scholarly journals Disparities in Cancer-Related Avoidable Mortality by the Level of Area Deprivation in South Korea

2021 ◽  
Vol 18 (15) ◽  
pp. 7856
Author(s):  
Woorim Kim ◽  
Seongkyeong Jang ◽  
Gangeun Lee ◽  
Yoon Jung Chang
Keyword(s):  
Poisson Regression ◽  
Causes Of Death ◽  
Mortality Rates ◽  
Area Deprivation ◽  
Percent Confidence Interval ◽  
Avoidable Mortality ◽  
Independent Variables ◽  
Regression Modelling ◽  
Community Health Survey ◽  
Rate Ratios

Background: This study investigated trends in cancer-related avoidable (preventable and treatable) mortality and its association with area deprivation in Korea. Methods: Cancer-related avoidable mortality rates per 100,000 population between 2015 and 2019 were measured using the Causes of Death Statistics. Area Deprivation Index (ADI) was measured from the Population and Housing Census and information on other independent variables from the Korea Community Health Survey. The gap in avoidable mortality between the more and less deprived groups was expressed as rate ratios (RR) and absolute differences (ADs) with a 95 percent confidence interval (95% CI). The association between avoidable mortality and ADI was investigated through Poisson regression modelling. Results: The more deprived areas had higher avoidable (RR 1.15, 95% CI 1.13–1.17; AD 6.58, 95% CI 5.59–7.57) and preventable (RR 1.19, 95% CI 1.17–1.21; AD 6.22, 95% CI 5.38–7.06) mortality. The overall cancer-related avoidable mortality decreased but the gap between the more and less deprived groups did not decline significantly during the study period. The association between avoidable and preventable mortality and area deprivation remained significant after adjusting for variables, including area levels of smokers and alcohol drinkers. Conclusions: The gap in avoidable mortality signifies the importance of addressing related disparities in cancer.

Substantial Within-Country Variation in the Incidence of Subarachnoid Hemorrhage: A Nationwide Finnish Study

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012129
Author(s):  
Ilari Rautalin ◽  
Joni Valdemar Lindbohm ◽  
Jaakko Kaprio ◽  
Miikka Korja
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Poisson Regression ◽  
Causes Of Death ◽  
Incidence Rates ◽  
Poisson Regression Model ◽  
Geographical Regions ◽  
Adjusted Incidence Rate ◽  
Rate Ratios ◽  
Adjusted Incidence ◽  
Finnish Study

Objective:To study whether the incidence of subarachnoid hemorrhage (SAH) varies between geographical regions of Finland.Methods:By utilizing the nationwide Causes of Death and Hospital Discharge Registers, we identified all first-ever, hospitalized and sudden-death (dying before hospitalization) SAH events in Finland between 1998 and 2017. Based on the SAH patients’ home residence, we divided SAHs into five geographical regions: 1) Southern, 2) Central, 3) Western, 4) Eastern, and 5) Northern Finland. We calculated crude and European age-standardized (ESP2013) SAH incidence rates for each region, and used a Poisson regression model to calculate age-, sex- and calendar year-adjusted incidence rate ratios (IRRs) and 95% confidence intervals for regional and time-dependent differences.Results:During the total 106 510 337 cumulative person-years, we identified 9 443 first-ever SAH cases, of which 24% died before hospitalization. As compared to Western Finland, where the SAH incidence was the lowest (7.4 per 100 000 persons), the ESP-standardized SAH incidence was 1.4 times higher in Eastern (10.2 per 100 000 persons; adjusted IRR=1.37 (1.27–1.47)) and Northern Finland (10.4 per 100 000 persons; adjusted IRR=1.40 (1.30–1.51)). These differences were similar when men and women were analyzed independently. Although SAH incidence rates decreased in all five regions over two decades, the rate of decrease varied significantly by region.Conclusion:SAH incidence appears to vary substantially by region in Finland. Our results suggest that regional SAH studies can identify high-risk subpopulations, but can also considerably over- or underestimate incidence on a nationwide level.

Mortality in serious mental illness

2011 ◽  
Vol 26 (S2) ◽  
pp. 2150-2150
Author(s):  
U. Osby
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Bipolar Disorder ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cerebrovascular Disease ◽  
Causes Of Death ◽  
Mortality Rates ◽  
Rate Ratios ◽  
Bipolar Patients

IntroductionThere is evidence that patients with bipolar disorder have an increased mortality from somatic causes of death, including coronary heart disease and myocardial infarction. However, present mortality ratios and mortality trends over time are not known.AimTo analyze relative mortality and mortality trends for patients with bipolar disorder in relation to the population for cerebrovascular disease, coronary heart disease and myocardial infarction.MethodsAll patients in Sweden with a clinical diagnosis of bipolar disorder from the introduction of ICD-10 (1987–2006) found in the National Swedish Patient Register were followed-up in the Cause of death register. Mortality rate ratios (MRR) for different cardiovascular diseases and different age groups were calculated, as well as numbers of excess deaths, relative to the population. Also, admission rate ratios (ARR) and yearly mortality rates for bipolar patients versus the population were calculated for the same time period.ResultsFrom all causes of death, there were 5,471 deaths for bipolar patients. MRR was 2.58 (95% CI: 2.51–2.65). For cerebrovascular disease MRR was 2.19 (95% CI: 2.01–2.40), and for coronary heart disease MRR was 2.10 (95% CI: 1.98–2.2.24). In the subgroup of acute myocardial infarction MRR was 1.97 (95% CI: 1.81–2.14). In cerebrovascular disease, ARR was increased to 1.47 (95% CI: 1.35–1.59), while in coronary heart disease ARR was 1.06 (95% CI: 0.98–2.24), and in acute myocardial infarction 1.09 (95% CI: 0.0.98–1.22). Yearly mortality rates for these causes of death decreased both among patients and the population, without indication of a decreasing gap.ConclusionsIn patients with bipolar disorder, mortality from cerebrovascular disease and coronary heart disease with its subgroup acute myocardial infarction was doubled during 1987–2006. In contrast, admission rates for coronary heart disease and acute myocardial infarction were not increased. Yearly mortality rates decreased both for the patients and the population, but there were no indications of a decreasing gap.KeywordsBipolar disorder; Register study; Cerebrovascular disease; Coronary heart disease; Acute myocardial infarction; Mortality rate ratios; Admission rate ratios.

scholarly journals Cause-specific mortality by occupational skill level in Canada: a 16-year follow-up study

2013 ◽  
Vol 33 (4) ◽  
pp. 195-203 ◽  
Author(s):  
M Tjepkema ◽  
R Wilkins ◽  
A Long
Keyword(s):  
Causes Of Death ◽  
Mortality Rates ◽  
Skill Level ◽  
Mortality Data ◽  
Excessive Alcohol Consumption ◽  
Skill Levels ◽  
Specific Mortality ◽  
Rate Ratios ◽  
Occupational Skill

Introduction Mortality data by occupation are not routinely available in Canada, so we analyzed census-linked data to examine cause-specific mortality rates across groups of occupations ranked by skill level. Methods A 15% sample of 1991 Canadian Census respondents aged 25 years or older was previously linked to 16 years of mortality data (1991–2006). The current analysis is based on 2.3 million people aged 25 to 64 years at cohort inception, among whom there were 164 332 deaths during the follow-up period. Occupations coded according to the National Occupation Classification were grouped into five skill levels. Age-standardized mortality rates (ASMRs), rate ratios (RRs), rate differences (RDs) and excess mortality were calculated by occupational skill level for various causes of death. Results ASMRs were clearly graded by skill level: they were highest among those employed in unskilled jobs (and those without an occupation) and lowest for those in professional occupations. All-cause RRs for men were 1.16, 1.40, 1.63 and 1.83 with decreasing occupational skill level compared with professionals. For women the gradient was less steep: 1.23, 1.24, 1.32 and 1.53. This gradient was present for most causes of death. Rate ratios comparing lowest to highest skill levels were greater than 2 for HIV/AIDS, diabetes mellitus, suicide and cancer of the cervix as well as for causes of death associated with tobacco use and excessive alcohol consumption. Conclusion Mortality gradients by occupational skill level were evident for most causes of death. These results provide detailed cause-specific baseline indicators not previously available for Canada.

scholarly journals P.1.40 Farmer’s suicide with the use of pesticides in different areas in spain

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A87.2-A87
Author(s):  
Guanlan Zhao ◽  
Elena Ronda ◽  
Gregorio Barrio ◽  
Enrique Regidor
Keyword(s):  
Mortality Rate ◽  
Causes Of Death ◽  
Geographical Location ◽  
Mortality Rates ◽  
Pesticide Use ◽  
Agricultural Pesticides ◽  
Rate Ratios ◽  
Annual Amount ◽  
Southeast Spain

IntroductionThere is considerable interest in the potential relation of suicide with the pesticide. Agriculture is the leading professional sector for pesticide use in the world with a turnover of about 40 billion US dollars in 2010. According to the WHO report in 2014, autointoxication with agricultural pesticides contributes greatly to the global burden of suicide. The aim of this study is to evaluate whether suicide of farmers was associated with the use of pesticide in different areas during the period 2001–2011 in Spain.MethodsThe cohort study followed 9.5 million men in Spain from 2001 to 2011. Participants aged 20–64 years were employed in 2001. The study subjects were grouped as farmers and non-farmers. We divided Spain into two areas depending on both geographical location and the mean annual amount of pesticides used: southeast Spain and the rest of Spain. The southeast Spain shows higher use of pesticides than the rest of Spain. For three major causes of death (suicide, unintentional accidents and rest of causes of death), we estimated the age-standardized mortality rates per 1000,000 person-years of follow-up, the ratio of age-standardized mortality rates with 95% confidence intervals (CI) between farmers and non-farmers in two areas were calculated.ResultsWith respect to the rest area of Spain, farmers in the southeast showed a lower mortality rate of suicide and unintentional accidents, which mortality rate ratios were 0.74 (95% CI 0.65–0.85) and 0.57 (95% CI 0.52–0.62).ConclusionOur findings do no support a possible association between pesticide use and suicide of farmers in Spain.

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

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.

scholarly journals Trends in mortality from external causes in the Republic of Seychelles between 1989 and 2018

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Anne Abio ◽  
Pascal Bovet ◽  
Joachim Didon ◽  
Till Bärnighausen ◽  
Masood Ali Shaikh ◽  
...  
Keyword(s):  
Causes Of Death ◽  
Road Traffic ◽  
Marked Change ◽  
Total Mortality ◽  
Mortality Rates ◽  
Vital Statistics ◽  
African Region ◽  
Road Traffic Injuries ◽  
External Causes ◽  
Over Time

AbstractData on injury-related mortality are scarce in the African region. Mortality from external causes in the Seychelles was assessed, where all deaths are medically certified and the population is regularly enumerated. The four fields for underlying causes of death recorded were reviewed in the national vital statistics register. The age-standardised mortality rates were estimated (per 100,000 person-years) from external causes in 1989–1998, 1999–2008, and 2009–2018. Mortality rates per 100,000 person-years from external causes were 4–5 times higher among males than females, and decreased among males over the three 10-year periods (127.5, 101.4, 97.1) but not among females (26.9, 23.1, 26.9). The contribution of external causes to total mortality did not change markedly over time (males 11.6%, females 4.3% in 1989–2018). Apart from external deaths from undetermined causes (males 14.6, females 2.4) and “other unintentional injuries” (males 14.1, females 8.0), the leading external causes of death in 2009–2018 were drowning (25.9), road traffic injuries (18.0) and suicide (10.4) among males; and road traffic injuries (4.6), drowning (3.4) and poisoning (2.6) among females. Mortality from broad categories of external causes did not change consistently over time but rates of road traffic injuries increased among males. External causes contributed approximately 1 in 10 deaths among males and 1 in 20 among females, with no marked change in cause-specific rates over time, except for road traffic injuries. These findings emphasise the need for programs and policies in various sectors to address this large, but mostly avoidable health burden.

Seasonal changes in mortality rates from main causes of death in Japan

2004 ◽  
Vol 19 (10) ◽  
pp. 905-913 ◽  
Author(s):  
Shigeyuki Nakaji ◽  
Stefano Parodi ◽  
Vincenzo Fontana ◽  
Takashi Umeda ◽  
Katsuhiko Suzuki ◽  
...  
Keyword(s):  
Seasonal Changes ◽  
Causes Of Death ◽  
Mortality Rates

scholarly journals Mortality in Dementia from 1996 to 2015: A National Registry-Based Cohort Study

2021 ◽  
Vol 79 (1) ◽  
pp. 289-300
Author(s):  
Lærke Taudorf ◽  
Ane Nørgaard ◽  
Gunhild Waldemar ◽  
Thomas Munk Laursen
Keyword(s):  
Elderly People ◽  
Age Groups ◽  
Mortality Rates ◽  
Similar Rate ◽  
National Registry ◽  
Healthcare Data ◽  
Appropriate Care ◽  
People With Dementia ◽  
Rate Ratios ◽  
Annual Mortality

Background: It remains unclear whether the increased focus on improving healthcare and providing appropriate care for people with dementia has affected mortality. Objective: To assess survival and to conduct a time trend analysis of annual mortality rate ratios (MRR) of dementia based on healthcare data from an entire national population. Methods: We assessed survival and annual MRR in all residents of Denmark ≥65 years from 1996–2015 using longitudinal registry data on dementia status and demographics. For comparison, mortality and survival were calculated for acute ischemic heart disease (IHD) and cancer. Results: The population comprised 1,999,366 people (17,541,315 person years). There were 165,716 people (529,629 person years) registered with dementia, 131,321 of whom died. From 1996–2015, the age-adjusted MRR for dementia declined (women: 2.76 to 2.05; men: 3.10 to 1.99) at a similar rate to elderly people without dementia. The sex-, age-, and calendar-year-adjusted MRR was 2.91 (95%CI: 2.90–2.93) for people with dementia. MRR declined significantly more for acute IHD and cancer. In people with dementia, the five-year survival for most age-groups was at a similar level or lower as that for acute IHD and cancer. Conclusion: Although mortality rates declined over the 20-year period, MRR stayed higher for people with dementia, while the MRR gap, compared with elderly people without dementia, remained unchanged. For the comparison, during the same period, the MRR gap narrowed between people with and without acute IHD and cancer. Consequently, initiatives for improving health and decreasing mortality in dementia are still highly relevant.

scholarly journals Febrile Neutropenia and Long-term Risk of Infection Among Patients Treated With Chemotherapy for Malignant Diseases

2018 ◽  
Vol 5 (10) ◽  
Author(s):  
Josefine Nordvig ◽  
Theis Aagaard ◽  
Gedske Daugaard ◽  
Peter Brown ◽  
Henrik Sengeløv ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Mortality Rates ◽  
Risk Of Infection ◽  
Increased Risk ◽  
Competing Events ◽  
Adjusted Incidence Rate ◽  
New Treatment ◽  
Rate Ratios

Abstract Background Febrile neutropenia (FN) is a common complication to chemotherapy, associated with increased short-term morbidity and mortality. However, the long-term outcomes after FN are poorly elucidated. We examined the long-term risk of infection and mortality rates in cancer patients with and without FN. Methods Patients aged >16 years treated with firstline chemotherapy were followed from 180 days after initiating chemotherapy until first infection, a new treatment with chemotherapy, death, or end of follow-up. Risk factors for infections were analyzed by competing risks regression, with death or another treatment with chemotherapy as competing events. Adjusted incidence rate ratios (aIRRs) of infection and death were analyzed using Poisson regression. In analyses of mortality, infection was included as a time-updated variable. Results We included 7190 patients with a median follow-up (interquartile range) of 0.58 (0.20–1.71) year. A total of 1370 patients had an infection during follow-up. The aIRRs of infection were 1.86 (95% confidence interval [CI], 1.56–2.22) and 2.19 (95% CI, 1.54–3.11) for patients with 1 or >1 episode of FN compared with those without FN. Mortality rate ratios were 7.52 (95% CI, 6.67–8.48) <1 month after, 4.24 (95% CI, 3.80–4.75) 1–3 months after, 2.33 (95% CI, 1.63–3.35) 3–6 months after, and 1.09 (95% CI, 0.93–1.29) >6 months after an infection, compared with the time before infection. Conclusions FN during chemotherapy is associated with a long-term increased risk of infection. Mortality rates are substantially increased for 6 months following an infection.

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