scholarly journals New perspective on geographical mortality divide in Russia: a district-level cross-sectional analysis, 2008–2012

2019 ◽  
Vol 74 (2) ◽  
pp. 144-150 ◽  
Author(s):  
Sergey Timonin ◽  
Domantas Jasilionis ◽  
Vladimir M. Shkolnikov ◽  
Evgeny Andreev
Keyword(s):  
Life Expectancy ◽  
Best Practice ◽  
National Level ◽  
Far East ◽  
Total Mortality ◽  
District Level ◽  
Mortality Data ◽  
Cross Sectional ◽  
Spatial Inequalities ◽  
New Perspective

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.

scholarly journals The decomposition of life expectancy for age and cause of death in Tuscany, Italy

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
N Nante ◽  
L Kundisova ◽  
F Gori ◽  
A Martini ◽  
F Battisti ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Causes Of Death ◽  
National Level ◽  
Age Groups ◽  
Resistant Bacteria ◽  
Mortality Data ◽  
Life Expectancy At Birth ◽  
Icd 10 ◽  
Reduction Of Mortality ◽  
The Impact

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.

scholarly journals Access to and adequacy of psychological services for adult patients in UK hospices: a national, cross-sectional survey

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Daisy McInnerney ◽  
Bridget Candy ◽  
Patrick Stone ◽  
Nicola Atkin ◽  
Joana Johnson ◽  
...  
Keyword(s):  
Best Practice ◽  
Online Survey ◽  
National Level ◽  
Psychological Support ◽  
Psychological Services ◽  
Adult Patients ◽  
Future Research ◽  
Cross Sectional ◽  
Facilitators And Barriers ◽  
The Uk

Abstract Background Providing psychological support to people living with terminal illness is a fundamental part of hospice care. Recent research on delivery of psychological services in hospices in the United Kingdom (UK) on a national level, including inequalities or variation in practice, is limited. A nationwide survey will highlight any differences in provision and in doing so help focus future research and inform best practice both within the UK, and internationally. The specific objectives of this survey are to (1) chart the types of psychological support available to adult patients in hospices in the UK in line with the National Institute for Health and Care Excellence model; (2) explore how services are organised; and (3) gather service perspectives on adequacy of care, and facilitators and barriers to appropriate practice. Methods A cross-sectional online survey emailed to adult hospices in the UK in November–December 2019. One staff member involved in the delivery and/or organisation of psychological support was invited to participate per hospice. Of 193 invited hospices, 116 took part. Results Sixteen percent rated their hospice psychological service as wholly adequate. The majority reported that services can access specialist professionals, but many relied on external referrals. Barriers to best practice included funding and staff capacity; facilitators included clear referral structures, audit and appropriate needs and outcome assessments. Conclusions Access to psychological professionals has improved since the last survey 15 years ago, but the majority of responders felt their overall service was not wholly adequate. Basic emotional support is largely felt to be sufficient, but our results indicate a need for improvements in access to more specialist care. Partnerships with external mental health services may be key. Our findings highlight core facilitators and barriers to providing good psychological care at the end of life that should be considered by services both within the UK and on an international level.

Longevity and Education: A Demographic Perspective

Gerontology ◽  
2015 ◽  
Vol 62 (3) ◽  
pp. 253-262 ◽  
Author(s):  
Domantas Jasilionis ◽  
Vladimir M. Shkolnikov
Keyword(s):  
Life Expectancy ◽  
Best Practice ◽  
National Level ◽  
Population Level ◽  
Reliable Data ◽  
Human Longevity ◽  
Evidence Based ◽  
Highly Educated ◽  
Level Statistics ◽  
Length Of Life

In the second half of the 20th century, the advances in human longevity observed have been accompanied by an increase in the disparities between countries and regions. Education is one of the strongest predictors of life expectancy. Studies have shown that both relative and absolute mortality differences by education within countries have been increasing, even in the most developed and egalitarian countries. It is possible to assume that groups of highly educated people who systematically display life expectancy levels which are higher than the observed best practice (record) life expectancy at the national level are vanguards who are leading the way toward a lengthening of life for the remaining population groups. This evidence based on population-level statistics and exploring an important single factor could inspire further discussion about the possibilities for extending human length of life at the national level. However, more comprehensive and reliable data covering a larger number of countries and more covariates are needed for understanding health effects of education and prospects of human longevity.

scholarly journals Spatial inequalities in life expectancy within postindustrial regions of Europe: a cross-sectional observational study

BMJ Open ◽  
2014 ◽  
Vol 4 (6) ◽  
pp. e004711-e004711 ◽  
Author(s):  
M. Taulbut ◽  
D. Walsh ◽  
G. McCartney ◽  
S. Parcell ◽  
A. Hartmann ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Observational Study ◽  
Cross Sectional ◽  
Spatial Inequalities

Analysis of Mortality Data due to Infectious Diseases: Life Table Methods Complementary to Direct Rates

1988 ◽  
Vol 27 (03) ◽  
pp. 137-141
Author(s):  
M. A. A. Moussa ◽  
M. M. Khogali ◽  
T. N. Sugathan
Keyword(s):  
Life Expectancy ◽  
Infectious Diseases ◽  
Life Table ◽  
Census Data ◽  
Total Mortality ◽  
Life Tables ◽  
Mortality Data ◽  
Men And Women ◽  
Male And Female ◽  
Life Expectancy At Birth

SummaryLife table methods are employed complementary to standard rates to analyse Kuwaiti mortality data due to infectious diseases. The procedure comprises total mortality, multiple-decrement, cause—elimination and cause—delay life tables. To improve reliability of estimated age-specific death rates, the numerator was based on the three-year average of deaths (1981-83), while the denominator was the mid 1982 population projected from the 1980 and 1985 population censuses. To overcome the difficulty of age heaping, both mortality and census data were graduated using the natural cubic spline approach. Proportional mortality was maximum in intestinal infectious diseases particularly in the rural Jahra Governorate. Infectious diseases caused 29.4 and 37.1% of male and female deaths respectively in infancy and early childhood. The male and female life expectancy at birth were 67 and 72 years, respectively.The multiple-decrement life tables showed that 3,346 men and 2,986 women out of the birth cohort (100,000) will ultimately die from infectious diseases. The average number of years lost due to infectious diseases were 0.75 years in both men and women. Relating this loss to the affected (saved) subpopulation only, large gains in life expectancy occur (22.3 and 25.2 years in men and women respectively).

scholarly journals Cross-sectional study of loss of life expectancy at different ages related to firearm deaths among black and white Americans

2018 ◽  
Vol 24 (2) ◽  
pp. 55-58 ◽  
Author(s):  
Bindu Kalesan ◽  
Mrithyunjay A Vyliparambil ◽  
Yi Zuo ◽  
Jeffrey J Siracuse ◽  
Jeffrey A Fagan ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Black Americans ◽  
Cross Sectional Study ◽  
Mortality Data ◽  
Online Data ◽  
Cross Sectional ◽  
Firearm Injury ◽  
Total Life Expectancy ◽  
Life Years ◽  
Prevention Programmes

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.

scholarly journals Subnational Mortality Modelling: A Bayesian Hierarchical Model with Common Factors

Risks ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 203
Author(s):  
Qian Lu ◽  
Katja Hanewald ◽  
Xiaojun Wang
Keyword(s):  
United States ◽  
Life Expectancy ◽  
National Level ◽  
Common Factors ◽  
The United States ◽  
Mortality Data ◽  
Bayesian Hierarchical ◽  
New Model ◽  
Mortality Modelling ◽  
Mortality Forecasts

We propose a new model in a Bayesian hierarchical framework to project mortality at both national and subnational levels based on sparse or missing data. The new model, which has a country–region–province structure, uses common factors to pool information at the national level and within regions consisting of several provinces or states. We illustrate the model’s use by drawing on a new database containing provincial-level mortality data for China from four censuses conducted during the period 1982–2010. The new model provides good estimates and reasonable forecasts at both the country and provincial levels. The model’s forecast intervals reflect provincial- and regional-level uncertainty. Using subnational data for the period 1999–2018 from the Centers for Disease Control and Prevention (CDC), we also apply the model to the United States. We use mortality forecasts to compute and compare national and subnational life expectancies for China and the United States. The model predicts that, in 2030, China will have a similar national life expectancy at age 60 and a similar heterogeneity in subnational life expectancy as the United States.

scholarly journals Heterogeneity in Subnational Mortality in The Context of The COVID-19 Pandemic: The Case of Belgian Districts

2021 ◽  
Author(s):  
Benjamin-Samuel Schlüter ◽  
Bruno Masquelier ◽  
Carlo Giovanni Camarda
Keyword(s):  
Life Expectancy ◽  
National Level ◽  
District Level ◽  
Mortality Trends ◽  
Stochastic Variation ◽  
Sources Of Uncertainty ◽  
Life Expectancy At Birth ◽  
Standardized Mortality Ratios ◽  
The Impact ◽  
Different Sources

Abstract Background: The COVID-19 pandemic has caused major shocks in mortality trends in many countries. Yet few studies have evaluated the heterogeneity of the mortality shock at the sub-national level, rigorously accounting for the different sources of uncertainty.Methods: Using death registration data from Belgium, we first assess the change in the heterogeneity of subnational standardized mortality ratios in 2020, when compared to previous years. We then measure the shock of the pandemic using district-level values of life expectancy, comparing the observed and projected districts life expectancy, accounting for all sources of uncertainty (related to the life-table construction at district level and to the projection methods at country and district level). The Bayesian modelling approach makes it easy to combine the different sources of uncertainty in the assessment of the shock. This is of particular interest at a finer geographical scale characterized by high stochastic variation in annual death counts.Results: The heterogeneity in the impact of the pandemic on all-cause mortality across districts is substantial, with some districts barely showing any impact whereas the Bruxelles-Capital and Mons districts experienced a decrease in life expectancy at birth of 2.24 (95% CI:1.33-3.05) and 2.10 (95% CI:0.86-3.30) years, respectively. The year 2020 was associated with an increase in mortality levels ' heterogeneity at a subnational level in comparison to past years measured by both the standardized mortality ratios and the life expectancies at birth. Decisions on uncertainty thresholds have a large bearing on the interpretation of the results.Conclusion: Developing sub-national mortality estimates with their uncertainty is key to understanding why certain areas have been hard hit in comparison to others.

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
Keyword(s):  
Life Expectancy ◽  
Causes Of Death ◽  
Outcome Measure ◽  
State Level ◽  
Mortality Data ◽  
Avoidable Mortality ◽  
Cross Sectional ◽  
Linear Integral ◽  
Almost All ◽  
Integral Decomposition

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.

COVID-19: knowledge, awareness and perceived stress among Jordanian healthcare providers (Preprint)

2020 ◽  
Author(s):  
Emad Aborajooh ◽  
Mohammed Qussay Al-Sabbagh ◽  
Baraa Mafrachi ◽  
Muhammad Yassin ◽  
Rami Dwairi ◽  
...  
Keyword(s):  
Social Media ◽  
Psychological Stress ◽  
Health Care Providers ◽  
Best Practice ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Cross Sectional ◽  
Ordinal Logistic Regression Analysis ◽  
Source Of Information

UNSTRUCTURED We aimed to measure levels of knowledge, awareness, and stress about COVID-19 among health care providers (HCP) in Jordan. This was a cross-sectional study on 397 HCPs that utilized an internet-based questionnaire to evaluate knowledge about COVID-19, availability of personal protective equipment (PEE), future perception, and psychological distress. Ordinal logistic regression analysis was used to evaluate factors associated with knowledge and psychological stress. Overall, 24.4% and 21.2% of the participants showed excellent knowledge and poor knowledge, respectively. Social media (61.7%) was the most commonly used source of information. Being female (β= 0.521, 95% CI 0.049 to 0.992), physician (β=1.421, 95% CI 0.849 to 1.992), or using literature to gain knowledge (β= 1.161, 95% CI 0.657 to 1.664) were positive predictors of higher knowledge. While having higher stress (β= -0.854, 95% CI -1.488 to -0.221) and using social media (β= -0.434, 95% CI -0.865 to -0.003) or conventional media (β= -0.884, 95% CI -1.358 to -0.409) for information were negative predictors of knowledge levels. HCPs are advised to use the literature as a source of information about the virus, its transmission, and the best practice. PPEs should be secured for HCPs to the psychological stress associated with treating COVID-19 patients.

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