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1.
J Korean Med Sci ; 35(12): e132, 2020 Mar 30.
Artículo en Inglés | MEDLINE | ID: mdl-32233161

RESUMEN

Since the identification of the first case of coronavirus disease 2019 (COVID-19), the global number of confirmed cases as of March 15, 2020, is 156,400, with total death in 5,833 (3.7%) worldwide. Here, we summarize the morality data from February 19 when the first mortality occurred to 0 am, March 10, 2020, in Korea with comparison to other countries. The overall case fatality rate of COVID-19 in Korea was 0.7% as of 0 am, March 10, 2020.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/mortalidad , Neumonía Viral/mortalidad , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Niño , Comorbilidad , Infecciones por Coronavirus/complicaciones , Brotes de Enfermedades , Femenino , Humanos , Huésped Inmunocomprometido , Pacientes Internos , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Pandemias , Neumonía Viral/complicaciones , Cuarentena , República de Corea/epidemiología , Factores Sexuales , Análisis de Supervivencia , Factores de Tiempo , Adulto Joven
3.
East Mediterr Health J ; 26(2): 161-169, 2020 Feb 24.
Artículo en Inglés | MEDLINE | ID: mdl-32141593

RESUMEN

Background: Child mortality rates are considered to be one of the key indicators of child health. Aims: The main objective of this research was to calculate child mortality rates (CMRs) indirectly, using census data, and to investigate using spatial pattern analysis the presence of any clustering patterns among provincial regions. Methods: The Trussell version of the Brass method and Coale-Demeny West model were used to estimate CMRs and life expectancy (LE) at birth. The analyses were performed using the QFive program of MORTPAK 4 software. For cluster analysis, local and global Moran's I indexes were measured. Results: Infant mortality rate, under-5 mortality rate, 1-4 mortality rate and LE at birth were estimated as 21.9, 26, 4.1 (deaths per 1000 live births) and 72.1 years, respectively. Global Moran's I index was calculated as 0.09, 0.09, 0.08 and 0.12, respectively. Conclusion: Special attention must be paid in provinces with high clusters regarding the evaluation of public health programmes, and the cause of failure of these programmes in reduction of childhood mortality indices.


Asunto(s)
Censos , Mortalidad del Niño , Esperanza de Vida , Mortalidad/tendencias , Distribución por Edad , Niño , Mortalidad del Niño/tendencias , Preescolar , Análisis por Conglomerados , Femenino , Humanos , Lactante , Mortalidad Infantil , Recién Nacido , Irán/epidemiología , Esperanza de Vida/tendencias , Masculino , Análisis Espacial
4.
Medicine (Baltimore) ; 99(12): e19575, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32195968

RESUMEN

Liver cirrhotic predisposes patients to coagulopathy and bleeding. Little is known about outcomes of acute myocardial infarction (AMI) in cirrhotic patients.Data from Taiwan National Health Insurance Research Database during 2001 to 2013 were retrieved for patients admitted with cirrhosis and AMI. We excluded patients with missing information, <20 years old, previous AMI, previous coronary intervention, and liver transplant. Patients were separated into cirrhotic and non-cirrhotic. Primary outcomes included all-cause mortality, recurrent myocardial infarction (MI), major cardiac and cerebrovascular events (MACCE: recurrent MI, revascularization, ischemic stroke, and heart failure), and liver outcomes (hepatic encephalopathy, ascites tapping, spontaneous peritonitis, and esophageal varices bleeding).A total of 3217 cirrhotic patients and 6434 non-cirrhotic patients were analyzed, with a mean follow up of 2.8 ±â€Š3.3 years. In cirrhotic patients with AMI, subsequent coronary and cerebrovascular events were lower in comparison to non-cirrhotic patients, with higher all-cause mortality observed from adverse liver related outcomes and bleeding. There were significantly lower cumulative incidence of both recurrent MI and MACCE in cirrhotic patients with AMI compared with non-cirrhotic patients with AMI (hazard ratio [HR] 0.82, confidence interval [CI] 0.71-0.94, P = .006 and HR 0.86, 95% CI 0.79-0.92, P < .001, respectively). There was significantly higher cumulative incidence of liver related outcome in cirrhotic patients with AMI compared with non-cirrhotic patients with AMI (HR 2.27, 95% CI 2.06-2.51, P < .001). And there was significantly higher all-cause mortality in cirrhotic patients with AMI compared with non-cirrhotic patients with AMI (HR 1.30, 95% CI 1.23-1.38, P < .001).In cirrhotic cohort with AMI, a decreased in coronary and cerebrovascular events were observed. However, these patients also had higher all-cause mortality due to adverse liver outcomes and bleeding.


Asunto(s)
Cirrosis Hepática/complicaciones , Cirrosis Hepática/mortalidad , Infarto del Miocardio/complicaciones , Infarto del Miocardio/mortalidad , Enfermedad Aguda , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Insuficiencia Cardíaca/etiología , Hemorragia/etiología , Hemorragia/mortalidad , Hospitalización/tendencias , Humanos , Incidencia , Cirrosis Hepática/epidemiología , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Infarto del Miocardio/epidemiología , Taiwán/epidemiología
7.
West Afr J Med ; 37(1): 67-73, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32030715

RESUMEN

OBJECTIVE: The purpose of this study was to examine trends in clinical characteristics and in-hospital mortality of HIV patients in a low resource setting in the period 2010 to 2016. METHODS: Data on socio-demographic and clinical characteristics of 313 hospitalized HIV positive patients at the University College Hospital, Ibadan, Nigeria were retrospectively extracted, described and examined for trends. Factors independently associated with mortality were identified using multiple logistic regression. RESULTS: The mean age was 39 years (SD = 9.8) and about two thirds were female. The proportion of females decreased significantly from 83.3% in 2010-2011 to 39.8% in 2016. There was a significant reduction in the diagnosis of disseminated tuberculosis and mortality from 19.4% and 42.9% in 2010-2011 to 4.8% and 27.9% in 2016 respectively. On multiple logistic regression, being male, having neurological features, meningitis, and shorter stay in hospital had significantly higher odds of mortality. CONCLUSION: There was a reduction in in-hospital mortality of HIV patients over the period from 2010 to 2016. Being male and presence of neurological features were associated with mortality. Larger prospective studies are needed to further investigate this observed reduction in mortality among hospitalised patients.


Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Infecciones por VIH/tratamiento farmacológico , Pacientes Internos/estadística & datos numéricos , Mortalidad/tendencias , Infecciones Oportunistas Relacionadas con el SIDA/mortalidad , Adolescente , Adulto , Fármacos Anti-VIH/administración & dosificación , Femenino , Infecciones por VIH/mortalidad , Hospitales de Enseñanza , Hospitales Universitarios , Humanos , Tiempo de Internación , Masculino , Meningitis/complicaciones , Meningitis/mortalidad , Persona de Mediana Edad , Nigeria/epidemiología , Admisión del Paciente/estadística & datos numéricos , Admisión del Paciente/tendencias , Estudios Retrospectivos , Distribución por Sexo , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/mortalidad , Adulto Joven
8.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(2): 160-164, 2020 Feb 06.
Artículo en Chino | MEDLINE | ID: mdl-32074703

RESUMEN

Objective: To analyze the long-term trend of mortality and years of life lost (YLL) of gastric cancer in Tianjin from 1999 to 2015. Methods: From January 1, 1999 to December 31, 2015, the data of gastric cancer deaths was collected from the Tianjin death surveillance system. The inclusion criteria of death due to gastric cancer were coded by using 151 in the 9(th) edition of the international classification of diseases (ICD) (1999-2002) and C16 in the 10(th) edition of ICD (2003-2015). The crude and age-standardized mortality rate (ASR) of gastric cancer was calculated according to Segi's world standard population. YLL was calculated according to the standard method of the disease burden of WHO. The Joinpoint regression was used to calculate the average annual percentage change (AAPC) to indicate the trend of mortality and YLL of gastric cancer. Results: From 1999 to 2015, there were 20 000 deaths of gastric cancer in Tianjin. The proportion of gastric cancer death in the population aged 0-44 years old, 45-64 years old, and 65 years old and above was 4.9%, 30.4%, and 64.8%, respectively. The proportion of males and urban was 67.1% and 67.5%, respectively. From 1999 to 2015, the crude mortality rate was from 12.10/100 000 to 12.58/100 000. The ASR was from 11.04/100 000 to 7.24/100 000. The average annual YLL number was 29 625.83 person-years and the rate was 3.09 person-years per thousand people. From 1999 to 2015, the crude mortality rate and the PYLL of gastric cancer in Tianjin were stable (the AAPC was 0.34% and -0.24%, all P values >0.05). The ASR showed a downward trend (AAPC=-2.58%, P<0.001). Conclusion: From 1999 to 2015, the ASR of gastric cancer in Tianjin showed a downward trend, and the YLL of gastric cancer was stable.


Asunto(s)
Esperanza de Vida/tendencias , Neoplasias Gástricas/mortalidad , Adolescente , Adulto , Anciano , Niño , Preescolar , China/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Adulto Joven
9.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(2): 228-232, 2020 Feb 06.
Artículo en Chino | MEDLINE | ID: mdl-32074716

RESUMEN

The energy adjustment models in nutritional epidemiological studies could substantially reduce the confounding effect of total energy intake from the intake of dietary components, and it could explore the real relationship between the intake of dietary component and research outcomes. Four energy adjustment models were introduced in this article, including the standard multivariate model, multivariate nutrient residual model, energy partition model, and multivariate nutrient density model. The four energy adjustment models were applied to analyze the association between the intake of saturated fatty acids and the risk of all-cause mortality based on the data of the US National Health and Nutrition Examination Survey. The consistent results of different energy adjustment models could indicate that the four models could better control the confounding effect of total energy intake.


Asunto(s)
Ingestión de Energía , Métodos Epidemiológicos , Modelos Teóricos , Ácidos Grasos/administración & dosificación , Ácidos Grasos/efectos adversos , Humanos , Mortalidad/tendencias , Encuestas Nutricionales , Estados Unidos/epidemiología
10.
BMJ ; 368: m234, 2020 02 19.
Artículo en Inglés | MEDLINE | ID: mdl-32075787

RESUMEN

OBJECTIVE: To describe the temporal and spatial trends of mortality and disability adjusted life years (DALYs) due to chronic respiratory diseases, by age and sex, across the world during 1990-2017 using data from the Global Burden of Disease Study 2017. DESIGN: Systematic analysis. DATA SOURCE: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017. METHODS: Mortality and DALYs from chronic respiratory diseases were estimated from the Global Burden of Disease Study 2017 using DisMod-MR 2.1, a Bayesian meta-regression tool. The estimated annual percentage change of the age standardised mortality rate was calculated using a generalised linear model with a Gaussian distribution. Mortality and DALYs were stratified according to the Socio-demographic index. The strength and direction of the association between the Socio-demographic index and mortality rate were measured using the Spearman rank order correlation. Risk factors for chronic respiratory diseases were analysed from exposure data. RESULTS: Between 1990 and 2017, the total number of deaths due to chronic respiratorydiseases increased by 18.0%, from 3.32 (95% uncertainty interval 3.01 to 3.43) million in 1990 to 3.91 (3.79 to 4.04) million in 2017. The age standardised mortality rate of chronic respiratory diseases decreased by an average of 2.41% (2.28% to 2.55%) annually. During the 27 years, the annual decline in mortality rates of chronic obstructive pulmonary disease (COPD; 2.36%, uncertainty interval 2.21% to 2.50%) and pneumoconiosis (2.56%, 2.44% to 2.68%) has been slow, whereas the mortality rate for interstitial lung disease and pulmonary sarcoidosis (0.97%, 0.92% to 1.03%) has increased. Reductions in DALYs for asthma and pneumoconiosis have been seen, but DALYs due to COPD, and interstitial lung disease and pulmonary sarcoidosis have increased. Mortality and the annual change in mortality rate due to chronic respiratory diseases varied considerably across 195 countries. Assessment of the factors responsible for regional variations in mortality and DALYs and the unequal distribution of improvements during the 27 years showed negative correlations between the Socio-demographic index and the mortality rates of COPD, pneumoconiosis, and asthma. Regions with a low Socio-demographic index had the highest mortality and DALYs. Smoking remained the major risk factor for mortality due to COPD and asthma. Pollution from particulate matter was the major contributor to deaths from COPD in regions with a low Socio-demographic index. Since 2013, a high body mass index has become the principal risk factor for asthma. CONCLUSIONS: Regions with a low Socio-demographic index had the greatest burden of disease. The estimated contribution of risk factors (such as smoking, environmental pollution, and a high body mass index) to mortality and DALYs supports the need for urgent efforts to reduce exposure to them.


Asunto(s)
Salud Global/tendencias , Años de Vida Ajustados por Calidad de Vida , Trastornos Respiratorios/epidemiología , Distribución por Edad , Factores de Edad , Enfermedad Crónica , Carga Global de Enfermedades/tendencias , Salud Global/estadística & datos numéricos , Humanos , Mortalidad/tendencias , Enfermedad Pulmonar Obstructiva Crónica/mortalidad , Factores de Riesgo , Factores Sexuales , Factores Socioeconómicos
11.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(1): 36-41, 2020 Jan 10.
Artículo en Chino | MEDLINE | ID: mdl-32062940

RESUMEN

Objective: To investigate the association between estimated glomerular filtration rate (eGFR) and all-cause mortality in the elderly aged 65 years and older in longevity areas in China. Methods: Data used in this study were obtained from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey, 1 802 elderly adults were collected in the study during 2012-2017/2018. In this study, the elderly were classified into 4 groups, moderate-to-severe group [<45 ml·min(-1)·(1.73 m(2))(-1)], mild-to-moderate group [45- ml·min(-1)·(1.73 m(2))(-1)], mild group [60- ml·min(-1)·(1.73 m(2))(-1)] and normal group [≥90 ml·min(-1)·(1.73 m(2))(-1)] according to their eGFR levels. Results: After 6 years of follow-up, 852 participants died, with a mortality rate of 47.3%. Multivariate Cox regression analysis showed that the levels of eGFR were negatively correlated with all-cause mortality risk in the elderly (the HR of elderly was 0.993 and the 95%CI was 0.989-0.997 for every unit of eGFR increased, P=0.001), while compared with the group with normal eGFR, the HRs (95%CI) of the elderly in the moderate-to-severe group, mild-to-moderate group, and mild group were 1.690 (1.224-2.332, P=0.001), 1.312 (0.978-1.758, P=0.070), 1.349 (1.047-1.737, P=0.020) respectively [trend test P<0.001]. Conclusion: The decrease in eGFR was associated with higher mortality risk among the elderly in longevity areas in China.


Asunto(s)
Tasa de Filtración Glomerular , Longevidad , Anciano , China/epidemiología , Estudios de Cohortes , Humanos , Mortalidad/tendencias , Medición de Riesgo , Factores de Riesgo
13.
Lancet ; 395(10224): 591-603, 2020 02 22.
Artículo en Inglés | MEDLINE | ID: mdl-32007142

RESUMEN

BACKGROUND: WHO is developing a global strategy towards eliminating cervical cancer as a public health problem, which proposes an elimination threshold of four cases per 100 000 women and includes 2030 triple-intervention coverage targets for scale-up of human papillomavirus (HPV) vaccination to 90%, twice-lifetime cervical screening to 70%, and treatment of pre-invasive lesions and invasive cancer to 90%. We assessed the impact of achieving the 90-70-90 triple-intervention targets on cervical cancer mortality and deaths averted over the next century. We also assessed the potential for the elimination initiative to support target 3.4 of the UN Sustainable Development Goals (SDGs)-a one-third reduction in premature mortality from non-communicable diseases by 2030. METHODS: The WHO Cervical Cancer Elimination Modelling Consortium (CCEMC) involves three independent, dynamic models of HPV infection, cervical carcinogenesis, screening, and precancer and invasive cancer treatment. Reductions in age-standardised rates of cervical cancer mortality in 78 low-income and lower-middle-income countries (LMICs) were estimated for three core scenarios: girls-only vaccination at age 9 years with catch-up for girls aged 10-14 years; girls-only vaccination plus once-lifetime screening and cancer treatment scale-up; and girls-only vaccination plus twice-lifetime screening and cancer treatment scale-up. Vaccination was assumed to provide 100% lifetime protection against infections with HPV types 16, 18, 31, 33, 45, 52, and 58, and to scale up to 90% coverage in 2020. Cervical screening involved HPV testing at age 35 years, or at ages 35 years and 45 years, with scale-up to 45% coverage by 2023, 70% by 2030, and 90% by 2045, and we assumed that 50% of women with invasive cervical cancer would receive appropriate surgery, radiotherapy, and chemotherapy by 2023, which would increase to 90% by 2030. We summarised results using the median (range) of model predictions. FINDINGS: In 2020, the estimated cervical cancer mortality rate across all 78 LMICs was 13·2 (range 12·9-14·1) per 100 000 women. Compared to the status quo, by 2030, vaccination alone would have minimal impact on cervical cancer mortality, leading to a 0·1% (0·1-0·5) reduction, but additionally scaling up twice-lifetime screening and cancer treatment would reduce mortality by 34·2% (23·3-37·8), averting 300 000 (300 000-400 000) deaths by 2030 (with similar results for once-lifetime screening). By 2070, scaling up vaccination alone would reduce mortality by 61·7% (61·4-66·1), averting 4·8 million (4·1-4·8) deaths. By 2070, additionally scaling up screening and cancer treatment would reduce mortality by 88·9% (84·0-89·3), averting 13·3 million (13·1-13·6) deaths (with once-lifetime screening), or by 92·3% (88·4-93·0), averting 14·6 million (14·1-14·6) deaths (with twice-lifetime screening). By 2120, vaccination alone would reduce mortality by 89·5% (86·6-89·9), averting 45·8 million (44·7-46·4) deaths. By 2120, additionally scaling up screening and cancer treatment would reduce mortality by 97·9% (95·0-98·0), averting 60·8 million (60·2-61·2) deaths (with once-lifetime screening), or by 98·6% (96·5-98·6), averting 62·6 million (62·1-62·8) deaths (with twice-lifetime screening). With the WHO triple-intervention strategy, over the next 10 years, about half (48% [45-55]) of deaths averted would be in sub-Saharan Africa and almost a third (32% [29-34]) would be in South Asia; over the next 100 years, almost 90% of deaths averted would be in these regions. For premature deaths (age 30-69 years), the WHO triple-intervention strategy would result in rate reductions of 33·9% (24·4-37·9) by 2030, 96·2% (94·3-96·8) by 2070, and 98·6% (96·9-98·8) by 2120. INTERPRETATION: These findings emphasise the importance of acting immediately on three fronts to scale up vaccination, screening, and treatment for pre-invasive and invasive cervical cancer. In the next 10 years, a one-third reduction in the rate of premature mortality from cervical cancer in LMICs is possible, contributing to the realisation of the 2030 UN SDGs. Over the next century, successful implementation of the WHO elimination strategy would reduce cervical cancer mortality by almost 99% and save more than 62 million women's lives. FUNDING: WHO, UNDP, UN Population Fund, UNICEF-WHO-World Bank Special Program of Research, Development and Research Training in Human Reproduction, Germany Federal Ministry of Health, National Health and Medical Research Council Australia, Centre for Research Excellence in Cervical Cancer Control, Canadian Institute of Health Research, Compute Canada, and Fonds de recherche du Québec-Santé.


Asunto(s)
Neoplasias del Cuello Uterino/mortalidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Países en Desarrollo , Detección Precóz del Cáncer/métodos , Femenino , Humanos , Renta , Lactante , Recién Nacido , Tamizaje Masivo/métodos , Persona de Mediana Edad , Modelos Biológicos , Mortalidad/tendencias , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/prevención & control , Vacunas contra Papillomavirus , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/prevención & control , Neoplasias del Cuello Uterino/virología , Vacunación/métodos , Organización Mundial de la Salud , Adulto Joven
14.
Nihon Ronen Igakkai Zasshi ; 57(1): 60-71, 2020.
Artículo en Japonés | MEDLINE | ID: mdl-32074562

RESUMEN

OBJECTIVES: We examined the associations of weight loss and low serum albumin level with death in community-dwelling elderly, as well as related factors by a systematic review with a meta-analysis. METHODS: We searched MEDLINE, Cochrane Library (CENTRAL), Web of Science, and CHINAL for articles on cohort studies investigating the association of weight loss and low serum albumin with death in community-dwelling elderly and extracted a total of 3,812 published articles. We also investigated the factors associated with this relationship. Relative risk ratios and 95% confidence intervals were cultivated. RESULTS: Based on our search for articles related to weight loss, we extracted 1,180 cases and finally analyzed 11 cases. The meta-analysis revealed that the risk ratio (RR) for mortality was 1.69 times higher than that in the weight loss group. Based on our search for articles related to low serum albumin, we extracted 2,632 cases and finally analyzed 10 cases. The mortality RR was 1.92 times higher than that in the maintenance group albumin low level group. Overall, the degree of heterogeneity in the analyzed studies was high. There were some influencing factors influencing the associations; however, the feeding behaviors, swallowing function and food eating patterns were not fully investigated. CONCLUSIONS: Our meta-analysis of the relevant literature revealed that the RR for mortality was significantly high in community dwelling elderly with weight loss or low serum albumin. Based on these results, the maintenance of body weight and serum albumin would be important for preventing death and serious diseases in the community dwelling elderly.


Asunto(s)
Vida Independiente , Albúmina Sérica , Pérdida de Peso , Anciano , Estudios de Cohortes , Humanos , Mortalidad/tendencias
16.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(1): 99-103, 2020 Jan 06.
Artículo en Chino | MEDLINE | ID: mdl-31914576

RESUMEN

To explore the epidemiological characteristics, trends and relevant factors of pre-hospital mortality due to acute myocardial infarction (AMI) from 1999 to 2016 in Tianjin city, based on mortality surveillance information and household registration population information. Standardized mortality rates were calculated using the year 2000 world standard population. From 1999 to 2016, the research result showed that the pre-hospital crude mortality rates of AMI were 39.47/100 000 to 90.64/100 000 and the standardized mortality rates were 30.92/100 000 to 53.90/100 000. The proportion of pre-hospital AMI deaths was 73.96%-81.92% (t=1.09, P>0.05) within the same period. Aged, female, rural residents, unmarried, divorced, widowed, low education level, and outdoor workers have a relative higher proportion of pre-hospital AMI mortality.


Asunto(s)
Infarto del Miocardio/mortalidad , Anciano , China/epidemiología , Ciudades , Femenino , Humanos , Masculino , Mortalidad/tendencias , Factores Socioeconómicos
17.
BMC Public Health ; 20(1): 8, 2020 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-31907012

RESUMEN

BACKGROUND: Poor health could influence how individuals are sorted into occupational classes. Health selection has therefore been considered a potential modifier to the mortality class gradient through differences in social mobility. Direct health selection in particular may operate in the short-term as poor health may lead to reduced work hours or achievement, downward social mobility, unemployment or restricted upward mobility, and death. In this study, the relationship between social mobility and mortality (all-cause, cancer-related, cardiovascular disease-related (CVD), and suicide) is explored when the relationship is adjusted for poor health. METHODS: Using Swedish register data (1996-2012) and discrete time event-history analysis, odds ratios and average marginal effects (AME) of social mobility and unemployment on mortality are observed before and after accounting for sickness absence in the previous year. RESULTS: After adjusting for sickness absence, all-cause mortality remained lower for men after upward mobility in comparison to not being mobile (OR 0.82, AME -0.0003, CI - 0.0003 to - 0.0002). Similarly, upward mobility continued to be associated with lower cancer-related mortality for men (OR 0.85, AME -0.00008, CI - 0.00002 to - 0.0002), CVD-related mortality for men (OR 0.76, AME -0.0001, CI - 0.00006 to - 0.0002) and suicide for women (OR 0.67, AME -0.00002, CI - 0.000002 to - 0.00003). The relationship between unemployment and mortality also persisted across most causes of death for both men and women after controlling for previous sickness absence. In contrast, adjusting for sickness absence renders the relationship between downward mobility and cancer-related mortality not statistically different from the non-mobile. CONCLUSIONS: Health selection plays a role in how downward mobility is linked to cancer related deaths. It additionally accounts for a portion of why upward mobility is associated with lower mortality. That health selection plays a role in how social mobility and mortality are related may be unexpected in a context with strong job protection. Job protection does not, however, equalize opportunities for upward mobility, which may be limited for those who have been ill. Because intra-generational upward mobility and mortality remained related after adjusting for sickness absence, other important mechanisms such as indirect selection or social causation should be explored.


Asunto(s)
Absentismo , Mortalidad/tendencias , Ausencia por Enfermedad/estadística & datos numéricos , Movilidad Social/estadística & datos numéricos , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sistema de Registros , Suecia/epidemiología , Adulto Joven
19.
BMC Public Health ; 20(1): 36, 2020 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-31924185

RESUMEN

BACKGROUND: To assess the trend in age- and sex-stratified mortality after hospitalization for heart failure (HF) in the Netherlands. METHODS: Two nationwide cohorts of patients, hospitalized for new onset heart failure between 01.01.2000-31.12.2002 and between 01.01.2008-31.12.2010, were constructed by linkage of the Dutch Hospital Discharge Registry and the National Cause of Death registry. 30-day, 1-year and 5 -year overall and cause-specific mortality rates stratified by age and sex were assessed and compared over time. RESULTS: We identified 40,230 men and 41,582 women. In both cohorts, men were on average younger than women (74-75 and 78-79 years, respectively) and more often had comorbid conditions (37 and 30%, respectively). In the 2008-10 cohort, mortality rates for men were 13, 32 and 64% for respectively 30-day, 1-year and 5-year mortality and 14, 33 and 66% for women. Mortality rates increased considerably with age similarly in men and women (e.g. from 10.5% in women aged 25-54 to 46.1% in those aged 85 and older after 1 year). Between the two time periods, mortality rates dropped across all ages, equally strong in women as in men. The 1-year absolute risk of death declined by 4.0% (from 36.1 to 32.1%) in men and 3.2% (from 36.2 to 33.0%) in women. CONCLUSIONS: Mortality after hospitalization for new onset HF remains high, however, both short-term and long-term survival is improving over time. This improvement was similar across all ages and equally strong in women as in men.


Asunto(s)
Insuficiencia Cardíaca/mortalidad , Hospitalización/estadística & datos numéricos , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Insuficiencia Cardíaca/terapia , Humanos , Masculino , Persona de Mediana Edad , Mortalidad/tendencias , Países Bajos/epidemiología , Distribución por Sexo
20.
Chemosphere ; 242: 125196, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31896208

RESUMEN

Lanzhou, an ex-heavily polluted city, was awarded "The Award for Today's Transformative Step" in 2015 World Climate Conference at Paris for its great efforts on air quality improvement since 2012. However, the health benefits from this improvement remain unclear. Therefore, we collected time-series data covering deaths, weather variables and air pollutants during the two periods (2004-2009, 2014-2017) and fitted single-pollutant models using the generalized additive models to evaluate the change of mortality risks associated with air pollutants in Lanzhou. Results showed that the annual average concentrations of respirable particulate matter (PM10) and sulfur dioxide (SO2) dropped by 19.28% and 66.29%, while the nitrogen dioxide (NO2) increased by 16.61% in 2014-2017 compared to 2004-2009. During the period 2004-2009, we found a 10-µg/m3 increase in PM10 (lag 2), SO2 (lag 0-5) and NO2 (lag 0-5) were associated with mortality increments of 0.12% (95% CI: 0.01, 0.22), 0.86% (95% CI: 0.42, 1.31) and 1.29% (95% CI: 0.70, 1.90), respectively. During the period 2014-2017, the association between PM10 and daily deaths was not significant, but we observed a 10-µg/m3 increase in SO2 (lag 0-5) and NO2 (lag 4) were related to mortality increments of 4.23% (95% CI: 1.82, 6.70) and 0.85% (95% CI: 0.19, 1.52), respectively. From 2004-2009 to 2014-2017, we observed markedly decline of mortality risk due to PM10, but not SO2 or NO2. In conclusion, the mortality risk of PM10 in Lanzhou has declined obviously after the substantially improved air quality due to the enforcement of air pollution controlling policies.


Asunto(s)
Contaminantes Atmosféricos/análisis , Contaminación del Aire/estadística & datos numéricos , Exposición a Riesgos Ambientales/estadística & datos numéricos , Mortalidad/tendencias , Contaminación del Aire/análisis , China/epidemiología , Clima , Contaminantes Ambientales , Humanos , Dióxido de Nitrógeno/análisis , Material Particulado/análisis , Dióxido de Azufre/análisis , Tiempo (Meteorología)
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