scholarly journals Education inequalities in adult all-cause mortality: first national data for Australia using linked census and mortality data

2019 ◽  
Vol 49 (2) ◽  
pp. 511-518
Author(s):  
Rosemary J Korda ◽  
Nicholas Biddle ◽  
John Lynch ◽  
James Eynstone-Hinkins ◽  
Kay Soga ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Census Data ◽  
International Comparisons ◽  
Negative Binomial Regression ◽  
Mortality Rates ◽  
Mortality Data ◽  
Age Group ◽  
National Data ◽  
Registration Data ◽  
All Cause Mortality

Abstract Background National linked mortality and census data have not previously been available for Australia. We estimated education-based mortality inequalities from linked census and mortality data that are suitable for international comparisons. Methods We used the Australian Bureau of Statistics Death Registrations to Census file, with data on deaths (2011–2012) linked probabilistically to census data (linkage rate 81%). To assess validity, we compared mortality rates by age group (25–44, 45–64, 65–84 years), sex and area-inequality measures to those based on complete death registration data. We used negative binomial regression to quantify inequalities in all-cause mortality in relation to five levels of education [‘Bachelor degree or higher’ (highest) to ‘no Year 12 and no post-secondary qualification’ (lowest)], separately by sex and age group, adjusting for single year of age and correcting for linkage bias and missing education data. Results Mortality rates and area-based inequality estimates were comparable to published national estimates. Men aged 25–84 years with the lowest education had age-adjusted mortality rates 2.20 [95% confidence interval (CI): 2.08‒2.33] times those of men with the highest education. Among women, the rate ratio was 1.64 (1.55‒1.74). Rate ratios were 3.87 (3.38‒4.44) in men and 2.57 (2.15‒3.07) in women aged 25–44 years, decreasing to 1.68 (1.60‒1.76) in men and 1.44 (1.36‒1.53) in women aged 65–84 years. Absolute education inequalities increased with age. One in three to four deaths (31%) was associated with less than Bachelor level education. Conclusions These linked national data enabled valid estimates of education inequality in mortality suitable for international comparisons. The magnitude of relative inequality is substantial and similar to that reported for other high-income countries.

scholarly journals Education-related inequalities in cause-specific mortality: First estimates for Australia using individual-level linked census and mortality data

2020 ◽  
Author(s):  
Jennifer Welsh ◽  
Grace Joshy ◽  
Lauren Morgan ◽  
Kay Soga ◽  
Hsei-Di Law ◽  
...  
Keyword(s):  
High Education ◽  
Causes Of Death ◽  
Negative Binomial ◽  
International Comparisons ◽  
Negative Binomial Regression ◽  
Medical Intervention ◽  
Mortality Data ◽  
Individual Level ◽  
Specific Mortality ◽  
Inequalities In Mortality

Background: Socioeconomic inequalities in mortality are evident in all high-income countries and ongoing monitoring is recommended using linked census-mortality data. Using such data, we provide first estimates of education-related inequalities in cause-specific mortality in Australia, suitable for international comparisons. Methods: Using Australian Census (2016) linked to 13-months of Death Registrations data (2016-17), we estimated relative rates (RR) and rate differences (RD, per100 000 person-years), comparing rates in low (no qualifications) and intermediate (secondary school) with high education (tertiary), for individual causes of death (among those 25-84y) and grouped according to preventability (25-74y), separately by sex and age group, adjusting for age, using negative binomial regression. Results: Among 13.9M people contributing 14 452 732 person-years, 84 743 deaths occurred. We observed inequalities in most causes of death for each age-sex group. Among men aged 25-44y, absolute and relative inequalities (low versus high education) were largest for injuries, e.g. transport accidents (RR=10.1 [95%CI: 5.4-18.7], RD=21.1 [15.9-26.3]). Among those aged 45-64y, inequalities were greatest for chronic diseases, e.g. lung cancer (men RR=6.6 [4.9-8.9], RD=55.6 [51.1-60.1]) and ischaemic heart disease (women RR=5.8 [3.7-9.1], RD=19.2 [17.0-21.5]), with similar patterns for people aged 65-84y. When grouped according to preventability, inequalities were large for causes amenable to behaviour change and medical intervention for all ages and causes amenable to injury prevention among young men. Conclusions: Australian education-related inequalities in mortality are substantial, generally higher than international estimates, and related to preventability. Findings highlight opportunities to reduce them and the potential to improve the health of the population.

scholarly journals Using Linked Whole-Of-Population Data to Estimate Education-Related Inequalities in Cause-Specific Mortality in Australia

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Jennifer Welsh ◽  
Grace Joshy ◽  
Lauren Moran ◽  
Kay Soga ◽  
Hsei Di Law ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Brain Cancer ◽  
Negative Binomial ◽  
Health Behaviours ◽  
Negative Binomial Regression ◽  
Population Data ◽  
Medical Intervention ◽  
Mortality Data ◽  
Registration Data ◽  
Specific Mortality

IntroductionOfficial Australian estimates of socioeconomic inequalities in cause-specific mortality have been based on area-level socioeconomic measures. Using area-level measures is known to underestimate inequalities. Objectives and ApproachUsing recently released census linked to mortality data, we estimate education-related inequalities in cause-specific mortality for Australia. We used 2016 Australian Census and Death Registration data (2016-17) linked via a Person Linkage Spine (linkage rates: 92% and 97%, respectively) from the Multi-Agency Data Integration Project (MADIP). Education, from the Census, was categorised as low (no secondary school graduation or other qualification), intermediate (secondary graduation with/without other non-tertiary qualifications) and high (tertiary qualification). Cause of death was coded according to the underlying cause of death using the ICD-10. We used negative binomial regression to estimate relative rates (RR) for cause-specific mortality at ages 25-84 years, in the 12-months following Census, comparing low vs high education, separately by sex and 20-year age group, adjusting for age. Results80,317 deaths occurred among 13,856,202 people. For those aged 25-44 years, relative inequalities were large for causes related to injury and smaller for lesspreventable deaths (e.g. for men, suicide RR=5.6, 95%CI: 4.1-7.5 and brain cancer RR=1.3, 0.6-3.1). For those aged 45-64, inequalities were large for causes related to health behaviours and amenable to medical intervention, e.g. lung cancer (men RR= 6.4, 4.7-8.8) and ischaemic heart disease (women RR=5.0, 3.2-7.7), and were small for less preventable causes e.g. brain cancer (women RR=0.9, 0.6-1.3). Patterns among those aged 65-84years were similar to those aged 45-64 years. Conclusion / ImplicationsIn Australia, inequalities in mortality are substantial. Our findings highlight the health burden from inequalities, opportunities for prevention and provide insights on targets to effectively reduce them.

scholarly journals THE US MIDLIFE MORTALITY CRISIS CONTINUES: INCREASED DEATH RATES FROM CAUSES OTHER THAN COVID-19 DURING 2020

2021 ◽  
Author(s):  
Dana A Glei
Keyword(s):  
Indirect Effect ◽  
Causes Of Death ◽  
Excess Mortality ◽  
Negative Binomial ◽  
National Level ◽  
Age Groups ◽  
Negative Binomial Regression ◽  
Negative Binomial Regression Model ◽  
Age Group ◽  
External Causes

COVID-19 has prematurely ended many lives, particularly among the oldest Americans, but the pandemic has also had an indirect effect on health and non-COVID mortality among the working-age population, who have suffered the brunt of the economic consequences. This analysis quantifies the changes in mortality for selected causes of death during the COVID 19 pandemic up to December 31, 2020, and investigates whether the levels of excess mortality varied by age group. The data comprise national-level monthly death counts by age group and selected causes of death from January 1999 to December 2020 combined with annual mid-year population estimates over the same period. A negative binomial regression model was used to estimate monthly cause-specific excess mortality during 2020 controlling for the pre-pandemic mortality patterns by age, calendar year, and season. To determine whether excess mortality varied by age, we tested interactions between broad age groups and dichotomous indicators for the pre-pandemic (January-February) and the pandemic (March-December) portions of 2020. In relative terms, excess all cause mortality (including COVID-19) peaked in December at ages 25-44 (RR=1.58 relative to 2019, 95% CI=1.50-1.68). Excluding COVID-19, all of the excess mortality occurred between ages 15 and 64, peaking in July among those aged 25-44 (RR=1.45, 95% CI 1.37-1.53). We find notable excess mortality during March-December 2020 for many causes (i.e., influenza/pneumonia, other respiratory diseases, diabetes, heart disease, cerebrovascular disease, kidney disease, and external causes), but almost exclusively among young and midlife (aged 25-74) Americans. For those aged 75 and older, there was little excess mortality from causes other than COVID-19 except from Alzheimer's disease. Excess non-COVID mortality may have resulted, at least partly, from incorrectly classified COVID-19 deaths, but neither misclassification nor an atypical flu season that disproportionately affected younger people is likely to explain the increase in mortality from external causes, which was evident even during January-February 2020. Exploratory analyses suggest that drug-related mortality may be driving the early rise in external mortality. The growth in drug overdoses well before there was any hint of a pandemic suggests it is probably not solely an indirect effect of COVID-19, although the pandemic may have exacerbated the problem.

Excess mortality monitoring in England and Wales during the influenza A(H1N1) 2009 pandemic

2011 ◽  
Vol 139 (9) ◽  
pp. 1431-1439 ◽  
Author(s):  
P. HARDELID ◽  
N. ANDREWS ◽  
R. PEBODY
Keyword(s):  
Pandemic Influenza ◽  
Influenza A ◽  
Excess Mortality ◽  
Cold Weather ◽  
Mortality Data ◽  
Age Group ◽  
England And Wales ◽  
Health Events ◽  
Influenza A H1n1 ◽  
All Cause Mortality

SUMMARYWe present the results from a novel surveillance system for detecting excess all-cause mortality by age group in England and Wales developed during the pandemic influenza A(H1N1) 2009 period from April 2009 to March 2010. A Poisson regression model was fitted to age-specific mortality data from 1999 to 2008 and used to predict the expected number of weekly deaths in the absence of extreme health events. The system included adjustment for reporting delays. During the pandemic, excess all-cause mortality was seen in the 5–14 years age group, where mortality was flagged as being in excess for 1 week after the second peak in pandemic influenza activity; and in age groups >45 years during a period of very cold weather. This new system has utility for rapidly estimating excess mortality for other acute public health events such as extreme heat or cold weather.

scholarly journals Multiple Sclerosis Mortality Rates in Canada, 1975-2009

2015 ◽  
Vol 43 (1) ◽  
pp. 134-141 ◽  
Author(s):  
Sharon A. Warren ◽  
Wonita Janzen ◽  
Kenneth G. Warren ◽  
Lawrence W. Svenson ◽  
Donald P. Schopflocher
Keyword(s):  
Multiple Sclerosis ◽  
General Population ◽  
Age Distribution ◽  
Mortality Rates ◽  
Age Group ◽  
Age At Death ◽  
Annual Percent Change ◽  
All Cause Mortality ◽  
Statistics Canada ◽  
Using Data

ABSTRACTBackground: This study examined mortality due to multiple sclerosis (MS) in Canada, 1975-2009 to determine whether there has been a change in age at death relative to the general population and decrease in MS mortality rates. Methods: Mortality rates/100,000 population for MS and all causes were calculated using data derived from Statistics Canada, age-standardized to the 2006 population. Results: The average annual Canadian MS mortality rate, 1975-2009 was 1.23/100,000. Five-year rates for 1975-79, 1980-84, 1985-89, 1990-94, 1995-99, 2000-04, 2005-09 were: 1.16, 0.94, 1.01, 1.16, 1.30, 1.43, 1.33. Trend analysis showed mortality rates over the entire 35 years were stable (average annual percent change of less than one percent). The average annual 1975-2009 rates for females and males were 1.45 and 0.99. Five-year female rates were always higher than males. Regardless of gender, there was a decrease in MS mortality rates in the 0-39 age group and increases in the 60-69, 70-79, and 80+ groups over time. In contrast, there were decreases in all-cause mortality rates across each age group. The highest MS mortality rates for 1975-2009 were consistently in the 50-59 and 60-69 groups for both genders, while the highest all-cause mortality rates were in the 80+ group. Conclusions: Changes in the age distribution of MS mortality rates indicate a shift to later age at death, possibly due to improved health care. However MS patients remain disadvantaged relative to the general population and changes in age at death are not reflected in decreased mortality rates.

scholarly journals Long-Term Trends in Unintentional Fall Mortality in China: A Population-Based Age-Period-Cohort Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Zhenkun Wang ◽  
Youzhen Hu ◽  
Fang Peng
Keyword(s):  
Public Health Problem ◽  
Mortality Rates ◽  
Population Based ◽  
Mortality Data ◽  
Major Public Health Problem ◽  
Age Group ◽  
Men And Women ◽  
Long Term Trends ◽  
Unintentional Falls

Background: Unintentional falls seriously threaten the life and health of people in China. This study aimed to assess the long-term trends of mortality from unintentional falls in China and to examine the age-, period-, and cohort-specific effects behind them.Methods: This population-based multiyear cross-sectional study of Chinese people aged 0–84 years was a secondary analysis of the mortality data of fall injuries from 1990 to 2019, derived from the Global Burden of Disease Study 2019. Age-standardized mortality rates of unintentional falls by year, sex, and age group were used as the main outcomes and were analyzed within the age-period-cohort framework.Results: Although the crude mortality rates of unintentional falls for men and women showed a significant upward trend, the age-standardized mortality rates for both sexes only increased slightly. The net drift of unintentional fall mortality was 0.13% (95% CI, −0.04 to 0.3%) per year for men and −0.71% (95% CI, −0.96 to −0.46%) per year for women. The local drift values for both sexes increased with age group. Significant age, cohort, and period effects were found behind the mortality trends of the unintentional falls for both sexes in China.Conclusions: Unintentional falls are still a major public health problem that disproportionately threatens the lives of men and women in China. Efforts should be put in place urgently to prevent the growing number of fall-related mortality for men over 40 years old and women over 70 years old. Gains observed in the recent period, relative risks (RRs), and cohort RRs may be related to improved healthcare and better education.

scholarly journals Trends in Infant Mortality and Stillbirth Rates in Scotland by Socio-Economic Position, 2000-2018: A Longitudinal Ecological Study

2021 ◽  
Author(s):  
Alice Harpur ◽  
Jon Minton ◽  
Julie Ramsay ◽  
Gerry McCartney ◽  
Lynda Fenton ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Mortality Rates ◽  
Early Years ◽  
Live Births ◽  
Before And After ◽  
Break Points ◽  
Economic Position ◽  
Economic Inequalities

Abstract Background:As Scotland strives to become a country where children flourish in their early years, it is faced with the challenge of socio-economic health inequalities, which are at risk of worsening amidst austerity policies. The aim of this study was to explore trends in infant mortality rates (IMR) and stillbirth rates by socio-economic position (SEP) in Scotland, between 2000-2018, inclusive.Methods:Data for live births, infant deaths, and stillbirths between 2000-2018 were obtained from National Records of Scotland. Annual IMR and stillbirth rates were calculated and visualised for all of Scotland and when stratified by SEP. Negative binomial regression models were used to estimate the association between SEP and infant mortality and stillbirth events, and to assess for break points in trends over time. The slope (SII) and relative (RII) index of inequality compared absolute and relative socio-economic inequalities in IMR and stillbirth rates before and after 2010.Results:IMR fell from 5.7 to 3.2 deaths per 1000 live births between 2000-2018, with no change in trend identified. Stillbirth rates were relatively static between 2000-2008 but experienced accelerated reduction from 2009 onwards. When stratified by SEP, inequalities in IMR and stillbirth rates persisted throughout the study and were greatest amongst the sub-group of post-neonates. Although comparison of the SII and RII in IMR and stillbirths before and after 2010 suggested that inequalities remained stable, descriptive trends in mortality rates displayed a 3-year rise in the most deprived quintiles from 2015 onwards.Conclusion:Whilst Scotland has experienced downward trends in IMR and stillbirth rates between 2000-2018, the persistence of socio-economic inequalities and suggestion that mortality rates amongst the most deprived groups may be worsening warrants further action to improve maternal health and strengthen support for families with young children.

scholarly journals Trends in infant mortality and stillbirth rates in Scotland by socio-economic position, 2000–2018: a longitudinal ecological study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alice Harpur ◽  
Jon Minton ◽  
Julie Ramsay ◽  
Gerry McCartney ◽  
Lynda Fenton ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Mortality Rates ◽  
Early Years ◽  
Live Births ◽  
Before And After ◽  
Break Points ◽  
Economic Position ◽  
Economic Inequalities

Abstract Background As Scotland strives to become a country where children flourish in their early years, it is faced with the challenge of socio-economic health inequalities, which are at risk of widening amidst austerity policies. The aim of this study was to explore trends in infant mortality rates (IMR) and stillbirth rates by socio-economic position (SEP) in Scotland, between 2000 and 2018, inclusive. Methods Data for live births, infant deaths, and stillbirths between 2000 and 2018 were obtained from National Records of Scotland. Annual IMR and stillbirth rates were calculated and visualised for all of Scotland and when stratified by SEP. Negative binomial regression models were used to estimate the association between SEP and infant mortality and stillbirth events, and to assess for break points in trends over time. The slope (SII) and relative (RII) index of inequality compared absolute and relative socio-economic inequalities in IMR and stillbirth rates before and after 2010. Results IMR fell from 5.7 to 3.2 deaths per 1000 live births between 2000 and 2018, with no change in trend identified. Stillbirth rates were relatively static between 2000 and 2008 but experienced accelerated reduction from 2009 onwards. When stratified by SEP, inequalities in IMR and stillbirth rates persisted throughout the study and were greatest amongst the sub-group of post-neonates. Although comparison of the SII and RII in IMR and stillbirths before and after 2010 suggested that inequalities remained stable, descriptive trends in mortality rates displayed a 3-year rise in the most deprived quintiles from 2016 onwards. Conclusion Whilst Scotland has experienced downward trends in IMR and stillbirth rates between 2000 and 2018, the persistence of socio-economic inequalities and suggestion that mortality rates amongst the most deprived groups may be worsening warrants further action to improve maternal health and strengthen support for families with young children.

scholarly journals Mortality from Alzheimer's disease in Brazil, 2000-2009

2015 ◽  
Vol 31 (4) ◽  
pp. 850-860 ◽  
Author(s):  
Jane Blanco Teixeira ◽  
Paulo Roberto Borges de Souza Junior ◽  
Joelma Higa ◽  
Mariza Miranda Theme Filha
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
The Elderly ◽  
Mortality Rates ◽  
Age Group ◽  
Mortality Trend ◽  
Elderly Men ◽  
Exponential Regression ◽  
All Cause Mortality ◽  
Regression Adjustment

Alzheimer's disease is the most prevalent type of dementia in the elderly worldwide. To evaluate the mortality trend from Alzheimer's disease in Brazil, a descriptive study was conducted with the Mortality Information System of the Brazilian Ministry of Health (2000-2009). Age and sex-standardized mortality rates were calculated in Brazil's state capitals, showing the percentage variation by exponential regression adjustment. The state capitals as a whole showed an annual growth in mortality rates in the 60 to 79 year age bracket of 8.4% in women and 7.7% in men. In the 80 and older age group, the increase was 15.5% in women and 14% in men. Meanwhile, the all-cause mortality rate declined in both elderly men and women. The increase in mortality from Alzheimer's disease occurred in the context of chronic diseases as a proxy for increasing prevalence of the disease in the population. The authors suggest healthcare strategies for individuals with chronic non-communicable diseases

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