scholarly journals Using Linked Whole-Of-Population Data to Estimate Education-Related Inequalities in Cause-Specific Mortality in Australia

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Jennifer Welsh ◽  
Grace Joshy ◽  
Lauren Moran ◽  
Kay Soga ◽  
Hsei Di Law ◽  
...  
Keyword(s):  
Cause Of Death ◽  
Brain Cancer ◽  
Negative Binomial ◽  
Health Behaviours ◽  
Negative Binomial Regression ◽  
Population Data ◽  
Medical Intervention ◽  
Mortality Data ◽  
Registration Data ◽  
Specific Mortality

IntroductionOfficial Australian estimates of socioeconomic inequalities in cause-specific mortality have been based on area-level socioeconomic measures. Using area-level measures is known to underestimate inequalities. Objectives and ApproachUsing recently released census linked to mortality data, we estimate education-related inequalities in cause-specific mortality for Australia. We used 2016 Australian Census and Death Registration data (2016-17) linked via a Person Linkage Spine (linkage rates: 92% and 97%, respectively) from the Multi-Agency Data Integration Project (MADIP). Education, from the Census, was categorised as low (no secondary school graduation or other qualification), intermediate (secondary graduation with/without other non-tertiary qualifications) and high (tertiary qualification). Cause of death was coded according to the underlying cause of death using the ICD-10. We used negative binomial regression to estimate relative rates (RR) for cause-specific mortality at ages 25-84 years, in the 12-months following Census, comparing low vs high education, separately by sex and 20-year age group, adjusting for age. Results80,317 deaths occurred among 13,856,202 people. For those aged 25-44 years, relative inequalities were large for causes related to injury and smaller for lesspreventable deaths (e.g. for men, suicide RR=5.6, 95%CI: 4.1-7.5 and brain cancer RR=1.3, 0.6-3.1). For those aged 45-64, inequalities were large for causes related to health behaviours and amenable to medical intervention, e.g. lung cancer (men RR= 6.4, 4.7-8.8) and ischaemic heart disease (women RR=5.0, 3.2-7.7), and were small for less preventable causes e.g. brain cancer (women RR=0.9, 0.6-1.3). Patterns among those aged 65-84years were similar to those aged 45-64 years. Conclusion / ImplicationsIn Australia, inequalities in mortality are substantial. Our findings highlight the health burden from inequalities, opportunities for prevention and provide insights on targets to effectively reduce them.

scholarly journals Education-related inequalities in cause-specific mortality: First estimates for Australia using individual-level linked census and mortality data

2020 ◽  
Author(s):  
Jennifer Welsh ◽  
Grace Joshy ◽  
Lauren Morgan ◽  
Kay Soga ◽  
Hsei-Di Law ◽  
...  
Keyword(s):  
High Education ◽  
Causes Of Death ◽  
Negative Binomial ◽  
International Comparisons ◽  
Negative Binomial Regression ◽  
Medical Intervention ◽  
Mortality Data ◽  
Individual Level ◽  
Specific Mortality ◽  
Inequalities In Mortality

Background: Socioeconomic inequalities in mortality are evident in all high-income countries and ongoing monitoring is recommended using linked census-mortality data. Using such data, we provide first estimates of education-related inequalities in cause-specific mortality in Australia, suitable for international comparisons. Methods: Using Australian Census (2016) linked to 13-months of Death Registrations data (2016-17), we estimated relative rates (RR) and rate differences (RD, per100 000 person-years), comparing rates in low (no qualifications) and intermediate (secondary school) with high education (tertiary), for individual causes of death (among those 25-84y) and grouped according to preventability (25-74y), separately by sex and age group, adjusting for age, using negative binomial regression. Results: Among 13.9M people contributing 14 452 732 person-years, 84 743 deaths occurred. We observed inequalities in most causes of death for each age-sex group. Among men aged 25-44y, absolute and relative inequalities (low versus high education) were largest for injuries, e.g. transport accidents (RR=10.1 [95%CI: 5.4-18.7], RD=21.1 [15.9-26.3]). Among those aged 45-64y, inequalities were greatest for chronic diseases, e.g. lung cancer (men RR=6.6 [4.9-8.9], RD=55.6 [51.1-60.1]) and ischaemic heart disease (women RR=5.8 [3.7-9.1], RD=19.2 [17.0-21.5]), with similar patterns for people aged 65-84y. When grouped according to preventability, inequalities were large for causes amenable to behaviour change and medical intervention for all ages and causes amenable to injury prevention among young men. Conclusions: Australian education-related inequalities in mortality are substantial, generally higher than international estimates, and related to preventability. Findings highlight opportunities to reduce them and the potential to improve the health of the population.

scholarly journals Education inequalities in adult all-cause mortality: first national data for Australia using linked census and mortality data

2019 ◽  
Vol 49 (2) ◽  
pp. 511-518
Author(s):  
Rosemary J Korda ◽  
Nicholas Biddle ◽  
John Lynch ◽  
James Eynstone-Hinkins ◽  
Kay Soga ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Census Data ◽  
International Comparisons ◽  
Negative Binomial Regression ◽  
Mortality Rates ◽  
Mortality Data ◽  
Age Group ◽  
National Data ◽  
Registration Data ◽  
All Cause Mortality

Abstract Background National linked mortality and census data have not previously been available for Australia. We estimated education-based mortality inequalities from linked census and mortality data that are suitable for international comparisons. Methods We used the Australian Bureau of Statistics Death Registrations to Census file, with data on deaths (2011–2012) linked probabilistically to census data (linkage rate 81%). To assess validity, we compared mortality rates by age group (25–44, 45–64, 65–84 years), sex and area-inequality measures to those based on complete death registration data. We used negative binomial regression to quantify inequalities in all-cause mortality in relation to five levels of education [‘Bachelor degree or higher’ (highest) to ‘no Year 12 and no post-secondary qualification’ (lowest)], separately by sex and age group, adjusting for single year of age and correcting for linkage bias and missing education data. Results Mortality rates and area-based inequality estimates were comparable to published national estimates. Men aged 25–84 years with the lowest education had age-adjusted mortality rates 2.20 [95% confidence interval (CI): 2.08‒2.33] times those of men with the highest education. Among women, the rate ratio was 1.64 (1.55‒1.74). Rate ratios were 3.87 (3.38‒4.44) in men and 2.57 (2.15‒3.07) in women aged 25–44 years, decreasing to 1.68 (1.60‒1.76) in men and 1.44 (1.36‒1.53) in women aged 65–84 years. Absolute education inequalities increased with age. One in three to four deaths (31%) was associated with less than Bachelor level education. Conclusions These linked national data enabled valid estimates of education inequality in mortality suitable for international comparisons. The magnitude of relative inequality is substantial and similar to that reported for other high-income countries.

scholarly journals Improving quality of medical certification of causes of death in health facilities in Tanzania 2014–2019

2021 ◽  
Vol 21 (S1) ◽  
Author(s):  
Trust Nyondo ◽  
Gisbert Msigwa ◽  
Daniel Cobos ◽  
Gregory Kabadi ◽  
Tumaniel Macha ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Policy ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Health Facilities ◽  
Mortality Data ◽  
Medical Certification ◽  
Specific Mortality ◽  
Icd 10

Abstract Background Monitoring medically certified causes of death is essential to shape national health policies, track progress to Sustainable Development Goals, and gauge responses to epidemic and pandemic disease. The combination of electronic health information systems with new methods for data quality monitoring can facilitate quality assessments and help target quality improvement. Since 2015, Tanzania has been upgrading its Civil Registration and Vital Statistics system including efforts to improve the availability and quality of mortality data. Methods We used a computer application (ANACONDA v4.01) to assess the quality of medical certification of cause of death (MCCD) and ICD-10 coding for the underlying cause of death for 155,461 deaths from health facilities from 2014 to 2018. From 2018 to 2019, we continued quality analysis for 2690 deaths in one large administrative region 9 months before, and 9 months following MCCD quality improvement interventions. Interventions addressed governance, training, process, and practice. We assessed changes in the levels, distributions, and nature of unusable and insufficiently specified codes, and how these influenced estimates of the leading causes of death. Results 9.7% of expected annual deaths in Tanzania obtained a medically certified cause of death. Of these, 52% of MCCD ICD-10 codes were usable for health policy and planning, with no significant improvement over 5 years. Of certified deaths, 25% had unusable codes, 17% had insufficiently specified codes, and 6% were undetermined causes. Comparing the before and after intervention periods in one Region, codes usable for public health policy purposes improved from 48 to 65% within 1 year and the resulting distortions in the top twenty cause-specific mortality fractions due to unusable causes reduced from 27.4 to 13.5%. Conclusion Data from less than 5% of annual deaths in Tanzania are usable for informing policy. For deaths with medical certification, errors were prevalent in almost half. This constrains capacity to monitor the 15 SDG indicators that require cause-specific mortality. Sustainable quality assurance mechanisms and interventions can result in rapid improvements in the quality of medically certified causes of death. ANACONDA provides an effective means for evaluation of such changes and helps target interventions to remaining weaknesses.

scholarly journals Evaluation of neonatal mortality data completeness and accuracy in Ghana

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0239049
Author(s):  
Dora Dadzie ◽  
Richard Okyere Boadu ◽  
Cyril Mark Engmann ◽  
Nana Amma Yeboaa Twum-Danso
Keyword(s):  
Public Sector ◽  
Data Quality ◽  
Neonatal Mortality ◽  
Cause Of Death ◽  
Health Facilities ◽  
Mortality Data ◽  
Death Certificates ◽  
Neonatal Deaths ◽  
Specific Mortality ◽  
Brong Ahafo

Background Cause-specific mortality data are required to set interventions to reduce neonatal mortality. However, in many developing countries, these data are either lacking or of low quality. We assessed the completeness and accuracy of cause of death (COD) data for neonates in Ghana to assess their usability for monitoring the effectiveness of health system interventions aimed at improving neonatal survival. Methods A lot quality assurance sampling survey was conducted in 20 hospitals in the public sector across four regions of Ghana. Institutional neonatal deaths (IND) occurring from 2014 through 2017 were divided into lots, defined as neonatal deaths occurring in a selected facility in a calendar year. A total of 52 eligible lots were selected: 10 from Ashanti region, and 14 each from Brong Ahafo, Eastern and Volta region. Nine lots were from 2014, 11 from 2015 and 16 each were from 2016 and 2017. The cause of death (COD) of 20 IND per lot were abstracted from admission and discharge (A&D) registers and validated against the COD recorded in death certificates, clinician’s notes or neonatal death audit reports for consistency. With the error threshold set at 5%, ≥ 17 correctly matched diagnoses in a sample of 20 deaths would make the lot accurate for COD diagnosis. Completeness of COD data was measured by calculating the proportion of IND that had death certificates completed. Results Nineteen out of 52 eligible (36.5%) lots had accurate COD diagnoses recorded in their A&D registers. The regional distribution of lots with accurate COD data is as follows: Ashanti (4, 21.2%), Brong Ahafo (7, 36.8%), Eastern (4, 21.1%) and Volta (4, 21.1%). Majority (9, 47.4%) of lots with accurate data were from 2016, followed by 2015 and 2017 with four (21.1%) lots. Two (10.5%) lots had accurate COD data in 2014. Only 22% (239/1040) of sampled IND had completed death certificates. Conclusion Death certificates were not reliably completed for IND in a sample of health facilities in Ghana from 2014 through 2017. The accuracy of cause-specific mortality data recorded in A&D registers was also below the desired target. Thus, recorded IND data in public sector health facilities in Ghana are not valid enough for decision-making or planning. Periodic data quality assessments can determine the magnitude of the data quality concerns and guide site-specific improvements in mortality data management.

Status of legal firearm possession and violent deaths: methods and protocol for a retrospective case-control study

2019 ◽  
Vol 25 (Suppl 1) ◽  
pp. i49-i58 ◽  
Author(s):  
Jennifer L Hernandez-Meier ◽  
Brenna Akert ◽  
Cheng Zheng ◽  
Clare E Guse ◽  
Peter M Layde ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Characteristic Curve ◽  
Negative Binomial Regression ◽  
Population Data ◽  
Public Health Research ◽  
Categorical Variables ◽  
Control Group ◽  
Continuous Variables ◽  
Retrospective Case ◽  
State Population

Background and objectiveThis project links population data to the Wisconsin Violent Death Reporting System (WVDRS) to determine the extent to which firearm possession criteria are being followed as well as the potential impact of the adoption of proposed possession criteria.Design and study populationCriminal justice data for WVDRS homicide suspects and victims and suicide decedents 2008–2011 and a sample of matched control group of driver’s license holders (to characterise the state population) will be abstracted.MethodsIndividual legal possession statuses (prohibited/not prohibited) under each current and expanded criterion will be determined. Proportions of interest will be calculated from two-way contingency tables, and tests between groups with categorical variables (eg, criterion is met or not) will be performed with Fisher’s exact or binomial proportion tests. Tests between groups with continuous variables (eg, number of misdemeanours) will be performed by zero inflated negative binomial regression. Area under the receiver operating characteristic curve will be used to quantify the prediction accuracy of specific univariate or multivariate logistic model for prediction. Inverse probability weighting will be used for analyses that extend from matched controls to the general state population of license holders.DiscussionLinked data sets and partnerships are challenging, but necessary for comprehensive public health research. Results of this study will contribute knowledge on the proportion of prohibited suspects and suicide decedents that used firearms in violent deaths and, if applying expanded criteria would have increased prohibited persons. This study will also investigate risk and protective factors for being a victim of homicide.

scholarly journals Association between homicide rates and suicide rates: a countrywide longitudinal analysis of 5507 Brazilian municipalities

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040069
Author(s):  
Daiane Borges Machado ◽  
Keltie McDonald ◽  
Luis F S Castro-de-Araujo ◽  
Delan Devakumar ◽  
Flávia Jôse Oliveira Alves ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Population Based ◽  
Sensitivity Analyses ◽  
Secondary Outcome ◽  
Mortality Data ◽  
Homicide Rates ◽  
Suicide Rates ◽  
Socioeconomic And Demographic Factors ◽  
The Relationship

ObjectiveTo estimate the association between homicide and suicide rates in Brazilian municipalities over a period of 7 years.DesignWe conducted a longitudinal ecological study using annual mortality data from 5507 Brazilian municipalities between 2008 and 2014. Multivariable negative binomial regression models were used to examine the relationship between homicide and suicide rates. Robustness of results was explored using sensitivity analyses to examine the influence of data quality, population size, age and sex on the relationship between homicide and suicide rates.SettingA nationwide study of municipality-level data.ParticipantsMortality data and corresponding population estimates for municipal populations aged 10 years and older.Primary and secondary outcome measuresAge-standardised suicide rates per 100 000.ResultsMunicipal suicide rates were positively associated with municipal homicide rates; after adjusting for socioeconomic and demographic factors, a doubling of the homicide rate was associated with 22% increase in suicide rate (rate ratio=1.22, 95% CI: 1.13 to 1.33). A dose–response effect was observed with 4% increase in suicide rates at the third quintile, 9% at the fourth quintile and 12% at the highest quintile of homicide rates compared with the lowest quintile. The observed effect estimates were robust to sensitivity analyses.ConclusionsMunicipalities with higher homicide rates have higher suicide rates and the relationship between homicide and suicide rates in Brazil exists independently of many sociodemographic and socioeconomic factors. Our results are in line with the hypothesis that changes in homicide rates lead to changes in suicide rates, although a causal association cannot be established from this study. Suicide and homicide rates have increased in Brazil despite increased community mental health support and incarceration, respectively; therefore, new avenues for intervention are needed. The identification of a positive relationship between homicide and suicide rates suggests that population-based interventions to reduce homicide rates may also reduce suicide rates in Brazil.

scholarly journals Interactions between Ambient Air Particles and Greenness on Cause-specific Mortality in Seven Korean Metropolitan Cities, 2008–2016

2019 ◽  
Vol 16 (10) ◽  
pp. 1866 ◽  
Author(s):  
Sera Kim ◽  
Honghyok Kim ◽  
Jong-Tae Lee
Keyword(s):  
Vegetation Index ◽  
Normalized Difference Vegetation Index ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Ambient Air ◽  
Metropolitan Cities ◽  
Increased Risk ◽  
Specific Mortality ◽  
High Level ◽  
Related Mortality

This study aims to investigate the association of particulate matter with an aerodynamic diameter smaller than 10 μm (PM10) and greenness with cause-specific mortality and their interactions in seven Korean metropolitan cities. We obtained the annual standardized cause-specific mortality rates, annual mean concentration of PM10, and annual Normalized Difference Vegetation Index (NDVI) for 73 districts for the period 2008–2016. We used negative binomial regression with city-specific random effects to estimate the association of PM10 and greenness with mortality. The models were adjusted for potential confounders and spatial autocorrelation. We also conducted stratified analyses to investigate whether the association between PM10 and mortality differs by the level of greenness. Our findings suggest an increased risk of all causes examined, except respiratory disease mortality, with high levels of PM10 and decreased risk of cardiovascular-related mortality with a high level of greenness. In the stratified analyses, we found interactions between PM10 and greenness, but these interactions in the opposite direction depend on the cause of death. The effects of PM10 on cardiovascular-related mortality were attenuated in greener areas, whereas the effects of PM10 on non-accidental mortality were attenuated in less green areas. Further studies are needed to explore the underlying mechanisms.

scholarly journals Primary malignant brain tumor-related mortality in the Belgrade population

2003 ◽  
Vol 60 (5) ◽  
pp. 565-568
Author(s):  
Tatjana Pekmezovic ◽  
Mirjana Jarebinski ◽  
Darija Kisic ◽  
Milen Pavlovic ◽  
Marina Nikitovic ◽  
...  
Keyword(s):  
Linear Trend ◽  
Population Data ◽  
Mortality Rates ◽  
Mortality Data ◽  
World Population ◽  
Age Group ◽  
Test Results ◽  
Female Population ◽  
Specific Mortality ◽  
Related Mortality

Background. The aim of this investigation was the analysis of primary malignant brain tumors (PMBT)-related mortality in the Belgrade population during the period 1983?2000. Methods. Mortality data (based on death records) for the period observed, as well as population data, were obtained from the unpublished material of the Municipal Institute of Statistics, Belgrade. The data analysis was adjusted to specific and standardized mortality rates and linear trend, using the world population as a standard. Regression coefficient was determined by Fisher?s test. Results. During the period 1983?2000, in the Belgrade population standardized mortality rates from PMBT were 6.29/100 000 (95%CI-confidence interval 5.33?7.24) for males, 4.50/100 000 (95%CI 3.84?5.17) for females, and 5.91/100 000 (95%CI 5.20?6.63) for total population. The age-specific mortality rates increased with age up to the age group 65?74, with the highest value of 21.21/100 000 (95%CI 16.03?26.39), and decreased in persons of 75 and more years of age. Conclusion. Mortality rates from PMBT in Belgrade had slightly increasing tendency in male (5.725+0.0592x, p=0.545), and decreasing tendency in female population (y=4.703-0.0213x, p=0.756), while statistically significant increasing mortality rate was registered only in the age group 65?74 (y=435+1.7707x, p=0.0001).

scholarly journals Modal lifespan and disparity at older ages by leading causes of death: a Canada-U.S. comparison

2020 ◽  
Vol 37 (4) ◽  
pp. 323-344
Author(s):  
Viorela Diaconu ◽  
Nadine Ouellette ◽  
Robert Bourbeau
Keyword(s):  
Old Age ◽  
Cause Of Death ◽  
Causes Of Death ◽  
Heart Diseases ◽  
Cerebrovascular Diseases ◽  
Mortality Data ◽  
Age At Death ◽  
Specific Mortality ◽  
The U.S ◽  
Country Specific

AbstractThe U.S. elderly experience shorter lifespans and greater variability in age at death than their Canadian peers. In order to gain insight on the underlying factors responsible for the Canada-U.S. old-age mortality disparities, we propose a cause-of-death analysis. Accordingly, the objective of this paper is to compare levels and trends in cause-specific modal age at death (M) and standard deviation above the mode (SD(M +)) between Canada and the U.S. since the 1970s. We focus on six broad leading causes of death, namely cerebrovascular diseases, heart diseases, and four types of cancers. Country-specific M and SD(M +) estimates for each leading cause of death are calculated from P-spline smooth age-at-death distributions obtained from detailed population and cause-specific mortality data. Our results reveal similar levels and trends in M and SD(M +) for most causes in the two countries, except for breast cancer (females) and lung cancer (males), where differences are the most noticeable. In both of these instances, modal lifespans are shorter in the U.S. than in Canada and U.S. old-age mortality inequalities are greater. These differences are explained in part by the higher stratification along socioeconomic lines in the U.S. than in Canada regarding the adoption of health risk behaviours and access to medical services.

Mortality among Institutionalised People with Learning Disabilities in Greece: A 30-Year Survey at the Leros PIKPA Asylum

1995 ◽  
Vol 167 (S28) ◽  
pp. 70-77 ◽  
Author(s):  
A. Perakis ◽  
G. Kolaitis ◽  
P. Kordoutis ◽  
M. Kranidioti ◽  
J. Tsiantis
Keyword(s):  
Learning Disabilities ◽  
General Population ◽  
Age Groups ◽  
Population Data ◽  
Differential Mortality ◽  
Mortality Data ◽  
Probability Of Survival ◽  
Age Related ◽  
Specific Mortality ◽  
Adults With Learning Disabilities

The life expectancy of institutionalised people with learning disabilities is shorter than that of the general population. Data on population dynamics in institutions for such people are vital for planning purposes. Mortality can be considered a crude measure of quality of health care. Mortality data on the 914 admissions to the Leros PIKPA asylum for children and young adults with learning disabilities and associated problems in the years 1961–91 were reviewed. The overall crude mortality rate was 59.2 deaths per 1000 person-years. Twenty-two per cent of the deaths occurred within a year after admission. Age-specific mortality rates were particularly high for those aged one to four years, and declined thereafter. Male residents had lower mortality than female residents in almost all of the age groups. Compared with sex- and age-specific mortality data for the general population of Greece, the observed rates were 20–150 times higher but still comparable to those reported for people with more severe learning disabilities in institutions in other countries. Lifetable analysis by length of stay showed that male residents had a statistically significant higher probability of survival than female residents, which could not be attributed to age-related differential mortality. Culture-specific differential admission criteria may account for the observed sex difference.

Sign in / Sign up

Export Citation Format

Share Document