scholarly journals Why do young children die in the UK? A comparison with Sweden

2015 ◽  
Vol 100 (10) ◽  
pp. 928-931 ◽  
Author(s):  
Parag Tambe ◽  
Helen M Sammons ◽  
Imti Choonara

BackgroundThe UK has a high child mortality rate, whereas Sweden's is lower (under-five mortality rates of five and three, respectively, in 2011).We therefore wished to compare causes of death in young children aged <5 years in the two countries.MethodsUnder-five mortality data were obtained from the Office of National Statistics for each of the individual countries within the UK for 3 years (2006–2008). Data for Sweden for the same period were obtained from the National Board of Health and Welfare. Causes of death were compared statistically using χ2 test.ResultsThere were a total of 14 104 and 1036 deaths aged <5 years in the UK and Sweden, respectively, between 2006 and 2008. The total numbers of live births during the same period were 2 295 964 and 315 884, respectively. The overall mortality rate in the UK was 614 per 100 000 children which was significantly higher than that in Sweden (328; p<0.001). The mortality rates for the three main causes of death in the UK (prematurity, congenital malformations and infections) were 138.5, 112.1 and 63.9, respectively, per 100 000 children. The mortality rates for the same three conditions in Sweden were 10.1, 88.6 and 34.8, respectively. They were all significantly more frequent in the UK than in Sweden (p<0.001), as were the majority of the disorders. Treatable infections, such as pneumonia, meningitis and septicaemia, in both neonates and young children had significantly higher mortality rates in the UK than in Sweden (p<0.001).ConclusionsIn order to reduce the mortality rate in the UK, we need to try and reduce the causes of prematurity. Additionally, the care of children with treatable infections should be reviewed to understand ways in which to reduce the differences in mortality seen.

2020 ◽  
Vol 2 (1) ◽  
pp. p1
Author(s):  
Rahman Olanrewaju Raji

Over the years, the rising unfriendly macroeconomic environment is a contributing factor to the infant and under-five mortality rate in Nigeria. The study investigated the role of macroeconomic conditions on infant and under-five mortality rates in Nigeria for the period 1986–2017 using the fully modified OLS technique. The results show that the unfriendly macroeconomic policy environment such as the instability of inflation rate, unemployment and exchange rate enhanced the increased level of infant and under-five mortality rate in Nigeria.  The study recommends that the authority should adopt more pro-growth policies that can ensure and maintain sound domestic macroeconomic policies to stem child mortality rate and promote economic growth through investment in food production and related investment in health. Most importantly, macroeconomic policies and institutions are highly needed to be strengthened in order to have a friendly macroeconomic environment which will in turn improve the population health of the country which can enhance sustainable and long term dietary as well as nutritional pattern of young age children and adult.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Eve Robinson ◽  
Lawrence Lee ◽  
Leslie F. Roberts ◽  
Aurelie Poelhekke ◽  
Xavier Charles ◽  
...  

Abstract Background The Central African Republic (CAR) suffers a protracted conflict and has the second lowest human development index in the world. Available mortality estimates vary and differ in methodology. We undertook a retrospective mortality study in the Ouaka prefecture to obtain reliable mortality data. Methods We conducted a population-based two-stage cluster survey from 9 March to 9 April, 2020 in Ouaka prefecture. We aimed to include 64 clusters of 12 households for a required sample size of 3636 persons. We assigned clusters to communes proportional to population size and then used systematic random sampling to identify cluster starting points from a dataset of buildings in each commune. In addition to the mortality survey questions, we included an open question on challenges faced by the household. Results We completed 50 clusters with 591 participating households including 4000 household members on the interview day. The median household size was 7 (interquartile range (IQR): 4—9). The median age was 12 (IQR: 5—27). The birth rate was 59.0/1000 population (95% confidence interval (95%-CI): 51.7—67.4). The crude and under-five mortality rates (CMR & U5MR) were 1.33 (95%-CI: 1.09—1.61) and 1.87 (95%-CI: 1.37–2.54) deaths/10,000 persons/day, respectively. The most common specified causes of death were malaria/fever (16.0%; 95%-CI: 11.0–22.7), violence (13.2%; 95%-CI: 6.3–25.5), diarrhoea/vomiting (10.6%; 95%-CI: 6.2–17.5), and respiratory infections (8.4%; 95%-CI: 4.6–14.8). The maternal mortality ratio (MMR) was 2525/100,000 live births (95%-CI: 825—5794). Challenges reported by households included health problems and access to healthcare, high number of deaths, lack of potable water, insufficient means of subsistence, food insecurity and violence. Conclusions The CMR, U5MR and MMR exceed previous estimates, and the CMR exceeds the humanitarian emergency threshold. Violence is a major threat to life, and to physical and mental wellbeing. Other causes of death speak to poor living conditions and poor access to healthcare and preventive measures, corroborated by the challenges reported by households. Many areas of CAR face similar challenges to Ouaka. If these results were generalisable across CAR, the country would suffer one of the highest mortality rates in the world, a reminder that the longstanding “silent crisis” continues.


Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Holly Kramer ◽  
Adam Bress ◽  
Srinivasan Beddhu ◽  
Paul Muntner ◽  
Richard S Cooper

Background: The Systolic Blood Pressure Intervention Trial (SPRINT) trial randomized 9,361 adults aged ≥50 years at high cardiovascular disease (CVD) risk without diabetes or stroke to intensive systolic blood pressure (SBP) lowering (≤120 mmHg) or standard SBP lowering (≤140 mmHg). After a median follow up of 3.26 years, all-cause mortality was 27% (95% CI 40%, 10%) lower with intensive SBP lowering. We estimated the potential number of prevented deaths with intensive SBP lowering in the U.S. population meeting SPRINT criteria. Methods: SPRINT eligibility criteria were applied to the National Health and Nutrition Examination Survey 1999-2006, a representative survey of the U.S. population, linked with the mortality data through December 2011. Eligibility included (1) age ≥50 years with (2) SBP 130-180 mmHg depending on number of antihypertensive classes being taken, and (3) presence of ≥1 CVD risk conditions (history of coronary heart disease, estimated glomerular filtration rate (eGFR) 20 to 59 ml/min/1.73 m 2 , 10-year Framingham risk score ≥15%, or age ≥75 years). Adults with diabetes, stroke history, >1 g/day proteinuria, heart failure, on dialysis, or eGFR<20 ml/min/1.73m 2 were excluded. Annual mortality rates for adults meeting SPRINT criteria were calculated using Kaplan-Meier methods and the expected reduction in mortality rates with intensive SBP lowering in SPRINT was used to determine the number of potential deaths prevented. Analyses accounted for the complex survey design. Results: An estimated 18.1 million U.S. adults met SPRINT criteria with 7.4 million taking blood pressure lowering medications. The mean age was 68.6 years and 83.2% and 7.4% were non-Hispanic white and non-Hispanic black, respectively. The annual mortality rate was 2.2% (95% CI 1.9%, 2.5%) and intensive SBP lowering was projected to prevent 107,453 deaths per year (95% CI 45,374 to 139,490). Among adults with SBP ≥145 mmHg, the annual mortality rate was 2.5% (95% CI 2.1%, 3.0%) and intensive SBP lowering was projected to prevent 60,908 deaths per year (95% CI 26, 455 to 76, 792). Conclusions: We project intensive SBP lowering could prevent over 100,000 deaths per year of intensive treatment.


2020 ◽  
Vol 5 (2) ◽  
pp. 99-104
Author(s):  
Evgenii L. Borschuk ◽  
Dmitrii N. Begun ◽  
Tatyana V. Begun

Objectives - to study the mortality indicators, their dynamics and structure, in the population of the Orenburg region in the period of 2011-2017. Material and methods. The study was conducted using the data from the territorial authority of statistics in the Orenburg region in the period from 2011 to 2017. The analytical, demographic and statistical methods were implemented for the study of the demographic indicators. Results. Cities and municipal settlements of the Orenburg region with high mortality indicators were included in the second and fourth clusters during the cluster analysis. The first and third clusters included cities and municipal settlements with an average mortality. The most favorable position has the Orenburg area with the lowest mortality rate in the region in 2017 - 8.4%. The dynamics of mortality rates among the male and female population tends to decrease, more pronounced dynamics is in men. Though, the male population is characterized by higher mortality rates in all age groups. The leading position among the causes of death is taken by diseases of the circulatory system (46.3% of the total mortality). The second position is occupied by tumors (17.2%), the third - by external causes (8.4%). Mortality from circulatory system diseases and from external causes has reduced. The dynamics of mortality from tumors does not change significantly. The rank of leading causes of death is not identical in the clusters: in the third and fourth clusters, the other causes occupy the second place in the structure of mortality, while tumors occupy the third. Conclusion. In the Orenburg region, the mortality rate is higher than overage in the Russian Federation by 0.9 per 1000 people. The study revealed significant territorial differences in the mortality rates. In general, the mortality among men in all age groups is higher than the mortality of women. The mortality rate from diseases of the circulatory system plays the leading role in the structure of mortality, but has the tendency for decline. Until 2006, the mortality from external causes ranked the second place, now the second place is taken by death from tumors The mortality from external causes is decreasing; mortality from tumors does not change significantly. The obtained results could be used by local authorities in developing the program of public health protection and assessing its effectiveness.


2021 ◽  
pp. 003335492110440
Author(s):  
Nicholas J. Braun ◽  
Kari M. Gloppen ◽  
Jon Roesler

Objective Overall trends in rates of fully alcohol-attributable mortality may mask disparities among demographic groups. We investigated overall, demographic, and geographic trends in fully alcohol-attributable mortality rates in Minnesota. Methods We obtained mortality data from Minnesota death certificates and defined fully alcohol-attributable deaths as deaths that would not occur in the absence of alcohol. We calculated age-adjusted death rates during 2000-2018 using 5-year moving averages stratified by decedents’ characteristics and geographic location. Results Chronic conditions accounted for most of the alcohol-attributable deaths in Minnesota (89% during 2014-2018). Alcohol-attributable mortality rates per 100 000 population increased from an average rate of 8.0 during 2000-2004 to 12.6 during 2014-2018. During 2000-2018, alcohol-attributable mortality rates were highest among males (vs females), adults aged 55-64 (vs other ages), and American Indian/Alaska Native people (vs other racial and ethnic groups) and lowest among people aged ≤24 years and Asian or Pacific Islander people. During 2014-2018, the alcohol-attributable mortality rate among American Indian/Alaska Native people was more than 5 times higher than the overall mortality rate in Minnesota. Conclusions Results from this study may increase awareness of racial and ethnic disparities and continuing health inequities and inform public health prevention efforts, such as those recommended by the Community Preventive Services Task Force, including regulating alcohol outlet density and increasing alcohol taxes.


Medicina ◽  
2011 ◽  
Vol 47 (9) ◽  
pp. 512 ◽  
Author(s):  
Henrikas Kazlauskas ◽  
Nijolė Raškauskienė ◽  
Rima Radžiuvienė ◽  
Vinsas Janušonis

The objective of the study was to evaluate the trends in stroke mortality in the population of Klaipėda aged 35–79 years from 1994 to 2008. Material and Methods. Mortality data on all permanent residents of Klaipėda aged 35–79 years who died from stroke in 1994–2008 were gathered for the study. All death certificates of permanent residents of Klaipėda aged 35–79 years who died during 1994–2008 were examined in this study. The International Classification of Diseases (ICD-9 codes 430–436, and ICD-10 codes I60–I64) was used. Sex-specific mortality rates were standardized according to the Segi’s world population; all the mortality rates were calculated per 100 000 population per year. Trends in stroke mortality were estimated using log-linear regression models. Sex-specific mortality rates and trends were calculated for 3 age groups (35–79, 35–64, and 65–79 years). Results. During the entire study period (1994–2008), a marked decline in stroke mortality with a clear slowdown after 2002 was observed. The average annual percent changes in mortality rates for men and women aged 35–79 years were –4.6% (P=0.041) and –6.5% (P=0.002), respectively. From 1994 to 2002, the stroke mortality rate decreased consistently among both Klaipėda men and women aged 35–64 years (20.4% per year, P=0.002, and 14.7% per year, P=0.006, respectively) and in the elderly population aged 65–79 years (13.8% per year, P=0.005; and 12% per year, P=0.019). During 2003–2008, stroke mortality increased by 16.3% per year in middle-aged men (35–64 years), whereas among women (aged 35–64 and 65–79 years) and elderly men (aged 65–79 years), the age-adjusted mortality rate remained relatively unchanged. Conclusions. Among both men and women, the mortality rates from stroke sharply declined between 1994 and 2008 with a clear slowdown in the decline after 2002. Stroke mortality increased significantly among middle-aged men from 2003, while it remained without significant changes among women of the same age and both elderly men and women.


1984 ◽  
Vol 3 (1_suppl) ◽  
pp. 145s-174S ◽  
Author(s):  
P.S. Dwyer ◽  
I.F. Jones

1 Coroners' files have been examined to ascertain the numbers of deaths involving self-poisoning with analgesic drugs with specific reference to the paracetamol/dextropropoxyphene combination. The period of study was 1976-1980. This report concentrates on cases in England, although reference is made to similar deaths occurring in Scotland and Northern Ireland. 2 Data have been collected extensively on a wide range of issues concerning fatal self-poisonings mainly by visiting coroners' offices in England to make direct investigation of records. 3 The total number of cases where the paracetamol/dextropropoxyphene combination can be considered as ingested in the self-poisoning episode is underestimated. The number of cases involving alcohol and/or other drugs taken together with the combination product is particularly underestimated. 4 Involvement of people aged 30 years and below comprises 32% of all cases. 5 'Gesture' overdoses comprise an estimated 14% of all cases in England. 6 An analysis of fatalities from cases where quantities in post-mortem blood of dextropropoxyphene < 1 μg/ml and paracetamol < 50 μg/ml are found and of cases where death occurs within 2 h of ingestion of the overdose has been carried out. The results are inconclusive. In most cases alcohol and/or other drugs are found to be involved. Critical inspection of coroners' files shows relatively few of these cases where the combination product is ingested on its own. 7 There is wide variability in the data available in coroners' files. In many cases data of value to this research are not recorded. Medical history and quantitative levels of drugs suspected (particularly dextropropoxyphene) are particular examples of factors which may not be recorded. 8 Office of Population, Censuses and Surveys (OPCS) mortality data are based on certified causes of death. Because of the underestimate of the involvement of this combination product and the under-reporting of other drug and/or alcohol ingestion with the combination, care must be exercised in quoting or drawing conclusions from OPCS statistics.


2020 ◽  
Author(s):  
Amaia Calderón-Larrañaga ◽  
Davide L Vetrano ◽  
Debora Rizzuto ◽  
Tom Bellander ◽  
Laura Fratiglioni ◽  
...  

AbstractBackgroundWe aimed to describe the distribution of excess mortality (EM) during the first weeks of the COVID-19 outbreak in the Stockholm Region, Sweden, according to individual age and sex, and the sociodemographic contextMethodsWeekly all-cause mortality data were obtained from Statistics Sweden for the period 01/01/2015 to 17/05/2020. EM during the first 20 weeks of 2020 was estimated by comparing observed mortality rates with expected mortality rates during the five previous years (N=2,379,792). EM variation by socioeconomic status (tertiles of income, education, Swedish-born, gainful employment) and age distribution (share of 70+ year-old persons) was explored based on Demographic Statistics Area (DeSO) data.FindingsAn EM was first detected during the week of March 23-29 2020. During the peaking week of the epidemic (6-12 April 2020), an EM of 160% was observed: 211% in 80+ year-old women; 179% in 80+ year-old men. During the same week, the highest EM was observed for DeSOs with lowest income (171%), lowest education (162%), lowest share of Swedish-born (178%), and lowest share of gainfully employed (174%). There was a 1.2 to 1.7-fold increase in EM between those areas with a higher vs. lower proportion of young people.InterpretationLiving in areas with lower socioeconomic status and younger populations is linked to COVID-19 EM. These conditions might have facilitated the viral spread. Our findings add to the well-known biological vulnerability linked to increasing age, the relevance of the sociodemographic context when estimating the individual risk to COVID-19.FundingNone.


Author(s):  
S. S. Aleksanin ◽  
E. V. Bobrinev ◽  
V. I. Evdokimov ◽  
A. A. Kondashov ◽  
N. A. Mukhina ◽  
...  

Relevance. Russia has high mortality rates in general and among the working-age population, with dominating effects of external causes.Intention– To study rates and structures of the medical-statistical indicators of mortality due to diseases and the effects of external causes in the employees of the State Fire Service of the EMERCOM of Russia over 20 years from 1996 to 2015.Methods.Annual population under study averaged (108.8 ± 6.2) thousand people, or about 80% of all the employees of the State Fire Service of Russia who had special military ranks. Operating staff comprised 53.4%, other employees – 46.6%. Mortality rates were calculated per 100 thousand employees of the State Fire Service of Russia. Data on the mortality of working-age men in Russia was obtained on the website of the Federal Statistics Service of Russia (Rosstat) [http://www.gks.ru/]. The unification of accounting and analysis of indicators was achieved using the International Statistical Classification of Diseases and Related Health Problems, the 10th revision (ICD-10). Results and Discussion. Mortality rate among employees of the State Fire Service of the EMERCOM of Russia in 1996–2015 was (116.9 ± 5.7) deaths per 100 thousand employees per year vs 11 times higher mortality rate among the working-age male population of Russia: (1063.9 ± 33.7) deaths per 100 thousand men (p < 0.001). The mean age of the deceased employees of the State Fire Service of Russia was (44.5 ± 0.3) years, with overall mean age (36.9 ± 1.6) years (p < 0.001). The leading causes of death among employees of the State Fire Service of Russia (from more to less significant) were injuries and other effects of external causes (ICD-10 chapter XIX), diseases of the circulatory system (chapter IX) and neoplasms (II), diseases of the digestive system (XI) and diseases of the respiratory system (X). Mortality rates from these causes per 100 thousand employees per year amounted to (63.3 ± 33.7), (32.6 ± 2.7), (7.1 ± 0.6), (5.3 ± 1.0) and (5.0 ± 0.9) deaths; in cause-of-death structure – 54.2, 27.9, 6.0, 4.5 and 4.3%, respectively. The mortality rate from suicide among working-age Russian men was 6.4 times higher than that of firefighters – (66.0 ± 4.1) and (10.3 ± 1.1) deaths per 100 thousand men, respectively. However, in the overall cause-of-death structure, this cause accounted for a larger share in employ ees of the Russian State Fire Service (6.2 vs 8.8%). Statistically significant difference (p < 0.05) was found when comparing occupational fatalities among the operating personnel of the State Fire Service of Russia and working population in Russia: (14.9 ±1.4) deaths per 100 thousand employees per year vs (11.6 ± 0.7) deaths per 100 thousand workers per year. Mortality rates of firefighters were calculated in the Federal districts and regions of Russia. For a number of causes of death in firefighters, there is a significant contribution of occupational factors, which require further research.Conclusion.There is a low alertness for identifying neoplasms and crisis conditions in firefighters. Focusing on the leading diseases, behavioral disorders, prevention of injuries, poisoning and other effects of external causes will improve health and reduce mortality of employees of the State Fire Service of Russia.Authors declare the absence of existing and potential conflicts of interest concerning the article publication. 


2020 ◽  
Vol 28 (1) ◽  
pp. 230949902090258
Author(s):  
Hyo Geun Choi ◽  
Bong Cheol Kwon ◽  
Joong Il Kim ◽  
Joon Kyu Lee

Introduction: Mortality rates and causes of death after total knee arthroplasty (TKA) are of great interest to surgeons. However, there is a shortage of studies regarding those of the Asian population. The aim of this study was to compare the mortality rate and causes of death in patients after TKA to the general population. Methods: National sample cohort data from the Korean Health Insurance Review and Assessment Service were used. In this study, 1:4 matched patients after TKA (TKA group: 5072) and general participants (control group: 20,288) were selected as subjects. Their average follow-up duration was 57.2 months ranging from a year up to 12 years. The matches were processed for age, gender, income, region of residence, and past medical history. Mortality rates and causes of death were compared between groups. Regarding the mortality rates, we also performed subgroup analyses according to age. Results: Adjusted hazard ratio (HR) of the TKA group for mortality rate was less than 1 with significance (adjusted HR = 0.61 (95% confidence interval = 0.54–0.70, p < 0.001)). The ratios were less than 1 for both age groups (<70 and ≥70 years), respectively; however, for patients under 70, they were insignificant. Among the 11 major causes of death, the circulatory disease showed the most significantly reduced mortality rate for the TKA group compared to the control group. The neoplasm was the only other cause with a significantly reduced mortality rate for the TKA group. Conclusion: The mortality rate in the TKA group was significantly lower than in the control group up to 12 years after the surgery in Korea. Among the major causes of death, circulatory disease and neoplasm showed a significant reduction in the mortality rate of the TKA group compared with the control group.


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