPLL, the human capital approach and life expectancy method were used, respectively. Results: There were 518,815 deaths due to the five main leading causes of death; of which, 58% occurred in males. The estimated YPPLL resulted in 209,552,135 YPPLL from 2006 to 2011; of which, 141,966,592 (67%) were in males and 67,585,543 (33%) in females. The total cost of productivity loss caused by premature deaths due to the five leading causes of death was 7.86 billion dollars (US$) from 2006 to 2010, ranging from 1.63 billion dollars in 2006 to 1.31 billion dollars in 2010. Conclusion: This study revealed that the economic burden of premature mortalities due to the five main causes of death is substantial, and that these five leading causes should be considered in policy/decision making and prevention programms. The allocation of financial resources to control these causes may decrease their economic burden, resulting in higher level of health and well-being.

A contribution to the problem of premature mortality among Polish population

The author analyzes trends in premature mortality in Poland from 1960 to 1995. "Over the last 35 years the percentage of premature deaths in Poland decreased systematically: from 55.5% to 33.2%.... The intensity of deaths among males over 30 [has increased rapidly]; during the same period the intensity of deaths among females was relatively stable, with a slight downward tendency."

Alcohol, smoking and mortality in France since 1950: an evaluation of the number of deaths in 1986 due to alcohol and tobacco consumption

"In the present study, we first attempt to evaluate how many deaths [in France] in a given year (1986) are brought on prematurely by drinking and smoking.... This first stage revealed a number of causes which are largely alcohol--or smoking--related. We next compare the time trends in mortality from these causes and in alcohol and tobacco consumption. Third, we consider these selected causes, along with traumas, another source of premature deaths, in relation to mortality from all causes, and follow the changes over time in levels and age structures. We thus measure the impact of these causes on the general death rates since 1950. Finally, we examine how these causes have contributed to the increase of excess male mortality during the last 40 years."

Changes in premature deaths in Finland: successful long-term prevention of cardiovascular diseases

This article describes the long-term consequences of successful cardiovascular disease (CVD) prevention and its influence on premature mortality in Finland, with special reference to North Karelia. Active community-based CVD prevention began in 1972 in the province of North Karelia (population, 180,000). Since 1977, active preventive work has been carried out nationwide, taking advantage of the experience from North Karelia, which continued as a demonstration area for integrated prevention of noncommunicable diseases. Comprehensive community-based interventions as part of WHO interhealth and CINDI programmes in North Karelia and nationwide aimed at changing the target risk factors and health behaviours (serum cholesterol, blood pressure, smoking, diet) at the population level. Age-adjusted mortality rates for CVD, coronary heart disease (CHD), cerebrovascular disease, all cancers, lung cancer, accidents and violence, and all causes in the population aged 35-64 years from the pre-programme period (1969-71) to 1995 were the main measures of the outcome. Among men there was a great reduction in deaths from CHD, CVD, cancer, and all causes in the whole country. From 1969-71 to 1995 the age-standardized CHD mortality (per 100,000) decreased in North Karelia by 73% (from 672 to 185) and nationwide by 65% (from 465 to 165). The reduction in CVD mortality was of the same magnitude. Among men, CHD mortality decreased in the 1970s, as did lung cancer mortality in the 1980s and 1990s, significantly more in North Karelia than in all of Finland. Among women there was a great reduction in CVD (including CHD and stroke) mortality and all-causes mortality, but only a small reduction in cancer mortality. These results show that a major reduction in CVD mortality among the working-age population can take place in association with active reduction of major risk factors, with a favourable impact on cancer and all-causes mortality.

Mortality risk perceptions: a Bayesian reassessment

"This study uses data on perceived and actual mortality risks to test several alternative Bayesian models of the factors influencing risk beliefs. The analysis...indicates that while the hazard rate for the individual age group is an influential factor, the overall population death rate and the discounted expected number of life years lost due to the cause of death are also influential in affecting risk perceptions.... The predictive power of a linear perception model increases with the level of the risk and is least accurate for very small risks."

Premature mortality in Italy during the first decade of the AIDS epidemic: 1984-1993

BACKGROUND

AIDS has become a leading cause of premature mortality in many countries, owing to the decline in other major causes of premature death and the increase in AIDS itself. This study was carried out to determine the trends in premature mortality due to selected causes in Italy.

METHODS

Data from the Italian Mortality Data Base, for the ten years from 1984 to 1993 (the first decade of the AIDS epidemic) were analysed. Premature mortality was measured in terms of years of potential life lost before the age of 70 years (YPLL), excluding infant mortality. Trends in premature mortality due to AIDS were compared with those of the principal causes of premature death: lung cancer, colon-rectum cancer, stomach cancer, leukaemia, female breast cancer, uterine cancer, myocardial infarction, stroke, liver diseases, suicide, road accidents and overdose.

RESULTS

In this period there has been a marked increase in premature mortality from AIDS both among males aged 1-69 years (from a rate of YPLL of 0.01 per 1000 in 1984 to 3.71 in 1993) and females of the same age group (from 0 deaths in 1984 to a rate of YPLL of 1.02). Throughout the same period all the other causes of premature death have been declining, with the exception of suicide and overdose among males, and overdose and lung cancer among females. For people aged 25-44 years, AIDS has become the greatest cause of premature death. The increasing trend in premature mortality due to AIDS is most pronounced in the northern and central areas of Italy.

CONCLUSIONS

AIDS is the leading cause of death among males aged 25-44 years in Italy and is having an important impact on premature mortality among females in the same age group.

[The use of years of life lost for measuring the level and change of mortality]

"The use of the new index of years of life lost allows us to relate mortality by age and causes of death to the change of the life expectancy, at birth or between any given ages. This index replaces the use of the multiple decrement life tables for analyzing the impact of the change in mortality by age and cause of death on the life expectancies....The article presents the theoretical derivation of the index, some examples of its use, and a detailed calculation." Examples provided include Mexico, Chile, and Argentina. (SUMMARY IN ENG)

[The relationship between years of life lost and life expectancy: applications to the analysis of mortality]

"This paper presents a new, continuous, version of the index of years of life lost (YLL) in the population, distinguishing different causes of death. Also, it shows the mathematical relationship between the YLL and temporary life expectancies in the discrete and continuous cases....The model is applied to the analysis of mortality of the province of Cordoba, Argentina, during 1947-1991." (SUMMARY IN ENG)

The impact on health of urban environments

The impact on healt of urban environments reviews the range and variety of environmental hazards present in urban areas including biological pathogens, chemical pollutants, physical hazards and psychosocial stressors and their impact on human health. It also discusses how and why it is low-income groups (and within such groups women and children) who generally bear most of the health burden.

Mortality trend in a rapidly developing economy in Taiwan. Part II: Life expectancy and "potential years of life lost"

Taiwan has made remarkable economic progress in the last 30 years. The life expectancy of its population improved steadily during this period. A male child born in 1983 could look forward to 70.4 years of life and a female child to 75.3 years, gains of 17.5 years and 19.0 years, respectively, since 1950. The potential gains in life expectancy of the Taiwan population are also examined if the five leading causes of death are reduced or eliminated. In addition, this paper discusses the concept of potential productive years of life lost (PYLL), examines the leading causes of premature death and shows how this measure can be used to target prevention programs and health care planning.

Analysis of accidental death among children and teenagers in Shanghai

Mortality due to accidents among children and adolescents is examined. "Data collection was restricted to Shanghai's Changning district, Luwan district, Baoshan county and Shanghai county, taking 0-19 year-old children and teenagers who died accidental deaths between 1980 and 1987 as its sample, and a retrospective survey organized taking children and teenagers who did not die of accidental injury of the same sex, same age, and same area as a comparison."