scholarly journals Widowhood and mortality: a Danish nationwide register-based cohort study

2020 ◽  
Vol 29 ◽  
Author(s):  
C. Blanner ◽  
A. Mejldal ◽  
A. M. Prina ◽  
P. Munk-Jørgensen ◽  
A. K. Ersbøll ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Oldest Old ◽  
Older Age ◽  
Spousal Loss ◽  
Married People ◽  
External Causes ◽  
Rate Ratios ◽  
Almost All

Abstract Aims Widowed people have increased mortality compared to married people of the same age. Although most widowed people are of older age, few studies include the oldest old. As life expectancy is increasing, knowledge of widowhood into older age is needed. This study aimed to examine mortality and widowhood in older age by comparing mortality in widowed and married people by sex, age, time since spousal loss and cause of death. Methods A Danish register-based matched cohort study of 10% of widowed persons ⩾65 years in the years 2000–2009. For each randomly drawn widowed person, five married persons were matched on sex and age. Mortality rate ratios (MRR) were calculated using Poisson regression, and stratified according to sex and 5-year age intervals. MRRs were furthermore calculated by time since spousal loss and by specific cause of death. Results The study included 82 130 persons contributing with 642 914.8 person-years. The overall MRR between widowed and married persons with up to 16 years of follow-up was 1.25 (95% CI 1.23–1.28). At age ⩾95 years for men, and ⩾90 years for women, no differences in mortality rates were seen between widowed and married persons. Mortality in widowed persons was increased for most specific causes of death, with the highest MRR from external causes (MRR 1.53 [1.35–1.74]) and endocrine diseases (MRR 1.51 [1.34–1.70]). Conclusions Widowhood was associated with increased mortality in older age for both men and women until age ⩾95 and ⩾90 years, respectively. Increased mortality was observed for almost all causes of death.

scholarly journals Induced abortion according to immigrants’ birthplace: a population-based cohort study

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Susitha Wanigaratne ◽  
Mei-ling Wiedmeyer ◽  
Hilary K. Brown ◽  
Astrid Guttmann ◽  
Marcelo L. Urquia
Keyword(s):  
Cohort Study ◽  
Birth Order ◽  
Western Europe ◽  
Population Based ◽  
Induced Abortion ◽  
Income Quintile ◽  
Refugee Status ◽  
Unintended Pregnancies ◽  
Rate Ratios ◽  
Almost All

Abstract Background Most abortions occur due to unintended pregnancy. Unintended pregnancies are linked to poor health outcomes. Canada receives immigrants from countries with disparate sexual and reproductive health contexts which may influence abortion rates post-migration. We examined the association between abortion and region of birth and birth order among Canadian immigrants. Methods We conducted a population-based person-years (PY) cohort study in Ontario, Canada using administrative immigration (1991–2012) and health care data (1991–2013). Associations between induced abortion and an immigrant’s region of birth were estimated using poisson regression. Rate ratios were adjusted for age, landing year, education, neighborhood income quintile and refugee status and stratified by birth order within regions. Results Immigrants born in almost all world regions (N = 846,444) were 2–5 times more likely to have an induced abortion vs. those born in the US/Northern & Western Europe/Australia & New Zealand (0.92 per 100 PY, 95% CI 0.89–0.95). Caribbean (Adjusted Rate Ratio [ARR] = 4.71, 95% CI 4.55–4.87), West/Middle/East African (ARR = 3.38, 95% CI 3.26–3.50) and South American (ARR = 3.20, 95% CI 3.09–3.32) immigrants were most likely to have an abortion. Most immigrants were less likely to have an abortion after vs. prior to their 1st birth, except South Asian immigrants (RR = 1.60, 95% CI 1.54–1.66; RR = 2.23, 95% CI 2.12–2.36 for 2nd and 3rd vs 1st birth, respectively). Secondary analyses included further stratifying regional models by year, age, education, income quintile and refugee status. Conclusions Induced abortion varies considerably by both region of birth and birth order among immigrants in Ontario.

scholarly journals Mortality among Italian male workers in the construction industry: a census-based cohort study

2019 ◽  
Vol 30 (2) ◽  
pp. 247-252 ◽  
Author(s):  
Gianfranco Alicandro ◽  
Paola Bertuccio ◽  
Gabriella Sebastiani ◽  
Carlo La Vecchia ◽  
Luisa Frova
Keyword(s):  
Cohort Study ◽  
Construction Industry ◽  
Excess Mortality ◽  
Geographic Area ◽  
Construction Workers ◽  
Skin Cancers ◽  
High Prevalence ◽  
External Causes ◽  
Rate Ratios ◽  
Melanoma Skin

Abstract Background Advances in technologies, occupational hygiene and increased surveillance have reduced the excess mortality previously found in the construction industry. This study is aimed to evaluate cause-specific mortality in a recent cohort of construction workers. Methods We carried out a record-linkage cohort study based on the 2011 Italian census and the mortality archives (2012–2015), including 1 068 653 construction workers. We estimated mortality rate ratios (MRR) using Poisson regression models including terms for age and geographic area. Results Compared with non-manual workers, construction workers showed an excess mortality from all causes (MRR: 1.34), all neoplasms (MRR: 1.30), head and neck (MRR: 2.05), stomach (MRR: 1.56), liver (MRR: 1.62), lung (MRR: 1.80), prostate (MRR: 1.24) and bladder (MRR: 1.60) cancers, respiratory (MRR: 1.41) and liver (MRR: 1.79) diseases, all external causes (MRR: 1.87), falls (MRR: 2.87) and suicide (MRR: 1.58). Compared with manual workers in other industries, construction workers showed excess mortality from prostate (MRR: 1.27) and non-melanoma skin cancers (MRR: 1.95), all external causes (MRR: 1.14), falls (MRR: 1.94) and suicide (MRR: 1.18). Most of this excess mortality disappeared after adjusting for education, with the exception of prostate and non-melanoma skin cancers, all external causes, falls and suicide. Conclusions Construction workers are at high risk of dying from external causes, while the excess mortality found for several cancers, liver and respiratory diseases may be at least partially due to the high prevalence of low education and unfavorable lifestyle factors. The excess mortality from prostate cancer requires further evaluations.

scholarly journals Measuring Substance-Related Disorders Using Canadian Administrative Health Databanks: Interprovincial Comparisons of Recorded Diagnostic Rates, Incidence Proportions and Mortality Rate Ratios

2021 ◽  
pp. 070674372110434
Author(s):  
Christophe Huỳnh ◽  
Steve Kisely ◽  
Louis Rochette ◽  
Éric Pelletier ◽  
Kenneth B. Morrison ◽  
...  
Keyword(s):  
Nova Scotia ◽  
Mortality Rate ◽  
Causes Of Death ◽  
International Classification Of Diseases ◽  
Vital Statistics ◽  
Canadian Provinces ◽  
Administrative Health Databases ◽  
Rate Ratios ◽  
Almost All ◽  
Substance Related Disorders

Context Assessing temporal changes in the recorded diagnostic rates, incidence proportions, and health outcomes of substance-related disorders (SRD) can inform public health policymakers in reducing harms associated with alcohol and other drugs. Objective To report the annual and cumulative recorded diagnostic rates and incidence proportions of SRD, as well as mortality rate ratios (MRRs) by cause of death among this group in Canada, according to their province of residence. Methods Analyses were performed on linked administrative health databases (AHD; physician claims, hospitalizations, and vital statistics) in five Canadian provinces (Alberta, Manitoba, Ontario, Québec, and Nova Scotia). Canadians 12 years and older and registered for their provincial healthcare coverage were included. The International Classification of Diseases (ICD-9 or ICD-10 codes) was used for case identification of SRD from April 2001 to March 2018. Results During the study period, the annual recorded SRD diagnostic rates increased in Alberta (2001–2002: 8.0‰; 2017–2018: 12.8‰), Ontario (2001–2002: 11.5‰; 2017–2018: 14.4‰), and Nova Scotia (2001–2002: 6.4‰; 2017–2018: 12.7‰), but remained stable in Manitoba (2001–2002: 5.5‰; 2017–2018: 5.4‰) and Québec (2001–2002 and 2017–2018: 7.5‰). Cumulative recorded SRD diagnostic rates increased steadily for all provinces. Recorded incidence proportions increased significantly in Alberta (2001–2002: 4.5‰; 2017–2018: 5.0‰) and Nova Scotia (2001–2002: 3.3‰; 2017–2018: 3.8‰), but significantly decreased in Ontario (2001–2002: 6.2‰; 2017–2018: 4.7‰), Québec (2001–2002: 4.1‰; 2017–2018: 3.2‰) and Manitoba (2001–2002: 2.7‰; 2017–2018: 2.0‰). For almost all causes of death, a higher MRR was found among individuals with recorded SRD than in the general population. The causes of death in 2015–2016 with the highest MRR for SRD individuals were SRD, suicide, and non-suicide trauma in Alberta, Ontario, Manitoba, and Québec. Discussion Linked AHD covering almost the entire population can be useful to monitor the medical service trends of SRD and, therefore, guide health services planning in Canadian provinces.

scholarly journals O6A.6 Mortality experience of in women in south african mining: 2013 – 2015

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A52.2-A52
Author(s):  
Kerry Wilson ◽  
Tahira Kootbodien ◽  
Nisha Naicker
Keyword(s):  
South Africa ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Smoking Status ◽  
Multiple Logistic Regression Analysis ◽  
Registration Data ◽  
Vital Registration Data ◽  
External Causes Of Death ◽  
Underlying Cause Of Death ◽  
External Causes

Mining is a high-risk industry with both continued accidents and occupational disease, despite controls introduced in the industry. In this study, we looked at the sex differences in mortality between male and female miners in South Africa.MethodsThe use of vital registration data for monitoring mortality in miners has largely been unexplored in South Africa. Statistics South Africa provides data from 2013 to 2015 which was used in students-t-tests along with proportion tests to investigate differences between death in all women and women miners along with differences in deaths in male miners and women miners. Multiple logistic regression analysis was performed to calculate mortality odds ratios (MORs) for the underlying cause of death in these groups, with adjustments for age, education level, province of death and smoking status.ResultsOf the 8769 deaths recorded with occupation miner ion the years 2013–2015, only 5.7% were in females. Significant differences between all women and women miners were found in age at death (58.8 vs 47.8), no 1 cause of death (ill-defined vs TB) and education (43.6% vs 63.6%). MORs were significantly increased in women miners for TB, HIV and external causes of death compared to all women while being protected from lifestyle and chronic diseases. Women miners compared to male miners had increased odds of HIV death and lifestyle diseases but a similar risk of external causes of death.DiscussionWomen miners appear to die at significantly younger ages than both male miners and other women despite a higher level of education. This may be due to the increased mortality due to HIV and external causes of death. Thus increased controls are required on mines to protect the health of women miners.

scholarly journals Variation in Cause-Specific Mortality Rates in Italy during the First Wave of the COVID-19 Pandemic: A Study Based on Nationwide Data

2022 ◽  
Vol 19 (2) ◽  
pp. 805
Author(s):  
Enrico Grande ◽  
Ugo Fedeli ◽  
Marilena Pappagallo ◽  
Roberta Crialesi ◽  
Stefano Marchetti ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Causes Of Death ◽  
Mortality Rates ◽  
Cerebrovascular Diseases ◽  
Suicide Mortality ◽  
Lombardy Region ◽  
Epidemic Area ◽  
Specific Mortality ◽  
External Causes Of Death ◽  
External Causes

Italy was a country severely hit by the first coronavirus disease 2019 (COVID-19) pandemic wave in early 2020. Mortality studies have focused on the overall excess mortality observed during the pandemic. This paper investigates the cause-specific mortality in Italy from March 2020 to April 2020 and the variation in mortality rates compared with those in 2015–2019 regarding sex, age, and epidemic area. Causes of death were derived from the national cause-of-death register. COVID-19 was the leading cause of death among males and the second leading cause among females. Chronic diseases, such as diabetes and hypertensive, ischemic heart, and cerebrovascular diseases, with decreasing or stable mortality rates in 2015–2019, showed a reversal in the mortality trend. Moreover, mortality due to pneumonia and influenza increased. No increase in neoplasm mortality was observed. Among external causes of death, mortality increased for accidental falls but reduced for transport accidents and suicide. Mortality from causes other than COVID-19 increased similarly in both genders and more at ages 65 years or above. Compared with other areas in Italy, the Lombardy region showed the largest excess in mortality for all leading causes. Underdiagnosis of COVID-19 at the beginning of the pandemic may, to some extent, explain the mortality increase for some causes of death, especially pneumonia and other respiratory diseases.

scholarly journals Causes of Death at Very Old Ages, Including for Supercentenarians

2020 ◽  
pp. 69-84
Author(s):  
France Meslé ◽  
Jacques Vallin
Keyword(s):  
Cause Of Death ◽  
Causes Of Death ◽  
Oldest Old ◽  
Very Old ◽  
Multiple Causes Of Death ◽  
The People ◽  
Health Event ◽  
Interesting Discussion ◽  
Age Range ◽  
Multiple Causes

AbstractThe causes of death reported on the death certificates of the oldest old are generally seen as unreliable, and as thus providing little useful information on the process leading to death. However, in advanced countries, a majority of the people who die each year are relatively old, and the level of detail provided on medical certificates about the causes of death among this older population is improving. At the same time, scholars are becoming increasingly interested in studying not just the initial cause of death, but multiple causes of death, thereby taking all of the information reported on the certificate into account. This study demonstrates that in a country like France, the cause-of-death pattern evolves regularly until around age 105. The share of people dying of circulatory diseases tends to be quite stable over the age range, while the share of individuals dying of cancer is declining, and the share of people dying of respiratory/infectious diseases is rising. Furthermore, among people who die at very old ages, a typology of multiple causes of death highlights the growing importance of ill-defined causes, while opening the door to an interesting discussion about the concept of cause of death in the supercentenarian population. Instead of representing an ill-defined cause, senility could be considered an actual cause of death. This suggests that daily care is more crucial to the survival of the oldest old than any conventional medical care or treatment. Supercentenarians tend to be so frail that any minor health event or brief lapse of attention on the part of their caregivers can be lethal.

scholarly journals Causes of Death in People With Cardiovascular Disease: A UK Biobank Cohort Study

2021 ◽  
Author(s):  
Michael Drozd ◽  
Mar Pujades‐Rodriguez ◽  
Fei Sun ◽  
Kevin N. Franks ◽  
Patrick J. Lillie ◽  
...  
Keyword(s):  
Cohort Study ◽  
Incidence Rate ◽  
Causes Of Death ◽  
Sociodemographic Factors ◽  
Cardiovascular Death ◽  
Uk Biobank ◽  
Personalized Care ◽  
Adjusted Incidence Rate ◽  
Rate Ratios ◽  
Adjusted Incidence

Background Therapeutic advances have reduced cardiovascular death rates in people with cardiovascular diseases (CVD). We aimed to define the rates of cardiovascular and noncardiovascular death in people with specified CVDs or accruing cardiovascular multimorbidity. Methods and Results We studied 493 280 UK residents enrolled in the UK Biobank cohort study. The proportion of deaths attributed to cardiovascular, cancer, infection, or other causes were calculated in groups defined by 9 distinct self‐reported CVDs at baseline, or by the number of these CVDs at baseline. Poisson regression analyses were then used to define adjusted incidence rate ratios for these causes of death, accounting for sociodemographic factors and comorbidity. Of 27 729 deaths, 20.4% were primarily attributed to CVD, 53.6% to cancer, 5.0% to infection, and 21.0% to other causes. As cardiovascular multimorbidity increased, the proportion of cardiovascular and infection‐related deaths was greater, contrasting with cancer and other deaths. Compared with people without CVD, those with 3 or more CVDs experienced adjusted incidence rate ratios of 7.0 (6.2–7.8) for cardiovascular death, 4.4 (3.4–5.6) for infection death, 1.5 (1.4–1.7) for cancer death, and 2.0 (1.7–2.4) for other causes of death. There was substantial heterogeneity in causes of death, both in terms of crude proportions and adjusted incidence rate ratios, among the 9 studied baseline CVDs. Conclusions Noncardiovascular death is common in people with CVD, although its contribution varies widely between people with different CVDs. Holistic and personalized care are likely to be important tools for continuing to improve outcomes in people with CVD.

scholarly journals Site-specific cancer mortality inequalities by employment and occupational groups: a cohort study among Belgian adults, 2001–2011

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e015216 ◽  
Author(s):  
Katrien Vanthomme ◽  
Laura Van den Borre ◽  
Hadewijch Vandenheede ◽  
Paulien Hagedoorn ◽  
Sylvie Gadeyne
Keyword(s):  
Cohort Study ◽  
Cancer Mortality ◽  
Mortality Rates ◽  
Temporary Employment ◽  
Occupational Group ◽  
Site Specific ◽  
Specific Cancer ◽  
White Collar Workers ◽  
Rate Ratios ◽  
Almost All

ObjectiveThis study probes into site-specific cancer mortality inequalities by employment and occupational group among Belgians, adjusted for other indicators of socioeconomic (SE) position.DesignThis cohort study is based on record linkage between the Belgian censuses of 1991 and 2001 and register data on emigration and mortality for 01/10/2001 to 31/12/2011.SettingBelgium.ParticipantsThe study population contains all Belgians within the economically active age (25–65 years) at the census of 1991.Outcome measuresBoth absolute and relative measures were calculated. First, age-standardised mortality rates have been calculated, directly standardised to the Belgian population. Second, mortality rate ratios were calculated using Poisson’s regression, adjusted for education, housing conditions, attained age, region and migrant background.ResultsThis study highlights inequalities in site-specific cancer mortality, both related to being employed or not and to the occupational group of the employed population. Unemployed men and women show consistently higher overall and site-specific cancer mortality compared with the employed group. Also within the employed group, inequalities are observed by occupational group. Generally manual workers and service and sales workers have higher site-specific cancer mortality rates compared with white-collar workers and agricultural and fishery workers. These inequalities are manifest for almost all preventable cancer sites, especially those cancer sites related to alcohol and smoking such as cancers of the lung, oesophagus and head and neck. Overall, occupational inequalities were less pronounced among women compared with men.ConclusionsImportant SE inequalities in site-specific cancer mortality were observed by employment and occupational group. Ensuring financial security for the unemployed is a key issue in this regard. Future studies could also take a look at other working regimes, for instance temporary employment or part-time employment and their relation to health.

scholarly journals Causes of death after emergency general surgical admission: population cohort study of mortality

BJS Open ◽  
2021 ◽  
Vol 5 (2) ◽  
Author(s):  
G Ramsay ◽  
J M Wohlgemut ◽  
M Bekheit ◽  
A J M Watson ◽  
J O Jansen
Keyword(s):  
Cohort Study ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Emergency General Surgery ◽  
Care Services ◽  
Patient Admissions ◽  
Population Cohort ◽  
Number Of Patients ◽  
Palliative Care Services ◽  
Population Cohort Study

Abstract Background A substantial number of patients treated in emergency general surgery (EGS) services die within a year of discharge. The aim of this study was to analyse causes of death and their relationship to discharge diagnoses, in patients who died within 1 year of discharge from an EGS service in Scotland. Methods This was a population cohort study of all patients with an EGS admission in Scotland, UK, in the year before death. Patients admitted to EGS services between January 2008 and December 2017 were included. Data regarding patient admissions were obtained from the Information Services Division in Scotland, and cross-referenced to death certificate data, obtained from the National Records of Scotland. Results Of 507 308 patients admitted to EGS services, 7917 died while in hospital, and 52 094 within 1 year of discharge. For the latter, the median survival time was 67 (i.q.r. 21–168) days after EGS discharge. Malignancy accounted for 48 per cent of deaths and was the predominant cause of death in patients aged over 35 years. The cause of death was directly related to the discharge diagnosis in 56.5 per cent of patients. Symptom-based discharge diagnoses were often associated with a malignancy not diagnosed on admission. Conclusion When analysed by subsequent cause of death, EGS is a cancer-based specialty. Adequate follow-up and close links with oncology and palliative care services merit development.

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