scholarly journals Scaling COVID-19 against inequalities: should the policy response consistently match the mortality challenge?

2020 ◽  
Author(s):  
Gerry McCartney ◽  
Alastair H. Leyland ◽  
David Walsh ◽  
Ruth Dundas
Keyword(s):  
Life Expectancy ◽  
Socioeconomic Inequality ◽  
Negative Impact ◽  
Disease Model ◽  
Mortality Rates ◽  
Economic Policies ◽  
Drug Poisoning ◽  
Infectious Disease Model ◽  
The Uk ◽  
The Impact

AbstractBackgroundThe mortality impact of COVID-19 has thus far been described in terms of crude death counts. We aimed to calibrate the scale of the modelled mortality impact of COVID-19 using age-standardised mortality rates and life expectancy contribution against other, socially-determined, causes of death in order to inform governments and the public.MethodsWe compared mortality attributable to suicide, drug poisoning and socioeconomic inequality with estimates of mortality from an infectious disease model of COVID-19. We calculated age-standardised mortality rates and life expectancy contributions for the UK and its constituent nations.ResultsMortality from a fully unmitigated COVID-19 pandemic is estimated to be responsible for a negative life expectancy contribution of −5.96 years for the UK. This is reduced to −0.33 years in the fully mitigated scenario. The equivalent annual life expectancy contributions of suicide, drug poisoning and socioeconomic inequality-related deaths are −0.25, −0.20 and −3.51 years respectively. The negative impact of fully unmitigated COVID-19 on life expectancy is therefore equivalent to 24 years of suicide deaths, 30 years of drug poisoning deaths, and 1.7 years of inequality-related deaths for the UK.ConclusionFully mitigating COVID-19 is estimated to prevent a loss of 5.63 years of life expectancy for the UK. Over 10 years there is a greater negative life expectancy contribution from inequality than around six unmitigated COVID-19 pandemics. To achieve long-term population health improvements it is therefore important to take this opportunity to introduce post-pandemic economic policies to ‘build back better’.Summary boxWhat is already known on this subject?COVID-19 has been modelled to create a substantial excess mortality in the UK, depending on the degree to which this is mitigated by social distancing measures. Best estimates of 510,000 and 20,000 crude deaths are predicted in unmitigated and fully mitigated scenarios respectively.What does this study add?We scale the mortality impact of the modelled COVID-19 on age-standardised mortality and life expectancy against suicide, drug poisonings and inequalities. The impact of COVID-19 on life expectancy is substantial (−5.96 years) if unmitigated, but over a decade the life expectancy impact of inequalities is around six times greater than even an unmitigated pandemic.

scholarly journals Scaling COVID-19 against inequalities: should the policy response consistently match the mortality challenge?

2020 ◽  
pp. jech-2020-214373
Author(s):  
Gerry McCartney ◽  
Alastair Leyland ◽  
David Walsh ◽  
Dundas Ruth
Keyword(s):  
Life Expectancy ◽  
Socioeconomic Inequality ◽  
Negative Impact ◽  
Disease Model ◽  
Mortality Rates ◽  
Economic Policies ◽  
Drug Poisoning ◽  
Infectious Disease Model ◽  
The Public ◽  
The Uk

BackgroundThe mortality impact of COVID-19 has thus far been described in terms of crude death counts. We aimed to calibrate the scale of the modelled mortality impact of COVID-19 using age-standardised mortality rates and life expectancy contribution against other, socially determined, causes of death in order to inform governments and the public.MethodsWe compared mortality attributable to suicide, drug poisoning and socioeconomic inequality with estimates of mortality from an infectious disease model of COVID-19. We calculated age-standardised mortality rates and life expectancy contributions for the UK and its constituent nations.ResultsMortality from a fully unmitigated COVID-19 pandemic is estimated to be responsible for a negative life expectancy contribution of −5.96 years for the UK. This is reduced to −0.33 years in the fully mitigated scenario. The equivalent annual life expectancy contributions of suicide, drug poisoning and socioeconomic inequality-related deaths are −0.25, −0.20 and −3.51 years, respectively. The negative impact of fully unmitigated COVID-19 on life expectancy is therefore equivalent to 24 years of suicide deaths, 30 years of drug poisoning deaths and 1.7 years of inequality-related deaths for the UK.ConclusionFully mitigating COVID-19 is estimated to prevent a loss of 5.63 years of life expectancy for the UK. Over 10 years, there is a greater negative life expectancy contribution from inequality than around six unmitigated COVID-19 pandemics. To achieve long-term population health improvements it is therefore important to take this opportunity to introduce post-pandemic economic policies to ‘build back better’.

scholarly journals The Impact of Bushfire Smoke on Cattle—A Review

Animals ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 848
Author(s):  
Benjamin Eid ◽  
David Beggs ◽  
Peter Mansell
Keyword(s):  
Particulate Matter ◽  
Prolonged Exposure ◽  
Negative Impact ◽  
Airborne Particulate Matter ◽  
Mortality Rates ◽  
Airborne Particulate ◽  
Primary Mechanism ◽  
Background Mortality ◽  
Fire Front ◽  
The Impact

In 2019–2020, a particularly bad bushfire season in Australia resulted in cattle being exposed to prolonged periods of smoke haze and reduced air quality. Bushfire smoke contains many harmful pollutants, and impacts on regions far from the fire front, with smoke haze persisting for weeks. Particulate matter (PM) is one of the major components of bushfire smoke known to have a negative impact on human health. However, little has been reported about the potential effects that bushfire smoke has on cattle exposed to smoke haze for extended periods. We explored the current literature to investigate evidence for likely effects on cattle from prolonged exposure to smoke generated from bushfires in Australia. We conducted a search for papers related to the impacts of smoke on cattle. Initial searching returned no relevant articles through either CAB Direct or PubMed databases, whilst Google Scholar provided a small number of results. The search was then expanded to look at two sub-questions: the type of pollution that is found in bushfire smoke, and the reported effects of both humans and cattle being exposed to these types of pollutants. The primary mechanism for damage due to bushfire smoke is due to small airborne particulate matter (PM). Although evidence demonstrates that PM from bushfire smoke has a measurable impact on both human mortality and cardiorespiratory morbidities, there is little evidence regarding the impact of chronic bushfire smoke exposure in cattle. We hypothesize that cattle are not severely affected by chronic exposure to smoke haze, as evidenced by the lack of reports. This may be because cattle do not tend to suffer from the co-morbidities that, in the human population, seem to be made worse by smoke and pollution. Further, small changes to background mortality rates or transient morbidity may also go unreported.

scholarly journals The contribution of changes to tax and social security to stalled life expectancy trends in Scotland: a modelling study

2020 ◽  
pp. jech-2020-214770
Author(s):  
Elizabeth Richardson ◽  
Martin Taulbut ◽  
Mark Robinson ◽  
Andrew Pulford ◽  
Gerry McCartney
Keyword(s):  
Life Expectancy ◽  
Social Security ◽  
Tax Credits ◽  
The Difference ◽  
Group Sex ◽  
The Uk ◽  
Social Security Benefits ◽  
The Impact ◽  
Welfare Reforms ◽  
Detrimental Impact

BackgroundLife expectancy (LE) improvements have stalled, and UK tax and welfare ‘reforms’ have been proposed as a cause. We estimated the effects of tax and welfare reforms from 2010/2011 to 2021/2022 on LE and inequalities in LE in Scotland.MethodsWe applied a published estimate of the cumulative income impact of the reforms to the households within Scottish Index of Multiple Deprivation (SIMD) quintiles. We estimated the impact on LE by applying a rate ratio for the impact of income on mortality rates (by age group, sex and SIMD quintile) and calculating the difference between inflation-only changes in benefits and the reforms.ResultsWe estimated that changes to household income resulting from the reforms would result in an additional 1041 (+3.7%) female deaths and 1013 (+3.8%) male deaths. These deaths represent an estimated reduction of female LE from 81.6 years to 81.2 years (−20 weeks), and male LE from 77.6 years to 77.2 years (−23 weeks). Cuts to benefits and tax credits were modelled to have the most detrimental impact on LE, and these were estimated to be most severe in the most deprived areas. The modelled impact on inequalities in LE was widening of the gap between the most and least deprived 20% of areas by a further 21 weeks for females and 23 weeks for males.InterpretationThis study provides further evidence that austerity, in the form of cuts to social security benefits, is likely to be an important cause of stalled LE across the UK.

Ethics and Efficiency in the Provision of Health Care

1988 ◽  
Vol 23 ◽  
pp. 111-126 ◽  
Author(s):  
Alan Williams
Keyword(s):  
Health Care ◽  
Driving Force ◽  
Mortality Rates ◽  
Equal Access ◽  
Demographic Structure ◽  
Major Purpose ◽  
Relative Mortality ◽  
Distribution Rule ◽  
The Uk ◽  
The Impact

1.1. A major purpose in nationalizing the provision of health care in the UK was to affect its distribution between people, and, in particular, to minimize the impact of willingness and ability to pay upon that distribution. It has never been clear, however, what alternative distribution rule is to apply. There is no shortage of rhetoric about ‘equality’ and ‘need’, but most of it is vacuous, by which I mean it does not lead to any clear operational guidelines about who should get priority and at whose expense. The closest we have got so far to such explicit guidelines has been the formulae which determine the geographical distribution of NHS funds, the driving force behind which is a notion of need based on relative mortality rates and on the demographic structure. The avowed objective is to bring about equal access for equal need irrespective of where in the UK you happen to be.

scholarly journals The perception of biopsychosocial impacts of COVID-19 during lockdown restrictions over time in the UK – a mixed methods study

2021 ◽  
Vol 4 (Special2) ◽  
pp. 402-414
Author(s):  
Samuel Grimwood ◽  
Kaz Stuart ◽  
Ruth Browning ◽  
Elaine Bidmead ◽  
Thea Winn-Reed
Keyword(s):  
Social Issues ◽  
Negative Impact ◽  
Mixed Methods Study ◽  
Biological Domain ◽  
Data Points ◽  
Integrated Recovery ◽  
Biopsychosocial Health ◽  
The Uk ◽  
The Impact ◽  
Over Time

Background: The COVID-19 pandemic has profoundly impacted the health of individuals physically, mentally, and socially. This study aims to gain a deeper understanding of this impact across the pandemic from a biopsychosocial stance. Methods: A survey created by the research team was employed between November 2020 and February 2021 across social media, relevant organizations, and networks. The survey incorporated 5-time points across the different stages of the pandemic, covering biological, psychological, and social. There were 5 items for each survey (Very Positive affect to Very Negative affect), and analysis was undertaken using SPSS version 16. Descriptive statistics and non-parametric Friedman and Wilcoxon Tests, as well as correlations between the three domains, were implemented. Results: This study included 164 participants (77.0% female and 35.0% male) across 24 out of 38 counties in the UK. The impact of COVID-19 on biological domain was significant across the five data points χ2(4) = 63.99, p < 0.001, psychological χ2(4) = 118.939, p <0.001 and socially χ2(4) = 186.43, p <0.001. Between the 5 data points, 4 out of 5 had a negative impact, however between the first stage of lockdown and the easing of restrictions, findings for biological (Z=-2.35, p <0.05), psychological (Z=-6.61, p < 0.001), and socially (Z = -8.61, p <0.001) were positive. Negative correlations between the three domains across the pandemic are apparent, but in later stages, the biological domain had a positive correlation r = 0.52, p < 0.001. Conclusion: The data shows a negative impact from the self-reported perception of wellbeing from a biopsychosocial stance over time, as well as perceiving the three domains to interact negatively. To address these biopsychosocial issues, the research implies a place-based integrated recovery effort is needed, addressing biological, psychological, and social issues simultaneously. Further research should investigate biopsychosocial health among a more generalizable population.

Ethics and Efficiency in the Provision of Health Care

1988 ◽  
Vol 23 ◽  
pp. 111-126
Author(s):  
Alan Williams
Keyword(s):  
Health Care ◽  
Driving Force ◽  
Mortality Rates ◽  
Equal Access ◽  
Demographic Structure ◽  
Major Purpose ◽  
Relative Mortality ◽  
Distribution Rule ◽  
The Uk ◽  
The Impact

1.1. A major purpose in nationalizing the provision of health care in the UK was to affect its distribution between people, and, in particular, to minimize the impact of willingness and ability to pay upon that distribution. It has never been clear, however, what alternative distribution rule is to apply. There is no shortage of rhetoric about ‘equality’ and ‘need’, but most of it is vacuous, by which I mean it does not lead to any clear operational guidelines about who should get priority and at whose expense. The closest we have got so far to such explicit guidelines has been the formulae which determine the geographical distribution of NHS funds, the driving force behind which is a notion of need based on relative mortality rates and on the demographic structure. The avowed objective is to bring about equal access for equal need irrespective of where in the UK you happen to be.

scholarly journals Examining the impact of introducing ICD-MM on observed trends in maternal mortality rates in the UK 2003–13

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Marian Knight ◽  
◽  
Manisha Nair ◽  
Peter Brocklehurst ◽  
Sara Kenyon ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Mortality Rates ◽  
The Uk ◽  
The Impact

scholarly journals The impact of temperature changes on vector-borne disease transmission: Culicoides midges and bluetongue virus

2017 ◽  
Vol 14 (128) ◽  
pp. 20160481 ◽  
Author(s):  
Samuel P. C. Brand ◽  
Matt J. Keeling
Keyword(s):  
Climate Change ◽  
Life Expectancy ◽  
Disease Transmission ◽  
Bluetongue Virus ◽  
Optimal Temperature ◽  
Climatic Fluctuations ◽  
Transmission Potential ◽  
Vector Borne ◽  
The Uk ◽  
The Impact

It is a long recognized fact that climatic variations, especially temperature, affect the life history of biting insects. This is particularly important when considering vector-borne diseases, especially in temperate regions where climatic fluctuations are large. In general, it has been found that most biological processes occur at a faster rate at higher temperatures, although not all processes change in the same manner. This differential response to temperature, often considered as a trade-off between onward transmission and vector life expectancy, leads to the total transmission potential of an infected vector being maximized at intermediate temperatures. Here we go beyond the concept of a static optimal temperature, and mathematically model how realistic temperature variation impacts transmission dynamics. We use bluetongue virus (BTV), under UK temperatures and transmitted by Culicoides midges, as a well-studied example where temperature fluctuations play a major role. We first consider an optimal temperature profile that maximizes transmission, and show that this is characterized by a warm day to maximize biting followed by cooler weather to maximize vector life expectancy. This understanding can then be related to recorded representative temperature patterns for England, the UK region which has experienced BTV cases, allowing us to infer historical transmissibility of BTV, as well as using forecasts of climate change to predict future transmissibility. Our results show that when BTV first invaded northern Europe in 2006 the cumulative transmission intensity was higher than any point in the last 50 years, although with climate change such high risks are the expected norm by 2050. Such predictions would indicate that regular BTV epizootics should be expected in the UK in the future.

scholarly journals Asthma Mortality in Canada, 1946 to 1990

1995 ◽  
Vol 2 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Robert S Hogg ◽  
Martin T Schechter ◽  
Julio SG Montaner ◽  
James C Hogg
Keyword(s):  
Life Expectancy ◽  
Mortality Rates ◽  
Population Based ◽  
Years Of Life Lost ◽  
Population Based Study ◽  
Specific Mortality ◽  
Statistics Canada ◽  
Standardized Mortality Ratios ◽  
The Impact ◽  
Asthma Mortality

OBJECTIVE: To assess the impact of asthma on Canadian mortality rates over a 45-year period.DESIGN: A descriptive, population-based study.SETTING: Canada.SUBJECTS: All persons who died from asthma in Canada from 1946 to 1990 as reported to Statistics Canada in Ottawa.MAIN OUTCOME MEASURES: Standardized mortality ratios, age-specific patterns of death, potential years of life lost (PYLL) and life expectancy lost.RESULTS: A total of 12,010 male and 8486 female asthma deaths were recorded in Canada from 1946 to 1990. Mortality rates for both sexes declined from a high of between three to six deaths in 1951 to 1955 to approximately two deaths per 100,000 in 1986 to 1990, with the decline in rates being greater for males than females. Age-specific mortality rates were highest al all ages in 1951 to 1955, except for 15 to 24 years when deaths rates for the 1981 to 1985 period were greater. PYLL exhibit the same pattern as mortality, peaking in 1951 to 1955 and subsequently declining with each period. Loss in life expectancy due to asthma was about one month (not significant) in all time periods.CONCLUSIONS: Asthma mortality rates have declined significantly over the study period. This decline appears to be linked with the convergence of sex-specific rates and with changes in the patterning or age-specific mortality. The impact of asthma on the life expectancy of Canadians is small.

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