Sex differentials in Indian mortality: recent changes and implications for sex ratio

"In this paper, the recent changes in sex differentials in India's mortality are studied first to ascertain the relative improvements and secondly to study the impact of these changes on [the] sex ratio of the population. The analysis...indicates that the reduction in mortality rates during 1971-1991 was higher for females, particularly...during 1981-91. The narrowing down of the gap between male and female mortality rates had started in the late 1970s and all the indicators considered here suggest that, at present, there is an excess of male mortality in India. The mortality change was favourable for improvement in sex ratio; the analysis shows that the changes in mortality differentials by sex alone would have led to an increase in sex ratio by more than 10 points during the last decade. Further analysis suggests that the sex ratio at birth in India changed considerably during the last decade and [that] most of the reduction in sex ratio [that] occurred during 1981-91 can be attributed to these changes."

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."

Maternal smoking in pregnancy and sex differences in perinatal death between boys and girls

The sex difference in perinatal mortality in developed countries is largely unexplained. The current study evaluated the differences in the impact of maternal smoking during pregnancy on the risk of perinatal death between males and females. The analysis involved 11,469 and 9,404 newborns derived from two population-based birth cohorts in Northern Finland, for 1966 and 1985-86, respectively. The perinatal mortality rate was 23 per thousand in the 1966 cohort and 9 per thousand in the 1985-86 cohort. The rate ratio (RR) for mortality for males over females is 1.15 and 1.60 in the two cohorts, respectively. Among children whose mothers smoked during pregnancy, the RR was 2.2 (95% CI 1.0, 4.7) for the former cohort and 4.8 (95% CI 1.5, 15.2) for the later cohort; and among the children whose mothers did not smoke the corresponding RR was 1.2 (95% CI 0.9, 1.6) and 1.1 (95% CI 0.6, 1.9). Maternal smoking during pregnancy could be an important determinant accounting for the excess perinatal death for males over females. Our results encourage evaluation of the findings among other populations.

Early selection and sex composition in Italy: a study at the regional level

We have chosen four Italian regions with different degrees of industrialization and socioeconomic levels to study environmental differences in the sex ratio. The improvement in living and sanitary conditions during the last century has led to a progressive reduction in early male extramortality, and the sex ratio at birth has been almost unchanged at least to the first year of life and probably up to reproductive age. To investigate whether socioeconomic, cultural, or biological factors still influence the sex ratio at birth, we studied the stillbirth rate and the relations between newborn viability and sex composition as a function of maternal age and educational level. Our results suggest that in less favorable environments early selection against male newborns is almost twice that against female newborns when the mothers are the least favored for socioeconomic status, cultural level, and biological conditions (older than 39 years).

Mortality trends in a cohort of homosexual men in New York City, 1978-1988

Trends in mortality related to infection by human immunodeficiency virus type 1 (HIV-1) and to other causes were examined from 1978 to 1988 in a cohort of 8,906 homosexual men who participated in studies of hepatitis B virus infection in the late 1970s in New York City. HIV-related mortality rates increased from 1 per 10,000 person-years in 1980 to 181 per 10,000 person-years in 1986, followed by a plateau from 1986 to 1988. The standardized mortality ratio among white men in the cohort was 3.7 (95% confidence interval (Cl) 3.4-3.9) as compared with white men from across the United States. Higher HIV-related mortality rates were associated with a higher number of sexual partners, a history of gonorrhea and/or syphilis, and serologic markers of infection with hepatitis B virus. After adjustment for demographics and sexual behaviors, the relative risk of mortality for Hispanic men as compared with white men was 1.5 (95% Cl 1.1-1.9). This study illustrates the large excess in mortality among homosexual men over the last decade, with the excess accounted for by deaths from HIV-related diseases. The recent plateau in mortality may be due to the effect of new treatments and/or the decline in new HIV-1 infections among homosexual men. The excess in HIV-related mortality among Hispanic homosexual men was not explained by differences in demographics and factors associated with the sexual transmission of HIV-1.

Perinatal mortality rate in a south Indian population

Perinatal mortality rate was assessed for 13964 consecutive births in SAT Hospital, Trivandrum, South India, during a period of one year. The overall perinatal mortality rate was 42.75, stillbirth rate 24.41 and early neonatal mortality rate 18.79. The perinatal mortality rate in multiple pregnancy was 156.65. Preventable causes of perinatal mortality still make a major contribution to perinatal deaths in developing countries.

[The impact of excess male mortality on sex structure. The Italian case, 1951-1981]

The purpose of this note is to analyze male excess mortality in relation to general mortality trends in a country with low levels of mortality, using Italian data for the period 1951-1981, and to examine the effect of this excess male mortality on the sex distribution of the population. Consideration is given to the apparent paradox whereby "at least during the first half of life, the sex ratio increases when excess male mortality increases. This paradox shows that the index traditionally used for measuring the disadvantage of men with regard to survival, is not the most appropriate one." (SUMMARY IN ENG AND SPA)