Relationship between participation in projects of incentives to promote walking and healthy aging among the older population: A four-year longitudinal study.

OBJECTIVE: This study aimed to evaluate the association between the Yokohama Walking Point Program, which promotes walking through feedback on step counts and incentives, and the extension of healthy life expectancy. METHODS: A total of 4298 individuals aged over 65 years who responded to the 2013 and 2016 surveys and who were not certified as needing long-term care in 2016 were included in this study. The participants were categorized into "non-participation," "participation without uploading," and "participation with uploading" groups based on their involvement and uploading of pedometer data. The objective variable was the occurrence of long-term care certification and deaths over the subsequent four years. A modified Poisson regression model was applied, adjusting for 15 variables before project initiation. RESULTS: A total of 440 participants (10.2 %) were included in the "participation with uploading" group and 206 (4.8 %) in the "participation without uploading" group. Compared with "non-participation," the risk ratio was 0.77 (95 % confidence interval (CI): 0.59-0.99) for "participation with uploading" and 1.02 (95 % CI: 0.75-1.38) for "participation without uploading". In the sensitivity analysis censoring death as an inapplicable outcome and considering functional decline, participation with uploading showed a risk ratio of 0.79 (95 % CI: 0.60-1.04) for the likelihood of functional decline. CONCLUSIONS: The use of pedometers and health point programs based on walking activity is associated with enhancing the health of older individuals participating in the program, representing a population-centric strategy targeting all citizens.

Carbon footprints and health security: A comparative assessment of the Sustainable Development Goals 3 and 13 in East Asian countries.

In East Asia, where several countries are among the top emitters of carbon dioxide globally, the need to address the dual challenges of reducing carbon footprints and ensuring health security is paramount. Against this backdrop, this study used a descriptive analysis to provide a comparative assessment of the carbon footprints and the level of health security in East Asia using secondary data, sourced from the World Development Indicators. The findings from the study show that it is only North Korea that its average carbon footprint of every person is less than 2.3 tons. However, China, Japan, Mongolia and South Korea are currently lagging behind in meeting the SDG 13 target. Meanwhile, North Korea recorded the highest incidence of tuberculosis in the region. Despite the fact that South Korea and Japan were the highest emitter of CO2, the duo had the lowest under five mortality, infant mortality, incidence of TB alongside the highest life expectancies which surpassed the regional performance. In view of the above, the policymakers in Asia and the rest of the countries with health insecurity should emulate the policymakers in Japan and South Korea by making adequate investment in health, education, and standard of living of their citizens.

En Asie de l'Est, où plusieurs pays comptent parmi les plus grands émetteurs de dioxyde de carbone au monde, la nécessité de relever le double défi de réduire l'empreinte carbone et d'assurer la sécurité sanitaire est primordiale. Dans ce contexte, cette étude a utilisé une analyse descriptive pour fournir une évaluation comparative des empreintes carbone et du niveau de sécurité sanitaire en Asie de l'Est à l'aide de données secondaires provenant des indicateurs de développement mondial. Les résultats de l'étude montrent que seule la Corée du Nord a une empreinte carbone moyenne par personne inférieure à 2,3 tonnes. Cependant, la Chine, le Japon, la Mongolie et la Corée du Sud sont actuellement à la traîne dans la réalisation de l'ODD 13. Pendant ce temps, la Corée du Nord a enregistré la plus forte incidence de tuberculose dans la région. Bien que la Corée du Sud et le Japon soient les plus grands émetteurs de CO2, ces deux pays ont les taux de mortalité des moins de cinq ans, de mortalité infantile et d'incidence de tuberculose les plus faibles, ainsi que les espérances de vie les plus élevées, dépassant les performances régionales. Compte tenu de ce qui précède, les décideurs politiques d'Asie et du reste des pays souffrant d'insécurité sanitaire devraient imiter les décideurs politiques du Japon et de la Corée du Sud en investissant de manière adéquate dans la santé, l'éducation et le niveau de vie de leurs citoyens.

Life Expectancy and Causes of Death in Patients with Myotonic Dystrophy Type 2.

Background: Myotonic Dystrophy type 2 (DM2) is a dominantly inherited multisystem disease caused by a CCTG repeat expansion in intron 1 of the CNBP gene. Although in the last two decades over 1500 patients with DM2 have been diagnosed worldwide, our clinical impression of a reduced life expectancy in DM2 has not been investigated previously. Objective: The aim of this observational study was to determine the life expectancy and the causes of death in patients with genetically confirmed DM2. Methods: We identified the data of all deceased patients with DM2 in the Dutch neuromuscular database between 2000 and 2023. Ages and causes of death and the patients' clinical features during lifetime were determined. Age of death in DM2 was compared to the general population by using life tables with prognostic cohort life expectancy (CLE) and period life expectancy (PLE) data of the Dutch electronic database of statistics (CBS StatLine). Results: Twenty-six deceased patients were identified in the Dutch DM2 cohort (n = 125). Median age of death in DM2 (70.9 years) was significantly lower compared to sex- and age-matched CLE (78.1 years) and PLE (82.1 years) in the Netherlands. Main causes of death were cardiac diseases (31%) and pneumonia (27%). Seven patients (27%) had a malignancy at the time of death. Conclusion: These results provide new insights into the phenotype of DM2. Life expectancy in patients with DM2 is reduced, possibly attributable to multiple causes including increased risk of cardiac disease, pneumonia, and malignancies. The occurrence of a significantly reduced life expectancy has implications for clinical practice and may form a basis for advanced care planning, including end-of-life care, to optimize quality of life for patients with DM2 and their family. Research in larger cohorts should be done to confirm these findings and to ascertain more about the natural course in DM2.

Importance of Lifestyle Activities for Older Adults' Psychosomatic Functions After Driving Cessation: Interpretation by a Mixed-Methods Study.

Older adults who cease driving are more likely to experience psychosomatic decline than those who continue driving. This mixed-methods study was intended to examine differences in psychosomatic functions depending on driving status and lifestyle activities, and factors affecting engagement in additional lifestyle activities after driving cessation. The quantitative analysis included individuals aged 60 and above. Driving status, lifestyle activities, and psychosomatic functions were assessed. For qualitative analysis, semi-structured interviews were conducted with the driving-cessation group to determine the factors affecting involvement in various lifestyle activities after driving cessation. Analysis of covariance was used for quantitative data, while text mining and qualitative inductive analysis were used for qualitative data. Older adults who engaged in more lifestyle activities walked faster than those who engaged in fewer lifestyle activities, even after driving cessation. Actively using local and personal resources may increase engagement in lifestyle activities after driving cessation.

Impact of education and income inequalities on life expectancy: insights from the new EU members.

Life expectancy is one of the primary population health indicators and in turn increases in life expectancy indicate improvements in population health and human welfare. Therefore, one of the ultimate goals of the countries is to increase the life expectancy. This article studies the effect of education and income inequalities, ICT indicators, CO2 emissions, and real GDP per capita on life expectancy in the new EU members for the period of 2010-2022 by employing fixed effects regression. The coefficients of panel regression uncover that education and income inequalities and CO2 emissions negatively impact life expectancy, but ICT indicators of internet usage and mobile cellular subscriptions and real GDP per capita positively affects the life expectancy. The findings of the panel regression analysis indicate that public policies to decrease the inequalities in education and income will make a contribution to life expectancy.

Identification and Assessment of Undiagnosed Fetal Alcohol Spectrum Disorder: A Report of Three Cases.

Fetal alcohol spectrum disorder (FASD) and its associated physical and mental conditions is the most prevalent congenital impairment causing developmental and intellectual disability worldwide. Like alcohol abuse, FASD is typically undiagnosed by primary care providers. And like alcohol abuse, life underwriters and medical directors need to be aware of the signs, symptoms, and behaviors associated with FASD to accurately detect, identify, evaluate and assess the mortality risk. Three cases of suspected undiagnosed FASD that were underwritten for life expectancies in legal matters are discussed in this report. Not only were these patients' risks for excess mortality elevated due to their initial neurologic injury due to prenatal exposure to alcohol, but these cases demonstrate the importance of the stability and care needed to make them insurable. The following paper discusses the clinical and social settings at birth that may give underwriters and medical directors some clue to a potential case of the child having FASD and then to assess their statistical and lifestyle mortality risks.

Contributions of injury deaths to the changes in sex gaps in life expectancy and life disparity in the Nordic countries in the 21st century.

OBJECTIVE: The objective of this study was to provide novel comparative insights on the contributions of injury deaths to the changes in sex gaps in life expectancy (SGLE) and sex gaps in life disparity (SGLD) across Nordic countries. STUDY DESIGN: Retrospective demographic analysis of aggregated mortality data. METHODS: To compute life expectancy (LE)/life disparity (LD), annual data on age- and sex-specific causes of death from the World Health Organization mortality database were used to construct abridged life tables for two periods: 2000-2002 and 2016-2018 (2014-2016 for Norway). The contributions of injury deaths to the changes in the SGLE and SGLD between these two periods were decomposed by age and cause using a continuous-change model. RESULTS: Females' LE and LD advantages due to injury deaths narrowed by 0.16-0.44 (0.06-0.35) years for LE (LD) over time. While self-inflicted injuries consistently played a predominant role in contributing to the SGLE/SGLD in all countries in both periods, in all countries but Finland, transport accidents had the greatest contributions to the narrowing SGLE/SGLD. Widening SGLE due to self-inflicted injuries in Iceland and due to falls in Sweden were unique to these countries. Accounting for >20% of total contributions of injury deaths, the age group of 20-24 years had the greatest contributions to the narrowing SGLE/SGLD. Deaths due to falls in older ages and assault in younger ages generally contributed to the widening SGLE/SGLD. CONCLUSIONS: Injury deaths, particularly transport accidents, contributed significantly to the narrowing SGLE and SGLD across Nordic countries, with cross-country variations in age- and cause-specific patterns. The results suggest the need for injury prevention policies targeting self-inflicted injuries in younger and falls in older males.

Assessment of Prognostic Indicators and Survival-Based Impact of Holistic Approach in Oral Cancer Patients: An Observational Study.

INTRODUCTION: Oral cancer is recognized as the sixth most common type of cancer globally. Instances have been recorded demonstrating an increase in its incidence, particularly in the territories of southern Asia, with a significant emphasis on India. Thus, the objectives of this investigation were to assess the efficacy of a holistic approach on the life expectancies of patients diagnosed with oral cancer, and to assess the prognostic indicators in such patients. MATERIAL AND METHODS: A retrospective study was conducted on medical records of 60 clinically and histopathologically confirmed cases of oral squamous cell carcinoma (OSCC) who received complete surgical intervention or radiation therapy or a combination of both modalities depending on stage of OSCC from January 2015 to December 2016. After completion of their treatment, 30 patients underwent Cancer Care program of Annabhai Chudamani Patil Memorial Medical College which consisted of yoga sessions, meditation, psychological counselling, nutritional counselling, emotional and social support (embracing a holistic approach, group 1) and 30 patients did not enroll in the Cancer Care initiative (not opting for holistic approach, group 2). The program was conducted for 21 days every six months for two years. Data pertaining to demographic characteristics, stage of OSCC, modalities of treatment administered, histopathological characteristics of the neoplasm, as well as the clinical outcome (Survival/Deceased) post a five-year duration subsequent to the primary diagnosis were extracted from the medical records to assess the role of holistic approach and various factors on the overall survival (OS) of the patients in both the groups. The data collected was subsequently subjected to a thorough statistical analysis. RESULTS: The mean age of the patients was 44.33±8.66 years (95% CI: 39.53-49.13) in group 1, and 51.20±9.99 years (95% CI: 39.53-49.13) in group 2. The mean survival time for group 1 was 81.60±5.02 months (95% CI: 78.817-84.383), and 66.00±20.29 months (95% CI: 54.761-77.239) in group 2 with statistically significant difference between the groups (p=0.007). Group 2 showed a 1.31 relative risk of mortality to group 1. The probability of death in group 2 was 1.39 times more than in group 1. Cox regression analysis revealed group 2 was significantly associated with the risk of OSCC in this analysis. Other variables were not significantly associated with the risk of the OSCC in this analysis. CONCLUSION: The current research indicated that employing a holistic strategy proves to be a successful approach in increasing the OS of patients with OSCC.

Statistical inference on nonparametric regression model with approximation of Fourier series function: Estimation and hypothesis testing.

Nonparametric regression is an approximation method in regression analysis that is not constrained by the assumption of knowing the regression curve. One of the functions to approximate the curve is a Fourier series function. The nonparametric regression model with approximation of a Fourier series function has been widely discussed by several researchers. However, discussions on statistical inference, particularly in partial hypothesis testing, has not been carried out previously. Therefore, the purpose of this research is to discuss the statistical inference on nonparametric regression model with approximation of a Fourier series function. The discussion includes parameter and model estimations, simultaneous and partial hypotheses testing. In the application, we use life expectancy data from East Java Province during 2022. Based on data analysis, we obtain a model estimation with an R-square value of 96.24 %. At a 5 % significance level, the parameters simultaneously have a significant influence on the model. Partially, four parameters are not significant. However, overall, the predictor variables significantly influence the life expectancy data.•The Fourier series function used is a Fourier series function introduced by Bilodeau (1992).•The model estimation is obtained by selecting the optimal number of oscillation parameters.•The statistical test is obtained using the LRT method.

Estimating expected years of life lost of psychiatric disorders in Taiwan: A Nationwide cohort study.

OBJECTIVES: This study employed a national longitudinal cohort to assess expected years of life lost (EYLL) in newly diagnosed psychiatric patients. METHODS: Data from Taiwan's National Death Registry and Health Insurance Research Database were scrutinized to identify patients with various psychiatric disorders. Disorders were ranked hierarchically, and age groups were categorized as young, middle-aged, and older adults. We utilized the semiparametric survival extrapolation method to estimate life expectancy (LE) and EYLL. Modifying effect of comorbid conditions and socioeconomic characteristics were also explored. RESULTS: Among the 5,757,431 cases, young adults with dementia, alcohol use disorder, schizophrenia, and bipolar disorder experienced an excess of 15 years of EYLL. Middle-aged adults faced approximately 9 years or more of EYLL, while older adults had lower EYLL values. Comorbid conditions, low income levels, and living in rural areas were associated with higher EYLL. CONCLUSIONS: This study underscores the substantial EYLL among young adults with psychiatric disorders and the significant impact of specific disorders on EYLL. Early intervention, tailored support, and healthcare system readiness are imperative for improved outcomes. Resource allocation and targeted interventions focusing on early detection and comprehensive treatment can alleviate the economic burden.

Beware the Black Widow at Claim Time: A Report of Three Cases.

Moral hazard is well known to life insurance underwriters and medical directors to increase the risk of adverse consequences to insured individuals. The underwriting investigation of proposed insureds at time of policy issue is done to ensure no likely moral hazard exists. However, not all situations involving moral hazard may be identified at time of underwriting and policy issue, and may only be identified at time of claim. Three cases that were underwritten for life expectancies in legal matters are described here as examples of moral hazard identified at time of severe injury and/or death. All three of these cases involved a woman who manipulated her male partner into situations that increased the man's risk of severe injury and/or death to the woman's financial benefit. Such "black widows" made a great deal of effort over an extensive period of time to ensure that the moral hazard set up for their male partners resulted in a substantial financial windfall through litigation. The moral hazard set up by a black widow thus can be considered by the life insurance industry as sufficiently anti-selective and speculative to deny a claim at any time after policy issue.

Association of lifestyle with valvular heart disease progression and life expectancy among elderly people from different socioeconomic backgrounds.

BACKGROUND: Current cardiovascular prevention strategies are based on studies that seldom include valvular heart disease (VHD). The role of modifiable lifestyle factors on VHD progression and life expectancy among the elderly with different socioeconomic statuses (SES) remains unknown. METHODS: This cohort study included 164,775 UK Biobank participants aged 60 years and older. Lifestyle was determined using a five-factor scoring system covering smoking status, obesity, physical activity, diet, and sleep patterns. Based on this score, participants were then classified into "poor," "moderate," or "ideal" lifestyle groups. SES was classified as high or low based on the Townsend Deprivation Index. The association of lifestyle with major VHD progression was evaluated using a multistate mode. The life table method was employed to determine life expectancy with VHD and without VHD. RESULTS: The UK Biobank documented 5132 incident VHD cases with a mean follow-up of 12.3 years and 1418 deaths following VHD with a mean follow-up of 6.0 years. Compared to those with a poor lifestyle, women and men followed an ideal lifestyle had lower hazard ratios for incident VHD (0.66 with 95% CI, 0.59-0.73 for women and 0.77 with 95% CI, 0.71-0.83 for men) and for post-VHD mortality (0.58 for women, 95% CI 0.46-0.74 and 0.62 for men, 95% CI 0.54-0.73). When lifestyle and SES were combined, the lower risk of incident VHD and mortality were observed among participants with an ideal lifestyle and high SES compared to participants with an unhealthy lifestyle and low SES. There was no significant interaction between lifestyle and SES in their correlation with the incidence and subsequent mortality of VHD. Among low SES populations, 60-year-old women and men with VHD who followed ideal lifestyles lived 4.2 years (95% CI, 3.8-4.7) and 5.1 years (95% CI, 4.5-5.6) longer, respectively, compared to those with poor lifestyles. In contrast, the life expectancy gain for those without VHD was 4.4 years (95% CI, 4.0-4.8) for women and 5.3 years (95% CI, 4.8-5.7) for men when adhering to an ideal lifestyle versus a poor one. CONCLUSIONS: Adopting a healthier lifestyle can significantly slow down the progression from free of VHD to incident VHD and further to death and increase life expectancy for both individuals with and without VHD within diverse socioeconomic elderly populations.

The Karnofsky Performance Status at Discharge Is a Prognostic Indicator of Life Expectancy in Patients With Glioblastoma.

Background Glioblastoma (GBM) is the most frequent invasive brain tumor and a rapidly progressive disease with a poor prognosis that predominantly affects middle-aged and older adults. The relationship between daily functioning and prognosis in patients with GBM will become more important as advances in multimodality treatment are expected to increase the number of long-term survivors. Methods Sixty-seven patients were initially diagnosed with GBM at our hospital between December 2013 and December 2022. All patients were divided into two groups: those who survived for one year or longer from the date of discharge (Group A) and those who died within one year from the date of discharge (Group B). Muscle strength, nutritional status, and Karnofsky Performance Status (KPS) were examined upon admission (p1), post-surgery (p2), and discharge (p3), and their relationships with prognosis were investigated. Results Group A was significantly younger than Group B, with a significant difference in the total radiation dose. There were no significant differences in the anatomical tumor location, whether the tumor occurred on the left or right side, or tumor size. KPS at discharge (p3) and the degree of improvement in the KPS between p1 and p3 were associated with a good prognosis. Conclusions The KPS varies throughout the treatment. When considering the KPS as a prognostic indicator, the KPS at discharge is the most important, given the structure of the disability and the course of treatment for GBM.

Divine Control Beliefs, Health Locus of Control, and Subjective Life Expectancy in the United States.

Little evidence has considered the extent to which feelings of health-related control may arise from religious beliefs to influence survival expectations. Moreover, research on the linkages between religion and sense of control has yielded mixed results. Using CHAPS (2021) data, this study examines whether divine control beliefs predict subjective life expectancy (SLE), and whether this link is mediated by an individual's health locus of control (HLC). Findings support a mediational model and show that individuals who place more dependence on God report a greater sense of control over their health, which in turn results in greater longevity expectations. Our findings offer insight into the mechanisms that underlie the association between divine control beliefs and SLE and add to the body of literature documenting religion's salutary role in promoting both a sense of empowerment and greater survival expectations.

Maternal smoking during pregnancy could accelerate aging in the adulthood: evidence from a perspective study in UK Biobank.

BACKGROUND: Maternal smoking during pregnancy (MSDP) is significantly linked to the short- or long-term health of offspring. However, little research has examined whether MSDP affect the aging rate of offspring. METHODS: This study used questionnaires to determine out whether the participants' mothers smoked when they were pregnant. For evaluating aging rate, we used the following several outcome measures: telomere length, frailty index, cognitive function, homeostatic dysregulation score, KDM-age, age-related hospitalization rate, premature death, and life expectancy. RESULT: After adjusting for covariates, we found that the offspring of the MSDP group had significantly shorter telomere length in adulthood by 0.8 % (ß = -0.008,95%CI:-0.009 to -0.006) compared with non-MSDP group. Compared to the non-MSDP group, participants in MSDP group showed higher levels of homeostatic dysregulation (ß = 0.015,95%CI: 0.007-0.024) and were frailer (ß = 0.008,95%CI:0.007-0.009). The KDM age increased by 0.100 due to MSDP (ß = 0.100,95 % CI:0.018-0.181), and the age acceleration of KDM algorithm also increases significantly (ß = 0.101, 95%CI:0.020-0.183). Additionally, we found that the risk of aging-related hospitalizations was significantly higher than the non-MSDP group by 10.4 %(HR = 1.104,95%CI:1.066-1.144). Moreover, MSDP group had a 12.2 % increased risk of all-cause premature mortality (HR = 1.122,95%CI:1.064-1.182) and a significant risk of lung cancer-specific premature mortality increased by 55.4 %(HR = 1.554,95%CI:1.346-1.793). In addition, participants in the MSDP group had significantly decreased cognitive function and shorter life expectancies than those in non-MSDP group. CONCLUSION: Our findings indicated a significant association between MSPD and accelerated aging, elevated hospitalization rates, increased premature mortality rates, and reduced life expectancies in offspring.

Sex Differences in Dementia, Cognition, and Health in the Cognitive Function and Ageing Studies (CFAS).

Background: There is renewed interest in whether sex differences in dementia risk exist, and what influence social and biological factors have. Objective: To review evidence from the Cognitive Function and Ageing Studies (CFAS), a multi-center population-representative cohort study in the UK; focusing on dementia and cognition, incorporating findings on participants' health and social circumstances. Methods: After identifying all CFAS publications, the results of all sex-stratified primary analyses of CFAS data were narratively reviewed. Results: Of 337 publications, 94 report results by sex (including null findings), which are summarized by theme: dementia epidemiology, cognition, mental health, health expectancy, social context and biological resource (including neuropathology). Conclusions: Where differences are found they most commonly favor men; however, greater mortality in men may confound associations with age-related outcomes. This 'survival bias' may explain findings of greater risk of dementia and faster cognitive decline in women. Age-specific dementia incidence was similar between sexes, although reduced incidence across study generations was more pronounced in men. Mood disorders were more prevalent in women, but adjusting for disability and deprivation attenuated the association. Prominent findings from other cohorts that women have more Alzheimer's disease pathology and greater risk of dementia from the Apolipoprotein E ɛ4 allele were not observed, warranting further investigation. The 'male-female health-survival paradox' is demonstrated whereby women live longer but with more comorbidity and disability. Examining why health expectancies changed differently over two decades for each sex (interacting with deprivation) may inform population interventions to improve cognitive, mental and physical health in later life.

Extent and socioeconomic correlates of small area variations in life expectancy in Canada and the United States.

Background: An extensive literature documents substantial variations in life expectancy (LE) between countries and at various levels of subnational geography. These variations in LE are significantly correlated with socioeconomic covariates, though no analyses have been produced at the finest feasible census tract (CT) level of geographic disaggregation in Canada or designed to compare Canada with the United States. Data and methods: Abridged life tables for each CT where robust estimates were feasible were estimated comparably with U.S. data. Cross-tabulations and graphical visualizations are used to explore patterns of LE across Canada, for Canada's 15 largest cities, and for the 6 largest U.S. cities. Results: LE varies by as much as two decades across CTs in both countries' largest cities. There are notable differences in the strength of associations with socioeconomic status (SES) factors across Canada's largest cities, though these associations with income-poverty rates are noticeably weaker for Canada's largest cities than for the United States' largest cities. Interpretation: Small area geographic variations in LE signal major health inequalities. The association of CT-level LE with SES factors supports and extends similar findings across many studies. The variability in these associations within Canada and compared with those in the United States reinforces the importance for population health of better understanding differences in social structures and public policies not only at the national and provincial or state levels, but also within municipalities to better inform interventions to ameliorate health inequalities.

Deciphering the Sex gap in global life expectancy: the impact of female-specific cancers 1990-2019.

BACKGROUND: Females live longer than males, which results in a sex gap in life expectancy. This study examines the contribution of female cancers to this differential by world region and country 1990-2019 with special focus to the 15-69 age group. METHODS: Cause-specific mortality data for 30 cancers, including four female-specific cancers from 238 countries and territories was retrieved from the Global Burden of Disease Study 2019. Using life table techniques and demographic decomposition analysis, we estimated the contribution of cancer deaths to the sex gap in life expectancy by age and calendar period. RESULTS: At ages 15-69, females had a higher life expectancy than males in 2019. Countries with the largest sex gaps or the largest female advantage in life expectancy were in Eastern Europe and Northern Asia, Latin America and Southern Africa. In contrast, countries with the smallest sex gaps were mainly located in Northern Africa, Northern America, and Northern Europe. The contribution of female-specific cancers to sex gaps in life expectancy were largely negative, ranging from -0.15 years in the Western Pacific to -0.26 years in the Eastern Mediterranean Region, implying that the disproportionately higher premature cancer mortality among females contributed to a reduction in the female life expectancy advantage. CONCLUSION: Female-specific cancers are important determinants of sex gaps in life expectancy. Their negative impact on life expectancy at working and reproductive age groups has far-reaching consequences for society. Increasing the availability and access to prevention, screening, timely diagnosis, and effective treatment can reduce this gap.

Impact of historical disease conditions on mortality and life expectancy in patients with advanced schistosomiasis in Hunan Province, China.

BACKGROUND: Although the prognosis of advanced schistosomiasis patients has significantly improved, the impact of historical disease conditions on life expectancy remains unclear. METHODS: Utilizing data from an advanced schistosomiasis cohort (n=10 362) from 2008 to 2019 in Hunan, China, we examined five historical disease conditions: times of praziquantel treatment, the history of ascites, splenectomy, upper gastrointestinal bleeding (UGIB) and hepatic coma. Using latent class analysis, participants were categorized into three groups: Group 1 (characterized by no risk conditions), Group 2 (had ≤3 times of praziquantel treatment without UGIB history) and Group 3 (had UGIB history). Life expectancies were calculated using the life table method. RESULTS: At the age of 45 y, patients with ≤3 times of praziquantel treatment, a history of ascites, UGIB, hepatic coma and those without splenectomy exhibited lower life expectancies. Groups 1, 2 and 3 had estimated life expectancies of 32.32, 26.76 and 25.38 y, respectively. Compared with Group 1, women in Group 3 experienced greater life expectancy loss than those in Group 2, with the difference narrowing with age. CONCLUSIONS: Based on the consideration of overall physical conditions, tailored treatment and healthcare, along with public health interventions targeting diverse populations, could mitigate the prevalence of poor disease conditions and premature deaths.