Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 12.119
Filtrar
Mais filtros

Intervalo de ano de publicação
2.
BMJ Open ; 12(8): e059042, 2022 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-35940840

RESUMO

OBJECTIVES: In this study, we aim to analyse the relationship between educational attainment and all-cause mortality of adults in the high-income Asia Pacific region. DESIGN: This study is a comprehensive systematic review and meta-analysis with no language restrictions on searches. Included articles were assessed for study quality and risk of bias using the Joanna Briggs Institute critical appraisal checklists. A random-effects meta-analysis was conducted to evaluate the overall effect of individual level educational attainment on all-cause mortality. SETTING: The high-income Asia Pacific Region consisting of Japan, South Korea, Singapore and Brunei Darussalam. PARTICIPANTS: Articles reporting adult all-cause mortality by individual-level education were obtained through searches conducted from 25 November 2019 to 6 December 2019 of the following databases: PubMed, Web of Science, Scopus, EMBASE, Global Health (CAB), EconLit and Sociology Source Ultimate. PRIMARY AND SECONDARY OUTCOME MEASURES: Adult all-cause mortality was the primary outcome of interest. RESULTS: Literature searches resulted in 15 345 sources screened for inclusion. A total of 30 articles meeting inclusion criteria with data from the region were included for this review. Individual-level data from 7 studies covering 222 241 individuals were included in the meta-analyses. Results from the meta-analyses showed an overall risk ratio of 2.40 (95% CI 1.74 to 3.31) for primary education and an estimate of 1.29 (95% CI 1.08 to 1.54) for secondary education compared with tertiary education. CONCLUSION: The results indicate that lower educational attainment is associated with an increase in the risk of all-cause mortality for adults in the high-income Asia Pacific region. This study offers empirical support for the development of policies to reduce health disparities across the educational gradient and universal access to all levels of education. PROSPERO REGISTRATION NUMBER: CRD42020183923.


Assuntos
Iniquidades em Saúde , Mortalidade , Adulto , Ásia/epidemiologia , Humanos , Japão , República da Coreia , Singapura
3.
BMJ Open ; 12(8): e059370, 2022 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-35948385

RESUMO

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.


Assuntos
Expectativa de Vida , Neoplasias , Adulto , Causas de Morte , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Fumar/epidemiologia , Espanha/epidemiologia
4.
Artigo em Inglês | MEDLINE | ID: mdl-35955062

RESUMO

This study aimed to estimate respiratory disease hospitalization costs attributable to ambient temperatures and to estimate the future hospitalization costs in Australia. The associations between daily hospitalization costs for respiratory diseases and temperatures in Sydney and Perth over the study period of 2010-2016 were analyzed using distributed non-linear lag models. Future hospitalization costs were estimated based on three predicted climate change scenarios-RCP2.6, RCP4.5 and RCP8.5. The estimated respiratory disease hospitalization costs attributable to ambient temperatures increased from 493.2 million Australian dollars (AUD) in the 2010s to more than AUD 700 million in 2050s in Sydney and from AUD 98.0 million to about AUD 150 million in Perth. The current cold attributable fraction in Sydney (23.7%) and Perth (11.2%) is estimated to decline by the middle of this century to (18.1-20.1%) and (5.1-6.6%), respectively, while the heat-attributable fraction for respiratory disease is expected to gradually increase from 2.6% up to 5.5% in Perth. Limitations of this study should be noted, such as lacking information on individual-level exposures, local air pollution levels, and other behavioral risks, which is common in such ecological studies. Nonetheless, this study found both cold and hot temperatures increased the overall hospitalization costs for respiratory diseases, although the attributable fractions varied. The largest contributor was cold temperatures. While respiratory disease hospitalization costs will increase in the future, climate change may result in a decrease in the cold attributable fraction and an increase in the heat attributable fraction, depending on the location.


Assuntos
Transtornos Respiratórios , Doenças Respiratórias , Austrália/epidemiologia , Mudança Climática , Temperatura Baixa , Hospitalização , Temperatura Alta , Humanos , Mortalidade , Doenças Respiratórias/epidemiologia , Temperatura
5.
Rev Panam Salud Publica ; 46, ago. 2022. Special Issue Emergency Preparedness in the Americas
Artigo em Espanhol | PAHOIRIS | ID: phr-56242

RESUMO

[RESUMEN]. Objetivo. Cuantificar las desigualdades socioeconómicas en la mortalidad por COVID-19 en Colombia y evaluar en qué medida el tipo de seguro de salud, la carga de enfermedades concomitantes, la zona de residencia y el origen étnico explican estas desigualdades. Métodos. Se analizaron los datos de una cohorte retrospectiva de casos de COVID-19. Se estimó el índice relativo de desigualdad (IRD) y el índice de desigualdad basado en la pendiente (IDP) utilizando modelos de supervivencia con todos los participantes, y estratificándolos por edad y sexo. El porcentaje de reducción del IRD y el IDP se calculó después de ajustar con respecto a factores que podrían ser relevantes. Resultados. Se pusieron en evidencia desigualdades notables en toda la cohorte y en los subgrupos (edad y sexo). Las desigualdades fueron mayores en los adultos más jóvenes y disminuyeron de manera gradual con la edad, pasando de un IRD de 5,65 (intervalo de confianza de 95% [IC 95%] = 3,25-9,82) en los participan- tes menores de 25 años a un IRD de 1,49 (IC 95% = 1,41-1,58) en los mayores de 65 años. El tipo de seguro de salud fue el factor más importante, al cual se atribuyó 20% de las desigualdades relativas y 59% de las absolutas. Conclusiones. La mortalidad por COVID-19 en Colombia presenta importantes desigualdades socioeconó- micas. El seguro de salud aparece como el factor que más contribuye a estas desigualdades, lo cual plantea retos al diseño de las estrategias de salud pública.


[ABSTRACT]. Objectives. To quantify socioeconomic inequalities in COVID-19 mortality in Colombia and to assess the extent to which type of health insurance, comorbidity burden, area of residence, and ethnicity account for such inequalities. Methods. We analyzed data from a retrospective cohort of COVID-19 cases. We estimated the relative and slope indices of inequality (RII and SII) using survival models for all participants and stratified them by age and gender. We calculated the percentage reduction in RII and SII after adjustment for potentially relevant factors. Results. We identified significant inequalities for the whole cohort and by subgroups (age and gender). Inequalities were higher among younger adults and gradually decreased with age, going from RII of 5.65 (95% confidence interval [CI] = 3.25, 9.82) in participants younger than 25 years to RII of 1.49 (95% CI = 1.41, 1.58) in those aged 65 years and older. Type of health insurance was the most important factor, accounting for 20% and 59% of the relative and absolute inequalities, respectively. Conclusions. Significant socioeconomic inequalities exist in COVID-19 mortality in Colombia. Health insu- rance appears to be the main contributor to those inequalities, posing challenges for the design of public health strategies.


[RESUMO]. Objetivos. Quantificar as desigualdades socioeconômicas na mortalidade por COVID-19 na Colômbia e ava- liar até que ponto o tipo de cobertura de assistência à saúde, a carga de comorbidades, o local de residência e a etnia contribuíram para tais desigualdades. Métodos. Analisamos dados de uma coorte retrospectiva de casos de COVID-19. Calculamos os índices relativo e angular de desigualdade (RII e SII, respectivamente) utilizando modelos de sobrevivência em todos os participantes, estratificando-os por idade e gênero. Calculamos o percentual de redução no RII e no SII após ajuste para fatores possivelmente relevantes. Resultados. Identificamos desigualdades significativas na coorte como um todo e por subgrupos (idade e gênero). As desigualdades foram maiores para adultos mais jovens e decaíram gradualmente com a idade, indo de um RII de 5,65 (intervalo de confiança [IC] de 95% = 3,25; 9,82] nos participantes com idade inferior a 25 anos a um RII de 1,49 [IC 95% = 1,41; 1,58] nas pessoas com 65 anos ou mais. O tipo de cobertura de assistência à saúde foi o fator mais importante, representando 20% e 59% das desigualdades relativa e absoluta, respectivamente. Conclusões. Desigualdades socioeconômicas significativas afetaram a mortalidade por COVID-19 na Colômbia. O tipo de cobertura de saúde parece ser o principal fator contribuinte para essas desigualdades, impondo desafios à elaboração de estratégias de saúde pública.


Assuntos
Fatores Socioeconômicos , Planos de Pré-Pagamento em Saúde , Mortalidade , COVID-19 , Colômbia , Fatores Socioeconômicos , Planos de Pré-Pagamento em Saúde , Mortalidade , Fatores Socioeconômicos , Planos de Pré-Pagamento em Saúde , Mortalidade , Colômbia
6.
Environ Res ; 214(Pt 3): 114082, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35964673

RESUMO

BACKGROUND: To date, little is known about the temporal variation of the temperature-mortality association among different demographic and socio-economic groups. The aim of this work is to investigate trends in cold- and heat- attributable mortality risk and burden by sex, age, education, marital status, and number of household occupants in the city of Turin, Italy. METHODS: We collected daily time-series of temperature and mortality counts by demographic and socio-economic groups for the period 1982-2018 in Turin. We applied standard quasi-Poisson regression models to data subsets of 25-year moving subperiods, and we estimated the temperature-mortality associations with distributed lag non-linear models (DLNM). We provided cross-linkages between the evolution of minimum mortality temperatures, relative risks of mortality and temperature-attributable deaths under cold and hot conditions. RESULTS: Our findings highlighted an overall increase in risk trends under cold and heat conditions. All-cause mortality at the 1st percentile increased from 1.15 (95% CI: 1.04; 1.28) in 1982-2006 to 1.24 (95% CI: 1.11; 1.38) in 1994-2018, while at the 99th percentile the risk shifted from 1.51 (95% CI: 1.41; 1.61) to 1.59 (95% CI: 1.49; 1.71). In relation to social differences, women were characterized by greater values in respect to men, and similar estimates were observed among the elderly in respect to the youngest subgroup. Risk trends by educational subgroups were mixed, according to the reference temperature condition. Finally, individuals living in conditions of isolation were characterized by higher risks, with an increasing vulnerability throughout time. CONCLUSIONS: The overall increase in cold- and heat- related mortality risk suggests a maladaptation to ambient temperatures in Turin. Despite alert systems in place increase public awareness and improve the efficiency of existing health services at the local level, they do not necessarily prevent risks in a homogeneous way. Targeted public health responses to cold and heat in Turin are urgently needed to adapt to extreme temperatures due to climate change.


Assuntos
Temperatura Baixa , Temperatura Alta , Idoso , Feminino , Humanos , Masculino , Mortalidade , Fatores de Risco , Fatores Socioeconômicos , Temperatura
7.
Artigo em Inglês | MEDLINE | ID: mdl-35886357

RESUMO

Whereas previous studies have assessed the overall health impact of temperature in Hong Kong, the aim of this study was to investigate whether the health impact is modified by local temperature of small geographic units, which may be related to the diverse socioeconomic characteristics of these units. The effects of local temperature on non-accidental and cause-specific mortality were analyzed using Bayesian spatial models at a small-area level, adjusting for potential confounders, i.e., area-level air pollutants, socioeconomic status, and green space, as well as spatial dependency. We found that a 10% increase in green space density was associated with an estimated 4.80% decrease in non-accidental mortality risk and a 5.75% decrease in cardiovascular disease mortality risk in Hong Kong, whereas variation in local annual temperature did not significantly contribute to mortality. We also found that the spatial variation of mortality within this city could be explained by the geographic distribution of green space and socioeconomic factors rather than local temperature or air pollution. The findings and methodology of this study may help to further understanding and investigation of social and structural determinants of health disparities, particularly place-based built environment across class-based small geographic units in a city, taking into account the intersection of multiple factors from individual to population levels.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Teorema de Bayes , Ambiente Construído , Hong Kong/epidemiologia , Mortalidade , Temperatura
8.
Liver Int ; 42(10): 2299-2316, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35779247

RESUMO

AIMS: This study aims to compare estimates of primary liver cancer mortality from World Health Organization (WHO), Global Burden Disease (GBD) and Global Cancer Observatory (GCO). METHODS: Liver cancer mortality was extracted from WHO, GBD and GCO for 92 countries for the most recent year. Age-standardized rate (ASR) was computed and used for current comparisons across the three data sources. Temporal trend for 75 countries was analysed and compared between WHO and GBD from 1990 to 2019 using joinpoint regression. Average annual percentage change for the most recent 10 years was used as indicator for change. RESULTS: The estimates of ASR were quite consistent across the three data sources, but most similar estimates were found between WHO and GCO in both region and country levels. The differences in ASR were negatively correlated with completeness of cause-of-death registration, human development index and proportion of liver cancer because of alcohol consumption. Consistent trends of ASR were found from 35 countries between WHO and GBD in the most recent 10 years. However, opposite trends were found from 10 countries with five from Southern America, four from Europe and one from Asia. Of the 18 countries for projection, opposite trends between WHO and GBD were found from seven countries. CONCLUSION: While the ASR of primary liver cancer mortality was comparable across the three data sources, most similar estimates were found between WHO and GCO. The opposite trends found from 10 countries between WHO and GBD raised concerns of true patterns in these countries.


Assuntos
Carga Global da Doença , Neoplasias Hepáticas , Ásia , Saúde Global , Humanos , Mortalidade , Organização Mundial da Saúde
9.
Epidemiol Prev ; 46(4): 25-32, 2022.
Artigo em Italiano | MEDLINE | ID: mdl-35862557

RESUMO

OBJECTIVES: to evaluate the impact on total mortality of the COVID-19 pandemic in Italy, by country of birth. DESIGN: historic cohort study based on administrative databases. SETTING AND PARTICIPANTS: the study is based on subjects included in the Base Register of Individuals of the Italian National Institute of Statistics on 01.01.2019, aged 35-64 years, and followed-up until 31.07.2021. MAIN OUTCOME MEASURES: age-standardized mortality rates were computed to analyse trends in overall mortality by country of birth grouped in three categories: 1. Italy and other high developed countries; 2. European countries with strong migratory pressure (EU-SMP); 3, non-European countries with strong migratory pressure (non-EU-SMP). Variations in mortality rates during the pandemic (March 2020-July 2021) with respect to the pre-pandemic period (January 2019-February 2020) were measured and compared across groups using mortality rate ratios (MRR) estimated by Poisson regression models, separately for men and women. RESULTS: the cohort includes 26,199,241 individuals, of whom 172,847 died during the follow-up. Over the whole period, mortality was consistently lower in individuals born in non-EU-SMP countries as compared to those born in Italy and other high developed countries. During the first pandemic wave (March-April 2020), individuals born in non-EU-SMP countries had higher excesses as compared to those born in Italy or other high developed countries (MRRs: 1.42 vs 1.28 in men and 1.30 vs 1.11 in women). Similar results were observed during the pandemic period October 2020-April 2021, when the MRRs were 1.37 vs 1.20 in men and 1.30 vs 1.11 in women. In the same period, the excess mortality among individuals born in EU-SMP did not significantly differ from that observed among those born in Italy and other high developed countries. CONCLUSIONS: in Italy, excess mortality during the COVID-19 pandemic was higher among immigrants born in non-EU-SMP countries as compared to the native population and immigrants born in high developed countries.


Assuntos
COVID-19 , Emigrantes e Imigrantes , Estudos de Coortes , Feminino , Humanos , Itália/epidemiologia , Masculino , Mortalidade , Pandemias
11.
RECIIS (Online) ; 16(2): 221-226, abr.-jun. 2022. graf
Artigo em Português | LILACS | ID: biblio-1378340

RESUMO

A dinâmica da pandemia de covid-19 vem evoluindo segundo fases marcadas por uma maior ou menor taxa de infecção, e diferentes impactos sobre o sistema de saúde e a mortalidade. Essas fases foram estudadas segundo quatro indicadores disponibilizados no sistema MonitoraCovid-19: positividade de testes de diagnóstico, número de casos, número de óbitos e o número de pessoas com ao menos duas doses de vacinas ­ padronizados numa série histórica para permitir sua comparação. São distinguidas cinco fases, marcadas pela circulação de diferentes variantes do vírus, estratégias de implementação ­ ou mesmo boicote ­ de medidas de controle e a vacinação gradativa da população. Esses indicadores podem ser usados no futuro para monitorar tendências e apontar políticas públicas adequadas.


The dynamics of the covid-19 pandemic has evolved according to phases marked by a higher or lower rate of infection, the different impacts on the health system and mortality. These phases were studied according to four indicators made available by the MonitoraCovid-19 system: positivity rates of diagnostic tests, number of cases, number of deaths and number of people who received at least two vaccine doses, standardized in a historical series to allow their comparison. Five phases are discerned, evidenced by the circulation of different virus variants, strategies employed to implement -or even undermine ­ disease control measures and the gradual vaccination of the population. These indicators can be used in the future to monitor trends and point out appropriate public policies.


La dinámica de la pandemia de covid-19 ha evolucionado según fases marcadas por una mayor o menor tasa de contagios, sus diferentes impactos en el sistema de salud y mortalidad. Estas fases se estudiaron según cuatro indicadores disponibles en el sistema MonitoraCovid-19: positividad de las pruebas diagnósticas, número de casos, número de defunciones y el número de personas vacunadas con al menos dos dosis, estandarizados en una serie histórica para permitir su comparación. Se distinguen cuatro fases, marcadas por la circulación de diferentes variantes del virus, las estrategias de implementación - o mismo el boicoteode medidas de control y la paulatina vacunación de la población. Estos indicadores pueden utilizarse en el futuro para monitorear tendencias y señalar políticas públicas apropiadas.


Assuntos
Humanos , Pandemias , COVID-19 , Política de Saúde , Indicadores e Reagentes , Brasil , Vacinação em Massa , Mortalidade , Técnicas e Procedimentos Diagnósticos
12.
Int J Equity Health ; 21(1): 96, 2022 07 14.
Artigo em Inglês | MEDLINE | ID: mdl-35836221

RESUMO

BACKGROUND: Research has generally found a significant inverse relationship in mortality risk across socioeconomic (SE) groups. This paper focuses on Spain, a country for which there continues to be very little evidence available concerning retirement pensioners. We draw on the Continuous Sample of Working Lives (CSWL) to investigate disparities in SE mortality among retired men aged 65 and above over the longest possible period covered by this data source: 2005-2018. We use the initial pension income (PI) level as our single indicator of the SE status of the retired population. METHODS: The mortality gradient by income is quantified in two ways: via an indicator referred to as "relative mortality", and by estimating changes in total life expectancy (LE) by PI level at ages 65 and 75 over time. We show that, should the information provided by the relative mortality ratio not be completely clear, a second indicator needs to be introduced to give a broad picture of the true extent of inequality in mortality. RESULTS: The first indicator reveals that, for the period covered and for all age groups, the differences in death rates across PI levels widens over time. At older age groups, these differences across PI levels diminish. The second indicator shows that disparities in LE at ages 65 and 75 between pensioners in the lowest and highest income groups are relatively small, although slightly higher than previously reported for Spain. This gap in LE widens over time, from 1.49 to 2.54 years and from 0.71 to 1.40 years respectively for pensioners aged 65 and 75. These differences are statistically significant. CONCLUSIONS: Along with other behavioral and structural aspects, a combination of factors such as the design of the pension system, the universality and quality of the health system, and high levels of family support could explain why LE inequalities for retired Spanish men are relatively small. To establish the reasons for this increased inequality in LE, more research needs to be carried out. An analysis of all Spanish social security records instead of just a sample would provide us with more information.


Assuntos
Expectativa de Vida , Aposentadoria , Idoso , Disparidades nos Níveis de Saúde , Humanos , Renda , Masculino , Mortalidade , Pensões , Fatores Socioeconômicos , Espanha/epidemiologia
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 43(6): 878-884, 2022 Jun 10.
Artigo em Chinês | MEDLINE | ID: mdl-35725345

RESUMO

Objective: To predicate whether China can achieve the United Nations Sustainable Development Goals (SDGs) 3.4.1 to reduce the age-standardized mortality rate of four major non-communicable diseases (NCDs) in residents aged 30-70 years by 2030 based on the trend of the mortality from 1990 to 2019. Methods: We collected the mortality data on cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes by age, gender and year in China from the Global Disease Burden Study 2019 (GBD2019). The age-period-cohort (APC) Bayesian model was applied for modeling the age-standardized mortality rate of four major NCDs in China during 2020-2030 according to the trend of the mortality during 1990-2019, and comparing the predicted value in 2030 with the observed value in 2015 to evaluate the possibility of achieving SDGs 3.4.1. Results: The age-standardized mortality rate of the four major NCDs in China showed a downward trend during 1990-2019. It is predicted that the number of death of the four NCDs in Chinese residents aged 30-70 years would increase from 2.96 million in 2020 to 3.19 million in 2030, while the age-standardized mortality rate would decrease from 308.49/100 000 in 2020 to 277.80/100 000 in 2030. The age-standardized mortality rate in 2030 would only decrease by 15.94% (18.73% for males and 14.31% for females) compared with 330.46/100 000 in 2015, with a 25.09% decrease for cardiovascular diseases, 4.76% for cancers, 37.21% for chronic respiratory diseases, and unchanged for diabetes. Conclusion: Although the age-standardized mortality rate of four major NCDs declined from 1990 to 2019 in China, it is difficult to achieve the SDGs of a 1/3 mortality rate reduction by 2030 according to the current declining trend, suggesting more active and effective efforts for NCD prevention and control are needed.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus , Neoplasias , Doenças não Transmissíveis , Teorema de Bayes , Doenças Cardiovasculares/prevenção & controle , China/epidemiologia , Feminino , Humanos , Masculino , Mortalidade , Mortalidade Prematura , Neoplasias/prevenção & controle , Doenças não Transmissíveis/prevenção & controle , Desenvolvimento Sustentável
14.
Health Place ; 76: 102848, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35759952

RESUMO

BACKGROUND: Observational studies have highlighted that where individuals live is far more important for risk of dying with COVID-19, than for dying of other causes. Deprivation is commonly proposed as explaining such differences. During the period of localised restrictions in late 2020, areas with higher restrictions tended to be more deprived. We explore how this impacted the relationship between deprivation and mortality and see whether local or regional deprivation matters more for inequalities in COVID-19 mortality. METHODS: We use publicly available population data on deaths due to COVID-19 and all-cause mortality between March 2020 and April 2021 to investigate the scale of spatial inequalities. We use a multiscale approach to simultaneously consider three spatial scales through which processes driving inequalities may act. We go on to explore whether deprivation explains such inequalities. RESULTS: Adjusting for population age structure and number of care homes, we find highest regional inequality in October 2020, with a COVID-19 mortality rate ratio of 5.86 (95% CI 3.31 to 19.00) for the median between-region comparison. We find spatial context is most important, and spatial inequalities higher, during periods of low mortality. Almost all unexplained spatial inequality in October 2020 is removed by adjusting for deprivation. During October 2020, one standard deviation increase in regional deprivation was associated with 20% higher local mortality (95% CI, 1.10 to 1.30). CONCLUSIONS: Spatial inequalities are greatest in periods of lowest overall mortality, implying that as mortality declines it does not do so equally. During the prolonged period of low restrictions and low mortality in summer 2020, spatial inequalities strongly increased. Contrary to previous months, we show that the strong spatial patterning during autumn 2020 is almost entirely explained by deprivation. As overall mortality declines, policymakers must be proactive in detecting areas where this is not happening, or risk worsening already strong health inequalities.


Assuntos
COVID-19 , Disparidades nos Níveis de Saúde , Inglaterra/epidemiologia , Humanos , Mortalidade , Fatores Socioeconômicos , País de Gales/epidemiologia
15.
Int J Public Health ; 67: 1604538, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35664647

RESUMO

Objectives: To examine recent age-period-cohort effects on suicide among foreign-born individuals, a particularly vulnerable sociodemographic group in Spain. Methods: Using 2000-2019 mortality data from Spain's National Institute of Statistics, we estimated age-period-cohort effects on suicide mortality, stratified by foreign-born status (native- vs. foreign-born) and, among the foreign-born, by Spanish citizenship status, a proxy for greater socioeconomic stability. Results: Annual suicide mortality rates were lower among foreign- than native-born individuals. There was heterogeneity in age-period-cohort effects between study groups. After 2010, suicide mortality increased markedly among the foreign-born-especially for female cohorts born around 1950, and slightly among native-born women-especially among female cohorts born after the 1960s. Among native-born men, suicide increased linearly with age and remained stable over time. Increases in suicide among the foreign-born were driven by increases among individuals without Spanish citizenship-especially among cohorts born after 1975. Conclusion: After 2010, suicide in Spain increased markedly among foreign-born individuals and slightly among native-born women, suggesting an association between the downstream effects of the 2008 economic recession and increases in suicide mortality among socioeconomically vulnerable populations.


Assuntos
Recessão Econômica , Suicídio , Estudos de Coortes , Feminino , Humanos , Internacionalidade , Masculino , Mortalidade , Espanha/epidemiologia
16.
Artigo em Espanhol | PAHOIRIS | ID: phr-56092

RESUMO

[RESUMEN]. Objetivo. Estimar el impacto de la pandemia de la COVID-19 durante el año 2020, a través del exceso de mortalidad por todas las causas y los años potenciales de vida laboral perdidos en la población en edad de trabajar, de una selección de países latinoamericanos y el Caribe. Métodos. Estudio basado en datos de defunciones por todas las causas entre 15 y 69 años, procedentes principalmente de los Institutos Nacionales de Estadísticas. Se estimaron defunciones esperadas a partir de las registradas entre 2015 y 2019. El exceso de mortalidad fue estimado a través del indicador P, la razón de mortalidad estandarizada (RME) y los años potenciales de vida laboral perdidos (AVLP) hasta los 70 años. Resultados. El exceso de defunciones en Brasil, Bolivia, Chile, Colombia, Costa Rica, Cuba, México, Perú y República Dominicana sumó 431 083 (282 558 en hombres y 148 575 en mujeres), lo que representó una pérdida de 5 715 770 (3 742 955 en hombres y 1 972 815 en mujeres) de APVLP. La mortalidad observada fue significativamente superior a la esperada en todos los países, menos República Dominicana. Conclusiones. El impacto de la COVID-19 en la población en edad de trabajar tendrá un impacto profundo en la situación socioeconómica. El recuento oportuno del exceso de muertes resulta útil y puede ser usado como un sistema de alerta temprana para monitorizar la magnitud de los brotes de COVID-19. La monitorización del exceso de mortalidad en personas en edad de trabajar, realizada por el Observatorio Iberoamericano de Seguridad y Salud en el Trabajo permite evaluar con mayor exactitud la carga social y económica de la COVID-19.


[ABSTRACT]. Objective. Estimate the impact of the COVID-19 pandemic in 2020, through excess all-cause mortality and potential years of productive life lost (YPLL) in the working-age population, in selected Latin American and Caribbean countries. Methods. Study based on data on deaths from all causes from age 15 to 69 years, mainly from national institutes of statistics. Estimates of expected deaths were based on reported deaths from 2015 to 2019. Excess mortality was estimated using the P indicator, standardized mortality ratio (SMR), and potential YPLL up to age 70 years. Results. Excess deaths in Brazil, Bolivia, Chile, Colombia, Costa Rica, Cuba, the Dominican Republic, Mexico, and Peru totaled 431 083 (282 558 men and 148 575 women), representing a potential loss of 5 715 770 (3 742 955 in men and 1 972 815 in women) years of productive life. Observed mortality was significantly higher than expected in all countries except the Dominican Republic. Conclusions. COVID-19 in the working-age population will have a profound impact on socio-economic conditions. Timely counting of excess deaths is useful and can be used as an early warning system to monitor the magnitude of COVID-19 outbreaks. Monitoring of excess mortality in working-age people by the Ibero-American Observatory on Safety and Health at Work enables more accurate assessment of the social and economic burden of COVID-19.


[RESUMO]. Objetivo. Estimar o impacto da pandemia de COVID-19 durante o ano de 2020, por meio do excesso de mortalidade por todas as causas e dos anos produtivos de vida perdidos (APrVP) na população em idade ativa, em uma seleção de países da América Latina e do Caribe. Métodos. Estudo baseado em dados de óbitos por todas as causas entre 15 e 69 anos, principalmente dos Institutos Nacionais de Estatística. Os óbitos esperados foram estimados a partir daqueles registrados entre 2015 e 2019. O excesso de mortalidade foi estimado por meio do indicador P, da razão de mortalidade padronizada (RMP) e dos APrVP até os 70 anos. Resultados. O excesso de óbitos no Brasil, na Bolívia, no Chile, na Colômbia, na Costa Rica, em Cuba, no México, no Peru e na República Dominicana totalizou 431 083 (282 558 em homens e 148 575 em mulheres), o que representou uma perda de 5 715 770 (3 742 955 em homens e 1 972 815 em mulheres) APrVP. A mortalidade observada foi significativamente maior do que o esperado em todos os países, exceto na República Dominicana. Conclusões. O impacto da COVID-19 na população em idade ativa terá um impacto profundo na situação socioeconómica. O cálculo oportuno do excesso de mortes é útil e pode ser usado como um sistema de alerta precoce para monitorar a magnitude dos surtos de COVID-19. O monitoramento do excesso de mortalidade em pessoas em idade ativa, realizado pelo Observatório Ibero-Americano de Segurança e Saúde no Trabalho, permite avaliar com mais precisão a carga social e econômica da COVID-19.


Assuntos
COVID-19 , Mortalidade , Expectativa de Vida , Carga Global da Doença , Mortalidade , Expectativa de Vida , Carga Global da Doença , Mortalidade , Expectativa de Vida , Efeitos Psicossociais da Doença
17.
Spat Spatiotemporal Epidemiol ; 41: 100501, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35691639

RESUMO

OBJECTIVES: Smoking-related mortality varies over different social, environmental, and policy contexts. However, spatial patterns, examined at a small area level, have been seldom considered. Therefore, the study provides a detailed analysis of socio-spatial inequalities in premature mortality related to smoking in the contemporary Czech adult population. DESIGN, SETTINGS, AND METHODS: We conducted a population-based, cross-sectional study to investigate the spatial pattern of the age-adjusted smoking-related mortality across Czechia. The spatial inequalities, as measured at the municipality level, were investigated using geostatistical modeling techniques. The ecological regression of the local mortality risk on socioeconomic composition of municipalities was also conducted. The target population was defined as permanent adult residents of Czechia aged 25-64 years in the period of 2011-2015. RESULTS: Among both sexes, a significant spatial gradient in the South-East (lower relative risk) - North-West (higher relative risk) axis was detected. The local mortality risk was significantly related to the level of relative deprivation of the municipalities (a composite index comprised from unemployment rate and level of education): adjusted RR among males (for an increase by 1 SD): 1.21 [95% CI: 1.158-1.256], p < 0.001; adjusted RR among females (for an increase by 1 SD): 1.14 [95% CI: 1.090-1.186], p < 0.001. Mortality among males was approximately twice as high as opposed to females. Regarding the spatial inequalities of the phenomena, however, only rather minor sex-specific patterns were identified. Contrasted to males, mortality among females was unrelated to unemployment rates. CONCLUSIONS: Consistent spatial patterns of the premature mortality were identified. The mortality risk was significantly related to socioeconomic composition of the Czech municipalities. The higher the level of local deprivation, the higher the local mortality risk. The results of the study can be found beneficial for planning of both socially and spatially integrated public health policy.


Assuntos
Mortalidade Prematura , Fumar , Adulto , Causas de Morte , Estudos Transversais , República Tcheca/epidemiologia , Feminino , Humanos , Masculino , Mortalidade , Sistema de Registros , Fatores de Risco , Análise de Pequenas Áreas , Fatores Socioeconômicos
18.
Int J Equity Health ; 21(1): 81, 2022 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-35676694

RESUMO

BACKGROUND: Healthcare system and intersectoral public health policies play a crucial role in improving population health and reducing health inequalities. This study aimed to quantify their impact, operationalized as avoidable deaths, on the gap in life expectancy (LE) and lifespan inequality (LI) between Iran and three neighbour countries viz., Turkey, Qatar, and Kuwait in 2015-2016. METHODS: Annual data on population and causes of deaths by age and sex for Iran and three neighbour countries were obtained from the World Health Organization mortality database for the period 2015-2016. A recently developed list by the OECD/Eurostat was used to identify avoidable causes of death (with an upper age limit of 75). The cross-country gaps in LE and LI (measured by standard deviation) were decomposed by age and cause of death using a continuous-change model. RESULTS: Iranian males and females had the second lowest and lowest LE, respectively, compared with their counterparts in the neighbour countries. On the other hand, the highest LIs in both sexes (by 2.3 to 4.5 years in males and 1.1 to 3.3 years in females) were observed in Iran. Avoidable causes contributed substantially to the LE and LI gap in both sexes with injuries and maternal/infant mortality represented the greatest contributions to the disadvantages in Iranian males and females, respectively. CONCLUSIONS: Higher mortality rates in young Iranians led to a double burden of inequality -shorter LE and greater uncertainty at timing of death. Strengthening intersectoral public health policies and healthcare quality targeted at averting premature deaths, especially from injuries among younger people, can mitigate this double burden.


Assuntos
Expectativa de Vida , Longevidade , Causas de Morte , Feminino , Humanos , Lactente , Irã (Geográfico)/epidemiologia , Masculino , Mortalidade , Mortalidade Prematura
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA