scholarly journals Increasing socioeconomic gap between the young and old: temporal trends in health and overall deprivation in England by age, sex, urbanity and ethnicity, 2004–2015

2018 ◽  
Vol 72 (7) ◽  
pp. 636-644 ◽  
Author(s):  
Evangelos Kontopantelis ◽  
Mamas A Mamas ◽  
Harm van Marwijk ◽  
Iain Buchan ◽  
Andrew M Ryan ◽  
...  
Keyword(s):  
Relative Deprivation ◽  
Important Determinant ◽  
Temporal Trends ◽  
Population Characteristics ◽  
Government Policies ◽  
Real Wages ◽  
Regional Variability ◽  
Cross Sectional ◽  
Index Of Multiple Deprivation ◽  
Over Time

BackgroundAt a low geographical level, little is known about the associations between population characteristics and deprivation, and their trends, which would be directly affected by the house market, labour pressures and government policies. We describe temporal trends in health and overall deprivation in England by age, sex, urbanity and ethnicity.MethodsRepeated cross-sectional whole population study for England, 2004–2015, at a low geographical level (average 1500 residents). We calculated weighted medians of the Index of Multiple Deprivation (IMD) for each subgroup of interest.ResultsOver time, we observed increases in relative deprivation for people aged under 30, and aged 30–59, while median deprivation decreased for those aged 60 or over. Subgroup analyses indicated that relative overall deprivation was consistently higher for young adults (aged 20–29) and infants (aged 0–4), with increases in deprivation for the latter. Levels of overall deprivation in 2004 greatly varied by ethnicity, with the lowest levels observed for White British and the highest for Blacks. Over time, small reductions were observed in the deprivation gap between White British and all other ethnic groups. Findings were consistent across overall IMD and its health and disability subdomain, but large regional variability was also observed.ConclusionsGovernment policies, the financial crisis of 2008, education funding and the increasing cost of houses relative to real wages are important parameters in interpreting our findings. Socioeconomic deprivation is an important determinant of health and the inequalities this work highlights may have significant implications for future fiscal and healthcare policy.

Temporal Trends in the Severity and Mortality of Neonatal Hypoxic-Ischemic Encephalopathy in the Era of Hypothermia

Neonatology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Cristina Vega-Del-Val ◽  
Juan Arnaez ◽  
Sonia Caserío ◽  
Elena Pilar Gutiérrez ◽  
Marta Benito ◽  
...  
Keyword(s):  
Temporal Trends ◽  
Cross Sectional Study ◽  
Annual Incidence ◽  
Hypoxic Ischemic Encephalopathy ◽  
Cross Sectional ◽  
Incidence And Mortality ◽  
Changes Over Time ◽  
Ischemic Encephalopathy ◽  
Annual Decline ◽  
Over Time

<b><i>Introduction:</i></b> There is a paucity of studies examining temporal trends in the incidence and mortality of moderate-to-severe hypoxic-ischemic encephalopathy (HIE) during the last decade of therapeutic hypothermia (TH). <b><i>Methods:</i></b> Multicenter cross-sectional study of all infants ≥35 weeks gestational age diagnosed with moderate-to-severe HIE within 6 h of birth in an extensive region of Spain between 2011 and 2019, in order to detect trend changes over time in the (1) annual incidence, (2) severity of neurological and systemic organ involvement, and (3) neonatal death from HIE. <b><i>Results:</i></b> Annual incidence rate of moderate-to-severe HIE was 0.84 (95% confidence interval [CI] 0.7–0.97) per 1,000 births, without trend changes over time (<i>p</i> = 0.8), although the proportion of severe HIE infants showed an average annual decline of 0.86 points (95% CI 0.75–0.98). There were 102 (70%) infants diagnosed with moderate HIE and 44 (30%) with severe HIE. TH was offered to 139/146 (95%) infants. Infants with clinical and/or electrical seizures showed a decreasing trend from 56 to 28% (<i>p</i> = 0.006). Mortality showed a nonstatistically significant decline (<i>p</i> = 0.4), and the severity of systemic damage showed no changes (<i>p</i> = 0.3). Obstetric characteristics remained unchanged, while higher perinatal pH values (<i>p</i> = 0.03) and Apgar scores (<i>p</i> = 0.05), and less need for resuscitation (<i>p</i> = 0.07), were found over time. <b><i>Conclusion:</i></b> The annual incidence of moderate-to-severe HIE has stabilized at around 1 per 1,000 births, with a temporal trend toward a decrease in severe HIE infants and a slight decline of mortality. No association was found between temporal trends and changes in perinatal/obstetric characteristics over time.

scholarly journals Persistent disparities in antiretroviral treatment (ART) coverage and virological suppression across Europe, 2004 to 2015

2018 ◽  
Vol 23 (21) ◽  
Author(s):  
Kamilla Laut ◽  
Leah Shepherd ◽  
Roxana Radoi ◽  
Igor Karpov ◽  
Milosz Parczewski ◽  
...  
Keyword(s):  
Best Practice ◽  
Western Europe ◽  
Antiretroviral Treatment ◽  
Temporal Trends ◽  
Virological Suppression ◽  
Hiv Care ◽  
Cross Sectional ◽  
Eurosida Study ◽  
Over Time ◽  
Country Specific

Background: Direct comparisons between countries in core HIV care parameters are often hampered by differences in data collection. Aim: Within the EuroSIDA study, we compared levels of antiretroviral treatment (ART) coverage and virological suppression (HIV RNA < 500 copies/mL) across Europe and explored temporal trends. Methods: In three cross-sectional analyses in 2004–05, 2009–10 and 2014–15, we assessed country-specific percentages of ART coverage and virological suppression among those on ART. Temporal changes were analysed using logistic regression. Results: Overall, the percentage of people on ART increased from 2004–05 (67.8%) to 2014–15 (78.2%), as did the percentage among those on ART who were virologically suppressed (75.2% in 2004–05, 87.7% in 2014–15). However, the rate of improvement over time varied significantly between regions (p < 0.01). In 2014–15, six of 34 countries had both ART coverage and virological suppression of above 90% among those on ART. The pattern varied substantially across clinics within countries, with ART coverage ranging from 61.9% to 97.0% and virological suppression from 32.2% to 100%. Compared with Western Europe (as defined in this study), patients in other regions were less likely to be virologically suppressed in 2014–15, with the lowest odds of suppression (adjusted odds ratio = 0.16; 95% confidence interval (CI): 0.13–0.21) in Eastern Europe. Conclusions: Despite overall improvements over a decade, we found persistent disparities in country-specific estimates of ART coverage and virological suppression. Underlying reasons for this variation warrant further analysis to identify a best practice and benchmark HIV care across EuroSIDA.

scholarly journals Age-Specific Rates of Onset of Cannabis Use in Mexico

2020 ◽  
Author(s):  
Mauricio López-Méndez ◽  
Angélica Ospina-Escobar ◽  
Rowan Iskandar ◽  
Fernando Alarid-Escudero
Keyword(s):  
Birth Cohort ◽  
Temporal Trends ◽  
Tobacco Consumption ◽  
Cannabis Use ◽  
Parametric Models ◽  
Birth Cohorts ◽  
Cross Sectional ◽  
Cannabis Consumption ◽  
Nationally Representative ◽  
Over Time

AbstractBackgroundOver the previous two decades, the prevalence of cannabis use has risen among the population in Mexico.AimsTo estimate the sex- and age-specific rates of onset of cannabis use over time.DesignTime-to-event flexible parametric models with spline specifications of the hazard function. Stratified analysis by sex, and control for temporal trends by year of data collection or decennial birth-cohort.SettingMexico.ParticipantsPooled sample of 141,342 respondents aged between 12 and 65 years from five nationally representative cross-sectional surveys, the Mexican National Surveys of Addictions (1998, 2002, 2008, 2012) and the Mexican National Survey on Drugs, Alcohol, and Tobacco Consumption (2016).MeasurementsWe estimated age-specific rates of onset of cannabis as the conditional rate of consuming cannabis for the first time at a specific age.FindingsAge-specific rates of onset of cannabis use per 1,000 individuals increased over time for both females and males. Peak rates per 1,000 ranged from 0.935 (95%CI= [0.754,1.140]) in 1998, to 5.390 (95%CI= [4.910,5.960]) in 2016 for females; and from 7.510 (95%CI= [5.516, 10.355]) in 1998, to 26.100 (95%CI= [23.162,30.169]) in 2016 for males. Across decennial birth-cohorts, peak rates of onset of cannabis use per 1,000 individuals for females ranged from 0.342 (95%CI= [0.127,0.898]) for those born in the 1930s, to 14.600 (95%CI= [13.200,16.100]) for those born in the 1990s; and for males, from 4.900 (95%CI= [0.768, 7.947]) for those born in the 1930s, to 38.700 (95%CI= [32.553,66.341]) for those born in the 1990s.ConclusionRates of onset of cannabis use for males are higher than for females; however, the change across recent cohorts of the rates of onset has increased at a faster rate among females. Our findings can inform and improve the implementation of policies around cannabis use by identifying subpopulations by age, sex, and birth-cohort that are at the highest risk of initiating cannabis consumption.

Mortality improvement by socio-economic circumstances in England (1982 to 2006)

2012 ◽  
Vol 19 (1) ◽  
pp. 1-35 ◽  
Author(s):  
J. L. C. Lu ◽  
W. Wong ◽  
M. Bajekal
Keyword(s):  
Financial Management ◽  
Relative Deprivation ◽  
Population Data ◽  
Mortality Rates ◽  
Mortality Data ◽  
Mortality Trends ◽  
Mortality Improvement ◽  
Index Of Multiple Deprivation ◽  
Insight Into ◽  
Over Time

AbstractAssessing longevity risk is crucial to the financial management of annuities and longevity-related financial instruments. Actuaries have been using socio-economic circumstances (SEC) of individuals estimated through postcodes, pension size and occupation to price annuities for prospective customers. Differences in mortality rates of people in different SEC have been discussed extensively but less is known about how their mortality rates have changed over time.A lack of regular, consistent and credible mortality data for people in different SEC has hampered the study of historical mortality trends. This in turn has made forecasting a greater challenge. To address some of these data issues, we have obtained mortality and population data between 1981 and 2007 for England, divided into SEC quintiles (measured by the relative deprivation of the area of residence according to the Index of Multiple Deprivation (IMD) 2007). Using the data, we have analysed the mortality trends by SEC. These findings can provide insight into mortality improvement for people in different SEC. This can contribute to commercial decisions for annuity businesses, reinsurance and longevity swaps.

scholarly journals Spatial distribution and temporal trends in social fragmentation in England, 2001−2011: a national study

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e025881
Author(s):  
Christos Grigoroglou ◽  
Luke Munford ◽  
Roger T Webb ◽  
Nav Kapur ◽  
Darren M Ashcroft ◽  
...  
Keyword(s):  
Mental Illness ◽  
Spatial Clustering ◽  
Temporal Trends ◽  
National Study ◽  
Spatial And Temporal Patterns ◽  
Regional Variability ◽  
Social Fragmentation ◽  
Private Renting ◽  
Health And Social Care ◽  
Over Time

ObjectiveSocial fragmentation is commonly examined in epidemiological studies of mental illness as high levels of social fragmentation are often found in areas with high prevalence of mental illness. In this study, we examine spatial and temporal patterns of social fragmentation and its underlying indicators in England over time.SettingData for social fragmentation and its underlying indicators were analysed over the decennial Censuses (2001–2011) at a small area geographical level (mean of 1500 people). Degrees of social fragmentation and temporal changes were spatially visualised for the whole of England and its 10 administrative regions. Spatial clustering was quantified using Moran’s I; changes in correlations over time were quantified using Spearman’s ranking correlation.ResultsBetween 2001 and 2011, we observed a strong persistence for social fragmentation nationally (Spearman’s r=0.93). At the regional level, modest changes were observed over time, but marked increases were observed for two of the four social fragmentation underlying indicators, namely single people and those in private renting. Results supported our hypothesis of increasing spatial clustering over time. Moderate regional variability was observed in social fragmentation, its underlying indicators and their clustering over time.ConclusionPatterns of social fragmentation and its underlying indicators persisted in England which seem to be driven by the large increases in single people and those in private renting. Policies to improve social cohesion may have an impact on the lives of persons who experience mental illness. The spatial aspect of social fragmentation can inform the targeting of health and social care interventions, particularly in areas with strong social fragmentation clustering.

scholarly journals Temporal Trends of Emergency Department Visits of Patients with Atrial Fibrillation: A Nationwide Population-Based Study

2020 ◽  
Vol 9 (5) ◽  
pp. 1485
Author(s):  
So-Ryoung Lee ◽  
Eue-Keun Choi ◽  
Seo-Young Lee ◽  
Euijae Lee ◽  
Kyung-Do Han ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
Temporal Trends ◽  
Population Based ◽  
Emergency Department Visits ◽  
Cross Sectional ◽  
Ed Visits ◽  
Management Approaches ◽  
Sectional Analysis ◽  
Over Time

We aimed to describe temporal trends in emergency department (ED) visits of patients with atrial fibrillation (AF) over 12 years. A repeated cross-sectional analysis of ED visits in AF patients using the Korean nationwide claims database between 2006 and 2017 were conducted. We identified AF patients who had ≥1 ED visits. The incidence of ED visits among total AF population, cause of ED visit, and clinical outcomes were evaluated. During 12 years, the annual numbers of AF patients who attended ED at least once a year continuously increased (40,425 to 99,763). However, the annual incidence of ED visits of AF patients was stationary at about 30% because the number of total AF patients also increased during the same period. The most common cause of ED visits was cerebral infarction. Although patients had a higher risk profile over time, the 30-day and 90-day mortality after ED visit decreased over time. ED visits due to ischemic stroke, intracranial hemorrhage, and myocardial infarction decreased, whereas ED visits due to AF, gastrointestinal bleeding, and other major bleeding slightly increased among total AF population over 12 years. A substantial proportion of AF patients attended ED every year, and the annual numbers of AF patients who visited the ED significantly increased over 12 years. Optimized management approaches in a holistic and integrated manner should be provided to reduce ED visits of AF patients.

scholarly journals Temporal Trends and Predictors of Modern Contraceptive Use in Lusaka, Zambia, 2004–2011

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Nancy L. Hancock ◽  
Carla J. Chibwesha ◽  
Marie C. D. Stoner ◽  
Bellington Vwalika ◽  
Sujit D. Rathod ◽  
...  
Keyword(s):  
Contraceptive Use ◽  
Temporal Trends ◽  
Unmet Need ◽  
Modern Contraceptive ◽  
Short Term ◽  
Cross Sectional ◽  
Oral Contraceptive Pills ◽  
Modern Methods ◽  
Modern Contraceptive Use ◽  
Over Time

Introduction. Although increasing access to family planning has been an important part of the global development agenda, millions of women continue to face unmet need for contraception.Materials and Methods. We analyzed data from a repeated cross-sectional community survey conducted in Lusaka, Zambia, over an eight-year period. We described prevalence of modern contraceptive use, including long-acting reversible contraception (LARC), among female heads of household aged 16–50 years. We also identified predictors of LARC versus short-term contraceptive use among women using modern methods.Results and Discussion. Twelve survey rounds were completed between November 2004 and September 2011. Among 29,476 eligible respondents, 17,605 (60%) reported using modern contraception. Oral contraceptive pills remained the most popular method over time, but use of LARC increased significantly, from less than 1% in 2004 to 9% by 2011 (p<0.001). Younger women (OR: 0.46, 95% CI: 0.34, 0.61) and women with lower levels of education (OR: 0.70, 95% CI: 0.56, 0.89) were less likely to report LARC use compared to women using short-term modern methods.Conclusions. Population-based assessments of contraceptive use over time can guide programs and policies. To achieve reproductive health equity and reduce unmet contraceptive need, future efforts to increase LARC use should focus on young women and those with less education.

Twitter Usage Using Common Reference to Tinnitus

2020 ◽  
Vol 29 (2) ◽  
pp. 206-217
Author(s):  
Jianyuan Ni ◽  
Monica L. Bellon-Harn ◽  
Jiang Zhang ◽  
Yueqing Li ◽  
Vinaya Manchaiah
Keyword(s):  
Nonprofit Organizations ◽  
Temporal Trends ◽  
Temporal Analysis ◽  
Cross Sectional ◽  
For Profit ◽  
Common Reference ◽  
Personal Experiences ◽  
Twitter Users ◽  
Sectional Analysis ◽  
Share Information

Objective The objective of the study was to examine specific patterns of Twitter usage using common reference to tinnitus. Method The study used cross-sectional analysis of data generated from Twitter data. Twitter content, language, reach, users, accounts, temporal trends, and social networks were examined. Results Around 70,000 tweets were identified and analyzed from May to October 2018. Of the 100 most active Twitter accounts, organizations owned 52%, individuals owned 44%, and 4% of the accounts were unknown. Commercial/for-profit and nonprofit organizations were the most common organization account owners (i.e., 26% and 16%, respectively). Seven unique tweets were identified with a reach of over 400 Twitter users. The greatest reach exceeded 2,000 users. Temporal analysis identified retweet outliers (> 200 retweets per hour) that corresponded to a widely publicized event involving the response of a Twitter user to another user's joke. Content analysis indicated that Twitter is a platform that primarily functions to advocate, share personal experiences, or share information about management of tinnitus rather than to provide social support and build relationships. Conclusions Twitter accounts owned by organizations outnumbered individual accounts, and commercial/for-profit user accounts were the most frequently active organization account type. Analyses of social media use can be helpful in discovering issues of interest to the tinnitus community as well as determining which users and organizations are dominating social network conversations.

Understanding Rising Income Inequality and Stagnating Ordinary Living Standards in Germany

2018 ◽  
Author(s):  
Gerhard Bosch ◽  
Thorsten Kalina
Keyword(s):  
Income Inequality ◽  
Labour Market ◽  
Economic Crisis ◽  
Household Income ◽  
Wage Bargaining ◽  
Living Standards ◽  
Social Model ◽  
Real Wages ◽  
The Impact ◽  
Over Time

This chapter describes how inequality and real incomes have evolved in Germany through the period from the 1980s, through reunification, up to the economic Crisis and its aftermath. It brings out how reunification was associated with a prolonged stagnation in real wages. It emphasizes how the distinctive German structures for wage bargaining were eroded over time, and the labour market and tax/transfer reforms of the late 1990s-early/mid-2000s led to increasing dualization in the labour market. The consequence was a marked increase in household income inequality, which went together with wage stagnation for much of the 1990s and subsequently. Coordination between government, employers, and unions still sufficed to avoid the impact the economic Crisis had on unemployment elsewhere, but the German social model has been altered fundamentally over the period

scholarly journals Is area deprivation associated with greater impacts of COVID-19 in care homes across England? A preliminary analysis of COVID-19 outbreaks and deaths

2021 ◽  
pp. jech-2020-215039 ◽  
Author(s):  
Anders Malthe Bach-Mortensen ◽  
Michelle Degli Esposti
Keyword(s):  
Negative Binomial ◽  
Care Home ◽  
Negative Binomial Regression ◽  
Population Characteristics ◽  
Care Homes ◽  
Future Research ◽  
Area Deprivation ◽  
Binomial Regression ◽  
Index Of Multiple Deprivation

IntroductionThe COVID-19 pandemic has disproportionately impacted care homes and vulnerable populations, exacerbating existing health inequalities. However, the role of area deprivation in shaping the impacts of COVID-19 in care homes is poorly understood. We examine whether area deprivation is linked to higher rates of COVID-19 outbreaks and deaths among care home residents across upper tier local authorities in England (n=149).MethodsWe constructed a novel dataset from publicly available data. Using negative binomial regression models, we analysed the associations between area deprivation (Income Deprivation Affecting Older People Index (IDAOPI) and Index of Multiple Deprivation (IMD) extent) as the exposure and COVID-19 outbreaks, COVID-19-related deaths and all-cause deaths among care home residents as three separate outcomes—adjusting for population characteristics (size, age composition, ethnicity).ResultsCOVID-19 outbreaks in care homes did not vary by area deprivation. However, COVID-19-related deaths were more common in the most deprived quartiles of IDAOPI (incidence rate ratio (IRR): 1.23, 95% CI 1.04 to 1.47) and IMD extent (IRR: 1.16, 95% CI 1.00 to 1.34), compared with the least deprived quartiles.DiscussionThese findings suggest that area deprivation is a key risk factor in COVID-19 deaths among care home residents. Future research should look to replicate these results when more complete data become available.

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