Cancer Mortality Rates Increasing vs Cardiovascular Disease Mortality Decreasing in the World: Future Implications.

OBJECTIVE: To highlight the current global trends in mortality for cardiovascular disease and cancer. METHODS: The World Health Organization and the World Bank DataBank databases were used to analyze mortality rates for cancer and cardiovascular disease by calculating age-standardized mortality rates (ASRs) from 2000 to 2015 for high-income, upper-middle-income, and lower-middle-income countries. Data for cancer mortality and population for 43 countries representing 5 of the 7 continents (except Australia and Antarctica) were analyzed. RESULTS: From 2000 to 2015, there was an increase in the ASR for cancer for both men and women irrespective of a country's income status, representing an overall 7% increase in cancer ASR (Pearson r, +0.99; P<.00001). We report a higher ASR for cancer in high-income countries than in upper-middle-income and lower-middle-income countries specifically; high-income countries saw a 3% increase in cancer ASR vs +31% for upper-middle-income and +19% for lower-middle-income countries (P<.01). There has been a decrease in the ASR for cardiovascular disease for the 15 years analyzed (P<.00001). In addition, high-income countries had a higher ASR for cardiovascular disease than upper-middle-income countries during the 15-year period (P<.05). CONCLUSION: We suspect that because of early detection and targeted interventions, cardiovascular disease mortality rates have decreased during the past decade. On the basis of our results, cancer mortality rates continue to rise, with the projection of surpassing cardiovascular disease mortality rates in the near future.

Toward social-ecological coastal zone governance of Chiloé Island (Chile) based on the DPSIR framework.

Coastal zones are complex systems where sustainability needs local participative governance, whose absence may result in conflicts between social actors. In its absence, the first step should be a diagnosis of the current situation based on integrative conceptual frameworks such as the DPSIR. However, in conflicting situations, the generated model needs validation from social actors. Chiloé Island is a critical Chilean coastal fishery and aquaculture area, coexisting with subsistence and cultural uses of marine resources. This article analyzes the current ecological state of the Chiloé coastal zone and its main social-ecological impact using a DPSIR model. We validated its results through a household survey and interviews with local experts and social actors. Results show that increased coastal fisheries and aquaculture generate a critical decrease of coastal species, eutrophication, and pollution that, along with harmful algal blooms, generate conflicts. Social validation showed that experts and local social actors have different perceptions of conflicting parties and conflict solutions. Following a post-normal approach, we propose three ideas to start social-ecological governance of Chiloé coastal marine ecosystems.