scholarly journals The Stratification Index for Comparing Between-Group Differences in Mortality: Evidence from Finnish Income Groups

2021 ◽  
Author(s):  
Jiaxin Shi ◽  
José Manuel Aburto ◽  
Pekka Martikainen ◽  
Lasse Tarkiainen ◽  
Alyson A van Raalte
Keyword(s):  
Life Expectancy ◽  
Mortality Rates ◽  
Income Quintile ◽  
Group Differences ◽  
Summary Measure ◽  
Income Groups ◽  
Inequalities In Mortality ◽  
Unique Domain ◽  
Group Characteristics ◽  
Mortality Inequality

The study of the mortality differences between groups has traditionally focused on metrics such as life expectancy and standardized mortality rates, which give insights into how group characteristics are linked with average levels of mortality. Additional insights can be gained by examining differences in lifespan distributions between groups. Here, we propose a new summary measure of mortality inequality by comparing group-specific lifespan distributions. Our proposed index, mortality stratification, measures the degree of overlap in the lifespan distributions. It helps to capture important between-group differences that conventional life-expectancy comparisons miss. In order to test its utility, we apply the stratification index to Finnish income quintile groups over the period from 1996 to 2017. We find that both stratification and life-expectancy differences between income groups increased substantially from 1996 to 2008; subsequently, the life-expectancy difference declined, whereas stratification stagnated for men and increased for women. By comparing results between different summary measures, we conclude that the stratification index can behave in different ways empirically and thus uncover a unique domain of inequalities in mortality.

scholarly journals Mortality Inequality: The Good News from a County-Level Approach

2016 ◽  
Vol 30 (2) ◽  
pp. 29-52 ◽  
Author(s):  
Janet Currie ◽  
Hannes Schwandt
Keyword(s):  
Life Expectancy ◽  
Mortality Rates ◽  
Good News ◽  
County Level ◽  
Life Expectancy At Birth ◽  
Specific Mortality ◽  
Smoking Patterns ◽  
The Subject ◽  
Over Time ◽  
Mortality Inequality

In this essay, we ask whether the distributions of life expectancy and mortality have become generally more unequal, as many seem to believe, and we report some good news. Focusing on groups of counties ranked by their poverty rates, we show that gains in life expectancy at birth have actually been relatively equally distributed between rich and poor areas. Analysts who have concluded that inequality in life expectancy is increasing have generally focused on life expectancy at age 40 to 50. This observation suggests that it is important to examine trends in mortality for younger and older ages separately. Turning to an analysis of age-specific mortality rates, we show that among adults age 50 and over, mortality has declined more quickly in richer areas than in poorer ones, resulting in increased inequality in mortality. This finding is consistent with previous research on the subject. However, among children, mortality has been falling more quickly in poorer areas with the result that inequality in mortality has fallen substantially over time. We also show that there have been stunning declines in mortality rates for African Americans between 1990 and 2010, especially for black men. Finally we offer some hypotheses about causes for the results we see, including a discussion of differential smoking patterns by age and socioeconomic status.

scholarly journals Not Just Smoking and High-Tech Medicine: Socioeconomic Inequities in U.S. Mortality Rates, Overall and by Race/Ethnicity, 1960–2006

2012 ◽  
Vol 42 (2) ◽  
pp. 293-322 ◽  
Author(s):  
Nancy Krieger ◽  
Jarvis T. Chen ◽  
Anna Kosheleva ◽  
Pamela D. Waterman
Keyword(s):  
Medical Care ◽  
Mortality Rates ◽  
Socioeconomic Inequalities ◽  
Income Quintile ◽  
High Tech ◽  
Mortality Data ◽  
Long Term Trends ◽  
Race Ethnicity ◽  
The 1960S ◽  
Inequalities In Mortality

Recent research on the post-1980 widening of U.S. socioeconomic inequalities in mortality has emphasized the contribution of smoking and high-tech medicine, with some studies treating the growing inequalities as effectively inevitable. No studies, however, have analyzed long-term trends in U.S. mortality rates and inequities unrelated to smoking or due to lack of basic medical care, even as a handful have shown that U.S. socioeconomic inequalities in overall mortality shrank between the mid-1960s and 1980. The authors accordingly analyzed U.S. mortality data for 1960–2006, stratified by county income quintile and race/ethnicity, for mortality unrelated to smoking and preventable by 1960s' standards of medical care. Key findings are that relative and absolute socioeconomic inequalities in U.S. mortality unrelated to smoking and preventable by 1960s' medical care standards shrank between the 1960s and 1980 and then increased and stagnated, with absolute rates on a par with several leading causes of death, and with the burden greatest for U.S. populations of color. None of these findings can be attributed to trends in smoking-related deaths and access to high-tech medicine, and they also demonstrate that socioeconomic inequities in mortality can shrink and need not inevitably rise.

scholarly journals Sex-Dependent End-of-Life Mental and Vascular Scenarios for Compensatory Mechanisms in Mice with Normal and AD-Neurodegenerative Aging

Biomedicines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 111
Author(s):  
Aida Muntsant ◽  
Francesc Jiménez-Altayó ◽  
Lidia Puertas-Umbert ◽  
Elena Jiménez-Xarrie ◽  
Elisabet Vila ◽  
...  
Keyword(s):  
Life Expectancy ◽  
End Of Life ◽  
Mortality Rates ◽  
Disability Adjusted Life Years ◽  
Pharmacological Interventions ◽  
Compensatory Mechanisms ◽  
Healthy Life ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Bidirectional Interactions

Life expectancy decreases with aging, with cardiovascular, mental health, and neurodegenerative disorders strongly contributing to the total disability-adjusted life years. Interestingly, the morbidity/mortality paradox points to females having a worse healthy life expectancy. Since bidirectional interactions between cardiovascular and Alzheimer’s diseases (AD) have been reported, the study of this emerging field is promising. In the present work, we further explored the cardiovascular–brain interactions in mice survivors of two cohorts of non-transgenic and 3xTg-AD mice, including both sexes, to investigate the frailty/survival through their life span. Survival, monitored from birth, showed exceptionally worse mortality rates in females than males, independently of the genotype. This mortality selection provided a “survivors” cohort that could unveil brain–cardiovascular interaction mechanisms relevant for normal and neurodegenerative aging processes restricted to long-lived animals. The results show sex-dependent distinct physical (worse in 3xTg-AD males), neuropsychiatric-like and cognitive phenotypes (worse in 3xTg-AD females), and hypothalamic–pituitary–adrenal (HPA) axis activation (higher in females), with higher cerebral blood flow and improved cardiovascular phenotype in 3xTg-AD female mice survivors. The present study provides an experimental scenario to study the suggested potential compensatory hemodynamic mechanisms in end-of-life dementia, which is sex-dependent and can be a target for pharmacological and non-pharmacological interventions.

scholarly journals Interrupted time series analyses to assess the impact of alcohol control policy on socioeconomic inequalities in mortality in Lithuania: a study protocol

2021 ◽  
Author(s):  
Jakob Manthey ◽  
Domantas Jasilionis ◽  
Huan Jiang ◽  
Olga Mesceriakova-Veliuliene ◽  
Janina Petkeviciene ◽  
...  
Keyword(s):  
Time Series ◽  
Research Ethics ◽  
Interrupted Time Series ◽  
Mortality Rates ◽  
Attributable Mortality ◽  
Population Census ◽  
Combining Data ◽  
Time Series Analyses ◽  
Inequalities In Mortality ◽  
The Impact

Introduction Alcohol use is a major risk factor for mortality. Previous studies suggest that the alcohol-attributable mortality burden is higher in lower socioeconomic strata. This project will test the hypothesis, that the 2017 increase of alcohol excise taxes for beer and wine, which was linked to lower all-cause mortality rates in previous analyses, will reduce socioeconomic mortality inequalities. Methods and analysis Data on all causes of deaths will be obtained from Statistics Lithuania. Record linkage will be implemented using personal identifiers combining data from 1) the 2011 whole-population census, 2) death records between March 1, 2011 (census date) and December 31, 2019, and 3) emigration records, for individuals aged 30 to 70 years. The analyses will be performed separately for all-cause and for alcohol-attributable deaths. Monthly age-standardized mortality rates will be calculated by sex, education, and three measures of socioeconomic status. Inequalities in mortality will be assessed using absolute and relative indicators between low and high SES groups. We will perform interrupted time series analyses, and test the impact of the 2017 rise in alcohol excise taxation using generalized additive mixed models. In these models, we will control for secular trends for economic development. Ethics and dissemination This work is part of project grant 1R01AA028224-01 by the National Institute on Alcohol Abuse and Alcoholism. It has been granted research ethics approval 050/2020 by CAMH Research Ethics Board on April 17, 2020, renewed on March 30, 2021.

scholarly journals Premature Mortality in Canada

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Catherine Liang ◽  
Emmalin Buajitti ◽  
Laura Rosella
Keyword(s):  
Cause Of Death ◽  
Descriptive Analysis ◽  
Premature Mortality ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Income Quintile ◽  
Mortality Trends ◽  
Premature Deaths ◽  
Central Canada ◽  
Over Time

Introduction: Premature mortality (deaths before age 75) is a well-established metric of population health and health system performance. In Canada, underlying differences between provinces/territories present a need for stratified mortality trends. Methods: Using data from the Canadian Vital Statistics Database, a descriptive analysis of sex-specific adult premature deaths over 1992-2015 was conducted by province, census divisions (CD), socioeconomic status (SES), age, and underlying cause of death. Premature mortality rates were calculated as the number of deaths per 100,000 individuals aged 18 to 74, per 8-year era. SES was measured using the income quintile of the neighbourhood of residence. Absolute and relative inequalities were respectively summarized using slope and relative indices of inequality, produced via unadjusted linear regression of the mortality rate on income rank. Results: Premature mortality in Canada declined by 21% for males and 13% for females between 1992-1999 and 2008-2015. The greatest reductions were in Central Canada, while Newfoundland saw notable increases. CD-level improvements appeared mostly in the southern half of Canada. As of 2008-2015, Newfoundland, Nova Scotia, and Nunavut had the highest mortality rates. Low area-level income was associated with higher mortality. SES inequalities grew over time. Newfoundland’s between-quintile differences rose from 1292 to 2389 deaths per 100k males, or 1.33 to 2.12-fold, and 586 to 1586 per 100k females, or 1.24 to 1.74-fold. In 2008-2015, mortality rates of the bottom quintile in Manitoba and Saskatchewan were more than 2.5 times those of the top. Mortality increased with age, and varied regionally. Low mortality in Central Canada and BC, and high mortality in the Territories were consistent across eras and sexes. Cause of death distributions shifted with age and sex, with more external deaths in younger males. Conclusion: Improvements were seen in adult premature mortality rates over time, but were unequal across geographies. Evidence exists for growing socioeconomic disparities in mortality.

Determinants of under-5 mortality in Burkina Faso

2018 ◽  
Vol 41 (3) ◽  
pp. 550-560
Author(s):  
Aristide Romaric Bado ◽  
A Sathiya Susuman
Keyword(s):  
Burkina Faso ◽  
Odds Ratio ◽  
Factors Associated ◽  
Logistics Regression ◽  
Poor Households ◽  
First Child ◽  
Analyse Data ◽  
Inequalities In Mortality ◽  
Group Characteristics ◽  
Children Under 5

Abstract Background The aim of this article is to determine the factors associated with under-5 mortality and their evolution from 1993 to 2010 and to analyse the contributors of socioeconomic inequalities in mortality of children under-5 years during the same period. Data and methods The data used in this study were derived from the four rounds of Demographic and Health Survey (DHS) conducted in Burkina Faso in 1993, 1998 and 2010. Concentration measurement, logistics regression and Oaxaca–Blinder decomposition method were used to analyse data. Results Multivariate analysis revealed that being the first child (odds ratio = 1.8 for 1993, 1.7 for 1998, 1.2 for 2003 and 1.3 for 2010) or a twin (odds ratio = 4.5 for 1993, 2.8 for 1998, 2.7 for 2003 and 4.8 for 2010) were also significantly associated with the probability of dying. The variable (parity) was the main contributor to the part of the inequality due to differences in group characteristics and that would be due to the fact that women from poor households have greater parity compared to those from rich households. Conclusion For a reduction in mortality and inequalities related to mortality, the implementation of actions in favour of poor households and promotion of family planning programmes for birth spacing will be required.

scholarly journals A large decrease in the magnitude of seasonal fluctuations in mortality among elderly explains part of the increase in longevity in Sweden during 20th century

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anders Ledberg
Keyword(s):  
Life Expectancy ◽  
20Th Century ◽  
Winter Season ◽  
Total Mortality ◽  
Mortality Rates ◽  
Relative Increase ◽  
Winter Mortality ◽  
Birth Cohorts ◽  
Seasonal Fluctuations ◽  
Time Period

Abstract Background Mortality rates are known to depend on the seasons and, in temperate climates, rates are highest during winter. The magnitude of these seasonal fluctuations in mortality has decreased substantially in many countries during the 20th century, but the extent to which this decrease has contributed to the concurrent increase in life expectancy is not known. Here, I describe how the seasonality of all-cause mortality among people ages 60 years or more has changed in Sweden between 1860 and 1995, and investigate how this change has contributed to the increase in life expectancy observed during the same time period. Methods Yearly sex-specific birth cohorts consisting of all people born in Sweden between 1800 and 1901 who reached at least 59 years of age were obtained from a genealogical database. The mortality rates for each cohort were modeled by an exponential function of age modulated by a sinusoidal function of time of year. The potential impact of seasonal fluctuations on life expectancy was investigated by a novel decomposition of the total mortality rate into a seasonal part and a part independent of the seasons. Cohort life expectancy at age 60 was used to quantify changes in lifespan during the time period. Results The magnitude of seasonal fluctuations in mortality rates decreased substantially between 1860 and 1995. For cohorts born in 1800, the risk of dying during the winter season was almost twice that of dying during summer. For cohorts born in 1900, the relative increase in winter mortality was 10%. Cohort life expectancy at age 60 increased by 4.3 years for men and 6.8 years for women, and the decrease in seasonal mortality fluctuations accounted for approximately 40% of this increase in average lifespan. Conclusion By following a large number of extinct cohorts, it was possible to show how the decrease in seasonal fluctuations in mortality has contributed to an increase in life expectancy. The decomposition of total mortality introduced here might be useful to better understand the processes and mechanisms underlying the marked improvements in life expectancy seen over the last 150 years.

scholarly journals The evolution of infant mortality inequality in the United States, 1960–2016

2020 ◽  
Vol 6 (29) ◽  
pp. eaba5908
Author(s):  
Nick Turner ◽  
Kaveh Danesh ◽  
Kelsey Moran
Keyword(s):  
United States ◽  
Infant Mortality ◽  
The United States ◽  
Mortality Rates ◽  
County Level ◽  
Level Data ◽  
Antipoverty Programs ◽  
The Relationship ◽  
Over Time ◽  
Mortality Inequality

What is the relationship between infant mortality and poverty in the United States and how has it changed over time? We address this question by analyzing county-level data between 1960 and 2016. Our estimates suggest that level differences in mortality rates between the poorest and least poor counties decreased meaningfully between 1960 and 2000. Nearly three-quarters of the decrease occurred between 1960 and 1980, coincident with the introduction of antipoverty programs and improvements in medical care for infants. We estimate that declining inequality accounts for 18% of the national reduction in infant mortality between 1960 and 2000. However, we also find that level differences between the poorest and least poor counties remained constant between 2000 and 2016, suggesting an important role for policies that improve the health of infants in poor areas.

scholarly journals Increasing Education-Based Disparities in Healthy Life Expectancy Among U.S. Non-Hispanic Whites, 2000–2010

2019 ◽  
Author(s):  
Phillip Cantu ◽  
Connor M Sheehan ◽  
Isaac Sasson ◽  
Mark D Hayward
Keyword(s):  
Life Expectancy ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
White Men ◽  
Mortality Rates ◽  
Healthy Life ◽  
Men And Women ◽  
Specific Mortality ◽  
Disability Prevalence ◽  
College Educated

Abstract Objectives To examine changes in Healthy Life Expectancy (HLE) against the backdrop of rising mortality among less educated white Americans during the first decade of the 21st century. Method This study documented changes in HLE by education among U.S. non-Hispanic whites, using data from the U.S. Multiple Cause of Death public-use files, the Integrated Public Use Microdata Sample (IPUMS) of the 2000 Census and the 2010 American Community Survey, and the Health and Retirement Study (HRS). Changes in HLE were decomposed into contributions from: (1) change in age-specific mortality rates; and (2) change in disability prevalence, measured via Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Results Between 2000 and 2010, HLE significantly decreased for white men and women with less than 12 years of schooling. By contrast, HLE increased among college-educated white men and women. Declines or stagnation in HLE among less educated whites reflected increases in disability prevalence over the study period, whereas improvements among the college educated reflected decreases in both age-specific mortality rates and disability prevalence at older ages. Discussion Differences in HLE between education groups increased among non-Hispanic whites from 2000 to 2010. In fact, education-based differences in HLE were larger than differences in total life expectancy. Thus, the lives of less educated whites were not only shorter, on average, compared with their college-educated counterparts, but they were also more burdened with disability.

scholarly journals A new record linkage for assessing infant mortality rates in Ontario, Canada

2019 ◽  
Vol 111 (2) ◽  
pp. 278-285 ◽  
Author(s):  
Deshayne B. Fell ◽  
Alison L. Park ◽  
Ann E. Sprague ◽  
Nehal Islam ◽  
Joel G. Ray
Keyword(s):  
Infant Mortality ◽  
Live Birth ◽  
Infant Death ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Infant Mortality Rate ◽  
Income Quintile ◽  
Alternative Source ◽  
Live Births ◽  
Birth Records

Abstract Objective Infant mortality statistics for Canada have routinely omitted Ontario—Canada’s most populous province—as a high proportion of Vital Statistics infant death registrations could not be linked with their corresponding Vital Statistics live birth registrations. We assessed the feasibility of linking an alternative source of live birth information with infant death registrations. Methods All infant deaths occurring before 365 days of age registered in Ontario’s Vital Statistics in 2010–2011 were linked with birth records in the Canadian Institute for Health Information’s hospitalization database. Crude birthweight-specific and gestational age-specific infant mortality rates were calculated, and rates examined according to maternal and infant characteristics. Results Of 1311 infant death registrations, only 47 (3.6%) could not be linked to a hospital birth record. The overall crude infant mortality rate was 4.7 deaths per 1000 live births (95% CI, 4.4 to 4.9), the same as previously reported for the rest of Canada in 2011. Infant mortality was higher in women < 20 years (5.8 per 1000 live births) and ≥ 40 years (5.9 per 1000 live births), and lowest among those aged 25–29 years (3.9 per 1000 live births). Infant mortality was notably higher in the lowest (5.1 per 1000 live births) residential income quintile than the highest (3.4 per 1000 live births). Conclusion Use of birth hospitalization records resulted in near-complete linkage of all Vital Statistics infant death registrations. This approach could enhance the conduct of representative surveillance and research on infant mortality when direct linkage of live birth and infant death registrations is not achievable.

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