scholarly journals A comparison of child mortality from potentially preventable causes in England and Sweden using birth cohorts from linked administrative datasets

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Ania Zylbersztejn ◽  
Ruth Gilbert ◽  
Anders Hjern ◽  
Pia Hardelid
Keyword(s):  
Child Mortality ◽  
Congenital Anomalies ◽  
Low Birthweight ◽  
Hospital Admissions ◽  
Cox Proportional Hazards ◽  
Economic Factors ◽  
Birth Cohorts ◽  
Birth Characteristics ◽  
Related Mortality ◽  
Socio Economic Factors

IntroductionChild mortality is nearly twice as high in England as in Sweden. A comparison of mortality from potentially preventable causes could inform health system responses. This study focused on respiratory tract infection (RTI)-related deaths, amenable to healthcare interventions, and sudden unexpected deaths in infancy (SUDI), amenable to public health interventions. Objectives and ApproachWe developed nationally-representative birth cohorts of singleton live births in 2003-2012 using a hospital admissions database in England and the Medical Birth Register in Sweden. Children were followed-up from 31st day of life until their fifth birthday via linkage to hospital admission and mortality records. We compared child mortality using Cox proportional hazards models to estimate hazard ratios (HR) for England versus Sweden for RTI-related mortality at 31-364 days and 1-4 years, and for SUDI mortality at 31-364 days. Models were adjusted for birth characteristics (gestational age, birthweight, sex, congenital anomalies), and socio-economic factors (maternal age and socio-economic status). ResultsOf 3,928,483 children in England, there were 807 RTI-related deaths at 31-364 days (17% of all deaths in the age range), 691 deaths at 1-4 years (31%), and 1,166 SUDIs (24%) in England. Corresponding figures for 1,012,682 children in Sweden were 136 (18%), 118 (25%) and 189 (24%). Unadjusted HRs for RTI-related deaths in England versus Sweden were 1.50 (95% confidence interval: 1.25-1.80) at 31-364 days. Adjustment for birth characteristics reduced the HR to 1.16 (0.97-1.39), and for socio-economic factors to 1.11 (0.92-1.33). Corresponding figures for RTI-related mortality at 1-4 years were 1.58 (1.30-1.92), 1.32 (1.09-1.61) and 1.30 (1.07-1.59), respectively. Unadjusted HRs for SUDIs reduced from 1.59 (1.36-1.85) to 1.40 (1.20-1.63) after adjusting for birth characteristics, and to 1.19 (1.02-1.39) after adjusting for socio-economic factors. Conclusion/ImplicationsHigher prevalence of adverse birth characteristics (such as prematurity, low birthweight, congenital anomalies) contributed to increased risks of RTI-related and SUDI mortality in England relative to Sweden. Therefore, preventive strategies should focus on maternal health and socio-economic circumstances before and during pregnancy to reduce RTI-related and SUDI mortality in England.

scholarly journals Suicide trends and characteristics in Brazil

2006 ◽  
Vol 3 (1) ◽  
pp. 5-7
Author(s):  
Carolina de Mello-Santos ◽  
José Manoel Bertolote ◽  
Yuan-Pang Wang
Keyword(s):  
Suicide Rate ◽  
World Health ◽  
Economic Factors ◽  
Factors Affecting ◽  
Youth Population ◽  
Self Harm ◽  
Health Organization ◽  
Populous Country ◽  
Related Mortality ◽  
Socio Economic Factors

Brazil is the largest and most populous country in South America (in 2002 the population was approximately 175 million). Although life expectancy in Brazil has increased, suicide and other forms of injury-related mortality, such as homicide and accident, have increased as a proportion of overall mortality (Oswaldo Cruz Foundation, 1984; Brazil Ministry of Health, 2001). The suicide rate in Brazil (3.0–4.0 per 100 000 inhabitants) is not considered high in global terms (World Health Organization, 1999). Nevertheless, it has followed the world tendency towards growth: during 1980–2000, the suicide rate in Brazil increased by 21%. Elderly people present the highest suicide rates in absolute numbers, but the alarming finding in the Brazilian data is that the youth population is increasingly dying by suicide (Mello-Santos et al, 2005). This statistic partially confirms a forecast by Diekstra & Guilbinat (1993) that the number of deaths by suicide would dramatically increase over the next decades, mainly in developing countries, including Latin America. In these regions, socio-economic factors (such as an increase in divorce and unemployment and a decrease in religiosity) increase the risk of self-harm. We discuss the reasons for the low suicide rate in Brazil and highlight the socio-economic factors affecting its increase among the youth population in particular.

Ethnicity, socio-economic status and self-harm in Swedish youth: a national cohort study

2008 ◽  
Vol 39 (1) ◽  
pp. 87-94 ◽  
Author(s):  
B. Jablonska ◽  
L. Lindberg ◽  
F. Lindblad ◽  
A. Hjern
Keyword(s):  
Proportional Hazards ◽  
Hospital Admissions ◽  
Economic Status ◽  
Economic Factors ◽  
Foreign Born ◽  
Majority Population ◽  
National Cohort ◽  
Self Harm ◽  
And Gender ◽  
Socio Economic Factors

BackgroundPrevious studies have shown an elevated risk for self-harm in adolescents from ethnic minorities. However, potential contributions to this risk from socio-economic factors have rarely been addressed. The main aim of this article was to investigate any such effects.MethodA national cohort of 1009 157 children born during 1973–1982 was followed prospectively from 1991 to 2002 in Swedish national registers. Multivariate Cox analyses of proportional hazards were used to estimate the relative risk of hospital admission for self-harm. Parental country/region of birth was used as proxy for ethnicity.ResultsYouth with two parents born outside Sweden (except those from Southern Europe) had higher age- and gender-adjusted hazard ratios (HRs) of self-harm than the majority population (HR 1.6–2.3). The HRs decreased for all immigrant groups when socio-economic factors were accounted for but remained significantly higher for immigrants from Finland and Western countries and for youth with one Swedish-born and one foreign-born parent.ConclusionsSocio-economic factors explain much of the variation by parental country of birth of hospital admissions for self-harm in youth in Sweden.

scholarly journals Congenital anomalies in Santa Catarina: case distribution and trends in 2010–2018

2022 ◽  
Vol 40 ◽  
Author(s):  
Bruna Muraro Vanassi ◽  
Gabriel Cremona Parma ◽  
Vivyane Santiago Magalhaes ◽  
Augusto César Cardoso dos Santos ◽  
Betine Pinto Moehlecke Iser
Keyword(s):  
Congenital Anomalies ◽  
Low Birthweight ◽  
Secondary Data ◽  
Santa Catarina ◽  
Infant Deaths ◽  
Live Births ◽  
Time Series Study ◽  
Series Study ◽  
Related Mortality ◽  
Case Distribution

Abstract Objective: To evaluate the distribution of cases of congenital anomalies in the state of Santa Catarina by health macro-region, to determine the frequency according to maternal and neonatal variables, to estimate the related mortality, and the trends in the period 2010–2018. Methods: An ecological time-series study with secondary data on congenital anomalies and the sociodemographic and health variables of mothers and newborns living in Santa Catarina, from 2010 to 2018. For temporal trend analysis, generalized linear regression was performed using the Prais-Winsten method with robust variance. Results: The average prevalence of congenital anomalies in the period was 8.9 cases per 1,000 live births, being 9.4 cases by 1,000 live births in 2010 and, in 2018, 8.2/1,000. The trend remained stable in the analyzed period. The major malformations were musculoskeletal, hip, and foot malformations, with a proportion ≥30%. There was a higher prevalence of congenital anomalies in low birthweight, preterm, male livebirths with Apgar≤7, born by cesarean section, mothers of older age (≥40 years), and less educated (less than eight years of study). Infant mortality due to congenital malformations was 2.6 deaths/1,000 live births, representing about 25.8% of the total infant deaths in the period. Conclusions: The frequency of congenital anomalies and the mortality with anomalies was stable in the studied period in Santa Catarina. The presence of anomalies was associated with low birth weight, prematurity, and low Apgar score. The highest proportion of congenital anomalies was in the musculoskeletal system.

Determinants of tooth loss and chewing ability in mid- and late life in three Swedish birth cohorts

2014 ◽  
Vol 35 (6) ◽  
pp. 1304-1317 ◽  
Author(s):  
DUANGJAI LEXOMBOON ◽  
INGER WÅRDH ◽  
MATS THORSLUND ◽  
MARTI G. PARKER
Keyword(s):  
Birth Cohort ◽  
Tooth Loss ◽  
Late Life ◽  
Economic Factors ◽  
Birth Cohorts ◽  
Lower Odds ◽  
Childhood Conditions ◽  
Chewing Ability ◽  
Natural Teeth ◽  
Socio Economic Factors

ABSTRACTThe aim of the research presented is to determine the influence of socio-economic factors in childhood and mid-life on multiple tooth loss and chewing problems in mid- and late life in three Swedish birth cohorts (1903–1910, 1911–1920 and 1921–1925). Longitudinal national Swedish surveys were used for the analysis. Participants were interviewed in mid-life in 1968 and later in life (77–99 years of age) in 2002. Childhood socio-economic positions (SEP) did not result in different odds of multiple tooth loss and chewing problems in mid- and late life, but persons with higher mid-life SEP had lower odds. Persons born into the 1921–1925 birth cohort had significantly lower odds of multiple tooth loss in late life than the 1903–1910 birth cohort. Women had higher odds of losing multiple teeth than men in late life but not mid-life. Neither gender nor childhood and mid-life SEP predicted chewing problems late in life, but older people with multiple tooth loss had higher odds of chewing difficulty than those with mainly natural teeth. Childhood conditions may contribute to multiple tooth loss in mid-life, which subsequently contributes to multiple tooth loss in late life. Tooth loss in late life is strongly associated with difficulty chewing hard food. Prevalence of multiple tooth loss is higher in women than in men in late life but not in mid-life.

scholarly journals Importance of bio-medical and socio-economic factors for increase of life expectancy

Stanovnistvo ◽  
2004 ◽  
Vol 42 (1-4) ◽  
pp. 93-107
Author(s):  
Biljana Radivojevic ◽  
Vukica Veljanovic-Moraca
Keyword(s):  
Life Expectancy ◽  
20Th Century ◽  
Child Mortality ◽  
National Income ◽  
Developed Countries ◽  
Economic Factors ◽  
Medical Factors ◽  
Correlation And Regression Analysis ◽  
Factors Analysis ◽  
Socio Economic Factors

This paper analyzes the connection between life expectancy according to sex and numerous factors on which its level depends on. Statistical analysis understood application of correlation and regression analysis for determining the connection strength of life expectancy and researched factors separately and then all factors together, as well as separately groups of health-medical and socio-economic factors. The analysis was carried out for a group of developed countries, medium developed, mixed group and Yugoslavia (now SCG) on available data for the second half of the 20th century. Analysis results for Yugoslavia showed that the greatest influence on life expectancy of all factors together were setting aside funds for social security (p<0.05). If only health-medical factors are observed, then child mortality up to 5 years and tumor mortality are in question. With women, the greatest influence is with child mortality up to five years old among all factors (<p0.05), or only among health-medical, but in that case it is far less than with men. In developed countries, the strongest connection with life expectancy were the number of sick-beds with men (p<0.05), and with women the parameter of potentially lost years due to tumor (p<0.01). In medium developed countries the most influence on women's life expectancy was maternal mortality (p=0.014), and with men no researched factor was statistically significant. In the mixed sample, the strongest connection with men was with gross national income per capita (p<0.01), and with women with child mortality up to five years old (p=0.017). Therefore on the basis of the determined statistical importance of certain factors analysis showed that the influence of socio-economic factors on life expectancy was very strong in present conditions of mortality, not only in positive, but in negative direction as well, and that their influence in that second half of the 20th century was greater than the influence of health-medical factors. Also, it seems that the males are more sensitive to these factors than women.

scholarly journals Trends and Variations in Perinatal Mortality and Low Birthweight: The Contribution of Socio-economic Factors

1999 ◽  
Vol 90 (6) ◽  
pp. 377-381 ◽  
Author(s):  
Isaac N. Luginaah ◽  
Kyong-Soon Lee ◽  
Thomas J. Abernathy ◽  
Debbie Sheehan ◽  
Greg Webster
Keyword(s):  
Perinatal Mortality ◽  
Low Birthweight ◽  
Economic Factors ◽  
Socio Economic Factors

scholarly journals Origins of disparities in preventable child mortality in England and Sweden: a birth cohort study

2019 ◽  
Vol 105 (1) ◽  
pp. 53-61 ◽  
Author(s):  
Ania Zylbersztejn ◽  
Ruth Gilbert ◽  
Anders Hjern ◽  
Pia Hardelid
Keyword(s):  
Cohort Study ◽  
Socioeconomic Factors ◽  
Birth Cohort ◽  
Child Mortality ◽  
Outcome Measures ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Birth Cohort Study ◽  
Unexpected Death ◽  
Birth Characteristics

ObjectiveTo compare mortality in children aged <5 years from two causes amenable to healthcare prevention in England and Sweden: respiratory tract infection (RTI) and sudden unexpected death in infancy (SUDI).DesignBirth cohort study using linked administrative health databases from England and Sweden.Setting and participantsSingleton live births between 2003 and 2012 in England and Sweden, followed up from age 31 days until the fifth birthday, death or 31 December 2013.Main outcome measuresThe main outcome measures were HR for RTI-related mortality at 31–364 days and at 1–4 years and SUDI mortality at 31–364 days in England versus Sweden estimated using Cox proportional hazards models. We calculated unadjusted HRs and HRs adjusted for birth characteristics (gestational age, birth weight, sex and congenital anomalies) and socioeconomic factors (maternal age and socioeconomic status).ResultsThe English cohort comprised 3 928 483 births, 768 RTI-related deaths at 31–364 days, 691 RTI-related deaths at 1–4 years and 1166 SUDIs; the corresponding figures for the Swedish cohort were 1 012 682, 131, 118 and 189. At 31–364 days, unadjusted HR for RTI-related death in England versus Sweden was 1.52 (95% CI 1.26 to 1.82). After adjusting for birth characteristics, the HR reduced to 1.16 (95% CI 0.96 to 1.40) and for socioeconomic factors to 1.11 (95% CI 0.92 to 1.34). At 1–4 years, unadjusted HR was 1.58 (95% CI 1.30 to 1.92) and decreased to 1.32 (95% CI 1.09 to 1.61) after adjusting for birth characteristics and to 1.30 (95% CI 1.07 to 1.59) after further adjustment for socioeconomic factors. For SUDI, the respective HRs were 1.59 (95% CI 1.36 to 1.85) in the unadjusted model, and 1.40 (95% CI 1.20 to 1.63) after accounting for birth characteristics and 1.19 (95% CI 1.02 to 1.39) in the fully adjusted model.ConclusionInterventions that improve maternal health before and during pregnancy to reduce the prevalence of adverse birth characteristics and address poverty could reduce child mortality due to RTIs and SUDIs in England.

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