#6751 WHY WE NEED TO ACHIEVE AN INTERNATIONALLY AGREED AGE DEFINITION OF THE ‘NEET’ GROUP

Internationally, significant variation exists between the use and application of the term ‘NEET’ (not in education, employment or training) to define levels of economic and social exclusion among groups of young people. It depends on the situation, and/or the context in which the term is applied. The term draw attention to unacceptably high levels of youth unemployment and economic inactivity, as well as the scarring consequences this may have on young people’s lives. The use of the term ‘NEET’ has faced a number of international challenges, including the age cohort to which the term is applied. This varies from one organisation to another, and the specific target group assigned and the variability of meaning of the term ‘NEET ‘itself. This paper aims to provide a review of the shifting and changing age cohort included within the NEET category since its inception in the 1990s. The study utilises an Entity-Related Diagram to demonstrate the international variation that now exists. Recommendations are made in order to maximise the deployment of a standardised definition of NEET, in order to achieve some commonality of understanding about how we measure and define ‘NEEThood’, and crucially, in developing and applying policy responses to address their needs.

Trends in infective endocarditis mortality in the United Kingdom and EU 15+ countries between 1990–2019: an analysis of the Global Burden of Diseases database

Background Infective Endocarditis (IE) is a relatively uncommon but lethal condition, with no convincing evidence to date of improving mortality trends (1). The epidemiology of IE is complex, driven by a wide range of constantly evolving factors. While marked international variation has been recently reported (2), temporal trends in mortality over recent decades remain unclear. Purpose To describe trends in IE mortality in high income countries over the last 30 years. Methods Age-standardised mortality rates (ASMR) for IE, stratified by sex, were extracted from the Global Burden of Disease (GBD) database (3) between 1990 and 2019. The United Kingdom and selected countries with comparable health expenditure (EU15+ countries) were included. Relative changes in ASMR over the observation period were determined and trends were analysed using Joinpoint regression analysis. Results Between 1990–2019 ASMR from IE increased for both sexes in all included countries except Finland (−20.1% in males, −15.1% in females) and Austria (−8.98% in males, −22.6% in females). The largest increase in ASMR in males was observed in Greece (+197%), while the largest increase in females was observed in Italy (246%). Joinpoint regression analysis identified multiple significant trends within this observation period (Figure 1; clear squares indicate males, filled circles indicate females and lines represent modelled trends based on joinpoint data). At the end of the observation period the Netherlands had the highest ASMR in both males and females (2.28/100,000 in males and 2.37/100,000 in females), while Finland had the lowest ASMR in both males and females (0.45/100,000 and 0.23/100,000 respectively). Conclusions Significant international variation in IE mortality rates were observed. While mortality from IE has generally increased over the last 30 years, recent data suggest this trend may now be plateauing or even reversing in certain countries. FUNDunding Acknowledgement Type of funding sources: None. Figure 1

The Influence of Government Effectiveness and Corruption on the High Levels of Homicide in Latin America

Most research that has examined the international variation in homicide levels has focused on structural variables, with the suggestion that socio-economic development operates as a cure for violence. In Latin America, development has occurred, but high homicide levels remain, suggesting the involvement of other influencing factors. We posit that government effectiveness and corruption control may contribute to explaining the variation in homicide levels, and in particular in the Latin America region. Our results show that social and economic structural variables are useful but are not conclusive in explaining the variation in homicide levels and that the relationship between homicide, government effectiveness, and corruption control was significant and highly pronounced for countries in the Latin American region. The findings highlight the importance of supporting institutions in improving their effectiveness in Latin America so that reductions in homicide (and improvements in citizen security in general) can be achieved.

The Changing Nature and Use of the Concept NEET in Contemporary Society

Internationally, significant variation exists between the use and application of the term ‘NEET' (not in education, employment, or training) to define levels of economic and social exclusion among groups of young people. It depends on the situation, and/or the context in which the term is applied. The term draw attention to unacceptably high levels of youth unemployment and economic inactivity, as well as the scarring consequences this may have on young people's lives. This chapter aims to provide a review of the shifting and changing age cohort included within the NEET category since its inception in the 1990s. The study utilises an entity-related diagram to demonstrate the international variation that now exists. Recommendations are made in order to maximise the deployment of a standardised definition of NEET, in order to achieve some commonality of understanding about how we measure and define ‘NEEThood', and crucially, in developing and applying policy responses to address their needs.

Underestimation of COVID-19 mortality during the pandemic

BackgroundThere has been considerable international variation in mortality during the COVID-19 pandemic. The objective of this study was to investigate the differences between mortality registered as due to COVID-19 and the excess all-cause mortality reported in countries worldwide during the COVID-19 pandemic.MethodsEcological analysis of 22 countries compared five-year historical all-cause mortality, reported all-cause mortality and expected all-cause mortality (calculated as the historical mortality plus the reported deaths attributed to COVID-19). Data available from the first week of January 2020 to that most recently available were analysed.ResultsCompared to the preceding five years, there was an excess of 716 616 deaths of which 64.3% were attributed to COVID-19. The proportion of deaths registered as COVID-19 related/excess deaths varied markedly between countries, ranging between 30% and 197% in those countries that had an excess of deaths during the period of observation. In most countries where a definite peak in COVID-19 related deaths occurred, the increase in reported all-cause mortality preceded the increase in COVID-19 reported mortality. During the latter period of observation, a few countries reported fewer all-cause deaths than the historical figures.ConclusionThe increases in all-cause mortality preceded the increase in COVID-19 mortality in most countries that had definite spikes in COVID-19 mortality. The number of deaths attributed to COVID-19 was underestimated by at least 35%. Together these findings suggest that calculation of excess all-cause mortality is a better predictor of COVID-19 mortality than the reported rates, in those countries experiencing definite increases in mortality.