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Nutrients Aug 2021Walnut consumption is associated with health benefits. We aimed to (1) examine the association between walnut consumption and mortality and (2) estimate life expectancy...
Walnut consumption is associated with health benefits. We aimed to (1) examine the association between walnut consumption and mortality and (2) estimate life expectancy in relation to walnut consumption in U.S. adults. We included 67,014 women of the Nurses' Health Study (1998-2018) and 26,326 men of the Health Professionals Follow-up Study (1998-2018) who were free of cancer, heart disease, and stroke at baseline. We used Cox regression models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During up to 20 years of follow-up, we documented 30,263 deaths. The hazard ratios for total mortality across categories of walnut intake (servings/week), as compared to non-consumers, were 0.95 (95% confidence interval (CI), 0.91, 0.98) for <1 serving/week, 0.94 (95% CI, 0.89, 0.99) for 1 serving/week, 0.87 (95% CI, 0.82, 0.93) for 2-4 servings/week, and 0.86 (95% CI, 0.79, 0.93) for >=5 servings/week ( for trend <0.0001). A greater life expectancy at age 60 (1.30 years in women and 1.26 years in men) was observed among those who consumed walnuts more than 5 servings/week compared to -consumers. Higher walnut consumption was associated with a lower risk of total and CVD mortality and a greater gained life expectancy among U.S. elder adults.
Topics: Adult; Aged; Cardiovascular Diseases; Cause of Death; Diet; Female; Follow-Up Studies; Humans; Juglans; Life Expectancy; Male; Middle Aged; Mortality; Nuts; Proportional Hazards Models; Regression Analysis; United States
PubMed: 34444859
DOI: 10.3390/nu13082699 -
Journal of Global Health Oct 2022China accounts for 13% of the world's 5-19-year-olds population. We estimated levels and trends of mortality by sex-age-cause among 5-19-year-olds at national and...
National and sub-national levels and causes of mortality among 5-19-year-olds in China in 2004-2019: A systematic analysis of evidence from the Disease Surveillance Points System.
BACKGROUND
China accounts for 13% of the world's 5-19-year-olds population. We estimated levels and trends of mortality by sex-age-cause among 5-19-year-olds at national and subnational levels in China annually from 2004 to 2019, to inform strategies for reducing child and adolescent mortality in China and other countries.
METHODS
We used adjusted empirical data on levels and causes of deaths from the China Center for Disease Control and Prevention's Disease Surveillance Point (DSP) system. We considered underreporting and surveillance sampling design, applied smoothing techniques to produce reliable time trends, and fitted age-specific deaths and population to national estimates produced by international agencies to allow for cross-national comparisons.
RESULTS
The top leading causes for 54 594 deaths among 5-19-year-olds were neoplasms, road traffic injuries, and drowning. All-cause mortality in 5-19-year-olds has been declining steadily between 2004-2019, with evident yet narrowing geographical and gender disparities. Injury mortalities were one of the fastest declining causes, but widespread disparities were observed across subpopulations. Falling injuries and rising non-communicable diseases had the most pronounced epidemiological transition in the eastern region. Decrease in drowning fractions stalled for 15-19-year-olds in central/western rural areas. Suicide shares sustained or increased for 15-19-year-olds except among females in eastern rural areas.
CONCLUSIONS
China made significant improvements in child and adolescent survival since 2004. However, constant targeted investments are needed to maintain and accelerate progress. A sustainable sample registration system like the DSP is likely essential for supporting such a process.
Topics: Adolescent; Cause of Death; Child; China; Drowning; Female; Global Health; Humans; Infant; Noncommunicable Diseases
PubMed: 36181508
DOI: 10.7189/jogh.12.11008 -
BMC Geriatrics Oct 2023This study aimed to determine long-term variations in mortality trends and identify the leading causes of death among older adults in China from 2009 to 2019 so as to...
BACKGROUND
This study aimed to determine long-term variations in mortality trends and identify the leading causes of death among older adults in China from 2009 to 2019 so as to propose interventions to further stabilise the mortality rate among older adults and facilitate healthy ageing.
METHODS
We extracted data from the China Death Surveillance database from 2009 to 2019 for all-cause mortality and cause-specific death among individuals aged ≥ 65 years. A joinpoint regression model was used to estimate mortality trends by calculating the annual percentage change (APC). A trend chi-square test was used to estimate sex differences in mortality, and descriptive analysis was used to estimate the leading causes of death. Semi-structured expert interviews were conducted to examine health interventions for older adults.
RESULTS
We observed an overall declining trend in age-adjusted mortality rates among older adults aged ≥ 65 years in China from 2009 to 2019 (APC, -2.44; P < 0.05). In this population, the male mortality rate was higher than the female mortality rate during this period (P < 0.05). However, the mortality rate among older adults aged ≥ 85 years increased since 2014, particularly among females. Cardiovascular disease (CVD) was the leading cause of death among older adults aged 65-84 years, whereas ischaemic heart disease was the leading cause of death among individuals aged ≥ 85 years, especially among females. The majority of injuries resulting in death were caused by falls, showing an increasing trend.
CONCLUSIONS
CVD is a major cause of death among older adults aged ≥ 65 years in China, and relevant health intervention strategies should be implemented from the perspectives of physiology, psychology, and living environment. The change in the mortality trend and the distribution of cause of death among older adults aged ≥ 85 years is noteworthy; a diagnostic and management model centred around females aged ≥ 85 years should be implemented. Additionally, a multidimensional fall prevention strategy involving primary medical institutions and care services needs to be implemented to reduce the risk of falls among older adults.
Topics: Humans; Male; Female; Aged; Cause of Death; Cardiovascular Diseases; Causality; China; Mortality
PubMed: 37821831
DOI: 10.1186/s12877-023-04346-7 -
The Science of the Total Environment Nov 2022Environmental factors have been associated with adverse health effects in epidemiological studies. The main exposure variable is usually determined via prior knowledge...
BACKGROUND
Environmental factors have been associated with adverse health effects in epidemiological studies. The main exposure variable is usually determined via prior knowledge or statistical methods. It may be challenging when evidence is scarce to support prior knowledge, or to address collinearity issues using statistical methods. This study aimed to investigate the importance level of environmental variables for the under-five mortality in Malaysia via random forest approach.
METHOD
We applied a conditional permutation importance via a random forest (CPI-RF) approach to evaluate the relative importance of the weather- and air pollution-related environmental factors on daily under-five mortality in Malaysia. This study spanned from January 1, 2014 to December 31, 2016. In data preparation, deviation mortality counts were derived through a generalized additive model, adjusting for long-term trend and seasonality. Analyses were conducted considering mortality causes (all-cause, natural-cause, or external-cause) and data structures (continuous, categorical, or all types [i.e., include all variables of continuous type and all variables of categorical type]). The main analysis comprised of two stages. In Stage 1, Boruta selection was applied for preliminary screening to remove highly unimportant variables. In Stage 2, the retained variables from Boruta were used in the CPI-RF analysis. The final importance value was obtained as an average value from a 10-fold cross-validation.
RESULT
Some heat-related variables (maximum temperature, heat wave), temperature variability, and haze-related variables (PM10, PM10-derived haze index, PM10- and fire-derived haze index, fire hotspot) were among the prominent variables associated with under-five mortality in Malaysia. The important variables were consistent for all- and natural-cause mortality and sensitivity analyses. However, different most important variables were observed between natural- and external-cause under-five mortality.
CONCLUSION
Heat-related variables, temperature variability, and haze-related variables were consistently prominent for all- and natural-cause under-five mortalities, but not for external-cause.
Topics: Air Pollutants; Air Pollution; Environmental Exposure; Hot Temperature; Malaysia; Mortality; Particulate Matter; Weather
PubMed: 35839873
DOI: 10.1016/j.scitotenv.2022.157312 -
Economic Crisis Impact and Social Determinants of Perinatal Outcomes and Infant Mortality in Greece.International Journal of Environmental... Sep 2020(1) Background: To explore the effects of the 2008 economic crisis on maternal, perinatal and infant mortality in Greece and the socio-economic determinants associated...
(1) Background: To explore the effects of the 2008 economic crisis on maternal, perinatal and infant mortality in Greece and the socio-economic determinants associated with them; (2) Methods: The annual rates of stillbirth (SBR), perinatal mortality (PMR), infant mortality (IMR), neonatal mortality (NNMR), post-neonatal mortality (PNMR), low birth weight (LBW), and maternal mortality (MMR) were calculated for the years 2000-2016. Average Annual Percent Changes (AAPC) were calculated by the period before and after 2008. The expected rates of 2009-2016 and the observed-to-expected rate ratios (RR) were calculated. Correlation and multiple linear regression analyses were used to test the impact of socio-economic variables on health outcomes; (3) Results: A reverse in downwards trends of PNM, IMR, and NNMR is observed since 2009. All observed values of 2009-2016 were found significantly higher than the expected ones by 12-34%. All indicators except SBR were found negatively correlated with GDP and DHI. A positive correlation was found between IMR, NNMR, and LBW and long-term unemployment, and no association with public health expenditure; (4) Conclusions: Economic crisis was associated with remarkable adverse effects on perinatal outcomes and infant mortality, mainly determined by long-term unemployment and income reduction. The findings stress a need for interventions to protect maternity and child health during crises.
Topics: Economic Recession; Female; Greece; Humans; Infant; Infant Mortality; Infant, Newborn; Perinatal Mortality; Pregnancy; Social Determinants of Health
PubMed: 32932859
DOI: 10.3390/ijerph17186606 -
Disaster Medicine and Public Health... Dec 2020
Topics: COVID-19; History, 19th Century; History, 20th Century; History, 21st Century; History, Medieval; Humans; Mortality; Pandemics
PubMed: 32854810
DOI: 10.1017/dmp.2020.307 -
Journal of Epidemiology and Community... Sep 2023Public health research increasingly acknowledges the influence of built environments (BE) on health; however, it is uncertain how BE change is associated with better...
BACKGROUND
Public health research increasingly acknowledges the influence of built environments (BE) on health; however, it is uncertain how BE change is associated with better population health and whether BE change can help narrow health inequalities. This knowledge gap is partly due to a lack of suitable longitudinal BE data in most countries. We devised a method to quantify BE change longitudinally and explored associations with mortality. The method is replicable in any nation that captures BE vector map data.
METHODS
Ordnance Survey data were used to categorise small areas as having no change, loss or gain, in buildings, roads, and woodland between 2015 and 2019. We examined individual mortality records for 2012-2015 and 2016-2019, using negative binomial regression to explore associations between BE change and all-cause and cause-specific mortality, adjusting for income deprivation.
RESULTS
BE change varied significantly by deprivation and urbanicity. Change in the BE and change in mortality were not related, however, areas that went on to experience BE change had different baseline mortality rates compared with those that did not. For example, areas that gained infrastructure already had lower mortality rates.
CONCLUSION
We provide new methodology to quantify BE change over time across a nation. Findings provide insight into the health of areas that do/do not experience change, prompting critical perspectives on cross-sectional studies of associations between BE and health. Methods and findings applied internationally could explore the context of BE change and its potential to improve health in areas most in need beyond the UK.
Topics: Humans; Built Environment; Cause of Death; Cross-Sectional Studies; Income; Mortality; Public Health
PubMed: 37369593
DOI: 10.1136/jech-2023-220681 -
BMJ Open Jun 2020Socioeconomic inequalities have a strong impact on population health all over the world. Occupational status is a powerful determinant of health in rich societies. We...
OBJECTIVES
Socioeconomic inequalities have a strong impact on population health all over the world. Occupational status is a powerful determinant of health in rich societies. We aimed at investigating the association between occupation and mortality in a large metropolitan study.
DESIGN
Cohort study.
SETTING
Rome, capital of Italy.
PARTICIPANTS
We used the Rome Longitudinal Study, the administrative cohort of residents in Rome at the 2001 general census, followed until 2015. We selected residents aged 15-65 years at baseline. For each subject, we had information on sex, age and occupation (occupational status and type of job) according to the Italian General Census recognition.
MAIN OUTCOME MEASURES
We investigated all-cause, cancer, cardiovascular and accidental mortality, major causes of death in the working-age population. We used Cox proportional hazards models to investigate the association between occupation and all-cause and cause-specific mortality in men and women.
RESULTS
We selected 1 466 726 subjects (52.1% women). 42 715 men and 29 915 women died during the follow-up. In men, 47.8% of deaths were due to cancer, 26.7% to cardiovascular causes and 6.4% to accidents, whereas in women 57.8% of deaths were due to cancer, 19.3% to cardiovascular causes and 3.5% to accidents. We found an association between occupational variables and mortality, more evident in men than in women. Compared with employed, unemployed had a higher risk of mortality for all causes with an HR=1.99 (95% CI 1.92 to 2.06) in men and an HR=1.49 (95% CI 1.39 to 1.60) in women. Compared with high-qualified non-manual workers, non-specialised manual workers had a higher mortality risk (HR=1.68, 95% CI 1.59 to 1.77 and HR=1.30, 95% CI 1.20 to 1.40, for men and women, respectively).
CONCLUSIONS
This study shows the importance of occupational variables as social health determinants and provides evidence for policy-makers on the necessity of integrated and preventive policies aimed at improving the safety of the living and the working environment.
Topics: Accidents, Occupational; Cardiovascular Diseases; Cause of Death; Cohort Studies; Employment; Female; Humans; Longitudinal Studies; Male; Mortality; Neoplasms; Rome; Social Determinants of Health; Socioeconomic Factors; Urban Population
PubMed: 32499259
DOI: 10.1136/bmjopen-2019-033776 -
BMC Cancer Dec 2020Breast cancer (BC) is the most common malignancy in Latin American women, but with a wide variability with respect to their mortality. This study aims to estimate the...
BACKGROUND
Breast cancer (BC) is the most common malignancy in Latin American women, but with a wide variability with respect to their mortality. This study aims to estimate the mortality rates from BC in Peruvian women and to assess mortality trends over 15 years.
METHODS
We calculated BC age-standardized mortality rate (ASMR) per 100,000 women-years using the world standard SEGI population. We estimated joinpoint regression models for BC in Peru and its geographical areas. The spatial analysis was performed using the Moran's I statistic.
RESULTS
In a 15-year period, Peru had a mortality rate of 9.97 per 100,000 women-years. The coastal region had the highest mortality rate (12.15 per 100,000 women-years), followed by the highlands region (4.71 per 100,000 women-years). In 2003, the highest ASMR for BC were in the provinces of Lima, Arequipa, and La Libertad (above 8.0 per 100,000 women-years), whereas in 2017, the highest ASMR were in Tumbes, Callao, and Moquegua (above 13.0 per women-years). The mortality trend for BC has been declining in the coastal region since 2005 (APC = - 1.35, p < 0.05), whereas the highlands region experienced an upward trend throughout the study period (APC = 4.26, p < 0.05). The rainforest region had a stable trend. Spatial analysis showed a Local Indicator of Spatial Association of 0.26 (p < 0.05).
CONCLUSION
We found regional differences in the mortality trends over 15 years. Although the coastal region experienced a downward trend, the highlands had an upward mortality trend in the entire study period. It is necessary to implement tailored public health interventions to reduce BC mortality in Peru.
Topics: Breast Neoplasms; Female; Humans; Mortality; Peru
PubMed: 33261561
DOI: 10.1186/s12885-020-07671-x -
Journal of General Internal Medicine Sep 2022Eliminating health disparities among different segments of the US population is an overarching goal of the US Healthy People 2020 objectives.
BACKGROUND
Eliminating health disparities among different segments of the US population is an overarching goal of the US Healthy People 2020 objectives.
OBJECTIVE
Examine changes in educational, rural-urban, and racial disparities in premature mortality during the past 10 years.
DESIGN AND PARTICIPANTS
Descriptive analysis of US mortality data from 2007 to 2017.
MAIN MEASURES
Relative and absolute rural-urban, educational attainment, and Black-White disparities in premature mortality for all-cause and top 10 causes of death among persons ages 25-74 years, estimated as rate ratios and rate differences between ≤12 and ≥16 years of education, rural versus urban, and non-Hispanic Black (Black) versus non-Hispanic White (White), respectively, in 2007 and 2017.
KEY RESULTS
During 2007-2017, mortality rates in persons aged 25-74 years in the USA increased for several leading causes of death, especially in persons with <16 years of education, rural residents, and White people. As a result, disparity in mortality between 2007 and 2017 widened on both relative and absolute scales for all-cause and for 6 of the top 10 causes of death by education and for all-cause and for 9 of the top 10 causes by rural/urban residence. In contrast, Black-White disparities narrowed for all-cause and for all 7 causes that Black people had a higher rate than White people. For all-cause mortality for example, absolute disparities in the number of deaths per 100,000 person-years between 2007 and 2017 increased from 454.0 (95%CI, 446.0-462.1) to 542.7 (535.6-549.7) for educational attainment and from 85.8 (82.8-88.8) to 140.5 (137.6-143.4) for rural versus urban; in contrast, absolute Black-White disparity decreased from 315.3 (311.0-319.7) to 221.7 (218.1-225.3).
CONCLUSIONS
Educational and rural-urban disparities in premature mortality widened, whereas Black-White disparities narrowed in the USA between 2007 and 2017, though overall rates remained considerably higher in Black people.
Topics: Ethnicity; Health Status Disparities; Humans; Mortality; Mortality, Premature; Racial Groups; Rural Population; United States
PubMed: 35731369
DOI: 10.1007/s11606-021-07268-5