scholarly journals Preventable deaths among youth in South Africa: Measuring life expectancy in the absence of non-communicable diseases and its implications for the healthcare system

2021 ◽  
Vol 111 (4) ◽  
pp. 361
Author(s):  
N De Wet-Billings
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chukwuedozie K. Ajaero ◽  
Nicole De Wet-Billings ◽  
Chiemezie Atama ◽  
Prince Agwu ◽  
Eberechukwu J. Eze

Abstract Background The socioeconomic conditions of different environments manifest in varying experiences of illnesses. Even as migrants do transit across these different environments for various reasons, including settlement, they are bound to have peculiar experiences of diseases, which could be traced to lifestyle, gender, adaptation, and reactions to specific social, economic, psychological and climatic conditions. Paying attention to such unique scenarios, our study examines the prevalence and contextual correlates of non-communicable diseases among inter-provincial migrants and non-migrants in South Africa. Methods Data was from the National Income Dynamics Study (NIDS), waves 5 of 2017, which comprised of 28,055 respondents aged 15–64 years made up of 22,849 inter-provincial non-migrants and 5206 inter-provincial migrants. A composite dependent/outcome variable of non-communicable diseases (NCDs) was generated for the study and data analysis involved descriptive statistics, chi Square analysis and multilevel logistic regression analysis. Results More migrants (19.81%) than non-migrants (16.69%) reported prevalence of NCDs. With the exception of household size for migrants and smoking for non-migrants, the prevalence of NCDs showed significant differences in all the community, behavioral, and individual variables. The factors in the full model, which significantly increased odds of NCDs among the migrants and the non-migrants, were older populations, the non-Blacks, and those with higher education levels. On the one hand, being married, having a household with 4–6 persons, and being residents of urban areas significantly increased odds of NCDs among the migrant population. While on the other, living in coastal provinces, being a female, and belonging to the category of those who earn more than 10,000 Rands were significantly associated with increased odds of NCDs among the non-migrants. Conclusions These findings, therefore, among other things underscore the need for increased education and awareness campaigns, especially among the older populations on the preventive and mitigative strategies for NCDs. In addition, changes in lifestyles with regard to smoking and physical exercises should be more emphasized in specific contextual situations for the migrant and non-migrant populations, as highlighted by the results of this study.


2013 ◽  
Vol 6 (1) ◽  
pp. 20936 ◽  
Author(s):  
Nancy Phaswana-Mafuya ◽  
Karl Peltzer ◽  
Witness Chirinda ◽  
Alfred Musekiwa ◽  
Zamakayise Kose ◽  
...  

Author(s):  
Bo Burström

This commentary refers to the article by Fisher et al on lessons from Australian primary healthcare (PHC), which highlights the role of PHC to reduce non-communicable diseases (NCDs) and promote health equity. This commentary discusses important elements and features when aiming for health equity, including going beyond the healthcare system and focusing on the social determinants of health in public health policies, in PHC and in the healthcare system as a whole, to reduce NCDs. A wider biopsychosocial view on health is needed, recognizing the importance of social determinants of health, and inequalities in health. Public funding and universal access to care are important prerequisites, but regulation is needed to ensure equitable access in practice. An example of a PHC reform in Sweden indicates that introducing market solutions in a publicly funded PHC system may not benefit those with greater needs and may reduce the impact of PHC on population health.


2017 ◽  
Vol 107 (4) ◽  
pp. 331 ◽  
Author(s):  
M Wandai ◽  
J Aagaard-Hansen ◽  
C Day ◽  
B Sartorius ◽  
K J Hofman

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Bano ◽  
L Chaker ◽  
F U S Mattace-Raso ◽  
R P Peeters ◽  
O H Franco

Abstract Background Variations in thyroid function within the reference ranges are associated with an increased risk of diseases and death. However, the impact of thyroid function on life expectancy (LE) and the number of years lived with and without non-communicable diseases (NCD) remains unknown. Purpose We aimed to investigate the association of thyroid function with total LE and LE with and without NCD among euthyroid subjects. Methods Participants of the Rotterdam Study without known thyroid disease and with thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels within the reference ranges were eligible. NCD were defined as the presence of cardiovascular disease, diabetes mellitus type 2, or cancer. We used multistate life tables to calculate the total LE and LE with and without NCD among TSH and FT4 tertiles, in men and women. LE estimates were obtained using prevalence, incidence rates and hazard ratios for three transitions (healthy to NCD, healthy to death and NCD to death). Analyses were adjusted for sociodemographic and cardiovascular risk factors. Results The mean (standard deviation) age of 7644 participants was 64.5 (9.7) years and 52.2% were women. Over a median follow-up of 8 years, we observed 1396 incident NCD events and 1422 deaths. Compared with those in the lowest tertile, men and women in the highest TSH tertile lived 1.5 (95% confidence interval [CI], 0.8; 2.3) and 1.5 (95% CI, 0.8; 2.2) years longer, respectively; of which 1.4 (95% CI, 0.5; 2.3) and 1.3 (95% CI, 0.3; 2.1) years with NCD. Compared with those in the lowest tertile, the difference in LE for men and women in the highest FT4 tertile was −3.7 (95% CI, −5.1 to −2.2) and −3.3 (95% CI, −4.7; −1.9), respectively; of which −1.8 (95% CI, −3.1 to −0.7) and −2.0 (95% CI, −3.4 to −0.7) years without NCD. Life expectancy in TSH and FT4 tertiles Conclusions There are meaningful differences in total LE, LE with and without NCD within the reference ranges of thyroid function. People with low-normal thyroid function live more years with and without NCD than those with high-normal thyroid function. These findings support a reevaluation of the current reference ranges of thyroid function.


2016 ◽  
Vol 106 (5) ◽  
pp. 436 ◽  
Author(s):  
Beatrice Nojilana ◽  
Debbie Bradshaw ◽  
Victoria Pillay-van Wyk ◽  
William Msemburi ◽  
Nontuthuzelo Somdyala ◽  
...  

2018 ◽  
Vol 18 (S1) ◽  
Author(s):  
Catherine Ndinda ◽  
Tidings P. Ndhlovu ◽  
Pamela Juma ◽  
Gershim Asiki ◽  
Catherine Kyobutungi

2020 ◽  
Author(s):  
Hanyi Chen ◽  
Yi Zhou ◽  
Lianghong Sun ◽  
Yichen Chen ◽  
Xiaobin Qu ◽  
...  

Abstract Background To address change in gender gap of life expectancy (GGLE) in Shanghai from 1973 to 2018, and to identify the major causes of death and age groups associated with the change overtime.Methods Retrospective demographic analysis with application of Joinpoint regression to evaluate the temporal trend in GGLE. Causes of death were coded in accordance with International Classification of Diseases and mapped with the Global Burden of Disease (GBD) cause list. Life table technique and decomposition method was used to express changes in GGLE.Results Trend of GGLE in Shanghai experienced two phases ie., a decrease from 8.4 to 4.2 years in the descent phase (1973-1999) and a fluctuation between 4.0 and 4.9 years in the plateau phase (1999-2018). The reduced age-specific mortality rates tended to concentrate to a narrower age range, from age 0-9 and above 30 years in the descent phase to age above 55 years in the plateau phase. Gastroesophageal and liver cancer, communicable, chronic respiratory and digestive diseases were once the major contributors to narrow GGLE in the descent phase. While importance should be attached to a widening effect on GGLE by lung cancer, cardiovascular diseases, other neoplasms like colorectal and pancreatic cancer and diabetes in recent plateau phase.Conclusions Non-communicable diseases (NCDs) have made GGLE enter a plateau phase from a descent phase in Shanghai China. Public efforts to reduce excess mortalities for male NCDs, cancers, cardiovascular diseases, chronic respiratory diseases and diabetes in particular and health policies focused on the middle-aged and elderly population might further narrow GGLE and ensure improvement in health and health equity in Shanghai China.


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