The decomposition of life expectancy for age and cause of death in Tuscany, Italy

Abstract Introduction Changing of life expectancy at birth (LE) over time reflects variations of mortality rates of a certain population. Italy is amongst the countries with the highest LE, Tuscany ranks fifth at the national level. The aim of the present work was to evaluate the impact of various causes of death in different age groups on the change in LE in the Tuscany region (Italy) during period 1987-2015. Material and methods Mortality data relative to residents that died during the period between 1987/1989 and 2013/2015 were provided by the Tuscan Regional Mortality Registry. The causes of death taken into consideration were cardiovascular (CVS), respiratory (RESP) and infective (INF) diseases and cancer (TUM). The decomposition of LE gain was realized with software Epidat, using the Pollard’s method. Results The overall LE gain during the period between two three-years periods was 6.7 years for males, with a major gain between 65-89, and 4.5 years for females, mainly improved between 75-89, <1 year for both sexes. The major gain (2.6 years) was attributable to the reduction of mortality for CVS, followed by TUM (1.76 in males and 0.83 in females) and RESP (0.4 in males; 0.1 in females). The major loss of years of LE was attributable to INF (-0.15 in females; -0.07 in males) and lung cancer in females (-0.13), for which the opposite result was observed for males (gain of 0.62 years of LE). Conclusions During the study period (1987-2015) the gain in LE was major for males. To the reduction of mortality for CVS have contributed to the tempestuous treatment of acute CVS events and secondary CVS prevention. For TUM the result is attributable to the adherence of population to oncologic screening programmes. The excess of mortality for INF that lead to the loss of LE can be attributed to the passage from ICD-9 to ICD-10 in 2003 (higher sensibility of ICD-10) and to the diffusion of multi-drug resistant bacteria, which lead to elevated mortality in these years. Key messages The gain in LE during the period the 1987-2015 was higher in males. The major contribution to gain in LE was due to a reduction of mortality for CVS diseases.

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How have changes in death by cause and age group contributed to the recent stalling of life expectancy gains in Scotland? Comparative decomposition analysis of mortality data, 2000–2002 to 2015–2017

BMJ Open ◽

10.1136/bmjopen-2019-036529 ◽

2020 ◽

Vol 10 (10) ◽

pp. e036529

Author(s):

Julie Ramsay ◽

Jon Minton ◽

Colin Fischbacher ◽

Lynda Fenton ◽

Maria Kaye-Bardgett ◽

...

Keyword(s):

Life Expectancy ◽

Cause Of Death ◽

Age Groups ◽

Decomposition Analysis ◽

Future Research ◽

Mortality Data ◽

Age Group ◽

Mortality Trends ◽

Life Expectancy At Birth ◽

The Impact

ObjectiveAnnual gains in life expectancy in Scotland were slower in recent years than in the previous two decades. This analysis investigates how deaths in different age groups and from different causes have contributed to annual average change in life expectancy across two time periods: 2000–2002 to 2012–2014 and 2012–2014 to 2015–2017.SettingScotland.MethodsLife expectancy at birth was calculated from death and population counts, disaggregated by 5 year age group and by underlying cause of death. Arriaga’s method of life expectancy decomposition was applied to produce estimates of the contribution of different age groups and underlying causes to changes in life expectancy at birth for the two periods.ResultsAnnualised gains in life expectancy between 2012–2014 and 2015–2017 were markedly smaller than in the earlier period. Almost all age groups saw worsening mortality trends, which deteriorated for most cause of death groups between 2012–2014 and 2015–2017. In particular, the previously observed substantial life expectancy gains due to reductions in mortality from circulatory causes, which most benefited those aged 55–84 years, more than halved. Mortality rates for those aged 30–54 years and 90+ years worsened, due in large part to increases in drug-related deaths, and dementia and Alzheimer’s disease, respectively.ConclusionFuture research should seek to explain the changes in mortality trends for all age groups and causes. More investigation is required to establish to what extent shortcomings in the social security system and public services may be contributing to the adverse trends and preventing mitigation of the impact of other contributing factors, such as influenza outbreaks.

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How have changes in death by cause and age group contributed to the recent stalling of life expectancy gains in Scotland? Comparative decomposition analysis of mortality data, 2000-02 to 2015-17

10.31235/osf.io/q8rme ◽

2019 ◽

Cited By ~ 3

Author(s):

Julie Ramsay ◽

Jonathan Minton ◽

Colin Fischbacher ◽

Lynda Fenton ◽

Maria Kaye-Bardgett ◽

...

Keyword(s):

Life Expectancy ◽

Cause Of Death ◽

Age Groups ◽

Decomposition Analysis ◽

Mortality Data ◽

Age Group ◽

Contributing Factors ◽

Mortality Trends ◽

Life Expectancy At Birth ◽

The Impact

BackgroundAnnual gains in life expectancy in Scotland were slower in recent years than in the previous two decades. This analysis investigates how deaths in different age groups and from different causes have contributed to annual average change in life expectancy across two time periods: 2000-02 to 2012-14 and 2012-14 to 2015-17. MethodsLife expectancy at birth was calculated from death and population counts, disaggregated by five-year age-group and by underlying cause of death. Arriaga’s method of life expectancy decomposition was applied to produce estimates of the contribution of different age-groups and underlying causes to changes in life expectancy at birth for the two periods.FindingsAverage annual life expectancy gains between 2012-14 to 2015-17 were markedly smaller than in the earlier period. Almost all age-groups saw worsening mortality trends, which deteriorated for most cause of death groups between 2012-14 and 2015-17. In particular, the previously observed substantial life expectancy gains due to reductions in mortality from circulatory causes, which most benefited those aged 55-84 years, more than halved. Mortality rates for those aged 30-54 years and 90+ years worsened, due in large part to increases in drug-related deaths, and dementia and Alzheimer’s disease respectively. InterpretationFuture research should seek to explain the changes in mortality trends for all age-groups and causes. More investigation is required to establish to what extent shortcomings in the social security system and public services may be contributing to the adverse trends and preventing mitigation of the impact of other contributing factors, such as influenza outbreaks.

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Gender gap in life expectancy in India and role of age groups: A comparison between before and after male – female life expectancy at birth crossover

PLoS ONE ◽

10.1371/journal.pone.0260657 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0260657

Author(s):

Girimallika Borah

Keyword(s):

Life Expectancy ◽

Gender Gap ◽

Age Groups ◽

Absolute Number ◽

Reproductive Age ◽

Sample Survey ◽

Mortality Data ◽

Female Life Expectancy ◽

Life Expectancy At Birth ◽

Before And After

To assess the gender gap in life expectancy at birth in India and its major states as well as the timing of male-female life expectancy at birth crossover. To analyze the age-specific contributions to the changing gender differences before and after the crossover at the national and sub-national levels. We have used sample-survey-based age-specific mortality data available for the periods 1970–2018 to construct abridged life tables. The contribution of different age groups to the gender gap is estimated by using Arriaga’s method of decomposition. During 1981–85 female life expectancy at birth caught up with male life expectancy at birth for India and by 2005 all major states completed the crossover. The male-female crossover in life expectancy at the national level in the early 80s is remarkable in the face of continued female disadvantage from birth till adolescence, even for some richer states. We provide evidence that gender difference in longevity in favour of females is largely a function of adult age groups and younger age groups contribute negatively to the gender gap in life expectancy at birth in most states. Juxtaposing the results from contribution in an absolute number of years and their relative contribution change before and after the crossover, it is established that although the adult and old age groups contribute the highest in the absolute number of years before and after the crossover, the contribution of the reproductive age groups and childhood years in the recent time is most relevant in relative terms.

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The impact of mortality for infectious diseases on life expectancy at birth in Tuscany, Italy

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.832 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L Kundisova ◽

N Nante ◽

A Martini ◽

F Battisti ◽

L Giovannetti ◽

...

Keyword(s):

Life Expectancy ◽

Infectious Diseases ◽

Antimicrobial Therapy ◽

Geographic Area ◽

Mortality Data ◽

Epidemiologic Transition ◽

Geographical Differences ◽

Life Expectancy At Birth ◽

Hospital Infection Control ◽

The Impact

Abstract Introduction The epidemiologic transition describes the reduction of mortality for infectious diseases (ID), followed by an increase in prevalence of non-communicable diseases. During recent years the situation has changed; an increase in mortality for sepsis was observed. Italy is amongst the countries with the highest prevalence of microorganisms resistant to antimicrobial therapy in Europe. The aim of the present work was to evaluate the impact of mortality for ID on life expectancy (LE) in the Tuscany region(Italy). Methods Mortality data relative to residents that died during the period 2000/2002- 2013/2015 were provided by the Tuscan Regional Mortality Registry. At first the analysis was performed for whole territory, then for geographic area (Nord-Est:NE, Centrum:C, South-East:SE). The analysis was realized with software Epidat,using the Pollard's method of decomposition of variations in LE for age and cause of death. Results The overall gain in LE was 2.9 years for males and 2.6 years for females. The increase in mortality for ID was responsible for the loss of 0.11 years of LE for males vs. 0.16 years for females. The loss was observed in males aged 45-89, for females from 69 years onwards, with the highest loss between 79-89 years. After analysis for area, geographical differences emerged, for both males and females the highest loss of LE was observed for NE (-0.23 years vs.-0.19), followed by C (-0.15 years vs. -0.16) and SE (-0.12 vs. -0.11). Conclusions The result can be partially explained by the transition from ICD-9 to ICD-10 (in 2010), which improved the sensitivity of codification, but also by diffusion of pathogens resistant to antimicrobial therapy. The highest impact of ID was observed in elderly, probably due to the existence of predisposing clinical condition. The ID deserve major attention; the programmes of hospital infection control and antimicrobial stewardship have to be potentiated in order to contain the phenomenon. Key messages During the study period an increase in mortality for infectious diseases comported the loss in terms of LE years. The growing diffusion of microorganisms resistent to antimicrobial therapy could have contributed to the higher mortality rates observed during the last period.

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At-a-glance - The impact of poisoning-related mortality on life expectancy at birth in Canada, 2000 to 2016

Health Promotion and Chronic Disease Prevention in Canada ◽

10.24095/hpcdp.39.2.03 ◽

2019 ◽

Vol 39 (2) ◽

pp. 56-60 ◽

Cited By ~ 4

Author(s):

Heather Orpana ◽

Justin J. Lang ◽

Diana George ◽

Jessica Halverson

Keyword(s):

Life Expectancy ◽

The United States ◽

Mortality Data ◽

Opioid Overdose ◽

Age Group ◽

Life Expectancy At Birth ◽

Current Trends ◽

National Mortality ◽

The Impact ◽

Related Mortality

Increases in opioid-related mortality have contributed to declines in life expectancy at birth in the United States and British Columbia. Canadian national mortality data from 2000 to 2016 were analyzed to determine the contribution of poisoning-related mortality to changes in life expectancy at birth by age group and sex. From 2000 to 2016, life expectancy at birth increased by almost three years; however, mortality due to unintentional poisonings, including those involving opioids, curbed this increase by 0.16 years. Although a national decrease in life expectancy at birth has not been observed in Canada during this period, current trends suggest that the national opioid overdose crisis will continue to attenuate gains to life expectancy.

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Impacto de causas de morte na esperança de vida em São Paulo, 2000 e 2010

Revista de Saúde Coletiva da UEFS ◽

10.13102/rscdauefs.v9i0.4688 ◽

2019 ◽

Vol 9 ◽

pp. 244

Author(s):

Fernando Flores Santos Ribeiro ◽

Eliane Menezes Flores Santos ◽

André Renê Barboni

Keyword(s):

Life Expectancy ◽

Causes Of Death ◽

Sao Paulo ◽

Capital City ◽

São Paulo ◽

Clear Trend ◽

Life Expectancy At Birth ◽

Life Years ◽

The Difference ◽

The Impact

Foi levantado e analisado o impacto de algumas causas de morte na esperança de vida (EV) dos residentes dos bairros centrais e periféricos de São Paulo (capital), 2000 e 2010. Analisou-se a importância dos grupos de causas de óbito na EV, utilizando-se tábuas de vida e a teoria de riscos competitivos. os cinco capítulos da CiD10 analisados abrangem mais de três quartos dos óbitos, em ambos os sexos, nos anos estudados. Nota-se uma clara tendência de envelhecimento de ambas as regiões. A diferença da Esperança de Vida ao Nascer (EVN) entre mulheres e homens do centro e da periferia diminuiu, mas a disparidade entre áreas aumentou. A análise dos Anos Potenciais de Vida Ganhos, através da eliminação do risco de morrer por alguns grupos de causa de morte, mostra diferenças em função da importância relativa que cada grupo tem em cada uma das populações e permite ao gestor estabelecer uma política mais específica e resolutiva que certamente irá se refletir na qualidade de vida. Fica claro que existem duas realidades muito diferentes dentro do mesmo município. Provavelmente isso também é válido para o restante do Brasil.AbstractThe study analyzed the impact of some causes of death in the life expectancy of the central and peripheral districts residents of São Paulo (capital city), 2000 and 2010. the importance of the groups of causes of death was measured by life tables and the theory of competitive risks. The five chapters of ICD10 analyzed cover more than three quarters of deaths in both sexes. there was a clear trend towards aging in both regions. The difference in Life Expectancy at Birth between women and men in the center and the periphery decreased, but the disparity between areas increased. the analysis of the Potential Life Years Earnings by eliminating the risk of dying by some cause of death groups shows differences depending on the relative importance that each group has in each of the populations and allows the manager to establish a more specific policy, which will certainly be reflected in the quality of life. It is clear that there are two very different realities within the same city. This is probably also true for the rest of Brazil

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Declines in Pneumonia Mortality Following the Introduction of Pneumococcal Conjugate Vaccines in Latin American and Caribbean Countries

Clinical Infectious Diseases ◽

10.1093/cid/ciaa614 ◽

2020 ◽

Cited By ~ 1

Author(s):

Lucia H de Oliveira ◽

Kayoko Shioda ◽

Maria Tereza Valenzuela ◽

Cara B Janusz ◽

Analía Rearte ◽

...

Keyword(s):

Latin American ◽

National Level ◽

Temporal Trends ◽

Age Groups ◽

Population Level ◽

Mortality Data ◽

Conjugate Vaccines ◽

Pneumococcal Conjugate Vaccines ◽

The Impact ◽

Latin American And Caribbean

Abstract Background Pneumococcal conjugate vaccines (PCVs) are recommended for use in pediatric immunization programs worldwide. Few data are available on their effect against mortality. We present a multicountry evaluation of the population-level impact of PCVs against death due to pneumonia in children < 5 years of age. Methods We obtained national-level mortality data between 2000 and 2016 from 10 Latin American and Caribbean countries, using the standardized protocol. Time series models were used to evaluate the decline in all-cause pneumonia deaths during the postvaccination period while controlling for unrelated temporal trends using control causes of death. Results The estimated declines in pneumonia mortality following the introduction of PCVs ranged from 11% to 35% among children aged 2–59 months in 5 countries: Colombia (24% [95% credible interval {CrI}, 3%–35%]), Ecuador (25% [95% CrI, 4%–41%]), Mexico (11% [95% CrI, 3%–18%]), Nicaragua (19% [95% CrI, 0–34%]), and Peru (35% [95% CrI, 20%–47%]). In Argentina, Brazil, and the Dominican Republic, the declines were not detected in the aggregated age group but were detected in certain age strata. In Guyana and Honduras, the estimates had large uncertainty, and no declines were detected. Across the 10 countries, most of which have low to moderate incidence of pneumonia mortality, PCVs have prevented nearly 4500 all-cause pneumonia deaths in children 2–59 months since introduction. Conclusions Although the data quality was variable between countries, and the patterns varied across countries and age groups, the balance of evidence suggests that mortality due to all-cause pneumonia in children declined after PCV introduction. The impact could be greater in populations with a higher prevaccine burden of pneumonia.

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Estimating the burden of the COVID-19 pandemic on mortality, life expectancy and lifespan inequality in England and Wales: a population-level analysis

Journal of Epidemiology & Community Health ◽

10.1136/jech-2020-215505 ◽

2021 ◽

pp. jech-2020-215505

Author(s):

Jose Manuel Aburto ◽

Ridhi Kashyap ◽

Jonas Schöley ◽

Colin Angus ◽

John Ermisch ◽

...

Keyword(s):

Life Expectancy ◽

Excess Mortality ◽

Prediction Interval ◽

Age Groups ◽

Population Level ◽

England And Wales ◽

Life Expectancy At Birth ◽

Using Data ◽

The Impact ◽

Excess Deaths

BackgroundDeaths directly linked to COVID-19 infection may be misclassified, and the pandemic may have indirectly affected other causes of death. To overcome these measurement challenges, we estimate the impact of the COVID-19 pandemic on mortality, life expectancy and lifespan inequality from week 10 of 2020, when the first COVID-19 death was registered, to week 47 ending 20 November 2020 in England and Wales through an analysis of excess mortality.MethodsWe estimated age and sex-specific excess mortality risk and deaths above a baseline adjusted for seasonality with a systematic comparison of four different models using data from the Office for National Statistics. We additionally provide estimates of life expectancy at birth and lifespan inequality defined as the SD in age at death.ResultsThere have been 57 419 (95% prediction interval: 54 197, 60 752) excess deaths in the first 47 weeks of 2020, 55% of which occurred in men. Excess deaths increased sharply with age and men experienced elevated risks of death in all age groups. Life expectancy at birth dropped 0.9 and 1.2 years for women and men relative to the 2019 levels, respectively. Lifespan inequality also fell over the same period by 5 months for both sexes.ConclusionQuantifying excess deaths and their impact on life expectancy at birth provide a more comprehensive picture of the burden of COVID-19 on mortality. Whether mortality will return to—or even fall below—the baseline level remains to be seen as the pandemic continues to unfold and diverse interventions are put in place.

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Rise in mortality involving poisoning by medicaments other than narcotics, including poisoning by psychotropic drugs in different age/racial groups in the US

10.1101/509729 ◽

2019 ◽

Author(s):

Edward Goldstein

Keyword(s):

Native Americans ◽

Psychotropic Drugs ◽

Causes Of Death ◽

Age Groups ◽

Epidemiological Data ◽

Psychotropic Medications ◽

Racial Groups ◽

The Us ◽

Icd 10 ◽

The Impact

AbstractBackgroundIncrease in mortality involving poisoning, particularly by narcotics, is known to have been one of the factors that affected life expectancy in the US during the last two decades, especially for white Americans and Native Americans. However, the contribution of medicaments other than narcotics to mortality in different racial/age groups is less studied.MethodsWe regressed annual rates of mortality involving poisoning by medicaments but not narcotics/psychodysleptics (ICD-10 codes T36-39.xx or T41-50.8 but not T40.xx present as either underlying or contributing causes of death), as well as annual rates of mortality for certain subcategories of the above, including mortality involving poisoning by psychotropic drugs but not narcotics/psychodysleptics (ICD-10 codes T43.xx but not T40.xx present as either underlying or contributing causes of death) in different age/racial groups for both the 2000-2011 period and the 2011-2017 period against calendar year.ResultsAnnual numbers of deaths involving poisoning by medicaments but not narcotics/psychodysleptics grew from 4,332 between 2000-2001 to 11,401 between 2016-2017, with the growth in the rates of those deaths being higher for the 2011-2017 period compared to the 2000-2011 period. The largest increases in the rates of mortality involving poisoning by medicaments but not narcotics/psychodysleptics were in non-elderly Non-Hispanic Native Americans, followed by Non-Hispanic whites. Most of those increases came from increases in the rates of mortality involving poisoning by psychotropic medications; the latter rates grew for the period of 2015-2017 vs. 2000-2002 by factors ranging from 2.75 for ages 35-44y to 5.37 for ages 55-64y.ConclusionsThere were major increases in mortality involving poisoning by non-narcotic, particularly psychotropic medicaments, especially in non-elderly non-Hispanic whites and Native Americans. Our results, and the epidemiological data on mortality involving poisoning by different drugs and medications in the US, which are quite different from the ones in many other countries support the need for a comprehensive evaluation of the effect of various drugs, including psychotropic medications on health-related outcomes, the associated mortality the does not involve poisoning being listed on a death certificate, and the impact of medication misuse.

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Heterogeneity in Subnational Mortality in The Context of The COVID-19 Pandemic: The Case of Belgian Districts

10.21203/rs.3.rs-1160099/v1 ◽

2021 ◽

Author(s):

Benjamin-Samuel Schlüter ◽

Bruno Masquelier ◽

Carlo Giovanni Camarda

Keyword(s):

Life Expectancy ◽

National Level ◽

District Level ◽

Mortality Trends ◽

Stochastic Variation ◽

Sources Of Uncertainty ◽

Life Expectancy At Birth ◽

Standardized Mortality Ratios ◽

The Impact ◽

Different Sources

Abstract Background: The COVID-19 pandemic has caused major shocks in mortality trends in many countries. Yet few studies have evaluated the heterogeneity of the mortality shock at the sub-national level, rigorously accounting for the different sources of uncertainty.Methods: Using death registration data from Belgium, we first assess the change in the heterogeneity of subnational standardized mortality ratios in 2020, when compared to previous years. We then measure the shock of the pandemic using district-level values of life expectancy, comparing the observed and projected districts life expectancy, accounting for all sources of uncertainty (related to the life-table construction at district level and to the projection methods at country and district level). The Bayesian modelling approach makes it easy to combine the different sources of uncertainty in the assessment of the shock. This is of particular interest at a finer geographical scale characterized by high stochastic variation in annual death counts.Results: The heterogeneity in the impact of the pandemic on all-cause mortality across districts is substantial, with some districts barely showing any impact whereas the Bruxelles-Capital and Mons districts experienced a decrease in life expectancy at birth of 2.24 (95% CI:1.33-3.05) and 2.10 (95% CI:0.86-3.30) years, respectively. The year 2020 was associated with an increase in mortality levels ' heterogeneity at a subnational level in comparison to past years measured by both the standardized mortality ratios and the life expectancies at birth. Decisions on uncertainty thresholds have a large bearing on the interpretation of the results.Conclusion: Developing sub-national mortality estimates with their uncertainty is key to understanding why certain areas have been hard hit in comparison to others.

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