Mortality in Tonga over three triennia, 2010–2018

Abstract Background Tonga is a South Pacific Island country with a population of 100,651 (2016 Census). This study examines Tongan infant mortality rates (IMR), under-five mortality rates (U5MR), adult mortality and life expectancy (LE) at birth from 2010 to 2018 using a recent collation of empirical mortality data over the past decade for comparison with other previously published mortality estimates. Methods Routinely collected mortality data for 2010–2018 from the Ministry of Health, national (Vaiola) hospital, community nursing reports, and the Civil Registry, were consolidated by deterministic and probabilistic linkage of individual death records. Completeness of empirical mortality reporting was assessed by capture-recapture analysis. The reconciled data were aggregated into triennia to reduce stochastic variation, and used to estimate IMR and U5MR (per 1000 live births), adult mortality (15–59, 15–34, 35–59, and 15–64 years), and LE at birth, employing the hypothetical cohort method (with statistical testing). Mortality trends and differences were assessed by Poisson regression. Mortality findings were compared with published national and international agency estimates. Results Over the three triennia in 2010–2018, levels varied minimally for IMR (12–14) and U5MR (15–19) per 1000 births (both ns, p > 0.05), and also for male LE at birth of 64–65 years, and female LE at birth 69–70 years. Cumulated risks of adult mortality were significantly higher in men than women; period mortality increases in 15–59-year women from 18 to 21% were significant (p < 0.05). Estimated completeness of the reconciled data was > 95%. International agencies reported generally comparable estimates of IMR and U5MR, with varying uncertainty intervals; but they reported significantly lower adult mortality and higher LE than the empirical estimates from this study. Conclusions Life expectancy in Tonga over 2010–2018 has remained relatively low and static, with low IMR and U5MR, indicating the substantial impact from premature adult mortality. This analysis of empirical data (> 95% complete) indicates lower LE and higher premature adult mortality than previously reported by international agencies using indirect and modelled methods. Continued integration of mortality recording and data systems in Tonga is important for improving the completeness and accuracy of mortality estimation for local health monitoring and planning.

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Trends in mortality and life expectancy in Fiji over 20 years

BMC Public Health ◽

10.1186/s12889-021-11186-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Catherine Dearie ◽

Christine Linhart ◽

Eric Rafai ◽

Devina Nand ◽

Stephen Morrell ◽

...

Keyword(s):

Life Expectancy ◽

Statistical Significance ◽

Age Groups ◽

Adult Mortality ◽

International Agency ◽

Mortality Trends ◽

Indian Women ◽

International Agencies ◽

Mortality Probability ◽

Inform Resource Allocation

Abstract Background Fiji, a Pacific Island nation of 884,887 (2017 census), has experienced a prolonged epidemiological transition. This study examines trends in mortality and life expectancy (LE) in Fiji by sex and ethnicity over 1996–2017, with comparisons to published estimates. Methods Trends in infant mortality rates (IMR), under-5 mortality (U5M), adult mortality (probability of dying), LE (at birth) and directly age-standardised death rates (DASRs) by sex and ethnicity, are calculated (with 95% confidence limits) using unit death records from the Fiji Ministry of Health and Medical Services. The LE gap between populations, or within populations over time, is examined using decomposition by age. Period trends are assessed for statistical significance using linear regression. Results Over 1996–98 to 2014–17: IMR and U5M for i-Taukei and Fijians of Indian descent declined; U5M decline for i-Taukei (24.6 to 20.1/1000 live births) was significant (p = 0.016). Mortality (15–59 years) for i-Taukei males was unchanged at 27% but declined for Indians 33 to 30% (p = 0.101). Mortality for i-Taukei females increased 22 to 24% (p = 0.011) but declined for Indians 20 to 18% (p = 0.240). DASRs 1996–2017 were lower for i-Taukei (9.3 to 8.2/1000 population) than Indian males (10.6 to 9.8/1000). DASRs declined for i-Taukei (both sexes, p < 0.05), and for Indians (both sexes, p > 0.05). Over 22 years, LE at birth increased by 1 year or less (p = 0.030 in male i-Taukei). In 2014–17, LE (years) for males was: i-Taukei 64.9, Indians 63.5; and females: i-Taukei 67.0 and Indians 68.2. Mortality changes in most 5-year age groups increased or decreased the LE gap less than 10 weeks over 22 years. Compared to international agency reports, 2014–17 empirical LE estimates (males 64.7, females 67.8) were lower, as was IMR. Conclusions Based on empirical data, LE in Fiji has minimally improved over 1996–2017, and is lower than some international agencies report. Adult mortality was higher in Indian than i-Taukei men, and higher in i-Taukei than Indian women. Exclusion of stillbirths resulted in IMRs lower than previously reported. Differing mortality trends in subgroups highlight the need to collect census and health data by ethnicity and sex, to monitor health outcomes and inform resource allocation.

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Recent adverse mortality trends in Scotland: comparison with other high-income countries

10.1101/542449 ◽

2019 ◽

Cited By ~ 2

Author(s):

Lynda Fenton ◽

Jon Minton ◽

Julie Ramsay ◽

Maria Kaye-Bardgett ◽

Colin Fischbacher ◽

...

Keyword(s):

Northern Ireland ◽

Life Expectancy ◽

Mortality Rates ◽

Recent Change ◽

High Income ◽

Mortality Data ◽

List Type ◽

Segmented Regression ◽

Mortality Trends ◽

The Usa

AbstractObjectiveGains in life expectancy have faltered in several high-income countries in recent years. We aim to compare life expectancy trends in Scotland to those seen internationally, and to assess the timing of any recent changes in mortality trends for Scotland.SettingAustria, Croatia, Czech Republic, Denmark, England & Wales, Estonia, France, Germany, Hungary, Iceland, Israel, Japan, Korea, Latvia, Lithuania, Netherlands, Northern Ireland, Poland, Scotland, Slovakia, Spain, Sweden, Switzerland, USA.MethodsWe used life expectancy data from the Human Mortality Database (HMD) to calculate the mean annual life expectancy change for 24 high-income countries over five-year periods from 1992 to 2016, and the change for Scotland for five-year periods from 1857 to 2016. One- and two-break segmented regression models were applied to mortality data from National Records of Scotland (NRS) to identify turning points in age-standardised mortality trends between 1990 and 2018.ResultsIn 2012-2016 life expectancies in Scotland increased by 2.5 weeks/year for females and 4.5 weeks/year for males, the smallest gains of any period since the early 1970s. The improvements in life expectancy in 2012-2016 were smallest among females (<2.0 weeks/year) in Northern Ireland, Iceland, England & Wales and the USA and among males (<5.0 weeks/year) in Iceland, USA, England & Wales and Scotland. Japan, Korea, and countries of Eastern Europe have seen substantial gains in the same period. The best estimate of when mortality rates changed to a slower rate of improvement in Scotland was the year to 2012 Q4 for males and the year to 2014 Q2 for females.ConclusionLife expectancy improvement has stalled across many, but not all, high income countries. The recent change in the mortality trend in Scotland occurred within the period 2012-2014. Further research is required to understand these trends, but governments must also take timely action on plausible contributors.Strengths and limitations of this studyThe use of five-year time periods for comparison of life expectancy changes reduces the influence of year-to-year variation on observations.Examining long-term trends addresses concerns that recent life expectancy stalling may be over-emphasised due to notably large gains in the immediately preceding period.The international comparison was limited to the 24 high-income countries for which data were readily available for the relevant period.Analysis of trend data will always be sensitive to the period selected, however segmented regression of the full period of mortality rates available offers an objective method of identifying the timing of a change in trend.

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Cancer Mortality Trend in Central Italy: Focus on A “Low Rate of Land Use” Area from 1982 to 2011

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16040628 ◽

2019 ◽

Vol 16 (4) ◽

pp. 628 ◽

Cited By ~ 1

Author(s):

Francesca Santilli ◽

Stefano Martellucci ◽

Jennifer Di Pasquale ◽

Cecilia Mei ◽

Fabrizio Liberati ◽

...

Keyword(s):

Land Use ◽

Cancer Mortality ◽

Central Italy ◽

Mortality Rates ◽

Mortality Data ◽

Mortality Trends ◽

High Prevalence ◽

Oncological Diseases ◽

Total Cancer ◽

Low Rate

The aim of the present study was to estimate total cancer mortality trends from 1982 to 2011 in a “low rate of land use” province of the Latium region (Rieti, central Italy) characterized by a low degree of urbanization, a high prevalence of elderly, and a low number of births. Mortality data of the studied period, provided by the Italian National Institute of Statistics, were used for calculating standardized cancer mortality rates. Trends in mortality were analyzed using Joinpoint regression analysis. Results showed that total standardized cancer mortality rates decreased in the monitored area over the study period. A comparison with other provinces of the same region evidenced that the studied province presented the lowest cancer mortality. The three systems/apparatuses affected by cancer that mainly influenced cancer mortality in the monitored province were the trachea-bronchus-lung, colorectal-anus, and stomach. These findings could be attributed to the implement of preventive initiatives performed in the early 2000s, to healthier environmental scenario, and to lower levels of carcinogenic pollutants in air, water, and soil matrices. Thus, our results indicate that the studied area could be considered a “healthy” benchmark for studies in oncological diseases.

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Early cohort mortality predicts the rate of aging in the cohort: a historical analysis

Journal of Developmental Origins of Health and Disease ◽

10.1017/s2040174412000281 ◽

2012 ◽

Vol 3 (5) ◽

pp. 380-386 ◽

Cited By ~ 35

Author(s):

H. Beltrán-Sánchez ◽

E. M. Crimmins ◽

C. E. Finch

Keyword(s):

20Th Century ◽

Early Life ◽

Later Life ◽

Mortality Rates ◽

Adult Mortality ◽

Mortality Data ◽

Early 20Th Century ◽

Adult Health ◽

Mortality Level ◽

Poor Nutrition

Early environmental influences on later-life health and mortality are well recognized in the doubling of life expectancy since 1800. To further define these relationships, we analyzed the associations between early-life mortality and both the estimated mortality level at age 40 and the exponential acceleration in mortality rates with age characterized by the Gompertz model. Using mortality data from 630 cohorts born throughout the 19th and early 20th century in nine European countries, we developed a multilevel model that accounts for cohort and period effects in later-life mortality. We show that early-life mortality, which is linked to exposure to infection and poor nutrition, predicts both the estimated cohort mortality level at age 40 and the subsequent Gompertz rate of mortality acceleration during aging. After controlling for effects of country and period, the model accounts for the majority of variance in the Gompertz parameters (about 90% of variation in the estimated level of mortality at age 40 and about 78% of variation in the Gompertz slope). The gains in cohort survival to older ages are entirely due to large declines in adult mortality level, because the rates of mortality acceleration at older ages became faster. These findings apply to cohorts born in both the 19th century and the early 20th century. This analysis defines new links in the developmental origins of adult health and disease in which effects of early-life circumstances, such as exposure to infections or poor nutrition, persist into mid-adulthood and remain evident in the cohort mortality rates from ages 40 to 90.

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Trends in Avoidable Mortality in Lithuania During 2001–2008 and Their Impact on Life Expectancy

Medicina ◽

10.3390/medicina47090067 ◽

2011 ◽

Vol 47 (9) ◽

pp. 504 ◽

Cited By ~ 2

Author(s):

Vilius Grabauskas ◽

Aldona Gaižauskienė ◽

Skirmantė Sauliūnė ◽

Rasa Mišeikytė

Keyword(s):

Life Expectancy ◽

Mortality Data ◽

Avoidable Mortality ◽

Average Life Expectancy ◽

Mortality Trends ◽

Annual Percent Change ◽

Increasing Trend ◽

Causes Of Deaths ◽

Changes Over Time ◽

The Impact

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.

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Identifying Structural Breaks in Stochastic Mortality Models

ASCE-ASME J Risk and Uncert in Engrg Sys Part B Mech Engrg ◽

10.1115/1.4029740 ◽

2015 ◽

Vol 1 (2) ◽

Cited By ~ 6

Author(s):

Colin O’Hare ◽

Youwei Li

Keyword(s):

Life Expectancy ◽

Structural Breaks ◽

Structural Break ◽

Mortality Rates ◽

Insurance Companies ◽

Mortality Data ◽

Stochastic Mortality ◽

Stochastic Mortality Models ◽

Mortality Models ◽

Mortality Forecasts

In recent years, the issue of life expectancy has become of utmost importance to pension providers, insurance companies, and government bodies in the developed world. Significant and consistent improvements in mortality rates and hence life expectancy have led to unprecedented increases in the cost of providing for older ages. This has resulted in an explosion of stochastic mortality models forecasting trends in mortality data to anticipate future life expectancy and hence quantify the costs of providing for future aging populations. Many stochastic models of mortality rates identify linear trends in mortality rates by time, age, and cohort and forecast these trends into the future by using standard statistical methods. These approaches rely on the assumption that structural breaks in the trend do not exist or do not have a significant impact on the mortality forecasts. Recent literature has started to question this assumption. In this paper, we carry out a comprehensive investigation of the presence or of structural breaks in a selection of leading mortality models. We find that structural breaks are present in the majority of cases. In particular, we find that allowing for structural break, where present, improves the forecast result significantly.

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Life expectancy, adult mortality and completeness of death counts in Brazil and regions: comparative analysis of IHME, IBGE and other researchers estimates of levels and trends

10.31219/osf.io/pj3sx ◽

2019 ◽

Author(s):

Bernardo L Queiroz ◽

Marcos Roberto Gonzaga ◽

Ana Maria Nogales ◽

Bruno Torrente ◽

Daisy Maria Xavier de Abreu

Keyword(s):

Life Expectancy ◽

State Level ◽

Adult Mortality ◽

Population Projections ◽

Spatial And Temporal Variation ◽

Mortality Data ◽

Death Registration ◽

Quality Of Data ◽

National Statistics

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.

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Leukemia mortality in children from Latin America: Trends and predictions to 2030

10.21203/rs.3.rs-64774/v2 ◽

2020 ◽

Author(s):

J. Smith Torres-Roman ◽

Bryan Valcarcel ◽

Pedro Guerra-Canchari ◽

Camila Alves Dos Santos ◽

Isabelle Ribeiro Barbosa ◽

...

Keyword(s):

Latin American ◽

Mortality Rates ◽

World Health ◽

Mortality Data ◽

Mortality Trends ◽

Annual Percent Change ◽

Universal Healthcare ◽

The World ◽

Health Organization ◽

Universal Healthcare Coverage

Abstract Background: Reports suggest that Latin American and Caribbean (LAC) countries have not reduced in leukemia mortality compared to high-income countries. However, updated trends remain largely unknown in the region. Given that leukemia is the leading cause of cancer-related death in LAC children, we evaluated mortality trends in children (0-14y) from 15 LAC countries for the period 2000-2017 and predicted mortality to 2030.Methods: We retrieved cancer mortality data using the World Health Organization Mortality Database. Mortality rates (standardized to the world standard SEGI population) were analyzed for 15 LAC countries. We evaluated the average mortality rates for the last 5 years (2013-2017). Joinpoint regression analysis was used to evaluate leukemia mortality trends and provide an estimated annual percent change (EAPC). Nordpred was utilized for the calculation of predictions until 2030.Results: Between 2013 and 2017, the highest mortality rates were reported in Venezuela, Ecuador, Nicaragua, Mexico, and Peru. Upward mortality trends were reported in Nicaragua (EAPC by 2.9% in boys, and EAPC by 2.0% in girls), and Peru (EAPC by 1.4% in both sexes). Puerto Rico experienced large declines in mortality among both boys (EAPC by −9.7%), and girls (EAPC by −6.0%). Leukemia mortality will increase in Argentina, Ecuador, Guatemala, Panama, Peru, and Uruguay by 2030.Conclusion: Leukemia mortality is predicted to increase in some LAC countries by 2030. Interventions to prevent this outcome should be tailor to reduce the socioeconomic inequalities and ensure universal healthcare coverage.

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Trends in Melanoma Mortality in Brazil: A Registry-Based Study

JCO Global Oncology ◽

10.1200/go.20.00426 ◽

2020 ◽

pp. 1766-1771

Author(s):

Guilherme Nader Marta ◽

Rodrigo Ramella Munhoz ◽

Monica La Porte Teixeira ◽

Bernadette Cunha Waldvogel ◽

Veridiana Pires de Camargo ◽

...

Keyword(s):

Mortality Rates ◽

Demographic Variables ◽

Southeastern Brazil ◽

Mortality Data ◽

Demographic Information ◽

Mortality Trend ◽

Mortality Trends ◽

Cross Sectional ◽

The Past ◽

Melanoma Mortality

PURPOSE A substantial increase in melanoma incidence has been consistently observed worldwide over the past decades. However, melanoma mortality rates have remained stable or declined over the past years in most regions. Given the paucity of melanoma mortality data for different Brazilian regions, we sought to describe melanoma mortality trends in southeastern Brazil and their relationship with demographic variables. MATERIALS AND METHODS A cross-sectional registry-based analysis was conducted to describe melanoma mortality trends in the state of São Paulo, Brazil, from 1996 to 2016. Demographic information from melanoma-related death records, including sex and age, was collected from the Fundação Sistema Estadual de Análise de Dados database. The annual percentage change (APC) was calculated to identify mortality trends over the period. RESULTS An increasing melanoma mortality trend was detected among males, regardless of age (APC, 1.72%; P < .001), and was more pronounced for men ≥ 60 years old (APC, 2.63%; P < .001). Melanoma mortality rates have also increased for patients ≥ 60 years old, regardless of sex (APC, 1.11%; P < .001). A non–statistically significant increase in the overall melanoma mortality rate was observed over the 20-year period analyzed (APC, 0.36%; P = .4). CONCLUSION Our data suggest a stable melanoma mortality over the past two decades for the overall population studied; however, a significant increase in melanoma mortality rates has been demonstrated among males and in the population ≥ 60 years old, emphasizing the need to implement prevention strategies and expand access to effective therapies for this population.

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Population-level mortality benefits of improved blood pressure control in Indonesia: a modelling study

International Journal of Epidemiology ◽

10.1093/ije/dyy232 ◽

2018 ◽

Vol 48 (3) ◽

pp. 954-965 ◽

Cited By ~ 2

Author(s):

Nikkil Sudharsanan

Keyword(s):

Blood Pressure ◽

Life Expectancy ◽

Blood Pressure Control ◽

Large Fraction ◽

Scale Up ◽

Adult Life ◽

Population Level ◽

Pressure Control ◽

Mortality Rates ◽

Adult Mortality

Abstract Background There are few estimates of the potential gains in adult mortality from population-level improvements in systolic blood pressure (SBP) in a major low-and-middle income country (LMIC). Using nationally representative cohort data from Indonesia—the third most populous LMIC— I estimated the gains in adult life expectancy from improving SBP control among adults ages 40 and above and assessed the benefits among richer and poorer subpopulations. Methods I used longitudinal data from 10 085 adults ages 40 and above (75 288 person-age observations) enrolled in the 2007 and 2014/15 waves of the Indonesian Family Life Survey. Next, I used Poisson-regression parametric g-formulas to directly estimate age-specific mortality rates under different blood pressure control strategies and constructed period life expectancies using the observed and counterfactual mortality rates. Results Fully controlling SBP to a population mean of under 125 mmHg was associated with a life expectancy gain at age 40 of 5.3 years [95% confidence interval (CI): 3.2, 7.4] for men and 6.0 years (95% CI: 3.6, 8.4) for women. The gains associated with blood pressure control were similar for both rich and poor subpopulations. The life expectancy gains under scenarios with imperfect blood pressure control and coverage were more modest in size and ranged between 1 and 2.5 years for a large fraction of the scenarios. Conclusions In Indonesia, elevated SBP carries a large mortality burden, though the results suggest that realistic efforts to address hypertension will likely produce more modest gains in life expectancy. Comparing improvements from different strategies and identifying the most cost-effective ways to introduce and scale up hypertension interventions is a critical focus for both research and policy.

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