The turn of the gradient? Educational differences in breast cancer mortality in 18 European populations during the 2000s.

This study aims to investigate the association between educational level and breast cancer mortality in Europe in the 2000s. Unlike most other causes of death, breast cancer mortality tends to be positively related to education, with higher educated women showing higher mortality rates. Research has however shown that the association is changing from being positive over non-existent to negative in some countries. To investigate these patterns, data from national mortality registers and censuses were collected and harmonized for 18 European populations. The study population included all women aged 30-74. Age-standardized mortality rates, mortality rate ratios, and slope and relative indexes of inequality were computed by education. The population was stratified according to age (women aged 30-49 and women aged 50-74). The relation between educational level and breast cancer mortality was predominantly negative in women aged 30-49, mortality rates being lower among highly educated women and higher among low educated women, although few outcomes were statistically significant. Among women aged 50-74, the association was mostly positive and statistically significant in some populations. A comparison with earlier research in the 1990s revealed a changing pattern of breast cancer mortality. Positive educational differences that used to be significant in the 1990s were no longer significant in the 2000s, indicating that inequalities have decreased or disappeared. This evolution is in line with the "fundamental causes" theory which stipulates that whenever medical insights and treatment become available to combat a disease, a negative association with socio-economic position will arise, independently of the underlying risk factors.

Inequalities in tuberculosis mortality: long-term trends in 11 European countries.

SETTING: Previous studies in many countries have shown that mortality due to tuberculosis (TB) is higher among people of lower socio-economic status. OBJECTIVE: To assess the magnitude and direction of trends in educational inequalities in TB mortality in 11 European countries. DESIGN: Data on TB mortality between 1980 and 2011 were collected among persons aged 35-79 years. Age-standardised mortality rates by educational level were calculated. Inequalities were estimated using the relative and slope indices of inequality. RESULTS: In the first decade of the twenty-first century, educational inequalities in TB mortality occurred in all countries in this study. The largest absolute inequalities were observed in Lithuania, and the smallest in Denmark. In most countries, relative inequalities have remained stable since the 1980s or 1990s, while absolute inequalities remained stable or went down. In Lithuania and Estonia, however, absolute inequalities increased substantially. CONCLUSION: The reduction in absolute inequalities in TB mortality, as seen in many European countries, is a major achievement; however, inequalities persist and are still a major cause for concern in the twenty-first century. Interventions aimed at preventing TB disease and reducing TB case fatality in lower socio-economic groups should be intensified, especially in the Baltic countries.

[Occurrence of cleft defects of the central nervous system in the Czech Republic 1961-1999. Incidence, prenatal diagnosis and prevalence based on maternal age]. / Výskyt rozstepových vad centrálního nervového systému v Ceské republice v období 1961-1999. Incidence, prenatální diagnostika a prevalence podle veku matky.

OBJECTIVE OF STUDY: Presentation of the incidence of neural tube defects (anencephaly, spina bifida, encephalocele) in the Czech Republic in 1961 to 1999. Analysis of the prevalence of these defects in different groups by maternal age. TYPE OF STUDY: Retrospective demographic-epidemiological study. METHOD: Epidemiological analysis of the incidence of neural tube defects diagnosed prenatally and postnatally in the Czech Republic in 1961-1999. Mathematical and statistical analysis of these defects by maternal age, the method of 95% confidence probability interval was used. Data from the nationwide register of inborn defects were used assembled in the Institute of Health Information and Statistics of the Czech Republic and data on the prenatal diagnosis from different departments of medical genetics. RESULTS: In the Czech Republic in 1961-1999 4629 cases of neural tube defects were recorded. This number comprised 1812 cases of anencephaly, 2420 cases of spina bifida and 397 cases of encephalocele. Of this total number of notified defects 386 cases of anencephaly were diagnosed prenatally and pregnancy was terminated. In spina bifida thus 261 pregnancies were terminated prematurely, in encephalocele 67 cases. CONCLUSION: A significant reduction of the incidence of anencephaly, spina bifida and encephalocele in the Czech Republic was found during the last decade of the investigation period (1961-1999). This decline is most probably due to advances of primary and secondary prevention. When evaluating maternal age as one of the risk factors for the development of neural tube defects, this risk was neither unequivocally confirmed nor ruled out.

[Condition of children after assisted reproduction in the Czech Republic in the period of 1995-1999]. / Stav detí po asistované reprodukci v Ceské republice za období let 1995-1999.

INTRODUCTION AND PROBLEM: Since the introduction of in vitro fertilization (IVF) there has been continuing discussion on possible genetic defects and malformations in children in connection with the technique of assisted reproduction. These data have not been so far analyzed in the all-state scale of the Czech Republic and our contribution thereby contributes by present complex analysis of the data to the knowledge of this problem in this country. MATERIAL AND METHODS: The paper analyzes data of children from IVF Registry for the years 1995-1998 and compares the results obtained with those of children born after spontaneous pregnancy in the Czech Republic in the period of 1995-1999. The incidence of inborn defects in children born after IVF methods has been confronted with data from the VV Registry after spontaneous conception. It is a retrospective analysis of individual anonymous data. RESULTS: In the period of 1995-1998 there were 3,782 successful pregnancies after IVF, which ended by successful delivery of the children. In the period of 1995-1999, 367,735 children were born in the Czech Republic on the whole. In the total number of 3,782 successful pregnancies, 5,126 children were born, 5,108 being born alive and were stillborn. The frequency of children having been delivered with an inborn defect were 2.98% in the IVF children and 2.77% in other born children, the difference not being statistically significant. CONCLUSION: The analysis of our cohort of IVF children has not revealed increased rate of inborn defects in comparison with children born after spontaneously conception.

[Probability of infant death by age groups in Czechoslovakia and Slovakia from 1966-1978]. / Pravdepodobnosti úmrtí kojencu podle veku v CSR a SSR v letech 1966-1978.

PIP: The author examines trends in infant mortality in Czechoslovakia between 1965 and 1978. Reasons for the significant declines that have occurred since 1976 are analyzed for the Czech and Slovak republics separately (SUMMARY IN ENG, RUS)^ieng

Socioeconomic inequalities in diabetes mellitus across Europe at the beginning of the 21st century.

AIMS/HYPOTHESIS: The aim of this study was to determine and quantify socioeconomic position (SEP) inequalities in diabetes mellitus in different areas of Europe, at the turn of the century, for men and women. METHODS: We analysed data from ten representative national health surveys and 13 mortality registers. For national health surveys the dependent variable was the presence of diabetes by self-report and for mortality registers it was death from diabetes. Educational level (SEP), age and sex were independent variables, and age-adjusted prevalence ratios (PRs) and risk ratios (RRs) were calculated. RESULTS: In the overall study population, low SEP was related to a higher prevalence of diabetes, for example men who attained a level of education equivalent to lower secondary school or less had a PR of 1.6 (95% CI 1.4-1.9) compared with those who attained tertiary level education, whereas the corresponding value in women was 2.2 (95% CI 1.9-2.7). Moreover, in all countries, having a disadvantaged SEP is related to a higher rate of mortality from diabetes and a linear relationship is observed. Eastern European countries have higher relative inequalities in mortality by SEP. According to our data, the RR of dying from diabetes for women with low a SEP is 3.4 (95% CI 2.6-4.6), while in men it is 2.0 (95% CI 1.7-2.4). CONCLUSIONS/INTERPRETATION: In Europe, educational attainment and diabetes are inversely related, in terms of both morbidity and mortality rates. This underlines the importance of targeting interventions towards low SEP groups. Access and use of healthcare services by people with diabetes also need to be improved.

[Nuptiality of single persons in the Czech Republic, past and present]. / Snatecnost svobodnych v Ceske Republice drive a dnes.

"Nuptiality...of single persons in the Czech Republic can be distributed into 3 stages. During the first one specified by the period since World War II until the beginning of the sixties nuptiality...developed in accordance with the European trends.... The second stage started in the sixties and was completed in 1989.... In this stage...the Czech Republic's population started its differentiation of nuptial behaviour as compared to a series of developed countries, where at the turn of the seventies the intensity of single persons' nuptiality has declined while the average age at the first marriage has been increasing. Since 1992 the third stage has appeared in the Czech Republic characterized by declining intensity and growth of marriage age." (SUMMARY IN ENG AND RUS)

[Infant mortality trends in countries of Central and Eastern Europe]. / Trendy kojenecke umrtnosti v zemich stredni a vychodni Evropy.

"After... World War II, infant mortality in countries of Central and Eastern Europe...started to diminish. This favourable trend lasted up to the beginning of the sixties. Later on the unfavourable evolution of infant mortality was connected with the failure in reduction of endogenous mortality, i.e. the mortality soon after the delivery. Nowadays [in some countries, such as the Czech Republic,]...the decrease continues and in [other] countries (Lithuania, Latvia, Estonia) the infant mortality rate has temporarily increased due to adoption of the international definition of live and still births, while in [the] majority of countries of the previous Soviet Union and former Yugoslavia...infant mortality...has increased." (SUMMARY IN ENG AND RUS)

[The importance of the longitudinal analysis of fertility for the development of population projections]. / L'importance de l'analyse longitudinale de la fecondite pour l'establissement des perspectives demographiques.

PIP: Estimation techniques used to project future trends in fertility in Czechoslovakia are described. (SUMMARY IN CZE)^ieng

[Mortality evolution in the Czech Socialist Republic, by sex and age in 1950-1984]. / Vyvoj umrtnosti v CSR podle pohlavi a veku v obdobi 1950-1984.

PIP: Postwar mortality evolution in the Czech Socialist Republic has run through 2 different stages with the turning point being 1960. Since about the beginning of the 1960s, the mortality level in the Czech Socialist Republic has quickly declined for both sexs and in each age category. The rate of decline has slowed with increasing age. Since the 1960s, the mortality of the older population has ceased to decline or has worsened; with men, this phenomenon spread even as low as 40 years old. Infant and child mortality, male mortality under 40 years of age, and female mortality under 50 years of age positively contributed to a longer life span, except between 1960 and 1970. The present mortality situation in the Czech Socialist Republic is the result of the unfavorable developments of the last 20 years, especially in the decade 1960-1970. The present age structure of mortality is characterized by higher infant mortality, higher male mortality above 40 years of age, and higher female mortality at 50-55 years of age. A certain improvement observed in the last few years is relative, as the mortality of the male population over 30 is the same today as it was 35 years ago and the mortality of the female population is the same as it was in the mid-1960s.^ieng

[Nuptiality and fertility of minors in the Czech Socialist Republic]. / Snatecnost a plodnost nezletilych v CSR.

PIP: The nuptiality and fertility patterns of those under age 18 in the Czech part of Czechoslovakia are analyzed and compared with those in other developed countries. The author notes that there have been no significant changes since 1970 despite the pro-natalist legislation adopted in the early 1970s. Most marriages at this age are due to pregnancy, with premarital conception more often resulting in marriage than in abortion. (SUMMARY IN ENG AND RUS)^ieng

Present demographic situation of Czechoslovakia.

PIP: Current demographic trends in Czechoslovakia are described. Consideration is given to age distribution, fertility, nuptiality, divorce, mortality, and population growth. The data are presented separately for the two constituent republics.^ieng

Contemporary mortality problems in Czechoslovakia.

PIP: The author examines recent mortality trends in Czechoslovakia. Aspects considered include age and sex differentials, causes of death, educational level, marital status, regional differences, public health, and the environment. (SUMMARY IN CZE)^ieng

[New reproductive behavior: the cases of France and the Czech Republic]. / Le nouveau comportement procreateur, le cas de la France et de la Republique Tcheque.

PIP: A comparison of fertility trends in France (1960-1985) and the Czech Republic (1960-1983) is presented. The author concludes that differences between the two countries are primarily due to changes that have occurred in family structures in France.^ieng

[Current changes in the characteristics of reproduction in the Czech Republic and the international situation]. / Soucasne zmeny charakteru reprodukce v Ceske republice a mezinarodni situace.

The author analyzes reproduction trends in the Czech Republic and compares them with patterns in some other European countries since World War II. "Population in the East has a stronger feeling of insecurity and of a certain personal distress and this fact contributes apparently towards creating...different family strategies compared to the past." (SUMMARY IN ENG)

Family formation in the Czech and Slovak Republics.

The author analyzes family formation trends in the Czech and Slovak Republics. Information is included on first marriage rates, divorce, remarriage, and fertility. "Procreative behaviour in each of the birth-cohorts in the Czech Republic (starting with the birth-cohort 1930) is at the level of simple reproduction. In Slovakia, the completed fertility rate continued declining so that today the two parts of the former federation show very similar levels of reproduction. Marriage is a very wide-spread institution in Czechoslovakia and it is situated in the younger age groups.... The popularity of legal unions in the Czech and Slovak Republics and the relatively higher fertility rate in the European context can be ascribed to the young age at which those events occur." (SUMMARY IN CZE)

[The significance of infant mortality in demographic reproduction]. / La portee de la mortalite infantile dans la reproduction demographique

PIP: The author calculates the gains in expectation of life at birth that can be attributed to declines in infant mortality in Sweden, France, the Czech regions, and Slovakia. Data are for various periods from 1780 to 1978. The methodology used in the calculations is discussed (SUMMARY IN CZE)^ieng

[Nuptiality tables and methods for constructing them]. / Tabulky snatecnosti a metody jejich konstrukce

PIP: Two methods of constructing nuptiality tables are described. One method involves modeling the process of marriage events in the population without taking other events, such as mortality of single persons, into account. The other method takes into account both marriage and intervening events, such as death, and involves the compilation of two-way tables of nuptiality. These methods are illustrated using data for Czechoslovakia. (summary in ENG, RUS)^ieng

[Prenatal human sex ratios]. / Prenatalni pomer pohlavi u cloveka

PIP: The author discusses the development of methods used to diagnose fetal sex, as well as the impact of such development on the accuracy of prenatal sex ratio estimates for Czechoslovakia. (summary in ENG, RUS)^ieng