scholarly journals Protocol of a research project ‘Projections of the burden of disease and disability in Finland – health policy prospects’ using cross-sectional health surveys and register-based follow-up

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e029338 ◽  
Author(s):  
Laura Paalanen ◽  
Tommi Härkänen ◽  
Hanna Tolonen
Keyword(s):  
Risk Factors ◽  
Health Policy ◽  
Burden Of Disease ◽  
Cerebrovascular Diseases ◽  
Chronic Obstructive ◽  
Health Examination ◽  
Research Project ◽  
Cross Sectional ◽  
Life Years ◽  
The Future

IntroductionWith the rapid ageing of the population in Europe, reliable estimates of the future development of the disease and disability burden as well as healthy life years in the older sections of the population are crucial. Meanwhile, the future prospects of the health and functional ability of the working-aged population are critical. The aims ofthe Projections of the burden of disease and disability in Finland – health policy prospectsresearch project are to provide information about the long-term consequences of health-related behaviours of the population and to project the potential improvement of the burden of disease and disability based on realistic scenarios about the development of risk behaviours in the total population and its subgroups.Methods and analysisThe analyses will be based on data from representative cross-sectional and longitudinal health examination surveys (HESs) conducted between 1972 to 2017 in Finland, and register data from several national administrative registers. Included HESs (FINRISK Surveys from 1972 to 2012, Mini-Finland Survey from 1978 to 1980, the Health 2000/2011 Surveys and the FinHealth 2017 Study) provide abundant information about biological and behavioural risk factors and the health and morbidity of the population. The modifiable risk factors used as predictors include hypertension, hyperlipidaemia, obesity, diabetes, physical inactivity, smoking, alcohol use and unfavourable diet. The main outcomes are ischaemic heart disease, cerebrovascular diseases, lung cancer, chronic obstructive pulmonary disease, Alzheimer’s disease and diabetes. Within the project, novel projection techniques of data-driven Bayesian hierarchical models to provide robust and comparable estimates will be developed.Ethics and disseminationThe prevailing legislation and regulations have been followed for all surveys. Surveys since 1997 have been approved by the respective Ethics Committees covering the scope of this project. A written informed consent was obtained from participants since 1997. The outputs of the project will include 8 to 10 scientific papers in peer-reviewed journals.

Projections for obesity, smoking and hypertension based on multiple imputation

2021 ◽  
pp. 140349482110610
Author(s):  
Jaakko Reinikainen ◽  
Tommi Härkänen ◽  
Hanna Tolonen
Keyword(s):  
Risk Factors ◽  
Multiple Imputation ◽  
Future Development ◽  
Health Indicators ◽  
Health Examination ◽  
Cross Sectional ◽  
Men And Women ◽  
Population Forecasts ◽  
The Future ◽  
Prevalence Of Obesity

Aims: Information on the future development of prevalences of risk factors and health indicators is needed to prepare for the forthcoming burden of disease in the population and to allocate resources properly for prevention. We aim to present how multiple imputation can be used flexibly to project future prevalences. Methods: The proposed approach uses data on repeated cross-sectional surveys from different years. We create future samples with age and sex distributions corresponding to the official national population forecasts. Then, the risk factors are simulated using multiple imputation by chained equations. Finally, the imputations are pooled to obtain the prevalences of interest. Covariates, such as sociodemographic variables as well as their possible interactions and non-linear terms, can be included in the modelling. The future development of these covariates is also projected simultaneously. We apply the procedure to data from five Finnish health examination surveys conducted between 1997 and 2017, and project the prevalences of obesity, smoking and hypertension to 2020 and 2025. Results: The prevalence of obesity is projected to increase to 24% for both men and women in 2025. The prevalences of hypertension and smoking are expected to continue decreasing, and the differences between men and women are projected to remain so that men will have higher prevalences. Conclusions: Simulation of future observations by multiple imputation can be used as a flexible yet relatively easy-to-use projection method.

scholarly journals Health Care Burden and Expenditure Associated with Adverse Childhood Experiences in Tennessee and Virginia

2021 ◽  
Author(s):  
Glory Okwori ◽  
Steven Stewart ◽  
Megan Quinn ◽  
Delaney Lawson
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Chronic Diseases ◽  
Adverse Childhood Experiences ◽  
Chronic Obstructive ◽  
Behavioral Risk ◽  
Cross Sectional ◽  
Childhood Experiences ◽  
Adverse Childhood ◽  
Life Years

AbstractTo estimate attributable burden and costs of conditions associated with exposure to Adverse Childhood Experiences (ACEs) in Tennessee (TN) and Virginia (VA) during 2017. This is a cross-sectional study of individuals aged 18+ having exposure to ACEs using Behavioral Risk Factor Surveillance System (BRFSS) data. Eight chronic diseases (asthma, obesity, hypertension, diabetes, chronic obstructive pulmonary disease (COPD), depression, cardiovascular disease, and arthritis) and two risk factors (smoking and drinking) associated with ACEs were analyzed. Pearson's chi-square tests analyzed the association between ACEs, risk factors and chronic diseases. The population attributable risks (PAR) were estimated for the ACEs related diseases and risk factors and combined with health care expenses and Disability Adjusted-Life-Years (DALYs). Among those who experienced at least 1 ACE in TN, 10% had COPD, 17% had diabetes, 36% had obesity, and 30% had depression. Individuals who experienced at least 1 ACE in VA had higher percentages for COPD, obesity and depression diseases compared to those who had no ACE (p< .0001). ACEs’ exposure resulted in a burden of about 115,000 years and 127,000 years in terms of DALYs in TN and VA, respectively. The total health spending associated with ACEs based on PARs was about $647 million ($165 per adult) and $942 million ($292 per adult) in TN and VA respectively. The total costs associated with ACEs was about $15.5 billion ($3948) per person) and $20.2 billion ($6288 per person) in TN and VA, respectively. This study emphasizes the need to reduce ACEs due to high health and financial costs.

Examination of incidence, mortality and disability-adjusted life years and risk factors of breast cancer in 49 Asian countries, 1990–2019: estimates from Global Burden of Disease Study 2019

2021 ◽  
Author(s):  
Rajesh Sharma
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Mortality Rate ◽  
Burden Of Disease ◽  
Global Burden ◽  
Disability Adjusted Life Years ◽  
Asian Countries ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Standardized Mortality Rate

Abstract Background This study presents an up-to-date, comprehensive and comparative examination of breast cancer’s temporal patterns in females in Asia in last three decades. Methods The estimates of incidence, mortality, disability-adjusted-life-years and risk factors of breast cancer in females in 49 Asian countries were retrieved from Global Burden of Disease 2019 study. Results In Asia, female breast cancer incidence grew from 245 045[226 259–265 260] in 1990 to 914 878[815 789–1025 502] in 2019 with age-standardized incidence rate rising from 21.2/100 000[19.6–22.9] to 35.9/100 000[32.0–40.2] between 1990 and 2019. The death counts more than doubled from 136 665[126 094–148 380] to 337 822[301 454–375 251]. The age-standardized mortality rate rose marginally between 1990 and 2019 (1990: 12.1[11.0–13.1]; 2019: 13.4[12.0–14.9]). In 2019, age-standardized incidence rate varied from 17.2/100 000[13.95–21.4] in Mongolia to 122.5[92.1–160.7] in Lebanon and the age-standardized mortality rate varied 4-fold from 8.0/100 000 [7.2–8.8] in South Korea to 51.9[39.0–69.8] in Pakistan. High body mass index (5.6%), high fasting plasma glucose (5.6%) and secondhand smoke (3.5%) were the main contributory risk factors to all-age disability-adjusted-life-years due to breast cancer in Asia. Conclusion With growing incidence, escalating dietary and behavioural risk factors and lower survival rates due to late-disease presentation in low- and medium-income countries of Asia, breast cancer has become a significant public health threat. Its rising burden calls for increasing breast cancer awareness, preventive measures, early-stage detection and cost-effective therapeutics in Asia.

scholarly journals The Contribution of Avoidable Mortality to the Life Expectancy Gains in Korea between 1998 and 2017

2020 ◽  
Vol 17 (18) ◽  
pp. 6499
Author(s):  
Jinwook Bahk ◽  
Kyunghee Jung-Choi
Keyword(s):  
Public Health ◽  
Health Policy ◽  
Life Expectancy ◽  
Traffic Accidents ◽  
Causes Of Death ◽  
Cross Sectional Study ◽  
Cerebrovascular Diseases ◽  
Avoidable Mortality ◽  
Cross Sectional ◽  
Major Factors

This study evaluated the contribution of avoidable causes of death to gains in life expectancy between 1998 and 2017 in Korea. This is a multi-year, cross-sectional study using national data. Death certificate data from 1998 to 2017 were obtained from Statistics Korea. The difference in life expectancy between 1998 and 2017 by age and cause of death were decomposed using Arriaga’s method. Life expectancy rose 7.73 years over 20 years in Korea, which was largely (more than 50%) due to changes in avoidable causes of death. As age increased, the contribution to changes in life expectancy increased, and the gain in life expectancy due to avoidable causes also tended to increase. The major factors that drove that gain in life expectancy were avoidable causes such as cerebrovascular diseases and traffic accidents. The gain in life expectancy from preventable diseases was greater in men than in women. The results of this study indicate that active public health programs have been effective in improving life expectancy in Korea. Moreover, avoidable mortality could be further improved with good public health policy. Health policy aimed at reducing amenable and preventable deaths should be further implemented to promote population health.

scholarly journals Prevalence and Risk Factors of Metabolic Associated Fatty Liver Disease in China: A Cross-Sectional Study

2021 ◽  
Author(s):  
Yuling Chen ◽  
Hao Li ◽  
Shu Li ◽  
Zhou Xu ◽  
Shen Tian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Metabolic Disorders ◽  
Menopausal Status ◽  
Cross Sectional Study ◽  
Health Examination ◽  
Sectional Study ◽  
Cross Sectional

Abstract BackgroundMetabolic associated fatty liver disease (MAFLD) is a new definition for liver disease associated with known metabolic dysfunction. Based on new diagnostic criteria, we aim to investigate its prevalence and risk factors in Chinese.MethodsThis cross-sectional study was implemented on 139170 subjects who participated in health examination.Results Among 139170 subjects, prevalence of MAFLD was 26.1% (males: 35.4%; females: 14.1%), and it was significantly higher before 65-year-old in males than that in females (36.2% vs. 12.2%, P<0.001), however significantly lower after 65 (28.2% vs. 33.0%, P<0.001). The prevalence in different female menopausal status (premenopause, perimenopause, postmenopause) was 6.1%,16.8%, and 30.2%, in BMI groups (underweight, normal, overweight and obese), it was 0.1%, 4.0%, 27.4% and 59.8%. Proportions of abnormal metabolic features in MAFLD group were significantly higher than those in non-MAFLD group, so as the proportion of elevated alanine aminotransferase (ALT) (42.5% vs. 11%, P<0.001). Prevalence of metabolic syndrome (MS), dyslipidemia, and hyperuricemia in MAFLD group (53.2%, 80.0%, and 45.0%) was significantly higher than that in non-MAFLD group (10.1%, 41.7%, and 16.8%). Logistic regression revealed that age, BMI, waist circumference, ALT, triglyceride, fasting glucose, uric acid and platelet count were associated with MAFLD.ConclusionsMAFLD is prevalent in China, its prevalence varies among different groups of age, gender, BMI, and female menopausal status. MAFLD was related to metabolic disorders especially obesity. People with MAFLD suffer high prevalence of MS, dyslipidemia, hyperuricemia, and elevated liver enzymes. Metabolic disorders should be paid attention to improve management of MAFLD.

scholarly journals The Global, Regional, and National Burden and Trends of Breast Cancer From 1990 to 2019: Results From the Global Burden of Disease Study 2019

2021 ◽  
Vol 11 ◽  
Author(s):  
Shangbo Xu ◽  
Yiyuan Liu ◽  
Taofeng Zhang ◽  
Jiehua Zheng ◽  
Weixun Lin ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Burden Of Disease ◽  
Global Burden Of Disease ◽  
Global Burden ◽  
Fasting Plasma ◽  
Life Years ◽  
High Fasting Plasma Glucose

BackgroundThe burden of breast cancer has been increasing globally. The epidemiology burden and trends need to be updated. This study aimed to update the burden and trends of breast cancer incidences, deaths, and disability-adjusted life-years (DALYs) from 1990 to 2019, using the Global Burden of Disease 2019 study.MethodsThe data of incidences, deaths, DALYs, and age-standardized rates were extracted. Estimated annual percentage changes were used to quantify the trends of age-standardized rates. Besides, the population attributable fractions of the risk factors of breast cancer were also estimated.ResultsGlobally, the incidences of breast cancer increased to 2,002,354 in 2019. High social-development index (SDI) quintiles had the highest incidence cases with a declining trend in age-standardized incidence rate. In 2019, the global deaths and DALYs of breast cancer increased to 700,660 and 20,625,313, respectively. From 1990 to 2019, the age-standardized mortality rates and age-standardized DALY rates declined globally, especially in high and high-middle SDI quintiles. Besides, the trends varied from different regions and countries. The proportion of the patients in the 70+ years age group increased globally. Deaths of breast cancer attributable to high fasting plasma glucose and high body mass index increased globally, and high fasting plasma glucose was the greatest contributor to the global breast cancer deaths.ConclusionThe burden of breast cancer in higher SDI quintiles had gone down while the burden was still on the rise in lower SDI quintiles. It is necessary to appeal to the public to decrease the exposure of the risk factors.

scholarly journals Global burden of breast cancer and attributable risk factors in 195 countries and territories, from 1990 to 2017: results from the Global Burden of Disease Study 2017

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Na Li ◽  
Yujiao Deng ◽  
Linghui Zhou ◽  
Tian Tian ◽  
Si Yang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Burden Of Disease ◽  
Attributable Risk ◽  
Global Burden Of Disease ◽  
Global Burden ◽  
Cancer Burden ◽  
Cancer Data ◽  
Life Years ◽  
Incident Cases

Abstract Background Statistical data on the incidence, mortality, and burden of breast cancer and the relevant risk factors are valuable for policy-making. We aimed to estimate breast cancer incidence, deaths, and disability-adjusted life years (DALYs) by country, gender, age group, and social-demographic status between 1990 and 2017. Methods We extracted breast cancer data from the 2017 Global Burden of Disease (GBD) study from 1990 through 2017 in 195 countries and territories. Data about the number of breast cancer incident cases, deaths, DALYs, and the age-standardized rates were collected. We also estimated the risk factors attributable to breast cancer deaths and DALYs using the comparative risk assessment framework of the GBD study. Results In 2017, the global incidence of breast cancer increased to 1,960,681 cases. The high social-development index (SDI) quintile included the highest number of breast cancer death cases. Between 2007 and 2017, the ASDR of breast cancer declined globally, especially in high SDI and high middle SDI countries. The related DALYs were 17,708,600 in 2017 with high middle SDI quintile as the highest contributor. Of the deaths and DALYs, alcohol use was the greatest contributor in most GBD regions and other contributors included high body mass index (BMI) and high fasting plasma glucose. Conclusion The increasing global breast cancer burden is mainly observed in lower SDI countries; in higher SDI countries, the breast cancer burden tends to be relieving. Therefore, steps against attributable risk factors should be taken to reduce breast cancer burden in lower SDI countries.

scholarly journals Environmental Burden of Childhood Disease in Europe

2019 ◽  
Vol 16 (6) ◽  
pp. 1084 ◽  
Author(s):  
David Rojas-Rueda ◽  
Martine Vrijheid ◽  
Oliver Robinson ◽  
Aasvang Gunn Marit ◽  
Regina Gražulevičienė ◽  
...  
Keyword(s):  
Risk Factors ◽  
Particulate Matter ◽  
Environmental Risk ◽  
Secondhand Smoke ◽  
Burden Of Disease ◽  
Environmental Risk Factors ◽  
World Health ◽  
Childhood Disease ◽  
Environmental Burden ◽  
Life Years

Background: Environmental factors determine children’s health. Quantifying the health impacts related to environmental hazards for children is essential to prioritize interventions to improve health in Europe. Objective: This study aimed to assess the burden of childhood disease due to environmental risks across the European Union. Methods: We conducted an environmental burden of childhood disease assessment in the 28 countries of the EU (EU28) for seven environmental risk factors (particulate matter less than 10 micrometer of diameter (PM10) and less than 2.5 micrometer of diameter (PM2.5), ozone, secondhand smoke, dampness, lead, and formaldehyde). The primary outcome was disability-adjusted life years (DALYs), assessed from exposure data provided by the World Health Organization, Global Burden of Disease project, scientific literature, and epidemiological risk estimates. Results: The seven studied environmental risk factors for children in the EU28 were responsible for around 211,000 DALYs annually. Particulate matter (PM10 and PM2.5) was the main environmental risk factor, producing 59% of total DALYs (125,000 DALYs), followed by secondhand smoke with 20% of all DALYs (42,500 DALYs), ozone 11% (24,000 DALYs), dampness 6% (13,000 DALYs), lead 3% (6200 DALYs), and formaldehyde 0.2% (423 DALYs). Conclusions: Environmental exposures included in this study were estimated to produce 211,000 DALYs each year in children in the EU28, representing 2.6% of all DALYs in children. Among the included environmental risk factors, air pollution (particulate matter and ozone) was estimated to produce the highest burden of disease in children in Europe, half of which was due to the effects of PM10 on infant mortality. Effective policies to reduce environmental pollutants across Europe are needed.

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