Area-based socioeconomic disparities in mortality due to unintentional injury and youth suicide in British Columbia, 2009–2013

Introduction The association between health outcomes and socioeconomic status (SES) has been widely documented, and mortality due to unintentional injuries continues to rank among the leading causes of death among British Columbians. This paper quantified the SES-related disparities in the mortality burden of three British Columbia’s provincial injury prevention priority areas: falls among seniors, transport injury, and youth suicide. Methods Mortality data (2009 to 2013) from Vital Statistics and dissemination area or local health area level socioeconomic data from CensusPlus 2011 were linked to examine age-standardized mortality rates (ASMRs) and disparities in ASMRs of unintentional injuries and subtypes including falls among seniors (aged 65+) and transport-related injuries as well as the intentional injury type of youth suicide (aged 15 to 24). Disparities by sex and geography were examined, and relative and absolute disparities were calculated between the least and most privileged areas based on income, education, employment, material deprivation, and social deprivation quintiles. Results Our study highlighted significant sex differences in the mortality burden of falls among seniors, transport injury, and youth suicide with males experiencing significantly higher mortality rates. Notable geographic variations in overall unintentional injury ASMR were also observed across the province. In general, people living in areas with lower income and higher levels of material deprivation had increasingly higher mortality rates compared to their counterparts living in more privileged areas. Conclusion The significant differences in unintentional and intentional injury-related mortality outcomes between the sexes and by SES present opportunities for targeted prevention strategies that address the disparities.

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Unintentional injury deaths among American Indian residents of the Fort Apache Indian Reservation, 2006–2012

Injury Prevention ◽

10.1136/injuryprev-2018-043082 ◽

2019 ◽

Vol 25 (6) ◽

pp. 574-576

Author(s):

Anne Kenney ◽

Wendy Shields ◽

Alexandra Hinton ◽

Francene Larzelere ◽

Novalene Goklish ◽

...

Keyword(s):

American Indian ◽

American Indians ◽

Age Distribution ◽

Unintentional Injury ◽

Public Health Problem ◽

Targeted Prevention ◽

Unintentional Injuries ◽

Indian Reservation ◽

Injury Death ◽

Fort Apache Indian Reservation

This study aims to describe the epidemiology of unintentional injury deaths among American Indian residents of the Fort Apache Indian Reservation between 2006 and 2012. Unintentional injury death data were obtained from the Arizona Department of Health Services and death rates were calculated per 100 000 people per year and age adjusted using data obtained from Indian Health Service and the age distribution of the 2010 US Census. Rate ratios were calculated using the comparison data obtained through CDC’s Web-based Injury Statistics Query and Reporting System. The overall unintentional injury mortality rate among American Indians residing on the Fort Apache Indian Reservation between 2006 and 2012 was 107.0 per 100 000. When stratified by age, White Mountain Apache Tribe (WMAT) mortality rates for all unintentional injuries exceed the US all races rate except for ages 10–14 for which there were no deaths due to unintentional injury during this period. The leading causes of unintentional injury deaths were MVCs and poisonings. Unintentional injuries are a significant public health problem in the American Indian and Alaska Native communities. Tribal-specific analyses are critical to inform targeted prevention and priority setting.

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Prevention of Traumatic Deaths to Children in the United States: How Far Have We Come and Where Do We Need to Go?

PEDIATRICS ◽

10.1542/peds.97.6.791 ◽

1996 ◽

Vol 97 (6) ◽

pp. 791-797

Author(s):

Frederick P. Rivara ◽

David C. Grossman

Keyword(s):

Unintentional Injury ◽

The United States ◽

Mortality Data ◽

Review Of The Literature ◽

Prevention Strategies ◽

Unintentional Injuries ◽

Injury Death ◽

Injury Mortality ◽

Injury Control ◽

Made In

Objective. To describe the changes in injury mortality from 1978 to 1991 and determine the number of preventable deaths with currently available intervention strategies. Methods. Comparison of injury mortality data for children and adolescents 0 to 19 years in 1978 and 1991. Review of the literature to determine the effectiveness of currently available prevention strategies and application of these to deaths in 1991. Results. The injury death rate declined by 26% over the 14-year period. Death rates of unintentional injuries decreased by 39%, with declines in all categories of unintentional injuries. Homicides increased by 67% and suicides by 17%; nearly all of this increase was in deaths from firearms. If currently available prevention strategies were fully used, 6640 deaths could have been prevented, a further 31% decrease. Conclusions. Although great strides have been made in preventing deaths from trauma, the application of currently available prevention strategies could save a large number of additional lives. However, the increasing problem of intentional injury will partly counterbalance the success in unintentional injury control.

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Mortality in Tonga over three triennia, 2010–2018

BMC Public Health ◽

10.1186/s12889-020-10023-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Carah Figueroa ◽

Christine Linhart ◽

Latu Fusimalohi ◽

Sioape Kupu ◽

Gloria Mathenge ◽

...

Keyword(s):

Life Expectancy ◽

Mortality Rates ◽

Adult Mortality ◽

Statistical Testing ◽

International Agency ◽

Mortality Data ◽

Local Health ◽

Mortality Trends ◽

Substantial Impact ◽

International Agencies

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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Injury-Related Deaths according to Environmental, Demographic, and Lifestyle Factors

Journal of Environmental and Public Health ◽

10.1155/2019/6942787 ◽

2019 ◽

Vol 2019 ◽

pp. 1-12 ◽

Cited By ~ 1

Author(s):

Ray M. Merrill

Keyword(s):

Population Density ◽

Cigarette Smoking ◽

Air Temperature ◽

Physical Inactivity ◽

Causes Of Death ◽

Mortality Rates ◽

Mortality Data ◽

Unintentional Injuries ◽

Negatively Associated ◽

Temperature And Precipitation

Background. Environmental, demographic, and lifestyle variables have been associated with injury-related deaths. The current study identifies the simultaneous association of selected environmental, demographic, and lifestyle variables with deaths from homicide, unintentional injuries, and suicide. Materials and Methods. Analyses are based on county-level mortality data in the contiguous United States, 2011–15. Basic summary statistics and Poisson regression were used to evaluate the data. Results. The selected causes of death were impacted differently by age, sex, and race: for homicide, mortality rates were greater in ages 20–39, males, and blacks; for unintentional injuries, the rates increased with age, most noticeably in the oldest age group, and were highest among males and whites; and for suicide, the rates tended to increase with age and were greater in males and whites. Mortality rates from homicide were positively associated with poverty, cigarette smoking, air temperature, and leisure-time physical inactivity. They were negatively associated with precipitation and sunlight. Mortality rates from unintentional injuries were positively associated with altitude, cigarette smoking, air temperature, poverty, obesity, and precipitation. They were negatively associated with population density. Mortality rates from suicides were positively associated with altitude, cigarette smoking, obesity, air temperature, and precipitation and negatively associated with population density. Conclusion. The results confirm and extend previous research in which death from homicide, unintentional injuries, and suicide are distinctly associated with a combination of environmental, demographic, and lifestyle variables. The findings may be useful in developing strategies for reducing injury-related deaths.

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Neonatal Mortality Burden and Trends in UNHCR Refugee Camps, 2006-2017: A Retrospective Analysis

10.21203/rs.3.rs-40237/v1 ◽

2020 ◽

Author(s):

Hannah Tappis ◽

Marwa Ramadan ◽

Josep Vargas ◽

Vincent Kahi ◽

Heiko Hering ◽

...

Keyword(s):

Health Information ◽

Neonatal Mortality ◽

Refugee Camp ◽

Mortality Rates ◽

Host Community ◽

Mortality Data ◽

Refugee Camps ◽

Neonatal Deaths ◽

Live Births ◽

Mortality Burden

Abstract Objective: To examine neonatal mortality burden and trends in refugee camps between 2006 and 2017.Methods: Refugee population and mortality data were exported from the United Nations High Commissioner (UNHCR) Health Information System (HIS) database. Tableau was used to export the data. Stata was used for data cleaning and statistical analysis. Neonatal mortality burdens and trends in refugee camps were analyzed and compared to national and subnational neonatal mortality rates captured by household surveys.Findings: 150 refugee camps in 21 countries were included in this study, with an average population of 1,725,433 between 2006 and 2017. A total of 663,892 live births and 3,382 neonatal deaths were captured during this period. Annual country-level refugee camp neonatal mortality rates (NMR) ranged from 12 to 56 neonatal deaths per 1,000 live births. In most countries and years where national population-based surveys are available, refugee camp NMR as reported in the UNHCR HIS was lower than that of the immediate host community.Conclusion: The UNHCR HIS provides insights into the neonatal mortality burden among refugees in camp settings and issues to consider in design and use of routine health information systems to monitor neonatal health in sub-national populations. Increased visibility of neonatal deaths and stillbirths among displaced populations can drive advocacy and inform decisions needed to strengthen health systems. Efforts to count every stillbirth and neonatal death are critical, as well as improvements to reporting systems and mechanisms for data review within broader efforts to improve the quality of neonatal care practices within and outside of health facilities.

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Inequalities and Impact of Socioeconomic-Cultural Factors in Suicide Rates Across Italy

Crisis ◽

10.1027/0227-5910/a000084 ◽

2011 ◽

Vol 32 (4) ◽

pp. 178-185 ◽

Cited By ~ 15

Author(s):

Maurizio Pompili ◽

Marco Innamorati ◽

Monica Vichi ◽

Maria Masocco ◽

Nicola Vanacore ◽

...

Keyword(s):

Suicide Rate ◽

Age Groups ◽

Premature Death ◽

Mortality Rates ◽

Mortality Data ◽

Italian Population ◽

Comprehensive Overview ◽

Suicide Rates ◽

Younger Age ◽

Age And Sex

Background: Suicide is a major cause of premature death in Italy and occurs at different rates in the various regions. Aims: The aim of the present study was to provide a comprehensive overview of suicide in the Italian population aged 15 years and older for the years 1980–2006. Methods: Mortality data were extracted from the Italian Mortality Database. Results: Mortality rates for suicide in Italy reached a peak in 1985 and declined thereafter. The different patterns observed by age and sex indicated that the decrease in the suicide rate in Italy was initially the result of declining rates in those aged 45+ while, from 1997 on, the decrease was attributable principally to a reduction in suicide rates among the younger age groups. It was found that socioeconomic factors underlined major differences in the suicide rate across regions. Conclusions: The present study confirmed that suicide is a multifaceted phenomenon that may be determined by an array of factors. Suicide prevention should, therefore, be targeted to identifiable high-risk sociocultural groups in each country.

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Mortality beyond emergency threshold in a silent crisis– results from a population-based mortality survey in Ouaka prefecture, Central African Republic, 2020

Conflict and Health ◽

10.1186/s13031-021-00385-2 ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Eve Robinson ◽

Lawrence Lee ◽

Leslie F. Roberts ◽

Aurelie Poelhekke ◽

Xavier Charles ◽

...

Keyword(s):

Central African Republic ◽

Causes Of Death ◽

Maternal Mortality Ratio ◽

Mortality Rates ◽

Population Based ◽

Access To Healthcare ◽

Mortality Data ◽

Humanitarian Emergency ◽

The World ◽

Mortality Survey

Abstract Background The Central African Republic (CAR) suffers a protracted conflict and has the second lowest human development index in the world. Available mortality estimates vary and differ in methodology. We undertook a retrospective mortality study in the Ouaka prefecture to obtain reliable mortality data. Methods We conducted a population-based two-stage cluster survey from 9 March to 9 April, 2020 in Ouaka prefecture. We aimed to include 64 clusters of 12 households for a required sample size of 3636 persons. We assigned clusters to communes proportional to population size and then used systematic random sampling to identify cluster starting points from a dataset of buildings in each commune. In addition to the mortality survey questions, we included an open question on challenges faced by the household. Results We completed 50 clusters with 591 participating households including 4000 household members on the interview day. The median household size was 7 (interquartile range (IQR): 4—9). The median age was 12 (IQR: 5—27). The birth rate was 59.0/1000 population (95% confidence interval (95%-CI): 51.7—67.4). The crude and under-five mortality rates (CMR & U5MR) were 1.33 (95%-CI: 1.09—1.61) and 1.87 (95%-CI: 1.37–2.54) deaths/10,000 persons/day, respectively. The most common specified causes of death were malaria/fever (16.0%; 95%-CI: 11.0–22.7), violence (13.2%; 95%-CI: 6.3–25.5), diarrhoea/vomiting (10.6%; 95%-CI: 6.2–17.5), and respiratory infections (8.4%; 95%-CI: 4.6–14.8). The maternal mortality ratio (MMR) was 2525/100,000 live births (95%-CI: 825—5794). Challenges reported by households included health problems and access to healthcare, high number of deaths, lack of potable water, insufficient means of subsistence, food insecurity and violence. Conclusions The CMR, U5MR and MMR exceed previous estimates, and the CMR exceeds the humanitarian emergency threshold. Violence is a major threat to life, and to physical and mental wellbeing. Other causes of death speak to poor living conditions and poor access to healthcare and preventive measures, corroborated by the challenges reported by households. Many areas of CAR face similar challenges to Ouaka. If these results were generalisable across CAR, the country would suffer one of the highest mortality rates in the world, a reminder that the longstanding “silent crisis” continues.

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Outcomes for Children and Adolescents With Cancer: Challenges for the Twenty-First Century

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.0421 ◽

2010 ◽

Vol 28 (15) ◽

pp. 2625-2634 ◽

Cited By ~ 593

Author(s):

Malcolm A. Smith ◽

Nita L. Seibel ◽

Sean F. Altekruse ◽

Lynn A.G. Ries ◽

Danielle L. Melbert ◽

...

Keyword(s):

United States ◽

Childhood Cancer ◽

Cancer Mortality ◽

Lymphoblastic Leukemia ◽

The United States ◽

Mortality Rates ◽

Mortality Data ◽

Childhood Cancers ◽

Essential Information ◽

The Impact

Purpose This report provides an overview of current childhood cancer statistics to facilitate analysis of the impact of past research discoveries on outcome and provide essential information for prioritizing future research directions. Methods Incidence and survival data for childhood cancers came from the Surveillance, Epidemiology, and End Results 9 (SEER 9) registries, and mortality data were based on deaths in the United States that were reported by states to the Centers for Disease Control and Prevention by underlying cause. Results Childhood cancer incidence rates increased significantly from 1975 through 2006, with increasing rates for acute lymphoblastic leukemia being most notable. Childhood cancer mortality rates declined by more than 50% between 1975 and 2006. For leukemias and lymphomas, significantly decreasing mortality rates were observed throughout the 32-year period, though the rate of decline slowed somewhat after 1998. For remaining childhood cancers, significantly decreasing mortality rates were observed from 1975 to 1996, with stable rates from 1996 through 2006. Increased survival rates were observed for all categories of childhood cancers studied, with the extent and temporal pace of the increases varying by diagnosis. Conclusion When 1975 age-specific death rates for children are used as a baseline, approximately 38,000 childhood malignant cancer deaths were averted in the United States from 1975 through 2006 as a result of more effective treatments identified and applied during this period. Continued success in reducing childhood cancer mortality will require new treatment paradigms building on an increased understanding of the molecular processes that promote growth and survival of specific childhood cancers.

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Do Different Models Induce Changes in Mortality Indicators? That Is a Key Question for Extending the Lee-Carter Model

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18042204 ◽

2021 ◽

Vol 18 (4) ◽

pp. 2204

Author(s):

Ana Debón ◽

Steven Haberman ◽

Francisco Montes ◽

Edoardo Otranto

Keyword(s):

Historical Data ◽

Mortality Rates ◽

Parametric Model ◽

Mortality Data ◽

Block Bootstrap ◽

Functional Anova ◽

Model Block ◽

The Usa ◽

Data Constraints ◽

Carter Model

The parametric model introduced by Lee and Carter in 1992 for modeling mortality rates in the USA was a seminal development in forecasting life expectancies and has been widely used since then. Different extensions of this model, using different hypotheses about the data, constraints on the parameters, and appropriate methods have led to improvements in the model’s fit to historical data and the model’s forecasting of the future. This paper’s main objective is to evaluate if differences between models are reflected in different mortality indicators’ forecasts. To this end, nine sets of indicator predictions were generated by crossing three models and three block-bootstrap samples with each of size fifty. Later the predicted mortality indicators were compared using functional ANOVA. Models and block bootstrap procedures are applied to Spanish mortality data. Results show model, block-bootstrap, and interaction effects for all mortality indicators. Although it was not our main objective, it is essential to point out that the sample effect should not be present since they must be realizations of the same population, and therefore the procedure should lead to samples that do not influence the results. Regarding significant model effect, it follows that, although the addition of terms improves the adjustment of probabilities and translates into an effect on mortality indicators, the model’s predictions must be checked in terms of their probabilities and the mortality indicators of interest.

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Incidence, Characteristics, and Outcome of COVID-19 in Adults on Kidney Replacement Therapy: A Regionwide Registry Study

Journal of the American Society of Nephrology ◽

10.1681/asn.2020060875 ◽

2020 ◽

pp. ASN.2020060875

Author(s):

Johan De Meester ◽

Dirk De Bacquer ◽

Maarten Naesens ◽

Bjorn Meijers ◽

Marie M. Couttenye ◽

...

Keyword(s):

General Population ◽

Excess Mortality ◽

Mortality Rates ◽

Incidence Rates ◽

Registry Study ◽

Additional Risk ◽

Mortality Burden ◽

Kidney Replacement Therapy ◽

Expected Mortality ◽

Chronic Comorbidities

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection disproportionally affects frail, elderly patients and those with multiple chronic comorbidities. Whether patients on RRT have an additional risk because of their specific exposure and complex immune dysregulation is controversial.MethodsTo describe the incidence, characteristics, and outcomes of SARS-CoV-2 infection, we conducted a prospective, multicenter, region-wide registry study in adult patients on RRT versus the general population from March 2 to May 25, 2020. This study comprised all patients undergoing RRT in the Flanders region of Belgium, a country that has been severely affected by coronavirus disease 2019 (COVID-19).Results At the end of the epidemic wave, crude and age-standardized cumulative incidence rates of SARS-CoV-2 infection were 5.3% versus 2.5%, respectively, among 4297 patients on hemodialysis, and 1.4% versus 1.6%, respectively, among 3293 patients with kidney transplants (compared with 0.6% in the general population). Crude and age-standardized cumulative mortality rates were 29.6% versus 19.9%, respectively, among patients on hemodialysis, and 14.0% versus 23.0%, respectively, among patients with transplants (compared with 15.3% in the general population). We found no excess mortality in the hemodialysis population when compared with mean mortality rates during the same 12-week period in 2015–2019 because COVID-19 mortality was balanced by lower than expected mortality among uninfected patients. Only 0.18% of the kidney transplant population died of SARS-CoV-2 infection.ConclusionsMortality associated with SARS-CoV-2 infection is high in patients on RRT. Nevertheless, the epidemic’s overall effect on the RRT population remained remarkably limited in Flanders. Calculation of excess mortality and age standardization provide a more reliable picture of the mortality burden of COVID-19 among patients on RRT.

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