scholarly journals COVID-19 and the gender health paradox

2020 ◽  
pp. 140349482097560
Author(s):  
Clare Bambra ◽  
Viviana Albani ◽  
Paula Franklin
Keyword(s):  
Mortality Rate ◽  
Economic Crisis ◽  
Health Inequalities ◽  
Government Policy ◽  
International Research ◽  
Social Economic ◽  
Mortality Rates ◽  
Policy Responses ◽  
Gender Based ◽  
Health Paradox

This article examines gender-based health inequalities arising from the COVID-19 pandemic by drawing on insights from research into the ‘gender health paradox’. Decades of international research shows that, across Europe, men have shorter life expectancies and higher mortality rates than women, and yet, women report higher morbidity. These gender-based health inequalities also appear to be evident within the pandemic and its aftermath. The article starts by providing an overview of the ‘gender health paradox’ and the biological, social, economic and political explanations for it. It then outlines the international estimates of gender-based inequalities in COVID-19 morbidity and mortality rates – where emerging data suggests that women are more likely to be diagnosed with COVID-19 but that men have a higher mortality rate. It then explores the longer term consequences for gender-based health inequalities of the aftermath of the COVID-19 pandemic, focusing on the impacts of government policy responses and the emerging economic crisis, suggesting that this might lead to increased mortality amongst men and increased morbidity amongst women. The essay concludes by reflecting on the pathways shaping gender-based health inequalities in the COVID-19 pandemic and the responses needed to ensure that it does not exacerbate gender-based health inequalities into the future.

scholarly journals The COVID-19 pandemic and health inequalities

2020 ◽  
pp. jech-2020-214401 ◽  
Author(s):  
Clare Bambra ◽  
Ryan Riordan ◽  
John Ford ◽  
Fiona Matthews
Keyword(s):  
Health Inequalities ◽  
Public Health Policy ◽  
Influenza Pandemic ◽  
Mortality Rates ◽  
Future Generations ◽  
Spanish Influenza ◽  
Policy Responses ◽  
Geographical Inequalities ◽  
The Social ◽  
H1n1 Outbreak

This essay examines the implications of the COVID-19 pandemic for health inequalities. It outlines historical and contemporary evidence of inequalities in pandemics—drawing on international research into the Spanish influenza pandemic of 1918, the H1N1 outbreak of 2009 and the emerging international estimates of socio-economic, ethnic and geographical inequalities in COVID-19 infection and mortality rates. It then examines how these inequalities in COVID-19 are related to existing inequalities in chronic diseases and the social determinants of health, arguing that we are experiencing a syndemicpandemic. It then explores the potential consequences for health inequalities of the lockdown measures implemented internationally as a response to the COVID-19 pandemic, focusing on the likely unequal impacts of the economic crisis. The essay concludes by reflecting on the longer-term public health policy responses needed to ensure that the COVID-19 pandemic does not increase health inequalities for future generations.

scholarly journals The Determinants of Infant Mortality and Public Policies in Brazil 2004-2015: A Descriptive Study

2021 ◽  
Author(s):  
Alexandre Hamilton Bugelli ◽  
Roxane Borgès Da Silva ◽  
Ladislau Dowbor ◽  
Claude Sicotte
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Social Determinants Of Health ◽  
Economic Crisis ◽  
Social Determinants ◽  
Mortality Rates ◽  
Fertility Rate ◽  
Determinants Of Health ◽  
Infant Mortality Rate ◽  
Bolsa Familia

Abstract BackgroundInfant mortality as a relevant indicator of population's health, social inequalities and living conditions has been fairly documented in the literature as it still represents a major challenge for emerging countries such as Brazil. While infant mortality rates have decreased in the last 30 years, some macro-regions of the country present great variability of infant mortality rates. These disparities, together with a rise in infant mortality and under-five mortality rates, and after the country experienced a political-economic crisis, draw attention to social determinants of health. MethodWe conducted a descriptive analysis of the determinants of infant mortality in Brazil between 2004 and 2015, based on the World Health Organization’s Commission on Social Determinants of Health conceptual framework aiming at analyzing the evolution of these determinants to understand the behavior of the infant mortality rate observed in recent years in the country.ResultsResults suggested that there is a correlation between infant mortality and structural determinants such as income, the Bolsa Família Program, education and employment, and intermediary determinants such as the number of livebirths by prenatal visits, the number of physicians and nurses per thousand inhabitants, fertility rate, safe water, and sewage service coverage rates.ConclusionResults suggest that inequalities in infant mortality observed among macro-regions in Brazil are related to disparities in the distribution of Social Determinants of Health such as income, Bolsa Família Program coverage, education attainment, employment, fertility rate and of health-related determinants such as quality of and accessibility to healthcare and water supply, as well as sewage services. These disparities impose different dynamics between the structural and intermediary determinants of health that likely limit further reductions in infant mortality, which would probably explain both the slowdown in the reduction and the tendency of IMR to remain at a relatively high level. Results also suggest that the increase of infant mortality rate in 2016 is attributable to the deterioration in one or more of those determinants, such as a fall in employment rate due to the economic crisis, may be pointed out as one of the causes of interruption on the trend of decline in infant mortality.

Initial Report of Off-Pump Coronary Artery Bypass Surgery as Sole Therapy for Moderate Ischemic Mitral Regurgitation: Operative and Intermediate-Term Outcome

2005 ◽  
Vol 8 (2) ◽  
pp. 89 ◽  
Author(s):  
Kevin M. Harris ◽  
Avinash Reddy ◽  
Dorothee Aepplii ◽  
Betsy Wilson ◽  
Robert W. Emery
Keyword(s):  
Coronary Artery ◽  
Mortality Rate ◽  
Mitral Regurgitation ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Mortality Rates ◽  
Off Pump ◽  
Moderate Ischemic Mitral Regurgitation ◽  
Pump Coronary Artery Bypass

Background: Patients undergoing on-pump coronary artery bypass surgery (CAB) with coexistent moderate ischemic mitral regurgitation (IMR) have a significant mortality rate compared to patients without MR. The mortality rate is elevated both perioperatively (0%-12% mortality), as well as over a 1- and 2-year postoperative period (15%-25%). It is thought that some patients are best served by off-pump CAB (OPCAB); however, outcomes have not been reported for such patients with coexistent moderate IMR. Methods: We reviewed the independent database of patients undergoing OPCAB between 1995 and 2002 to find 989 patients, 17 (1.7%) of whom had moderate or moderately severe MR. Patients were contacted and clinical and echocardiographic data were obtained. Results: The patient group consisted of 11 men and 6 women (age, 65 15 years). The study group had a PA pressure of 52 14, creatinine of 1.6 0.7, and left ventricular ejection fraction of 43 18. Nine patients (53%) had advanced New York Heart Association (class III-IV) heart failure. Mortality rates perioperatively and at 1, 2, and 3 years were 0%, 6.25% (1/16), 12.5% (2/16), and 38% (4/8), respectively. At the time of this report, no patient had returned for a reparative procedure. Conclusion: In patients felt to be best served by OPCAB with ischemic MR, operative and intermediate mortality rates are remarkably similar to those previously reported for on-pump series. These data underscore the continued need to understand which patients undergoing CAB require mitral valve problems to be addressed at the time of surgery.

scholarly journals Effects of some bioinsecticides on the tomato leaf miner, Tuta absoluta (Meyrick, 1917) (Lepidoptera: Gelechiidae)

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Alime Bayindir Erol ◽  
Oktay Erdoğan ◽  
İsmail Karaca
Keyword(s):  
Mortality Rate ◽  
Active Ingredient ◽  
Metarhizium Anisopliae ◽  
Mortality Rates ◽  
Tomato Leaf ◽  
Tuta Absoluta ◽  
Leaf Miner ◽  
Verticillium Lecanii ◽  
Main Body ◽  
Tomato Leaf Miner

Abstract Background In this study, commercial bioinsecticides including entomopathogenic fungi, Beauveria bassiana, Metarhizium anisopliae, and Verticillium lecanii, and Spinetoram active ingredient insecticide were evaluated against the tomato leaf miner, Tuta absoluta (Meyrick, 1917) (Lepidoptera: Gelechiidae) larvae. Main body The active ingredients were prepared at the recommended concentrations under laboratory conditions and applied to the 2nd instar larvae of T. absoluta by spraying with a hand sprayer. On the 1st, 3rd, 5th, and 7th days of the application, evaluations were made by counting survived individuals. The findings showed that the highest mortality rates were detected in the case of Spinetoram with 56, 60, 88, and 100% on all counting days of the experiments, respectively. The highest mortality rate among bioinsecticides was recorded for M. anisopliae, with 87% mortality on the 7th day of application. Short conclusion As a result, Spinetoram was found the most effective insecticide when applied to T. absoluta, followed by M. anisopliae.

scholarly journals Long-Term Exposure to Fine and Coarse Particulate Matter and COVID-19 Incidence and Mortality Rate in Chile during 2020

2021 ◽  
Vol 18 (14) ◽  
pp. 7409
Author(s):  
Macarena Valdés Salgado ◽  
Pamela Smith ◽  
Mariel Opazo ◽  
Nicolás Huneeus
Keyword(s):  
Mortality Rate ◽  
Incidence Rate ◽  
Air Pollutants ◽  
Negative Binomial ◽  
Transport Model ◽  
Surface Concentration ◽  
Mortality Rates ◽  
Incidence And Mortality ◽  
Pm2.5 And Pm10

Background: Several countries have documented the relationship between long-term exposure to air pollutants and epidemiological indicators of the COVID-19 pandemic, such as incidence and mortality. This study aims to explore the association between air pollutants, such as PM2.5 and PM10, and the incidence and mortality rates of COVID-19 during 2020. Methods: The incidence and mortality rates were estimated using the COVID-19 cases and deaths from the Chilean Ministry of Science, and the population size was obtained from the Chilean Institute of Statistics. A chemistry transport model was used to estimate the annual mean surface concentration of PM2.5 and PM10 in a period before the current pandemic. Negative binomial regressions were used to associate the epidemiological information with pollutant concentrations while considering demographic and social confounders. Results: For each microgram per cubic meter, the incidence rate increased by 1.3% regarding PM2.5 and 0.9% regarding PM10. There was no statistically significant relationship between the COVID-19 mortality rate and PM2.5 or PM10. Conclusions: The adjusted regression models showed that the COVID-19 incidence rate was significantly associated with chronic exposure to PM2.5 and PM10, even after adjusting for other variables.

scholarly journals Mortality in Patients with Brainstem Cavernous Malformations

2021 ◽  
pp. 1-7
Author(s):  
Julia Velz ◽  
Marian Christoph Neidert ◽  
Yang Yang ◽  
Kevin Akeret ◽  
Peter Nakaji ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Postoperative Mortality ◽  
Mortality Rates ◽  
Cavernous Malformations ◽  
Patient Cohort ◽  
Actual Risk ◽  
Single Center Study

<b><i>Objective:</i></b> Brainstem cavernous malformations (BSCM)-associated mortality has been reported up to 20% in patients managed conservatively, whereas postoperative mortality rates range from 0 to 1.9%. Our aim was to analyze the actual risk and causes of BSCM-associated mortality in patients managed conservatively and surgically based on our own patient cohort and a systematic literature review. <b><i>Methods:</i></b> Observational, retrospective single-center study encompassing all patients with BSCM that presented to our institution between 2006 and 2018. In addition, a systematic review was performed on all studies encompassing patients with BSCM managed conservatively and surgically. <b><i>Results:</i></b> Of 118 patients, 54 were treated conservatively (961.0 person years follow-up in total). No BSCM-associated mortality was observed in our conservatively as well as surgically managed patient cohort. Our systematic literature review and analysis revealed an overall BSCM-associated mortality rate of 2.3% (95% CI: 1.6–3.3) in 22 studies comprising 1,251 patients managed conservatively and of 1.3% (95% CI: 0.9–1.7) in 99 studies comprising 3,275 patients with BSCM treated surgically. <b><i>Conclusion:</i></b> The BSCM-associated mortality rate in patients managed conservatively is almost as low as in patients treated surgically and much lower than in frequently cited reports, most probably due to the good selection nowadays in regard to surgery.

Outcome in an Urban Pediatric Trauma System with Unified Prehospital Emergency Medical Services Care

1995 ◽  
Vol 10 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Michael J. VanRooyen ◽  
Edward P. Sloan ◽  
John A. Barrett ◽  
Robert F. Smith ◽  
Hernan M. Reyes
Keyword(s):  
Head Injury ◽  
Mortality Rate ◽  
Trauma Center ◽  
Pediatric Trauma ◽  
Trauma System ◽  
Age Groups ◽  
Mortality Rates ◽  
Trauma Centers ◽  
Field Triage ◽  
Pediatric Trauma Center

AbstractHypothesis:Pediatric mortality is predicted by age, presence of head trauma, head trauma with a low Glasgow Coma Scale (GCS) score, a low Pediatric Trauma Score (PTS), and transport directly to a pediatric trauma center.Population:Studied were 1,429 patients younger than 16 years old admitted to or declared dead on arrival (DOA) in a pediatric trauma center from January through October, 1988. The trauma system, which served 3-million persons, included six pediatric trauma centers.Methods:Data were obtained by a retrospective review of summary statistics provided to the Chicago Department of Health by the pediatric trauma centers.Results:Overall mortality was 4.8% (68 of 1429); 32 of the patients who died (47.1%) were DOA. The in-hospital mortality rate was 2.6%. Head injury was the principal diagnosis in 46.2% of admissions and was a factor in 72.2% of hospital deaths. The mortality rate was 20.3% in children with a GCS≤10 and 0.4% when the GCS was >10 (odds ratio [OR] = 67.0, 95% CI = 15.0–417.4). When the PTS was ≤ 5, mortality was 25.6%; with a PTS > 5, the mortality was 0.2% (OR = 420.7, 95% CI = 99.3–2,520). Although transfers to a pediatric trauma center accounted for 73.6% of admissions, direct field triage to a pediatric trauma center was associated with a 3.2 times greater mortality risk (95% CI = 1.58–6.59). Mortality rates were equal for all age groups. Pediatric trauma center volume did not influence mortality rates.Conclusions:Head injury and death occur in all age groups, suggesting the need for broad prevention strategies. Specific GCS and PTS values that predict mortality can be used in emergency medical services (EMS) triage protocols. Although the high proportion of transfers mandates systemwide transfer protocols, the lower mortality in these patients suggests appropriate EMS field triage. These factors should be considered as states develop pediatric trauma systems.

scholarly journals Optimal timing of endoscopic retrograde cholangiopancreatography for acute cholangitis associated with distal malignant biliary obstruction

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Namyoung Park ◽  
Sang Hyub Lee ◽  
Min Su You ◽  
Joo Seong Kim ◽  
Gunn Huh ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Biliary Obstruction ◽  
Acute Cholangitis ◽  
Mortality Rates ◽  
Malignant Biliary Obstruction ◽  
Optimal Timing ◽  
Endoscopic Retrograde ◽  
The Difference ◽  
Distal Malignant Biliary Obstruction

Abstract Background There is a lack of studies regarding the optimal timing for endoscopic retrograde cholangiopancreatography (ERCP) in patients with cholangitis caused by distal malignant biliary obstruction (MBO). This study aims to investigate the optimal timing of ERCP in patients with acute cholangitis associated with distal MBO with a naïve papilla. Methods A total of 421 patients with acute cholangitis, associated with distal MBO, were enrolled for this study. An urgent ERCP was defined as being an ERCP performed within 24 h following emergency room (ER) arrival, and early ERCP was defined as an ERCP performed between 24 and 48 h following ER arrival. We evaluated both 30-day and 180-day mortality as primary outcomes, according to the timing of the ERCP. Results The urgent ERCP group showed the lowest 30-day mortality rate (2.2%), as compared to the early and delayed ERCP groups (4.3% and 13.5%) (P < 0.001). The 180-day mortality rate was lowest in the urgent ERCP group, followed by early ERCP and delayed ERCP groups (39.4%, 44.8%, 60.8%; P = 0.006). A subgroup analysis showed that in both the primary distal MBO group, as well as in the moderate-to-severe cholangitis group, the urgent ERCP had significantly improved in both 30-day and 180-day mortality rates. However, in the secondary MBO and mild cholangitis groups, the difference in mortality rate between urgent, early, and delayed ERCP groups was not significant. Conclusions In patients with acute cholangitis associated with distal MBO, urgent ERCP might be helpful in improving the prognosis, especially in patients with primary distal MBO or moderate-to-severe cholangitis.

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