scholarly journals Uneven state distribution of homicides in Brazil and their effect on life expectancy, 2000–2015: a cross-sectional mortality study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e044706
Author(s):  
José Manuel Aburto ◽  
Julia Calazans ◽  
Bernardo Lanza Queiroz ◽  
Shammi Luhar ◽  
Vladimir Canudas-Romo

ObjectiveTo determine cause-specific and age-specific contributions to life expectancy changes between 2000 and 2015, separately by state and sex in Brazil, with a focus on homicides.DesignRetrospective cross-sectional demographic analysis of mortality.Setting and populationBrazilian population by age, sex and state from 2000 to 2015.Main outcome measureUsing mortality data from the Brazilian Mortality Information System and population estimates from the National Statistics Office, we used death distribution methods and the linear integral decomposition model to estimate levels and changes in life expectancy. We also examine how multiple causes of death, including those attributable to homicides and amenable/avoidable mortality, contributed to these changes from 2000 to 2015.ResultsBetween 2000 and 2015, life expectancy in Brazil increased from 71.5 to 75.1 years. Despite state-level variation in gains, life expectancy increased in almost all states over this period. However across Brazil, homicide mortality contributed, to varying degrees, to either attenuated or decreased male life expectancy gains. In Alagoas in 2000–2007 and Sergipe in 2007–2015, homicides contributed to a reduction in life expectancy of 1.5 years, offsetting gains achieved through improvements due to medically amenable causes. In the period 2007–2015, male life expectancy could have been improved by more than half a year in 12 of Brazil’s states if homicide mortality had remained at the levels of 2007.ConclusionsHomicide mortality appears to offset life expectancy gains made through recent improvements to mortality amenable to medical services and public health interventions, with considerable subnational heterogeneity in the extent of this phenomenon. Efforts combating the causes of homicides can increase life expectancy beyond what has been achieved in recent decades.

Author(s):  
Jinwook Bahk ◽  
Kyunghee Jung-Choi

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.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N Nante ◽  
L Kundisova ◽  
F Gori ◽  
A Martini ◽  
F Battisti ◽  
...  

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.


Medicina ◽  
2011 ◽  
Vol 47 (9) ◽  
pp. 504 ◽  
Author(s):  
Vilius Grabauskas ◽  
Aldona Gaižauskienė ◽  
Skirmantė Sauliūnė ◽  
Rasa Mišeikytė

The process of the restructuring of health care system in Lithuania demonstrates the need to continue the monitoring of changes in avoidable mortality. Objective. To assess the level of avoidable mortality as well as its changes over time in Lithuania during 2001–2008 and to define the impact of avoidable mortality on life expectancy. Material and Methods. The mortality data were taken from the Lithuanian Department of Statistics. Twelve avoidable causes of deaths (treatable and preventable) were analyzed. Mortality trends were assessed by computing the average annual percent change (AAPC). The shortening of average life expectancy was computed from survival tables. Results. During the period 2001–2008, the avoidable mortality was increasing more significantly (AAPC 3.0%, P<0.05) than the overall mortality (AAPC 1.7%, P<0.05) in the population aged 5–64 years. The increasing trend was mainly determined by mortality from preventable diseases (AAPC 4.6%, P<0.05). The avoidable causes of death reduced the life expectancy by 1.77 years (preventable by 1.12 and treatable by 0.63 years). Diversity in trends in mortality of different avoidable causes was disclosed. A declining trend in mortality caused by chronic rheumatic heart disease and lung cancer was observed for males (AAPC –22.6% and –2.1%, respectively; P<0.05). However, the mortality caused by liver cirrhosis was increasing for both genders (AAPC 16.1% for males and 17.6% for females, P<0.01) and that caused by tuberculosis – only for females (AAPC 7.8%, P<0.05). Conclusions. An increasing trend in avoidable mortality was observed. Deaths caused by the diseases that could have been prevented had the greatest impact on the increasing mortality and decreasing life expectancy.


2019 ◽  
Author(s):  
Bernardo L Queiroz ◽  
Marcos Roberto Gonzaga ◽  
Ana Maria Nogales ◽  
Bruno Torrente ◽  
Daisy Maria Xavier de Abreu

Estimates of completeness of death registration are crucial to produce estimates of life tables, population projections and to the global burden of diseases study. They are an imperative step in quality of data analysis. In the case of state level data in Brazil, it is important to consider spatial and temporal variation in the quality of mortality data. In this paper, we compare and discuss alternative estimates of completeness of death registration, adult mortality (45q15) and life expectancy estimates produced by the National Statistics Office (IBGE), Institute for Health Metrics and Evaluation (IHME) and estimates presented in Queiroz, et.al (2017) and Schmertmann and Gonzaga (2018), for 1980 and 2010. We find significant differences in estimates that affect both levels and trends of completeness of adult mortality in Brazil and states. IHME and Queiroz, et.al (2017) estimates converge in 2010, but there are large differences when compared to estimates from the National Statistics Office (IBGE). Larger differences are observed for less developed states.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ali Kiadaliri

Abstract Background Avoidable mortality is considered as a potential indicator of the influences of public health policies and healthcare quality on population health. This study aimed to examine the trend in avoidable mortality and its influence on rising life expectancy (LE) and declining gender gap in LE (GGLE) in Sweden. Methods We extracted data on causes of death by age, sex, and year from national registry from 1997 to 2018. The UK Office for National Statistics definition was used to divide causes of death into five mutually exclusive categories: amenable, preventable, amenable & preventable, ischemic heart disease (IHD), and non-avoidable causes. We applied Joinpoint regression to analyse temporal trends in age-standardized mortality rates. The Arriaga method was applied to decompose changes in LE and GGLE by age group and causes of death. Results Average annual reductions in avoidable vs. non-avoidable mortality were 2.6% (95% CI:2.5, 2.7) vs. 1.4% (95% CI:1.3, 1.5) in men, and 1.6% (95% CI:1.4, 1.9) vs. 0.9% (95% CI:0.7, 1.0) in women over the study period. LE in men rose by 4.1 years between 1997 and 2018 (from 72.8 to 76.9 years), of which 2.4 years (59.3%) were attributable to reductions in avoidable mortality. Corresponding LE gain was 2.3 years in women (from 78.0 in 1997 to 80.3 in 2018) and avoidable mortality accounted for 1.0 year (45.6%) of this gain. Between 1997 and 2018, the GGLE narrowed by 1.9 years, of which 1.4 years (77.7%) were attributable to avoidable causes. Among avoidable causes, while preventable causes had the largest contribution to the GGLE, IHD had the greatest contributions to LE gains and the narrowing GGLE. Conclusions Our findings showed that avoidable causes had a substantial contribution to gain in LE with more profound gain in men than in women, resulting in narrowing the GGLE. Lower pace of reductions in preventable than amenable mortality highlights the need for improving the effectiveness of inter-sectoral health policies aimed at behavioural changes.


2016 ◽  
Vol 4 (2) ◽  
pp. 279
Author(s):  
Mariana Mourgova

Mortality due to avoidable causes of death is one of the most often used quality and efficiency indicators for the health care system and the policies of prevention of morbidity and mortality by causes of death due to behavioural or environmental factors. The objective of the article is to study the impact of avoidable mortality including amenable and preventable mortality on the life expectancy in Bulgaria during the period 2005-2012. The classification of avoidable mortality, proposed by the Office for National Statistics of the United Kingdom in 2011, is used. The methods of decomposing the change in two life expectancies by age and the change in two life expectancies by age according to the causes of death by E. Andreev and E. Arriaga are applied to measure the impact on the change in life expectancy. The main results of the study show that during the period 2005-2012 along with the decrease in the total mortality, also the avoidable mortality has dropped – from 34. 72% to 29. 12% of the mortality due to all causes of death. The avoidable causes’ of death contribution to life expectancy increase is by 1. 20 years and it is considerably greater than those of the other causes. Mortality due to amenable and preventable causes of death is also decreasing. Greater is the effect of the amenable causes of death on the life expectancy increase.


2019 ◽  
Vol 4 ◽  
pp. 49 ◽  
Author(s):  
Robert W Aldridge ◽  
Dee Menezes ◽  
Dan Lewer ◽  
Michelle Cornes ◽  
Hannah Evans ◽  
...  

Background: Homelessness has increased by 165% since 2010 in England, with evidence from many settings that those affected experience high levels of mortality. In this paper we examine the contribution of different causes of death to overall mortality in homeless people recently admitted to hospitals in England with specialist integrated homeless health and care (SIHHC) schemes. Methods: We undertook an analysis of linked hospital admission records and mortality data for people attending any one of 17 SIHHC schemes between 1st November 2013 and 30th November 2016. Our primary outcome was death, which we analysed in subgroups of 10th version international classification of disease (ICD-10) specific deaths; and deaths from amenable causes. We compared our results to a sample of people living in areas of high social deprivation (IMD5 group).Results: We collected data on 3,882 individual homeless hospital admissions that were linked to 600 deaths. The median age of death was 51.6 years (interquartile range 42.7-60.2) for SIHHC and 71.5 for the IMD5 (60.67-79.0).  The top three underlying causes of death by ICD-10 chapter in the SIHHC group were external causes of death (21.7%; 130/600), cancer (19.0%; 114/600) and digestive disease (19.0%; 114/600).  The percentage of deaths due to an amenable cause after age and sex weighting was 30.2% in the homeless SIHHC group (181/600) compared to 23.0% in the IMD5 group (578/2,512).Conclusion: Nearly one in three homeless deaths were due to causes amenable to timely and effective health care. The high burden of amenable deaths highlights the extreme health harms of homelessness and the need for greater emphasis on prevention of homelessness and early healthcare interventions.


2018 ◽  
Vol 24 (2) ◽  
pp. 55-58 ◽  
Author(s):  
Bindu Kalesan ◽  
Mrithyunjay A Vyliparambil ◽  
Yi Zuo ◽  
Jeffrey J Siracuse ◽  
Jeffrey A Fagan ◽  
...  

Understanding the life years lost by assault and suicide due to firearms among white and black Americans can help us understand the race-specific and intent-specific firearm mortality burden and inform prevention programmes. The objective was to assess national and race-specific life expectancy loss related to firearms in the USA due to assault and suicide. We used firearm mortality data available from Wide-ranging Online Data for Epidemiologic Research to calculate the life expectancy loss between 2000 and 2016 separately for assaults and suicides among white and black Americans. The total national life expectancy loss due to firearms was 2.48 (2.23 whites, 4.14 blacks) years. The total life expectancy loss in years due to firearm assault was 0.95 (0.51 whites, 3.41 blacks) and suicide was 1.43 (1.62 whites, 0.60 blacks), respectively. Firearm life expectancy loss in years at birth, 20, 40 and 60 years of age was 0.29 (0.22 whites, 0.56 blacks), 0.25 (0.21 whites, 0.47 blacks), 0.09 (0.10 whites, 0.08 blacks) and 0.03 (0.03 whites, 0.01 blacks) years. National firearm life expectancy loss in days from 20 to 60 years declined by 79.5 (65.8 whites, 166.3 blacks); for assault by 37.5 (18.9 whites, 141.0 blacks) and suicides by 38.7 (43.9 whites, 20.3 blacks). Americans lose substantial years of life due to firearm injury. This loss in life years is characterised by a large racial gap by age and intent. Tailored prevention programmes are needed to reduce this loss and lessen the racial gaps.


2019 ◽  
Vol 74 (2) ◽  
pp. 144-150 ◽  
Author(s):  
Sergey Timonin ◽  
Domantas Jasilionis ◽  
Vladimir M. Shkolnikov ◽  
Evgeny Andreev

BackgroundPrior studies on spatial inequalities in mortality in Russia were restricted to the highest level of administrative division, ignoring variations within the regions. Using mortality data for 2239 districts, this study is the first analysis to capture the scale of the mortality divide at a more detailed level.MethodsAge-standardised death rates are calculated using aggregated deaths for 2008–2012 and population exposures from the 2010 census. Inequality indices and decomposition are applied to quantify both the total mortality disparities across the districts and the contributions of the variations between and within regions.ResultsRegional variations in mortality mask one-third (males) and one-half (females) of the inequalities observed at the district level. A comparison of the 5% of individuals residing in the districts with the highest and the lowest mortality shows a gap of 15.5 years for males and 10.3 years for females. The lowest life expectancy levels are in the shrinking areas of the Far East and Northwest of Russia. The highest life expectancy clusters are in the intercity districts of Moscow and Saint Petersburg, and in several science cities. Life expectancy in these best-practice districts is close to the national averages of Poland and Estonia, but is still substantially below the averages in Western countries.ConclusionThe large between-regional and within-regional disparities suggest that national-level mortality could be lowered if these disparities are reduced by improving health in the laggard areas. This can be achieved by introducing policies that promote health convergence both within and between the Russian regions.


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