Spatial disparities in mortality by causes of death in the Republic of Moldova

Background: Previous studies have shown long-term unfavourable changes in mortality in the Republic of Moldova accompanied by recent improvements. Little is known about the regional mortality differentiation which is an important tool for evidence-based public health policy. The aim of the study is to assess the current geographical disparities of all-cause and cause-specific mortality in Moldova and to identify evidence-based modalities to reduce them. Material and methods: This cross-sectional study is based on the corrected results of the 2014 census and individual death records for the 2012-2016 period provided by the National Agency for Public Health. Global Moran’s index and local indicators of spatial autocorrelation were computed based on contiguity matrix. Results: All-cause mortality gradient between the northern and central regions was found for males (Moran’s index=0.47, p<0.001) and females (Moran’s index=0.44, p<0.001). Digestive and cardiovascular diseases for both sexes and external causes of death for males had a statistically significant influence on the inter-regional mortality differentiation. Liver cirrhosis contributed the most to the geographical difference between the North and the Centre (Moran’s index=0.59, p<0.001), especially for females. Conclusions: The results of this study point to the existence of different drinking habits of the Moldovan population between the northern and central regions. The central regions that form the cluster of “high-high” mortality from liver cirrhosis should be considered as primarily targets for antialcohol policies

ASSESSMENT OF THE DEPENDENCE OF THE AVERAGE LIFE EXPECTANCY OF THE POPULATION RESIDING IN THE TULA REGION IN THE AREAS WITH A HIGH CONTENT OF HEA VYMETALS IN THE SOIL

The article presents the relevance of the problem, defines the research purpose: to compare the average life expectancy of the population in the areas of the Tula region with different contents of heavy metals in the class of causes of death “Respiratory diseases ”. The authors used the data of the regional mortality register, the results of analyzes of the content of heavy metals (copper, lead, zinc, nickel) in the soil by atomic absorption spectroscopy, and the calculation of the average life expectancy by the algebraic model of constructive logic. The results indicate a decrease in average life expectancy due to the presence of heavy metals in the soil, but the average life expectancy in both contaminated and non-contaminated areas is gradually increasing.

Covid-19: Open-Data Resources for Monitoring, Modeling, and Forecasting the Epidemic

We provide an insight into the open-data resources pertinent to the study of the spread of the Covid-19 pandemic and its control. We identify the variables required to analyze fundamental aspects like seasonal behavior, regional mortality rates, and effectiveness of government measures. Open-data resources, along with data-driven methodologies, provide many opportunities to improve the response of the different administrations to the virus. We describe the present limitations and difficulties encountered in most of the open-data resources. To facilitate the access to the main open-data portals and resources, we identify the most relevant institutions, on a global scale, providing Covid-19 information and/or auxiliary variables (demographics, mobility, etc.). We also describe several open resources to access Covid-19 datasets at a country-wide level (i.e., China, Italy, Spain, France, Germany, US, etc.). To facilitate the rapid response to the study of the seasonal behavior of Covid-19, we enumerate the main open resources in terms of weather and climate variables. We also assess the reusability of some representative open-data sources.

Declining regional disparities in mortality in the context of persisting large inequalities in economic conditions: the case of Germany

Background Subnational regional mortality inequalities are large and appear to be mostly increasing within industrialized countries, although comparative studies across high-income countries are scarce. Germany is an important country to examine because it continues to experience considerable economic disparities between its federal states, in part resulting from its former division. Methods We analyse state-level mortality in Germany utilizing data from a newly constructed regional database based on the methodology of the Human Mortality Database. We compare time trends (1991–2015) in the German state-level standard deviation in life expectancy to that of other large, wealthy countries and examine the association between mortality and economic inequalities at the regional level. Finally, using contour-decomposition methods, we investigate the degree to which age patterns of mortality are converging across German federal states. Results Regional inequalities in life expectancy in Germany are comparatively low internationally, particularly among women, despite high state-level inequalities in economic conditions. These low regional mortality inequalities emerged 5–10 years after reunification. Mortality is converging over most ages between the longest- and shortest-living German state populations and across the former East–West political border, with the exception of an emerging East–West divergence in mortality among working-aged men. Conclusions The German example shows that large regional economic inequalities are not necessarily paralleled with large regional mortality disparities. Future research should investigate the factors that fostered the emergence of this unusual pattern in Germany.

Major amputations in type 2 diabetes between 2001 and 2015 in Spain: regional differences.

Aims To analyze the evolution of type 2 diabetes major amputations (MA) in the Regions of Spain from 2001 to 2015.Methods Descriptive study of 40,392 MA from the national hospital discharge database in patients with type 2 diabetes. The incidence rate was calculated in each region, in addition to the incidence ratios (IR) between annual incidence and 2001 incidence. The length of hospital stays and mortality risks were analyzed adjusting regression models for sex, age and smoking.Results The MA incidence rate per 100,000 persons-year was 0.48 in Spain; Canary Islands showed the highest incidence (0.81). The trend was a slight decrease or stability of the incidence in all regions except in the Canary Islands (IR 2015 = 2.0 [CI95%=1.5, 2.6]) and in Madrid (IR 2015 = 0.1 [CI95%=0.1, 0.2]). Mortality after MA was 10% in Spain; Cantabria suffered the highest risk of death [1.7 (CI95%=1.4; 2.1), p<0.001] and La Rioja the lowest risk (0.5 [CI95%=0.2; 0.9]; p = 0.026). The longest hospital stay was registered in the Canary Islands [(CI95%=11.4;13.3],p<0.001)], and the shortest in the Valencian Community [(CI95%= -7.3; -5.8),p<0.001)].Conclusion MA in the Canary Islands followed a growing trend that diverged from the downward trend in the whole country. Regional mortality and hospital stay variability advise to review the clinical management, while sudden incidence decrease in Madrid suggests to check the record procedures of hospital discharges.

Economic Losses from Mortality Due to External Factors

Mortality Due to External Causes is a world-scale problem. The paper presents the results of life opportunities and societys damage from mortality due to external factors in a biggest subject of Russias European North - Arkhangelsk Oblast. The regions territory is characterized by its climate-geographical and organizational-public health features, mono-productive infrastructure, and so on. The maximum economic loss in the region was in 1980-1982, 1992-1998, 2000-2006. Among the urban population, the biggest losses fell at 1990-s, which is explained by the highest mortality indicators connected as well with the socio-economic crisis, including the default of 1998. The leading causes of the life opportunity economic losses due to external factors were suicides, accidental alcohol poisoning, murders and traffic accidents. The analysis performed allows to offer a number of preventive actions in decreasing the regional mortality, which will produce a medical, economic and social effect.

MORTALITY FROM CIRCULATORY SYSTEM DISEASES IN THE KEMEROVO REGION AND THE RUSSIAN FEDERATION IN 2000–2016

Aim. To estimate the trends in mortality from circulatory system diseases, including coronary artery disease and cerebrovascular diseases, in the Kemerovo region in the period from 2000 to 2016 and compare it with the national trends.Methods. Data on national mortality rates, including those among adults of working age (men 16–59 years, women 16–54 years) from circulatory system diseases, coronary artery disease and cerebrovascular diseases in the period from 2000 to 2016 were obtained through the national statistical reports. A linear trend in the regional mortality rate to the national one has been reported.Results. Mortality rate from circulatory system diseases in the period from 2000 to 2016 tends to a decrease in the Kemerovo region and the Russian Federation. The comparative analysis of mortality rates in the Kemerovo region and the Russian Federation reported lower regional mortality rates in the general population. Despite lower mortality rates from coronary artery disease in the general population and working population, there are higher mortality rates from cerebrovascular diseases. Conclusion. The trend in mortality from circulatory system diseases in the Kemerovo region is comparable to that in the Russian Federation. Specific regional features related to the interaction of various factors, including regional healthcare system, have been determined. The trends in mortality from coronary artery disease and cerebrovascular diseases in the period from 2000 to 2016 have been presented.