Epidemiology of Suicide Mortality in Paraguay from 2005 to 2019: A Descriptive Study.

Suicide is an important public health problem, fundamentally affecting the younger population and responding to multiple biological, psychological, and social causes. The objective of this study was to characterize changes in suicide mortality, suicide methods, and years of potential life lost from 2005 to 2019 in Paraguay. This observational, descriptive study used data from the Vital Statistics Information Subsystem of the Ministry of Public Health and Social Welfare. The average mortality rate from suicide was 4.9 per 100,000 inhabitants, with an increase from 4.2 between 2005 and 2009 to 5.8 from 2014 to 2019. Suicide was more common in men (75%) than in women. In men, the highest mortality rate was observed among those 20-24 years old, whereas in women, the ages most affected were the 15-19-year-old age group. The most-used method for suicide was hanging. The most frequent place of suicide occurrence was at home (73%). The seasonality of suicide occurrence showed a slight increase in the spring-summer months compared with autumn-winter (53% vs. 47%). The rate of potential years of life lost statistically significantly increased from 2005 to 2019. Public health measures need to be implemented to investigate the underlying reasons and implement interventions in the population to decrease suicide mortality in Paraguay.

Trends and projections of cause-specific premature mortality in Australia to 2044: a statistical modelling study.

Background: Long-term projections of premature mortality (defined as deaths age <75 years) help to inform decisions about public health priorities. This study aimed to project premature mortality rates in Australia to 2044, and to estimate numbers of deaths and potential years of life lost (PYLL) due to premature mortality overall and for 59 causes. Methods: We examined the past trends in premature mortality rates using Australian mortality data by sex, 5-year age group and 5-year calendar period up to 2019. Cigarette smoking exposure data (1945-2019) were included to project lung cancer mortality. Age-period-cohort or generalised linear models were developed and validated for each cause to project premature mortality rates to 2044. Findings: Over the 25-year period from 1990-1994 to 2015-2019, there was a 44.4% decrease in the overall age-standardised premature mortality rate. This decline is expected to continue, from 162.4 deaths/100,000 population in 2015-2019 to 141.7/100,000 in 2040-2044 (12.7% decrease). Despite declining rates, total numbers of premature deaths are projected to increase by 22.8%, rising from 272,815 deaths in 2015-2019 to 334,894 deaths in 2040-2044. This is expected to result in 1.58 million premature deaths over the 25-year period 2020-2044, accounting for 24.5 million PYLL. Of the high-level cause categories, cancer is projected to remain the most common cause of premature death in Australia by 2044, followed by cardiovascular disease, external causes (including injury, poisoning, and suicide), and respiratory diseases. Interpretation: Despite continuously declining overall premature mortality rates, the total number of premature deaths in Australia is projected to remain substantial, and cancer will continue to be the leading cause. These projections can inform the targeting of public health efforts and can serve as benchmarks against which to measure the impact of future interventions. They emphasise the ongoing importance of accelerating the prevention, early detection, and treatment of key health conditions. Funding: No funding was provided for this study.

Anos Potenciais de Vida Perdidos devido à COVID-19, segundo a raça/cor e gênero, no Brasil, entre 2020 e 2021 / Years of Potential Life Lost due to COVID-19 according to race/color and gender in Brazil between 2020 and 2021

Resumo A mortalidade provocada pela pandemia da COVID-19 tem produzido impactos aos indicadores de Anos Potenciais de Vida Perdidos (APVP) em nível mundial. Objetiva-se estimar os APVP devido à mortalidade por COVID-19, segundo sexo, faixa etária e raça/cor, no período de março de 2020 a dezembro de 2021, no Brasil. Foram caracterizadas as mortes por COVID-19, estimadas e comparadas as taxas e razão de taxas padronizadas de APVP, a média de anos potenciais de vida não vividos (APVNV) e a idade média do óbito (IMO). No geral, foram perdidos 13.776.969,50 anos potenciais de vida, o que determinou uma perda média de 22,5 anos potenciais não vividos. Houve maior perda de anos potenciais de vida nos homens (58,12%) e nas faixas etárias de 0 a 59 anos nas populações negra (58,92%) e indígena (63,35%), enquanto nas faixas etárias de 60 anos e mais foi observada maior perda de APVP nas populações branca (45,89%) e amarela (53,22%). As mulheres registraram as maiores IMO, com exceção das mulheres indígenas. Homens brancos (1,63), pardos (1,59) e pretos (1,61) tiveram as maiores taxas em comparação às mulheres brancas. Apesar da COVID-19 ter tido maior impacto em idosos, foram as populações negra e indígena na faixa de menos de 60 anos quem teve maior perda de anos potenciais de vida.

Abstract Mortality caused by the COVID-19 pandemic has impacted indicators of Years of Potential Life Lost (YPLL) worldwide. This study aimed to estimate the YPLL due to mortality caused by COVID-19, according to sex, age group, and race/color in Brazil, from March 2020 to December 2021. Deaths caused by COVID-19 were characterized, in which the rates and ratios of standardized YPLL rates, the average number of years of potential life lost (ANYPLL), and the average age at death (AAD) were estimated and compared. Overall, 13,776,969.50 potential years of life were lost, which resulted in an average loss of 22.5 potential years not lived. A greater loss of potential years of life was identified in men (58.12%) and in the age groups from 0 to 59 years in the black (58.92%) and indigenous (63.35%) populations, while in the age groups of 60 years and over, a greater loss of YPLL was observed in the white (45.89%) and yellow (53.22%) populations. Women recorded the highest ADD, with the exception of indigenous women. White men (1.63), brown men (1.59), and black men (1.61) had the highest rates when compared to white women. Although COVID-19 has a greater impact on the elderly, it was the black and indigenous populations under the age of 60 who had the greatest loss of potential years of life.

Trends in Cause-Specific Injury Mortality in China in 2005-2019: Longitudinal Observational Study.

BACKGROUND: Over the last few decades, although the age-standardized mortality rate (ASMR) of injury has shown a significant declining trend in China, this pattern has dramatically reversed recently. OBJECTIVE: We aimed to elucidate the geographical, demographic, and temporal trends of cause-specific injuries, the reversal phenomenon of these trends, and the fluctuations of injury burden from 2005 to 2019 in China. METHODS: A longitudinal observational study was performed using the raw data of injury deaths in the National Cause-of-Death surveillance data provided by the disease surveillance points system in 2005-2019. The cause-specific injuries were divided into disparate subgroups by sex, age, urban/rural region, and eastern/central/western areas of China. The burden of injury was assessed using potential years of life lost (PYLL), average years of life lost (AYLL), and PYLL rate (PYLLR). Temporal trends of mortality rates and burden were evaluated using best-fitting joinpoint models. RESULTS: Injury deaths accounted for 7.51% (1,156,504/15,403,835) of all-cause deaths in China in 2005-2019. The crude mortality rate of all-cause injury was 47.74 per 100,000 persons. The top 3 injury types (traffic accident, falls, and suicide) accounted for 70.57% (816,145/1,156,504) of all injury-related deaths. The ASMR of all-cause injury decreased (P=.003), while the crude mortality rate remained unchanged (P=.52) during 2005-2019. A significant reverse trend in ASMR of all-cause injury was observed in urban older adults since 2013, mainly due to the inverted trend in injuries from falls. A reverse trend in ASMR of suicide was observed among individuals aged 10-24 years, with notable increases by 35.18% (annual percentage change 15.4%, 95% CI 4.1%-28.0%) in men since 2017. The AYLL and PYLLR of all-cause injury among older adults showed consistent ascending trends from 2005 to 2019 (average annual percentage change [AAPC] 6.1%, 95% CI 5.4%-6.9%, 129.04% increase for AYLL; AAPC 5.4%, 95% CI 2.4%-8.4%, 105.52% increase for PYLLR). The AYLL due to suicide for individuals aged 10-24 years showed a considerable upswing tendency (AAPC 0.5%, 95% CI 0.4%-0.7%, 8.02% increase). CONCLUSIONS: Although the ASMR of all-cause injury decreased in China from 2005 to 2019, the trend in suicide among adolescents and young adults and falls among older adults has been on the rise in recent years. Interventions should be encouraged to mitigate the cause-specific burdens of injury death.

Disease burden and health risk to rural communities of northeastern India from indoor cooking-related exposure to parent, oxygenated and alkylated PAHs.

Exposure to a total of 51 targeted and non-targeted polycyclic aromatic hydrocarbons (PAHs) and their oxygenated and alkylated derivatives associated with size-segregated aerosol was investigated in rural kitchens using liquefied petroleum gas (LPG), mixed biomass (MB) and firewood (FW) fuels in northeastern India. The averaged PM10-associated parent-, alkylated-, and oxygenated-PAHs concentrations increased notably from LPG (257, 54, and 116 ng m-3) to MB (838, 119, and 272 ng m-3) to FW-using kitchens (2762, 225, and 554 ng m-3), respectively. PAHs were preferentially associated with the PM1 fraction with contributions increasing from 80 % in LPG to 86 % in MB and 90 % in FW-using kitchens, which in turn was dominated by <0.25 µm particles (54-75 % of the total). A clear profile of enrichment of low-molecular weight PAHs in cleaner fuels (LPG) and a contrasting enrichment of high-molecular weight PAHs in biomass-based fuels was noted. The averaged internal dose of Benzo[a]pyrene equivalent was the lowest in the case of LPG (19 ng m-3), followed by MB (161 ng m-3) and the highest in FW users (782 ng m-3). Estimation of incremental lifetime cancer risk (ILCR) from PAH exposure revealed extremely high cancer risk in biomass users (factors of 8-40) compared to LPG. The potential years of life lost (PYLL) and PYLL rate averaged across kitchen categories was higher for lung cancer (PYLL: 10.55 ± 1.04 years; PYLL rate: 204 ± 426) compared to upper respiratory tract cancer (PYLL: 10.02 ± 0.05 years; PYLL rate: 4 ± 7), and the PYLL rates for biomass users were higher by factors of 9-56 as compared to LPG users. These findings stress the need for accelerated governmental intervention to ensure a quick transition from traditional biomass-based fuels to cleaner alternatives for the rural population of northeastern India.

Años de vida perdidos y distribución espacial de la mortalidad por incidente vial en Medellín, 2010-2020

Objetivo: Estimar los años potenciales de vida perdidos y la distribución espacial de la mortalidad por incidente vial según modo de transporte en Medellín 2010-2020, como línea base para la implementación de la estrategia Visión Cero, de la Organización Mundial de la Salud, en la movilidad de la ciudad. Metodología: Estudio retrospectivo y descriptivo de corte transversal, con fuente secundaria. El cálculo de los años potenciales de vida perdidos se hizo tomando como edad límite la esperanza de vida al nacer de Colombia, según año y género. El análisis espacial se realizó a partir de la dirección del incidente; la representación de la densidad de Kernel fue por el método de clasificación estándar-cuantil, y las zonas de influencia se crearon por el método búfer de anillos múltiples, con distancias de 500 y 1000 metros. Resultados: Medellín, entre 2010 y 2020, registró 2988 muertes por incidente vial. Quienes más murieron fueron los peatones, con 1423 (47,6 %) muertes, seguidos por los motociclistas, con 1295 (43,3 %). Los años potenciales de vida perdidos fueron 98 787. Las comunas de mayor concentración en muerte de peatones fueron: Candelaria, Buenos Aires y Manrique; en motociclistas, la mayor concentración se evidenció en el sistema vial del río. Por zonas de influencia, los peatones fallecidos en un radio de 1000 metros del sistema vial del río fueron 688 (49,8 %), y los motociclistas, 636 (52,2 %). Conclusión: Los motociclistas fueron quienes murieron más jóvenes y más años dejaron de vivir. Politraumatismos son diagnósticos constantes de muerte, pero lesiones en cabeza, cráneo y tórax son más letales en peatones y motociclistas.

Objective: To estimate the potential years of life lost and the spatial distribution of mortality from road incidents by mode of transport in Medellín 2010-2020, as a baseline for the implementation of the Vision Zero strategy of the World Health Organization in the city's mobility. Methodology: This is a retrospective and descriptive cross-sectional study, with a secondary source. The calculation of the potential years of life lost was made using the life expectancy at birth in Colombia as the age limit, according to year and gender. The spatial analysis was carried out from the direction of the incident; Kernel density was represented by the standard-quantile classification method, and the zones of influence were created by the multiple ring buffer method, with distances of 500 and 1000 meters. Results: Between 2010 and 2020, Medellín registered 2,988 deaths due to road incidents. Those who died the most were pedestrians, with 1,423 (47.6%) deaths, followed by motorcyclists, with 1,295 (43.3%). Potential years of life lost were 98,787. The zones (comunas) with the highest concentration of pedestrian deaths were: Candelaria, Buenos Aires and Manrique; in motorcyclists, the highest concentration was evidenced in the river road system. By areas of influence, pedestrians killed within a radius of 1,000 meters from the river road system were 688 (49.8%), and motorcyclists, 636 (52.2%). Conclusion: Motorcyclists were the ones who died the youngest and the most years they stopped living. Polytrauma is a constant diagnosis of death, but injuries to the head, skull and thorax are more lethal in pedestrians and motorcyclists.

Objetivo: Estimar os anos potenciais de vida perdidos e a distribuição espacial da mortalidade por incidente de trânsito segundo o modo de transporte em Medellín 2010-2020, como linha base para a implementação da estratégia Visão Zero, da Organização Mundial da Saúde, na mobilidade da cidade. Metodologia: Estudo retrospectivo e descritivo de corte transversal, com fonte secundária. O cálculo dos anos potenciais de vida perdidos foi feito considerando como idade limite a esperança de vida ao nascer da Colômbia, segundo ano e gênero. A análise espacial realizou-se a partir do local do incidente; a representação da densidade de Kernel foi pelo método de classificação padrão-quantil, e as zonas de influência criaram-se pelo método buffer de anéis múltiplos, com distâncias de 500 e 1000 metros. Resultados: Medellín, entre 2010 e 2020, registrou 2988 mortes por incidente de trânsito. O maior número de mortes foi de pedestres, sendo 1423 (47,6%), seguido pelo de motoqueiros, sendo 1295 (43,3%). Os anos potenciais de vida perdidos foram 98.787. As localidades com maior concentração de mortes de pedestres foram: Candelaria, Buenos Aires e Manrique; no caso dos motoqueiros, a maior concentração evidenciou-se no sistema viário do rio. Por zonas de influência, os pedestres falecidos em um raio de 1000 metros do sistema viário do rio foram 688 (49,8%), e os motoqueiros 636 (52,2%). Conclusão: Os motoqueiros foram quem morreram mais novos e mais anos deixaram de viver. Politraumatismos são diagnósticos constantes de morte, mas lesões na cabeça, no crâneo e no tórax são mais letais em pedestres e motoqueiros.

Diferencias de sexo asociadas al suicidio y años potenciales de vida perdidos: un estudio retrospectivo

Objetivo: Identificar las diferencias de sexo asociadas a los años potenciales de vida perdidos por suicidio en el departamento de Nariño, periodo 2005-2019. Metodología: Estudio de tipo descriptivo observacional y retrospectivo, en el que se analizaron 1686 certificados de defunción por suicidio de hombres y mujeres en el departamento de Nariño, identificados en el Departamento Nacional Administrativo de Estadística. Resultados: En el periodo 2005-2019, se observaron 1212 suicidios en hombres y 474 en mujeres. Estas se suicidaron a edades más bajas que aquellos. El 50,5 % de los hombres habían cursado básica primaria, y el 46,0 % de las mujeres, básica secundaria. El mayor número de casos de suicidios en hombres y mujeres se presentaron en el área urbana (51,2 % y 45,1 % respectivamente). El envenenamiento fue el mecanismo de suicidio más utilizado por las mujeres (66,7 %), y para los hombres, el mayor porcentaje (41,7) correspondió al ahorcamiento. La tendencia anual de muertes por suicidio fue mayor en hombres que en mujeres. En aquellos, la tasa de suicidio se situó por encima de 4,5 suicidios por 100 000 habitantes, mientras que, en ellas, se mantuvo por debajo de 3,0. Conclusiones: Hubo un aumento en la tendencia de muertes en el periodo de tiempo analizado y el riesgo de morir por suicidio en el hombre fue 3,9 veces el riesgo de morir en una mujer. El estudio contempla importantes aspectos para ser abordados en la prevención del suicidio.

Objective: To identify the sex differences associated with the potential years of life lost due to suicide in the department of Nariño, from 2005 to 2019. Methodology: Descriptive, observational and retrospective study, in which 1686 death certificates by suicide of men and women in the department of Nariño, identified in the National Administrative Department of Statistics, were analyzed. Results: From 2005 to 2019, 1,212 suicide cases of men were observed and 474 of women. Women committed suicide at younger ages than men. 50.5% of the men had completed primary school, and 46.0% of the women, secondary school. The highest number of suicide cases of men and women occurred in the urban area (51.2% and 45.1% respectively). Poisoning was the suicide mechanism most used by women (66.7%), and for men, the highest percentage (41.7) corresponded to hanging. The annual trend of deaths by suicide was higher in men than in women. For men, the suicide rate was above 4.5 suicides per 100,000 inhabitants, while for women, it remained below 3.0. Conclusions: There was an increase in the trend of deaths in the period analyzed and the risk of dying by suicide in men was 3.9 times the risk of dying by suicide in women. The study contemplates important aspects to be addressed in suicide prevention.

Objetivo: Identificar as diferenças de sexo associadas aos anos potenciais de vida perdidos por suicídio no departamento de Nariño, no período 2005-2019. Metodologia: Estudo de tipo descritivo observacional e retrospectivo, em que foram analisados 1686 certificados de óbito por suicídio de homens e mulheres no departamento de Nariño, identificados no Departamento Nacional Administrativo de Estatística. Resultados: No período de 2005-2019, observaram-se 1212 suicídios em homens e 474 em mulheres. Elas suicidaram-se em idades menores do que eles. O 50,5% dos homens cursaram o ensino fundamental, e o 46% das mulheres o ensino médio. O maior número de casos de suicídios em homens e mulheres apresentou-se na área urbana (51,2% y 45,1%, respectivamente). O envenenamento foi o mecanismo de suicídio mais utilizado pelas mulheres (66,7%), e para os homens, a maior percentagem (41,7%) correspondeu ao enforcamento. A tendência anual de mortes por suicídio foi maior em homens do que em mulheres. Neles, a taxa de suicídio esteve por cima de 4,5 suicídios por 100.000 habitantes, enquanto nelas se manteve abaixo de 3,0. Conclusões: Houve um aumento na tendência de mortes no período de tempo analisado e o risco de morrer por suicídio no caso dos homens foi 3,9 vezes o risco de morrer de uma mulher. O estudo contempla aspectos importantes a serem abordados na prevenção do suicídio.

Mortality rates for Parkinson's disease are increasing in Spain. An age-period-cohort and joinpoint analysis of mortality rates from 1981 to 2020.

BACKGROUND: Mortality in Parkinson's disease is increasing worldwide, but Spanish data need further study. OBJECTIVE: To analyse the mortality trends of Parkinson's disease in Spain between 1981 and 2020. METHODS: This observational retrospective study assessed the Parkinson's disease mortality data from 1981 to 2020 collected from the National Statistics Institute of Spain. Age-standardised mortality rates were analysed by age and sex groups, detecting significant mortality trends through a joinpoint analysis. Age-period-cohort effect and potential years of life lost analyses were conducted. The European standard population of 2013 was considered for the analyses. RESULTS: A total of 88 034 deaths were assessed. The overall age-standardised mortality rate rose throughout the period from 3.67 to 8.57 per 100 000 inhabitants. Mortality rates in men were higher than in women, 11.63 versus 6.57 deaths per 100 000 inhabitants. The sex ratio showed an increase in premature mortality in men during 2020. The overall joinpoint analysis recorded a rise in mortality, primarily since the 20th century, mainly in male and older groups, that matched with a period effect. The age effect was detected, confirming higher mortality at an older age. The analysis of potential years of life lost detected a growth in this rate, changing from 0.66 in 1981 to 1.06 in 2020. CONCLUSIONS: Mortality data for Parkinson's disease in Spain rose significantly in forty years. Mortality rate was higher in the male and age group above 75 years of age. The sex ratio showed premature mortality in men in 2020, which will need further study.

Caracterización de la mortalidad por accidentes en Cuba en el decenio 2010-2019

Fundamento: los accidentes constituyen cadenas de eventos y circunstancias que llevan a la ocurrencia de lesiones no intencionales. Son responsables de numerosas muertes cada año en el mundo. En el año 2019, los accidentes del tránsito y las caídas estuvieron entre las primeras 20 causas de muerte. En Cuba se erigieron como la quinta causa de mortalidad por todas las causas y edades en el decenio 2010-2019. Objetivo: caracterizar la mortalidad por accidentes en Cuba en el decenio 2010- 2019. Métodos: se realizó un estudio ecológico, longitudinal, descriptivo, de la mortalidad anual por accidentes en Cuba, a lo largo del decenio que comprende los años 2010 al 2019. Los anuarios estadísticos, publicados desde el año 2012 al 2022, por la Dirección de Registros Médicos y Estadísticas de Salud, del Ministerio de Salud Pública de Cuba, constituyeron la principal fuente de información. Para su procesamiento estadístico, los datos obtenidos fueron incluidos en una hoja de cálculo en Microsoft Excel y los resultados se expresaron en figuras y tablas. Resultados: las tasas brutas de mortalidad por accidentes en Cuba en el decenio 2010- 2019 se incrementaron de 43 a 49,9 por 100 000 habitantes, las más elevadas fueron por caídas: 23,7 en el año 2018 y 23,4 por 100 000 habitantes en el 2019. Los años de vida potencialmente perdidos por accidentes disminuyeron de 5,4 a 4,7 por 1 000 habitantes de 1 a 74 años. Conclusiones: en Cuba, en el decenio 2010- 2019, se observó un aumento en la mortalidad por accidentes a expensas de las caídas accidentales, estas con mayor frecuencia en el sexo femenino.

Background: accidents constitute chains of events and circumstances that lead to the occurrence of unintentional injuries. They are responsible for numerous deaths every year in the world. In 2019, traffic accidents and falls were among the top 20 causes of death. In Cuba, they stood as the fifth cause of mortality from all causes and ages in the decade 2010-2019. Objective: to characterize mortality from accidents in Cuba in the 2010-2019 decade. Methods: an ecological, longitudinal, descriptive study of annual mortality due to accidents in Cuba was carried out, throughout the decade from 2010 to 2019. The statistical yearbooks, published from 2012 to 2022, by the Directorate of Medical Records and Health Statistics, from the Ministry of Public Health of Cuba, constituted the main source of information. For its statistical processing, the data obtained were included in a spreadsheet in Microsoft Excel and the results were expressed in figures and tables. Results: the gross mortality rates due to accidents in Cuba in the 2010-2019 decade increased from 43 to 49.9 per 100,000 inhabitants, the highest being due to falls: 23.7 in 2018 and 23.4 per 100 000 inhabitants in 2019. The years of potential life lost due to accidents decreased from 5.4 to 4.7 per 1,000 inhabitants between 1 and 74 years of age. Conclusions: in Cuba, in the 2010-2019 decade, an increase in mortality from accidents was observed at the expense of accidental falls, these more frequently in the female sex.

Understanding population exposure to size-segregated aerosol and associated trace elements during residential cooking in northeastern India: Implications for disease burden and health risk.

Mass-size distribution of respirable aerosol and 13 associated trace elements (TEs) were investigated in rural kitchens using liquefied petroleum gas (LPG), firewood and mixed biomass fuels across three northeastern Indian states. The averaged PM10 (particulate matter with aerodynamic diameter ≤ 10 µm) and ΣTE concentrations were 403 and 30 µg m-3 for LPG, 2429 and 55 µg m-3 for firewood, and 1024 and 44 µg m-3 for mixed biomass-using kitchens. Mass-size distributions were tri-modal with peaks in the ultrafine (0.05-0.08 µm), accumulation (0.20-1.05 µm), and coarse (3.20-4.57 µm) modes. Respiratory deposition, estimated using the multiple path particle dosimetry model, ranged from 21 % to 58 % of the total concentration across fuel types and population age categories. Head, followed by pulmonary and tracheobronchial, was the most vulnerable deposition region, and children were the most susceptible age group. Inhalation risk assessment of TEs revealed significant non-carcinogenic as well as carcinogenic risk, especially for biomass fuel users. The potential years of life lost (PYLL) was the highest for chronic obstructive pulmonary disease (COPD: 15.9 ± 3.8 years) followed by lung cancer (10.3 ± 0.3 years) and pneumonia (10.1 ± 0.1 years), while the PYLL rate was also highest for COPD, with Cr(VI) being the major contributor. Overall, these findings reveal the significant health burden faced by the northeastern Indian population from indoor cooking using solid biomass fuels.

Asthma Mortality in Spain From 1980 to 2019: Trends and Perspectives in the New Treatment Era.

BACKGROUND AND OBJECTIVE: Previous studies suggest that asthma mortality rates in Spain have been decreasing in recent years. However, this trend is not homogeneous across age groups. Objective: To analyze asthma mortality rates over a 40-year period, focusing on changes associated with the development of new therapeutic approaches. METHODS: Death records and mid-year population data were collected from the National Statistics Institute. Using the direct method, agestandardized mortality rates were calculated for the overall population and for each sex and age group. Significant changes in mortality trends were identified using joinpoint regression analysis. The independent effects of age, period, and cohort and potential years of life lost due to asthma were also analyzed. RESULTS: Age-standardized asthma mortality rates decreased in Spain from 7.38 to 2.03 deaths per 100 000 from the first to the last quinquennium of the study (1980-1984 to 2015-2019) for the whole population. This decrease was more intense among men, where a decrease from 10.37/100 000 to 0.91/100 000 was observed compared with 5.53 to 2.77/100 000 in women. Mortality decreased in all age groups. During the last 3 years, the decrease stabilized in patients aged >64 years but increased in those aged 35-64. Mortality has been decreasing rapidly since the 1990s in patients aged <35 years. CONCLUSION: Asthma mortality rates began to decline in 1980. The decrease was observed among younger cohorts starting in the 1990s, thus confirming earlier trends. Improved diagnosis and development of new therapies for asthma may have played a role in the changes observed. Close monitoring of asthma mortality rates is necessary to confirm these trends.

Mortality and potential years of life lost of major kidney diseases among residents in Wuhan in 2014 -2019 / 公共卫生与预防医学

Objective To investigate the epidemiological characteristics of major kidney disease deaths and the potential years of life lost among residents in Wuhan from 2014 to 2019, and to provide a scientific basis for the prevention and treatment of kidney diseases. Methods The major kidney diseases deaths among residents in Wuhan during 2014-2019 were collected from the population-based Mortality Surveillance System. The standardized mortality rate and potential years of life lost rate (PYLLR) of major kidney diseases among residents in different ages and genders were calculated, and the epidemiological characteristics and trends were analyzed. Results There were 4 100 deaths (2 380 in male and 1 720 in female) from major kidney diseases among residents in Wuhan between 2014 to 2019, with an age-standardized mortality rate of 6.22/100 000. The mortality rate of major kidney diseases showed an upward trend with the increasing age groups. The age-standardized mortality rate and the age-standardized potential years of life lost rate (SPYLLR) in glomerular disease and tubulo-interstitial diseases were significantly decreased (P＜0.05). The age-standardized mortality rate of the kidney failure was significantly increased (P＜0.05), especially in the male (APC=25.10% , P＜0.05). Conclusion From 2014 to 2019, there was no significant change in the overall mortality rate of major kidney diseases among residents in Wuhan. The death burden and disease burden of glomerular diseases and tubulo-interstitial diseases were significantly decreased, while the mortality rate of male kidney failure was significantly increased, indicating the need for targeted prevention and treatment of kidney diseases.

Mortality and years of life lost of lung cancer among residents in Pudong New Area of Shanghai from 1995 to 2021 / 上海预防医学

ObjectiveTo investigate the epidemiological traits and potential years of life lost associated with lung cancer mortality among inhabitants of Shanghai's Pudong New Area from 1995 to 2021， in order to serve as a reference for developing intervention approaches. MethodsThe death surveillance system was used to gather statistics on lung cancer deaths. Crude mortality rate （CMR）， standardized mortality rate （SMR）， potential years of life lost （PYLL）， average years of life lost （AYLL）， annual percent change （APC） of the lung cancer deaths were analyzed. The impact of age-structural and non-age-structural factors on changes in lung cancer mortality was quantified using difference decomposition. ResultsThe CMR and SMR of lung cancer among residents in Pudong New Area between 1995 and 2021 were 58.21/105 and 26.75/105， respectively. The CMR of lung cancer increased over the years （APC=1.91%， 95%CI=1.60%‒2.30%； Z=11.487， P<0.001）， and the SMR of lung cancer declined over the years （APC=-1.50%， 95%CI=-1.80%‒-1.20%； Z=-9.006， P<0.001）. Age structure factors and gender factors contributed to the increase of lung cancer mortality， while non-population age structure factors overall appeared to play a protective role which might be related to the improvements in factors such as tobacco control and environmental management. The PYLL of lung cancer was 160 296 person years， the PYLL rate was 2.24‰， and the AYLL was 3.86 years per person. ConclusionAge structure factors are a significant contributor to the disease burden and result in the increase in the crude lung cancer mortality rate of Pudong residents of shanghai. Comprehensive monitoring， preventive， and control methods should be implemented.

Asthma Mortality in Spain From 1980 to 2019: Trends and Perspectives in the New Treatment Era

Background: Previous studies suggest that asthma mortality rates in Spain have been decreasing in recent years. However, this trend is not homogeneous across age groups. Objective: To analyze asthma mortality rates over a 40-year period, focusing on changes associated with the development of new therapeutic approaches. Methods: Death records and mid-year population data were collected from the National Statistics Institute. Using the direct method, agestandardized mortality rates were calculated for the overall population and for each sex and age group. Significant changes in mortality trends were identified using joinpoint regression analysis. The independent effects of age, period, and cohort and potential years of life lost due to asthma were also analyzed. Results: Age-standardized asthma mortality rates decreased in Spain from 7.38 to 2.03 deaths per 100 000 from the first to the last quinquennium of the study (1980-1984 to 2015-2019) for the whole population. This decrease was more intense among men, where a decrease from 10.37/100 000 to 0.91/100 000 was observed compared with 5.53 to 2.77/100 000 in women. Mortality decreased in all age groups. During the last 3 years, the decrease stabilized in patients aged >64 years but increased in those aged 35-64. Mortality has been decreasing rapidly since the 1990s in patients aged <35 years. Conclusion: Asthma mortality rates began to decline in 1980. The decrease was observed among younger cohorts starting in the 1990s, thus confirming earlier trends. Improved diagnosis and development of new therapies for asthma may have played a role in the changes observed. Close monitoring of asthma mortality rates is necessary to confirm these trends (AU)

Introducción: Estudios previos sugieren que las tasas de mortalidad en España han disminuido en los últimos años, aunque esta tendencia no se ha observado de forma homogénea en todos los grupos de edad. Objetivo: Se analizan las tasas de mortalidad por asma de los últimos 40 años en España, centrándose en los cambios relacionados con el desarrollo de nuevas terapias. Métodos: Se obtuvieron los registros de defunción y los datos de población del Instituto Nacional de Estadística. Se calcularon las tasas de mortalidad estandarizadas por edad utilizando el método directo para la población global y para cada sexo y grupos de edad. Se identificaron cambios significativos en las tendencias de mortalidad mediante modelos de regresión Joinpoint (puntos de cambio). También se analizaron los efectos de la edad, período y cohorte, y se calcularon los años potenciales de vida perdidos debido al asma. Resultados: Las tasas de mortalidad estandarizadas por asma disminuyeron en España de 7,38 a 2,03 muertes por 100.000 entre el primer y el último quinquenio del estudio (1980-1984 a 2015-2019) para la población general. Esta disminución fue más intensa entre los hombres, donde se observó una disminución de 10,37/100.000 a 0,91/100.000 frente a 5,53 a 2,77 / 100.000 en las mujeres. Todos los grupos de edad han reducido su mortalidad globalmente en el periodo estudiado. Mientras que los mayores de 64 años han estabilizado su descenso y la población entre 35 y 64 incluso ha incrementado la mortalidad en los últimos 3 años, los menores de 35 años mantienen un rápido descenso desde la década de 1990. Conclusión: Hay una disminución en las tasas de mortalidad por asma a partir de 1980, incluidas las cohortes más jóvenes a partir de la década de 1990, lo que confirma tendencias anteriores. Las mejoras en el diagnóstico y el desarrollo de nuevas terapias para el asma pueden tener un papel en estos hallazgos (AU)

Early physicians' mortality in Espírito Santo: a decade trend.

Introduction: Mortality data make it possible to develop indicators to guide the planning of health promotion and prevention actions in order to reduce mortality from preventable causes. However, there are no publications on physicians' mortality in the state of Espírito Santo, Brazil. Objectives: To describe mortality distribution and potential years of life lost from 2006 to 2015 among physicians who lived in Espírito Santo. Methods: This is a descriptive study of secondary data from the Mortality Information System of the Brazilian Ministry of Health. The distribution of socio-demographic variables and of basic cause of death was studied by absolute and relative frequencies. Potential years of life lost in each death were considered the years remaining from age at death up to the age limit of 70 years. Results: There were 20 deaths of female physicians (14.5%) and 118 (85.5%) of male physicians, with predominance of whites (87.9%) and married (56%) individuals. The main causes of death were neoplasms (39.1%), diseases of the circulatory system (19.6%), and external causes (19.6%). The majority of female and male deaths occurred from 60 to 69 years, but average death was significantly lower among women compared to men (respectively 58.3 and 67.0 years). Potential years of life lost totaled 1,226 years, with a mean of 14.6, which was greater in women (20.4) compared to men (13.4). Conclusions: Mortality trends observed in the general population were also present among physicians in Espírito Santo. However, contrary to the general population pattern, average death age was lower in women. Early mortality caused many lost years of life, especially among women.

Situación del suicidio en Antioquia-Colombia durante los años 2016 y 2017: Resultados de los datos de vigilancia epidemiológica

Introducción: la vigilancia epidemiológica del suicidio en una región permite identificar los patrones, la distribución y las características con que ocurre y sentar las bases de intervenciones para prevenirlo. Objetivo: describir la situación del suicidio en Antioquia para el periodo 2016-2017. Métodos: estudio descriptivo basado en datos del Sistema de Vigilancia Epidemiológica de Lesiones de Causa Externa del Instituto Nacional de Medicina Legal y Ciencias forenses. Se calcularon las tasas de suicidio y los años de vida potencialmente perdidos (AVPP) y se describieron las circunstancias del evento. Resultados: hubo 425 suicidios en 2016 y 419 en el 2017, con una tasa de suicidio de 6,50 y 6,34 por 100.000 habitantes/año respectivamente, y 16.446,8 AVPP para 2016 y 16.019,94 para 2017. La mayor parte de los suicidios se presentó en el sexo masculino, en los grupos de edad jóvenes, residentes en área urbana y estado civil soltero. Con respecto a las características del suicidio, el mecanismo más frecuentemente utilizado fue la asfixia mecánica seguido por el envenenamiento, en cerca del 40% de los casos se estableció un evento vital desencadenante como los conflictos de pareja, y se presentaron con mayor frecuencia los días domingo y lunes y en la noche y madrugada. Conclusión: las tasas de suicidio en Antioquia se han incrementado en 2016 y 2017 con respecto a años anteriores. Es más frecuente en hombres y en edades económicamente productivas, lo que explica los altos AVPP. La descripción de las características del suicidio podría facilitar la discusión de intervenciones preventivas.

Summary Background: Identifying the patterns, distribution, and characteristics of suicide in a region is possible with epidemiological surveillance which may lay the foundations for suicide prevention. Objective: To describe the situation of suicide in Antioquia during the period 2016-2017. Methods: Descriptive study based on data from the Epidemiological Surveillance System for External Cause Injuries of the National Institute of Legal Medicine and Forensic Sciences. Suicides rates and Years of Life Lost (YLL) were calculated and the circumstances of the event were described. Results: There were 425 suicides in 2016 and 419 in 2017, with a suicides rate of 6.50 and 6.34 per 100,000 inhabitants/year respectively, and 16,446.8 YLL for 2016 and 16,019.94 YLL for 2017. Most of the suicides occurred in males, in young age groups, urban residents and single marital status. Regarding the characteristics of suicide, the most frequently used mechanism was mechanical asphyxia followed by poisoning, in about 40% of cases a triggering life event was established, such as partner conflicts, and were more frequent on Sunday and Monday and at night and early morning. Conclusion: The incidence of suicide in Antioquia increased in 2016 and 2017 compared to previous years. It was more frequent in economically productive ages, which explains the high YLL. The description of the characteristics of suicide may facilitate the discussion of preventive interventions.

Disparities in premature mortality: Evidence for the OECD countries.

This paper studies the existence of international health outcome disparities. We focus on the use of the potential years of life lost for a database that includes information from 33 OECD countries and covers the period 1990-2017. The methodology proposed by Phillips and Sul (2007) allows us to reject the existence of a single pattern of behaviour between countries for both males and females, suggesting the existence of severe health outcome inequalities. This methodology estimates the existence of four convergence clubs whose composition slightly varies when comparing the male and female cases. Some socioeconomic factors are found to be very important in explaining the forces that may drive the creation of these convergence clubs. In particular, the evolution of the economy and health policies are pivotal to understanding the creation of these estimated convergence clubs. Additionally, our results offer evidence in favor of the importance of environmental policies to explain these health outcome differences.

Tuberculosis Mortality in Children under Fifteen Years of Age: Epidemiological Situation in Colombia, 2010-2018.

Pediatric tuberculosis is a serious infectious disease and a hidden global epidemic. The objective of this study was to describe the epidemiological situation of tuberculosis mortality in children under 15 years of age in Colombia in the period 2010-2018. A longitudinal descriptive study was conducted. The variables sex, age groups, and origin were studied. This study had 260 cases for analysis and was carried out in three phases. The first phase was the determination of the sociodemographic and clinical characteristics. The second phase was the construction of indicators by territorial entities. The third phase was stratification into four epidemiological situations according to the mortality rate and years of life lost. The median age was 7 years (range 0-14), 66.5% of cases were pulmonary tuberculosis (97.7% without bacteriological confirmation), 14.3781 years of life lost were recorded (95% CI: 142.811-168.333), and in children under 10-14 years, the loss was 110,057. Amazonas had the highest adjusted YLL rate (3979.7). In total, 36.4% of the territories had a high mortality, and 30.3% adjusted to the situation designated as 1. This is the first study that has used composite indicators to address the problem of premature mortality from childhood tuberculosis in Colombia. Our results allow us to specify that this disease remains a challenge for public health. It requires models of care and differential strategies by region. It also requires ensuring opportunities in diagnosis with sensitive methods, as well as intersectoral work for the optimal approach.

Potential years of life lost to cancer in Mato Grosso, stratified by sex: 2000 to 2019 / Anos potenciais de vida perdidos por câncer em Mato Grosso, estratificados por sexo: 2000 a 2019

Aim: To estimate the potential years of life lost (PYLL) to cancer in the State of Mato Grosso, from 2000 to 2019, stratified by sex, according to age groups and cancer types. Methods: It is a quantitative study with ecological approach, developed from secondary data, using the PYLL and its derivatives. Results: In the period analyzed, deaths from cancer in Mato Grosso resulted in 680,338 PYLL before the age of 80, with a variation of 82.5%. Of this total, 52.7% were assigned to males. The rate of the PYLL for cancer before the age of 60 was 70.9% in males, and 80.1% among women. The rates of PYLL increased in the period and showed slightly higher values in males. In the analysis according to age group, the rates of PYLL were also higher in males, except between the ages of 30 and 49. Lung cancers and lymphomas/leukemias resulted in greater losses of PYLL among men and those specifically female (breast, cervix and body of the uterus, and ovarian) accounted for 36.26% of the PYLL among women, with variability per age groups. Conclusion: In Mato Grosso, the PYLL indicator for cancer presented unfavorable evolution between 2000 and 2019, with greater damage for males and for the younger population. Leukemias, lymphomas, and lung and breast cancers were the main causes for the PYLL.

Objetivo: Estimar os anos potenciais de vidas perdidos (APVP) por câncer no Estado de Mato Grosso, no período de 2000 a 2019, estratificados por sexo, segundo faixas etárias e tipos de câncer. Métodos: Trata-se de um estudo quantitativo, com abordagem ecológica a partir de dados secundários, utilizando-se o indicador APVP e seus derivados. Resultados: No período analisado, as mortes por câncer em Mato Grosso resultaram em 680.338 APVP antes dos 80 anos, com variação de 82,5%. Desse total, 52,7% foram atribuídos ao sexo masculino. O peso dos APVP por câncer antes dos 60 anos foi de 70,9% no sexo masculino e 80,1% entre as mulheres. As taxas de APVP aumentaram no período e apresentaram valores ligeiramente mais elevados entre os homens. Na análise segundo faixas etárias, as taxas de APVP também foram maiores entre os homens, exceto entre 30 e 49 anos. Os cânceres de pulmão e linfomas/leucemias resultaram em maiores perdas de APVP entre os homens e os de especificidade feminina (mama, colo e corpo do útero e ovário) responderam por 36,26% dos APVP entre as mulheres, com variabilidade por faixas etárias. Conclusão: Em Mato Grosso, o indicador APVP por câncer apresentou evolução desfavorável entre 2000 e 2019, com maior prejuízo para o sexo masculino e para a população mais jovem. As leucemias, linfomas e os cânceres de pulmão e mama foram os principais responsáveis pelos APVP.

Mortality trend and analysis of potencial years of life lost due to leukemia and lymphoma in Brazil and Mato Grosso / Tendência de mortalidade e análise de anos potenciais de vida perdidos por leucemias e linfomas no Brasil e Mato Grosso

Objective: To estimate the mortality trend and analyze the potential years of life lost (PYLL) due to leukemias and lymphomas in Brazil and Mato Grosso, from 2001 to 2019. Methods: Time-series study of deaths from leukemias and lymphomas obtained from the Mortality Information System. Trends were calculated by age group by the Joinpoint regression method, using calendar year as regressor variable, and estimated annual percentage change (APC) and mean annual percentage change, considering 95% confidence intervals. APVP rates were collected from the Cancer Mortality Altas. Results: In Brazil, the mortality rate trend showed stability for both diseases, leukemias (APC=0.2; 95%CI-0.0;0.3) and lymphomas (APC=0.2; 95%CI-0.4;0.1). In the state, the rate for leukemias also showed stability (APC=0.3; 95%CI-1.0;1.6). For lymphomas, the trend was upward (APC=2.3; 95%CI0.5;4.2), however, decreasing trend was observed among those younger than 59 years. For leukemias, the APVP rates were 64 and 65/100,000 in Brazil and Mato Grosso, respectively. For lymphomas, these rates were 27 and 22/100,000, respectively, with the highest rates found in males. Conclusion: The mortality rates from leukemia and lymphoma in Mato Grosso show a behavior different from that observed nationally, with an increasing trend for lymphomas and no differences between age groups for both diseases. The APVP rates for leukemias were similar, however, for lymphomas, it was higher among men and lower for the state when compared to Brazil.

Objetivo: Estimar a tendência de mortalidade e analisar os anos potenciais de vida perdidos (APVP) por leucemias e linfomas no Brasil e Mato Grosso, entre os anos de 2001 a 2019. Métodos: Estudo de série temporal de óbitos por leucemias e linfomas obtidos do Sistema de Informações sobre Mortalidade. As tendências foram calculadas por faixa etária pelo método de regressão Joinpoint, usando ano calendário como variável regressora, e estimadas a variação percentual anual (APC) e variação percentual média anual, considerando intervalos de confiança de 95%. As taxas de APVP foram coletadas do Altas de Mortalidade por câncer. Resultados: No Brasil, a tendência da taxa de mortalidade apresentou estabilidade para ambos os agravos, leucemias (APC=0,2; IC95%-0,0;0,3) e linfomas (APC=0,2; IC95%-0,4;0,1). No estado, a taxa por leucemias também apresentou estabilidade (APC=0,3; IC95%-1,0;1,6). Para os linfomas, a tendência foi de aumento (APC=2,3; IC95%0,5;4,2), contudo, tendência decrescente foi observada entre aqueles com menos de 59 anos. Para leucemias, as taxas de APVP foram de 64 e 65/100.000 no Brasil e no Mato Grosso, respectivamente. Para linfomas, esses valores foram de 27 e 22/100.000, respectivamente, sendo as maiores taxas encontradas no sexo masculino. Conclusão: As taxas de mortalidade por leucemias e linfomas no Mato Grosso apresentam comportamento diferente do observado nacionalmente, com tendência crescente para linfomas e sem diferenças entre as faixas etárias, para ambos os agravos. As taxas de APVP por leucemias foram semelhantes, no entanto, para os linfomas, foi maior entre os homens e menores para o estado, quando comparadas as do Brasil.