scholarly journals Temporal Trends in Notification and Mortality of Tuberculosis in China, 2004–2019: A Joinpoint and Age–Period–Cohort Analysis

Author(s):  
Luqi Wang ◽  
Weibing Wang

Tuberculosis (TB) remains a major public health problem in China and worldwide. In this article, we used a joinpoint regression model to calculate the average annual percent change (AAPC) of TB notification and mortality in China from 2004 to 2019. We also used an age–period–cohort (APC) model based on the intrinsic estimator (IE) method to simultaneously distinguish the age, period and cohort effects on TB notification and mortality in China. A statistically downward trend was observed in TB notification and mortality over the period, with AAPCs of −4.2% * (−4.9%, −3.4%) and −5.8% (−7.5%, −4.0%), respectively. A bimodal pattern of the age effect was observed, peaking in the young adult (aged 15–34) and elderly (aged 50–84) groups. More specifically, the TB notification risk populations were people aged 20–24 years and 70–74 years; the TB mortality risk population was adults over the age of 60. The period effect suggested that TB notification and mortality risks were nearly stable over the past 15 years. The cohort effect on both TB notification and mortality presented a continuously decreasing trend, and it was no longer a risk factor after 1978. All in all, the age effect should be paid more attention.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nam-Hee Kim ◽  
Ichiro Kawachi

AbstractThere have been marked improvements in oral health in Korea during the past 10 years, including chewing ability. We sought to disentangle age, period, and cohort effects in chewing ability between 2007 and 2018. We analyzed data from the Korea National Health and Nutrition Examination Survey. The main variable was chewing difficulty, which was assessed among participants aged 20 years and older. APC analysis revealed three trends in chewing difficulty: (1) there was an increase in chewing difficulty starting at around 60 years of age (age effect), (2) there was a steady decrease in chewing difficulty during the observation period (period effect), and (3) chewing ability improved with each successive generation born after 1951 (cohort effect). Regarding recent improvements in chewing ability, cohort effects were somewhat more important than period effects.


2021 ◽  
Author(s):  
Yufeng Wang ◽  
Xueying Huang ◽  
Huan Ma ◽  
Suru Yue ◽  
Jie Liu ◽  
...  

Abstract Background Migraine is a common disorder of the nervous system in China, imposing heavy burdens on individuals and societies. Optimal healthcare planning requires understanding the magnitude and changing trend of migraine incidence in China. However, the secular trend of migraine incidence in China remains unclear. Methods Data were collected from the Global Burden of Disease Study 2019 in China from 1990 to 2019 to investigate changes in the incidence rate of migraine. The average annual percent change and relative risk were calculated using joinpoint regression and an age–period–cohort model, respectively. Results From 1990 to 2019, the age-standardized incidence rates of migraine in China increased by 0.26% (95% CI: 0.22 to 0.31) and 0.23% (95% CI: 0.19 to 0.28) per year in males and females, respectively. The age effect exerted the most significant impact on the incidence of migraine. The period effect showed a slightly decreasing trend in the incidence of migraine. In terms of the cohort effect, people born after the 1960s presented a higher risk of migraine as compared with the total cohort, with the occurrence risk of migraine increasing with birth cohorts. Conclusion Migraine incidence shows an overall increasing trend in China, with a significant gender difference. An intensive understanding of the risk characteristics and disease pattern of migraine could allow the early detection of persons with a high risk of developing migraine and promote the development of timely intervention measures to relieve this burden effectively.


Author(s):  
Chunhui Li ◽  
Songbo Hu ◽  
Chuanhua Yu

The aim was to study the variation trends of all-cause and cancer mortality during 1984–2013 in Macheng City, China. The mortality data were collected from Macheng City disease surveillance points system and Hubei Center for Disease Control and Prevention. The model life table system was used to adjust mortality rates due to an under-reporting problem. An age-period-cohort model and intrinsic estimator algorithm were used to estimate the age effect, period effect, and cohort effect of all-cause mortality and cancer mortality for males and females. Age effect of all-cause mortality for both sexes increased with age, while the age effect of cancer mortality for both sexes reached a peak at the age group of 55–59 years old and then decreased. The relative risks (RRs) of all-cause mortality for males and females declined with the period and decreased by 51.13% and 63.27% during the whole study period, respectively. Furthermore, the period effect of cancer mortality in both sexes decreased at first and then increased. The cohort effect of all-cause and cancer mortality for both sexes born after 1904 presented the pattern of “rise first and then fall,” and decreased by 82.18% and 90.77% from cohort 1904–1908 to 1989–1993, respectively; especially, the risk of all-cause and cancer mortality for both sexes born before 1949 was much higher than that for those born after 1949.


2015 ◽  
Vol 42 (3-4) ◽  
pp. 1 ◽  
Author(s):  
Lise Thibodeau

Suicide rates raise with age has remained consistent for more than 150 years but over the last 50 years major changes occurred. We examined Age-Period-Cohort (APC) effects on suicide mortality rate by gender in Canada and in Quebec from 1926 to 2008. Durkheim theoretical framework is used to interpret our findings. Descriptive analysis and APC models relating to the Intrinsic Estimator (IE) were used to assess these effects. IE model shows suicide net age effect for men in Canada and Quebec as death rate increased until 25 years old before reaching a plateau. For women it’s an inverted "U" shape peaking at mid-adulthood. While period effect differs, a net cohort effect is found for men born in 1941, and women in 1981 until most recent cohorts. 


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jun Hyun Hwang ◽  
Soon-Woo Park

Abstract Background There has been a gender difference in adolescents’ lifetime smoking prevalence trends over the last 10 years. This study aimed to explain the gender differential secular trend in adolescents’ lifetime smoking prevalence using age-period-cohort (APC) analysis and suggests possible causes for this trend, including Korean tobacco control policies during the last 10 years. Methods We utilized the 2006–2017 Korea Youth Risk Behavior Web-based Survey enrolling grades 7 to 12. Using year of survey and year of entry into middle school, we classified 859,814 students who had ever smoked into 6 age groups, 12 periods, and 17 school admission cohorts. Using APC analysis with the intrinsic estimator method, the effects of age, period, and school admission cohort on lifetime smoking prevalence were analyzed according to gender. Results Overall, there was a similar tendency of all the three effects on lifetime smoking prevalence between genders: an increasing age effect with grade, negative period effect with survey period, and similar pattern of school admission cohort groups. However, compared to boys, girls experienced reduction in the increasing age effect in the 12th grade, consistent and steeper decreasing trend in the period effect from 2006 to 2016, and shorter and lower school admission cohort effect. Conclusions Gender differential response to chronological changes in lifetime smoking prevalence was measured by the APC effect, which affected the gender differential secular trend in lifetime smoking prevalence. Therefore, considering the APC effect could help us understand the trend in smoking rates, as well as the contextual factors that affect it.


Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 283
Author(s):  
Irena Ilic ◽  
Sandra Sipetic Grujicic ◽  
Jovan Grujicic ◽  
Djordje Radovanovic ◽  
Ivana Zivanovic Macuzic ◽  
...  

Background and Objectives: Trends of liver cancer mortality vary widely around the world. The purpose of this study was to assess the trend of liver cancer mortality in Serbia. Material and Methods: Descriptive epidemiological study design was used in this research. The age-standardized rates (ASRs, per 100,000) were calculated using the direct method, according to the World standard population. Temporal trends were assessed using the average annual percent change (AAPC) with 95% confidence interval (95% CI), according to joinpoint regression. An age-period-cohort analysis was used to evaluate the underlying factors for liver cancer mortality trends. Results: In Serbia from 1991 to 2015, over 11,000 men and nearly 8000 women died from liver cancer. The trend in liver cancer mortality significantly decreased both in men (AAPC = −1.3%; 95% CI = −1.7 to −0.9) and women (AAPC = −1.5%; 95% CI = −1.9 to −1.1). For liver cancer mortality, statistically significant cohort and period effects were observed in both genders. Conclusions: The downward trends in liver cancer mortality in Serbia are recorded during the past decades.


2017 ◽  
Vol 3 (1) ◽  
Author(s):  
William Campbell ◽  
Jean Twenge ◽  
Nathan Carter

In three large, nationally representative surveys of U.S. 12th graders, college students, and adults (N = 9 million) conducted 1968–2015, Americans became significantly more supportive of legal marijuana (cannabis) starting in the mid-1980’s. Hierarchical models using age-period-cohort analysis on the adult (General Social Survey) sample showed that the increased support for legalization is primarily a time period effect rather than generational or age effect; thus, Americans of all ages became more supportive of legal marijuana. Among 12th graders, support for marijuana legalization was closely linked to perceptions of marijuana safety.


2018 ◽  
Vol 38 (9) ◽  
pp. 317-327 ◽  
Author(s):  
Minh T. Do ◽  
Vicky C. Chang ◽  
Semra Tibebu ◽  
Wendy Thompson ◽  
Anne-Marie Ugnat

Introduction The opioid epidemic is currently a major public health problem in Canada. As such, knowledge of upstream risk factors associated with opioid use is needed to inform injury prevention, health promotion and harm reduction efforts. Methods We analyzed data extracted from 11 pediatric and 6 general hospital emergency departments (EDs) as part of the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP) from March 2011 to June 2017. We identified suspected opioid-related injuries using search strings and manually verified them. We computed age-adjusted and sex-stratified proportionate injury ratios (PIRs) and 95% confidence intervals (CIs) to compare opioid-related injuries to all injuries in eCHIRPP. Negative binomial regression was used to determine trends over time. We conducted qualitative analyses of narratives to identify common themes across life stages. Results Between March 2011 and June 2017, 583 suspected opioid-related poisoning/ injury cases were identified from eCHIRPP. Most of the cases were females (55%). Many of the injuries occurred in patients’ own homes (51%). Forty-five percent of the injuries were intentional self-harm. Among children (aged 1–9 years), most injuries were caused by inadvertent consumption of opioids left unattended. Among youth (aged 10–19 years) and adults (aged 20–49 years), opioid use was associated with underlying mental illness. Overall, the average annual percent change (AAPC) in the rate of injuries (per 100 000 eCHIRPP cases) has been increasing since 2012 (AAPC = 11.9%, p $lt; .05). The increase is particularly evident for males (AAPC = 16.3%, p $lt; .05). Compared to other injuries, people with suspected opioid-related injuries were more likely to be admitted to hospital (PIR = 5.3, 95% CI: 4.6–6.2). Conclusion The upstream determinants of opioid-related injuries are complex and likely vary by subpopulations. Therefore, continued monitoring of risk factors is important in providing the evidence necessary to prevent future overdoses and deaths.


Author(s):  
Xiaoxue Liu ◽  
Chuanhua Yu ◽  
Yongbo Wang ◽  
Yongyi Bi ◽  
Yu Liu ◽  
...  

Background: The prevalence of diabetes mellitus is rapidly increasing in China, but the secular trends in incidence and mortality remain unknown. This study aims to examine time trends from 1990 to 2017 and the net age, period, and cohort effects on diabetes incidence and mortality. Methods: Incidence and mortality rates of diabetes (1990–2017) were collected for each 5-year age group (from 5–9 to 80–84 age group) stratified by gender from the Global Burden of Disease 2017 Study. The average annual percentage changes in incidence and mortality were analyzed by joinpoint regression analysis; the net age, period, and cohort effects on the incidence and mortality were estimated by age-period-cohort analysis. Results: The joinpoint regression analysis showed that age-standardized incidence significantly rose by 0.92% (95% CI: 0.6%, 1.3%) in men and 0.69% in women (95% CI: 0.3%, 1.0%) from 1990 to 2017; age-standardized mortality rates rose by 0.78% (95% CI: 0.6%, 1.0%) in men and decreased by 0.12% (95% CI: −0.4%, 0.1%) in women. For age-specific rates, incidence increased in most age groups, with exception of 30–34, 60–64, 65–69 and 70–74 age groups in men and 25–29, 30–34, 35–39 and 70–74 age groups in women; mortality in men decreased in the younger age groups (from 20–24 to 45–49 age group) while increased in the older age groups (from 50–54 to 80–84 age group), and mortality in women decreased for all age groups with exception of the age group 75–79 and 80–84. The age effect on incidence showed no obvious changes with advancing age while mortality significantly increased with advancing age; period effect showed that both incidence and mortality increased with advancing time period while the period trend on incidence began to decrease since 2007; cohort effect on incidence and mortality decreased from earlier birth cohorts to more recent birth cohorts while incidence showed no material changes from 1982–1986 to 2012–2016 birth cohort. Conclusions: Mortality decreased in younger age groups but increased in older age groups. Incidence increased in most age groups. The net age or period effect showed an unfavorable trend while the net cohort effect presented a favorable trend. Aging likely drives a continued increase in the mortality of diabetes. Timely population-level interventions aiming for obesity prevention, healthy diet and regular physical activity should be conducted, especially for men and earlier birth cohorts at high risk of diabetes.


2010 ◽  
Vol 26 (7) ◽  
pp. 1446-1456 ◽  
Author(s):  
Christiane Maria Meurer Alves ◽  
Ronaldo Rocha Bastos ◽  
Maximiliano Ribeiro Guerra

This study identifies the period and cohort effects on the decreasing mortality trend of cancer of the uterine cervix and of the uterus, part unspecified, in the state of Minas Gerais, Brazil, during the period 1980-2005. 11,243 cases were included. A non-parametric method was used to calculate Z statistics and p-values. The cohorts were assessed one by one and also in blocks of three, so as to allow for a larger number of comparisons to be made. Greater than expected mortality reduction was observed for the cohort blocks of women born in 1913-1920; 1927-1936; 1937-1946; 1949-1956; 1963-1970; and 1969-1976. For the 1901-1908 and 1921-1928 cohort blocks a smaller than expected mortality decrease was found. As for period effect, we found a greater than expected reduction for the 2000-2001 period, in comparison with the previous one. The study suggests the existence of a significant cohort effect on mortality due to cancer of the uterine cervix in the study population, and such results have been placed in their social and political contexts.


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