The decline of 'Deaths of Despair' in Italy: unveiling this phenomenon in a new context.

The term ”Deaths of Despair” (DoD) refers to mortality due to alcohol consumption, drug use, and suicides. While the concept has predominantly been studied in the United States, where these deaths have increased significantly, this analysis examines its application to Italy, a country with comparatively lower DoD rates. This work aims to analyse the magnitude of these causes of death in Italy and examine both their joint and independent trends to determine whether they can be treated as a single group of causes. We employ the Potential Gain in Life Expectancy to assess the impact of these causes on overall mortality in Italy, then investigate the identified time series leveraging Cointegration Analysis. Utilizing ISTAT data from 1983 to 2018, aggregated by gender and age groups at the NUTS1 level, the study reveals a decline in DoD mortality in Italy, driven mainly by a reduction in alcohol-related deaths. The magnitude and trajectory of the analysed causes offer valuable insights into the unique dynamics of DoD in Italy and its regional variations. Cointegration Analysis indicates that there is no significant dependency structure between these causes or across regions, with only a few exceptions. These findings suggest that in Italy, DoD should not be treated as a homogeneous group, but rather as distinct outcomes of despair that require separate consideration in public health interventions.

Measuring the impact of HIV/AIDS, heart disease and malignant neoplasms on life expectancy in the USA from 1987 to 2000

Background: Life expectancy is a statistical measure to depict average life span a person is expected to live at a given age under given age-specific mortality rates. Cause-elimination life table measures potential gain in life expectancy after elimination of a specific disease. The present study aims to estimate potential gain in life expectancy by gender in urban India after complete and partial elimination of ten leading causes of deaths using secondary data of medical certification of cause of death (MCCD) for the year 2015.Methods: Life table method was used for estimating potential gain after eliminating diseases to the tune of 25%, 50%, 75% and 100%.Results: Maximum gain in life expectancy at birth estimated from complete elimination of diseases of the circulatory system (11.1 years in males versus 13.1 years in females); followed by certain infectious and parasitic diseases (2.2 versus 2.1 years); diseases of the respiratory system (2.2 versus 2.1); injury, poisoning and certain other consequences of external causes (1.1 versus 0.7); neoplasms (0.9 versus 1.0); endocrine, nutritional and metabolic diseases (0.8 versus 0.9); diseases of the digestive system (0.8 versus 0.4); diseases of the genitourinary system (0.6 versus 0.6); diseases of the nervous system (0.4 versus 0.4); and diseases of blood & blood forming organs and certain disorders involving the immune mechanism (0.2 versus 0.3 years).Conclusions: Elimination of the circulatory diseases resulted into maximum gain in life expectancy. These findings may have implications in setting up health goals, allocating resources and launching tailor-made health programmes.

ABSTRACTObjective: The aim of this study was to estimate the impact of deaths of despair (DoD) on life expectancy at birth and by sex in Brazil in 2019, as well as the contribution of different age groups to this loss.Methods: We used life tables from the Brazilian Institute of Geography and Statistics and cause-specific mortality data by age and sex from the Mortality Information System. A cause-deleted life table methodology was applied, assuming independence between DoD and other causes of death. The difference in life expectancy with and without DoD was decomposed by age using Arriaga’s method. DoD included deaths from suicide, intentional or accidental poisoning, and mental and behavioral disorders due to substance use.Results: In 2019, there were 23,391 DoD in Brazil (1.73% of all deaths), 89% of which were due to suicide. Removing these deaths would increase life expectancy by 0.43 years for men and 0.12 years for women, with men experiencing a 3.5 times greater impact. The 35-49 age group had the highest relative contribution, especially among men, where DoD accounted for up to 9.7% of the loss in life expectancy. The impact was more concentrated and earlier in men and more diffuse among women.Conclusion: Although lower in absolute numbers, DoD have a measurable impact on life expectancy, especially among young men. These findings highlight the need for public policies focused on suicide prevention and addressing the social determinants that sustain despair.

BackgroundTo estimate the potential gain in life expectancy from addressing modifiable risk factors for all-cause mortality (excluding suicide and deaths from accidents or violence) across specific serious mental illness (SMI) subgroups, namely schizophrenia, schizoaffective disorders, and bipolar disorders in a Western population.MethodsWe have used relative risks from recent meta-analyses to estimate the population attribution fraction (PAF) due to specific modifiable risk factors known to be associated with all-cause mortality within SMI. The potential gain in life expectancy at birth, age 50 and age 65 years were assessed by estimating the combined effect of modifiable risk factors from different contextual levels (behavioural, healthcare, social) and accounting for the effectiveness of existing interventions tackling these factors. Projections for annual gain in life expectancy at birth during a two-decade was estimated using the Annual Percentage Change (APC) formula. The predicted estimates were based on mortality rates for year 2014–2015.ResultsBased on the effectiveness of existing interventions targeting these modifiable risk factors, we estimated potential gain in life expectancy at birth of four (bipolar disorders), six (schizoaffective disorders), or seven years (schizophrenia). The gain in life expectancy at age 50 years was three (bipolar disorders) or five (schizophrenia and schizoaffective disorders) years. The projected gain in life expectancy at age 65 years was three (bipolar disorders) or four (schizophrenia and schizoaffective disorders) years.ConclusionsThe implementation of existing interventions targeting modifiable risk factors could narrow the current mortality gap between the general and the SMI populations by 24% (men) to 28% (women). These projections represent ideal circumstances and without the limitation of overestimation which often comes with PAFs.

To estimate the potential gain in life expectancy from addressing modifiable risk factors for all-cause mortality (excluding suicide and deaths from accidents or violence) across specific serious mental illness (SMI) subgroups, namely schizophrenia, schizoaffective disorders, and bipolar disorders in a Western population. We have used relative risks from recent meta-analyses to estimate the population attribution fraction (PAF) due to specific modifiable risk factors known to be associated with all-cause mortality within SMI. The potential gain in life expectancy at birth, age 50 and age 65 years were assessed by estimating the combined effect of modifiable risk factors from different contextual levels (behavioural, healthcare, social) and accounting for the effectiveness of existing interventions tackling these factors. Projections for annual gain in life expectancy at birth during a two-decade was estimated using the Annual Percentage Change (APC) formula. The predicted estimates were based on mortality rates for year 2014-2015. Based on the effectiveness of existing interventions targeting these modifiable risk factors, we estimated potential gain in life expectancy at birth of four (bipolar disorders), six (schizoaffective disorders), or seven years (schizophrenia). The gain in life expectancy at age 50 years was three (bipolar disorders) or five (schizophrenia and schizoaffective disorders) years. The projected gain in life expectancy at age 65 years was three (bipolar disorders) or four (schizophrenia and schizoaffective disorders) years. The implementation of existing interventions targeting modifiable risk factors could narrow the current mortality gap between the general and the SMI populations by 24% (men) to 28% (women). These projections represent ideal circumstances and without the limitation of overestimation which often comes with PAFs.

This article aims to make projections of future trends in stroke mortality in the Year 2030 based on recent trends in stroke mortality in 7 Western European countries. Mortality data were obtained from national cause of death registries. Annual rates of decline in stroke mortality of 1980 to 2005 were determined for men and women in the United Kingdom, France, the Netherlands, and 4 Nordic countries on the basis of regression analysis. Estimated rates of decline were extrapolated until 2030. Cause-elimination life tables were used to determine the effect of stroke in 2030 in terms of potential gain in life expectancy. The absolute numbers of stroke deaths in 2030 were estimated using national population projections of Eurostat. In all countries, stroke mortality rates declined incessantly until 2005 among both men and women. If these trends were to continue, age-adjusted mortality rates would decline by approximately half between 2005 and 2030 with larger declines in France (approximately two thirds) and smaller declines in the Netherlands, Denmark, and Sweden (approximately one fourth). Similar rates of decline would be observed in terms of potential gain in life expectancy. Because of population aging, the absolute number of stroke deaths would decline slowly in the United Kingdom and France and stabilize or even increase in other countries. In the near future, stroke may lose much of its effects on life expectancy but remain a frequent cause of death among elderly populations. The prevention of stroke-related disability instead of mortality may become increasingly more important.

Background: Over the past century, non-communicable diseases have emerged as the primary cause of death globally. Among them, Endocrine, Nutritional and Metabolic diseases have shown an increasing trend from 2017 to 2020, likely the ranking rising from the 8th to the 5th in the MCCD data. In southern India, people are living longer, but not always healthier. Diabetes and thyroid disorders are silently shortening lives, often without drawing the attention they deserve. Methods: The estimated data for India was extracted from the Medically Certified Data (MCCD)2020. The gain in life expectancy is calculated by following the elimination method (Shuji Hashimoto et al, 2012). Abridged Life tables were constructed using Chaing’s method in the United Nations’ software package for mortality measurements (MORTPAK). For the construction of the life table, first, calculate the nqx values from the observed age-specific death rates nmx. A life table that eliminated deaths caused by disease was constructed using data on the number of deaths and life tables without disease elimination. The study is a cohort study that was conducted from January 2024 to August 2024. Results: The potential gain in life expectancy ranges from 0 to 7.84 years. By comparing other southern states, Tamil Nadu witnessed drastic changes in the life expectancy of males (7.84 years) and females (0 years) in the age group 25 to 35 age group. Conclusions: The significant impact of Endocrine Nutritional and Metabolic diseases on mortality and life expectancy across southern Indian states, underlining the critical need for healthcare interventions.

Large cities are often at the forefront of social change, not only in their region, but throughout the country. Therefore, the analysis of their demographic trends, in particular mortality by causes of death, is important not only by itself, but also in the context of general demographic prospects of the country. The aim of this study is to make a comparative analysis of the gains in life expectancy in Dnipro, Kyiv, Lviv, Odesa and Kharkiv over the period 2005— 2019, and an estimation of the cause-specific mortality contributions to the life expectancy changes. For the first time, decompositions analyses are conducted to evaluate contributions to fluctuations in life expectancy not only by age and sex, but also by causes of death for each of the five largest cities of Ukraine. The following statistical measures and methods are used: calculation and analysis of demographic rates, life tables, graphic method and decomposition method. Our results show that, during the observed period, life expectancy at birth has increased in all cities, mostly due to changes in mortality from circulatory diseases, which have resulted in a one-year increase in life expectancy among men in Odesa to almost 2.5 years among women of Kharkiv. However, it might be possible that such a large contribution in Kharkiv is a result of a part of the deaths falling into the category of ill-defined causes, for which mortality has increased rapidly in that city. The second major contribution to the improvement in life expectancy is attributable to external causes of death: from 0.3 years of increase in females of Lviv to almost 1.9 years in females of Odesa. Males in Odesa benefited the most from the reduction in mortality due to infectious diseases (+2 years). In some cases, there was a significant positive contribution of the reduction in mortality from diseases of the digestive system (+0.5 years in men of Dnipro). The decline in cancer mortality also had a positive impact on life expectancy in all cities, except for Kharkiv. Overall, the increase in life expectancy for men was due to a reduction in mortality at younger ages than for women. In particular, the common age interval for all five cities, with men having the greatest gain in life expectancy, is 45-59 years, while for women it is 65 to 79 years. In men, the gain in life expectancy was accounted for by the decline in mortality at the age 45 to 59 years, with 24.4 per cent in Odesa and almost 46 per cent in Lviv and Kharkiv, mainly due to a reduction in mortality from circulatory diseases and external causes. In women, the decline in mortality at the age 65 to 79 years contributed 30.3-34.8 per cent of the increase in life expectancy in Dnipro, Kyiv and Lviv; however, in Odesa it was only 19.4 per cent, in Kharkiv it was almost 54.3 per cent, which seems unlikely due to an increase in the proportion of ill-defined causes of death. In all five cities, the main trend over 2005-2013 years was the decline in mortality from the major causes of death, while the period 2013-2019 was turbulent, with mortality by causes of death changing in different directions even in the same city. Some contradictory results may be explained by the deterioration in the quality of the registration of demographic events as well as changes in the age and sex structure of the population of cities, which have not been reflected in the current estimates of the State Statistical Committee of Ukraine due to the long absence of a population census.

Addiction as a Coping Response: Hyperkatifeia, Deaths of Despair, and COVID-19.

Overdose mortality is reducing the gains in life expectancy of antiretroviral-treated people living with HIV in British Columbia, Canada.

Apheis aims to provide European decision makers, environmental-health professionals and the general public with up-to-date and easy-to-use information on air pollution (AP) and public health (PH). In the Apheis-3 phase we quantified the PH impact of long-term exposure to PM(2.5) (particulate matter < 2.5 microm) in terms of attributable number of deaths and the potential gain in life expectancy in 23 European cities. We followed the World Health Organization (WHO) methodology for Health Impact Assessment (HIA) and the Apheis guidelines for data collection and analysis. We used the programme created by PSAS-9 for attributable-cases calculations and the WHO software AirQ to estimate the potential gain in life expectancy. For most cities, PM(2.5) levels were calculated from PM10 measurements using a local or European conversion factor. The HIA estimated that 16,926 premature deaths from all causes, including 11,612 cardiopulmonary deaths and 1901 lung-cancer deaths, could be prevented annually if long-term exposure to PM(2.5 )levels were reduced to 15 microg/m3 in each city. Equivalently, this reduction would increase life expectancy at age 30 by a range between one month and more than two years in the Apheis cities. In addition to the number of attributable cases, our HIA has estimated the potential gain in life expectancy for long-term exposure to fine particles, contributing to a better quantification of the impact of AP on PH in Europe.

BackgroundThe level of premature deaths (deaths among those aged 30–69 years) caused by cancer is an important indicator of evaluating the level of cancer prevention and control. However, the current burden and temporal trends in cancer-related premature deaths, and their impact on life expectancy at the global, regional, and national levels are not clear.MethodsCancer mortality data for 185 countries were obtained from the GLOBOCAN 2022 database. High-quality cancer mortality data and national population statistics for 47 countries were extracted from the United Nations and national cancer registry databases, covering the period 2003–2022. Countries were classified based on the human development index (HDI). The death probability, the year of life lost (YLL), and the potential gain in life expectancy (PGLE) attributable to premature deaths from site-specific and all-cancers combined were calculated.ResultsGlobally, the probability of premature cancer deaths was 6.49% (95% UI 6.49–6.50). The YLLs caused by cancer-related premature death were 163.86 million (95% UI 163.70–164.03), constituting 65.58% of the total cancer-related YLLs. The PGLEs were 1.16 years (95% UI 1.16–1.16). The premature death probability increased with higher HDI levels in men, but decreased in women. Cancer-related premature deaths as a proportion of total cancer deaths varied from 18.31% (95% UI 18.20–18.43) in Japan to 84.44% (95% UI 76.10–91.16) in São Tomé and Príncipe. Lung cancer was the leading cause of cancer-related premature deaths in men, and breast cancer ranked first in women. By eradicating premature deaths attributable to lung, liver, colorectal, and stomach cancer in men, and to breast, cervical, and lung cancer in women, 0.55 years (95% UI 0.55–0.55) and 0.49 years (95% UI 0.49–0.49) of PGLEs could be achieved, accounting for 48.67% and 42.24% of the total PGLEs, respectively. Cancer-related premature deaths decreased significantly in 38 countries during 2003–2022 (P < 0.05). The probability of premature cancer-related deaths decreased by more than 15.50% from 2015 to 2022 in 16 countries.ConclusionsCancer-related premature deaths declined in many countries, with 16 of them having achieved the expected reduction by 2022. The current burden of cancer-related premature deaths is profound but varies around the world. Eliminating premature deaths from major cancer types could substantially increase life expectancy, underscoring the importance of prevention and treatment efforts for these cancers.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40779-025-00645-9.

Deaths of despair: The singularities of French overseas territories.

Essential for the description of the health situation of a nation is an assessment of the contribution that different diseases make to the burden of illness, disability and premature death. Comparisons of diseases in terms of deaths have a long tradition, and have led to the development of a number of life-table based measures such as the potential gain in life expectancy by eliminating specific causes of death. These measures provide an easy-to-grasp and powerful summary of the relative importance of specific causes of death, as well as of the potential benefits of intervention programmes (Chiang, 1978; Preston et al., 1972, US Department of Health, 1988; Tsai et al., 1978; Keyfitz, 1977).