Cardiovascular Revolution Research Articles

The epidemiological transition and its interpretations

A critical analysis of A. Omran's theory of epidemiological transition (ET) and its various interpretations. The periodization of ET proposed by Omran is questioned, and the differentiation of the two "epidemiological revolutions" by M. Terris is compared with it. The great world historical significance of ET as a trigger and an integral part of the demographic transition as a whole is noted, and disagreement with the interpretation of ET as an integral part of the “sanitary transition” is substantiated. The concept of the "cardiovascular revolution" is contested. A method of graphical representation of ET is proposed and criteria for its completion are discussed. Grounds are given for disagreement with ideas about the "first", Neolithic, and coming "third" ET, as well as about a "reverse" ET. The problems of “catching-up” ET in developing countries are considered.

Main components of life expectancy increase during the cardiovascular revolution in spain

The circulatory system diseases have contributed decisively to an increase in life expectancy (LE) in Spain. The contribution to LE is calculated through a decomposition analysis by sex and five-year age groups. We divide the years studied into two periods, 1980–1996 and 1996–2012. Using the Human Cause-of-Death Database (HCD), we examine specific subcauses at a 4-digit ICD-10 level and how they contribute to the change in LE among men and among women. The analysis shows that cerebrovascular diseases (CBVDs) contribute most to years gained until 1996, while ischemic heart diseases (IHDs) contribute most thereafter. Among women, the largest increase is due to specific CBVDs subcauses; among men IHD subcauses also have an important role. Regarding contribution by age, gains by CVDs are particularly significant at older ages, while contributions by IHDs are more relevant from the age of 50 onwards, especially among men. Furthermore, the gender gap in LE is influenced by the different evolution of various circulatory diseases during the period of study, but the evolution of these diseases is not always reflected equally in both sexes. The study evidences the need for greater precision in the registers in order to take advantage of the potentialities of the 4-digit classification of the ICD, thus leading to a better in depth knowledge in health trends. Finally, it shows the mortality due to modifiable factors mainly classified in IHDs, and the consequent need for the Spanish health system to act on them.Las enfermedades del sistema circulatorio, han contribuido de manera decisiva al aumento de la esperanza de vida (LE) en España. Las contribuciones a la LE se calculan a través de un análisis de descomposición por sexo y grupos de edad quinquenales. Dividimos los años estudiados en dos períodos, 1980–1996 y 1996–2012. Utilizando la Human Cause-of-Death Database (HCD), examinamos subcausas específicas a un nivel de 4 dígitos de ICD-10 y cómo contribuyen al aumento o disminución de LE tanto en hombres como en mujeres. El análisis muestra que las enfermedades cerebrovasculares (CBVD) son las que más contribuyen a los años ganados hasta 1996, mientras que las enfermedades isquémicas (IHD) son las que más contribuyen posteriormente. Entre las mujeres, el mayor aumento se debe a subcausas específicas de las CBVD; en los hombres, las subcausas de IHD también tienen un papel importante. En lo que respecta a la contribución por edad, las ganancias por CBVDs son particularmente significativas en las edades mayores, mientras que las contribuciones por las IHD son más relevantes a partir de los 50 años, especialmente entre los hombres. La brecha entre hombres y mujeres en la LE está influenciada por la evolución diferente de varias enfermedades circulatorias durante el período de estudio, pero la evolución de estas enfermedades no siempre se refleja por igual en ambos sexos. Además, se pone en evidencia la necesidad de una mayor precisión en los registros para aprovechar las potencialidades de la clasificación a 4 dígitos de la CIE, alcanzando de este modo un conocimiento más profundo de las tendencias de salud. Finalmente, el estudio muestra la mortalidad debida a factores modificables que se clasifican principalmente en las IHD, y la consiguiente necesidad de que el sistema de salud español actúe sobre ellas.

Эпидемиологический переход и его интерпретации

Критический анализ теории эпидемиологического перехода (ЭП) А. Омрана и ее различных интерпретаций. Ставится под сомнение предложенная Омраном периодизация ЭП, с ней сопоставляется разграничение двух «эпидемиологических революций» М. Терриса. Отмечается огромное всемирно-историческое значение ЭП как триггера и составной части демографического перехода в целом и обосновывается несогласие с трактовкой ЭП как составной части «санитарного перехода». Оспаривается концепция «кардиоваскулярной революции». Предлагается метод графического представления ЭП и обсуждаются критерии его завершения. Обосновывается несогласие с представлениями о «первом», неолитическом, и «третьем», ожидаемом в будущем, ЭП, а также об «обратном» ЭП. Рассматриваются проблемы «догоняющего» ЭП в развивающихся странах.

Age- and Cause-Specific Components of Recent Life Expectancy Improvements in Croatia, Serbia and Slovenia

All ex-Yugoslav countries experienced improvements in life expectancy during the last few decades. This study describes and compares recent life expectancy trends in Croatia, Serbia and Slovenia. What age groups and what causes of death account for the largest mortality declines? Have the three countries joined the cardiovascular revolution? Do patterns differ between countries? And, is there room for further improvements? We use life tables and decomposition methods to address these questions. Our key findings are: 1) lower mortality from circulatory diseases at older ages contributed most to life expectancy growth 2001– 2017 for both sexes in all three countries; 2) despite this common pattern, life expectancy in Slovenia grew fastest and the gap between countries increased; 3) under the Slovenian age- -specific cardiovascular mortality schedule, Croatia added 1.79 years to both female and male life expectancies, while Serbia added 3.97 and 3.26 to female and male life expectancies.

Completing the cardiovascular revolution: smoking, alcohol, diet, and air pollution

Completing the cardiovascular revolution: smoking, alcohol, diet, and air pollution

Alcohol, policy, and public health in Lithuania: what was done and what might the effects be?

Session 2. Completing the cardiovascular revolution: smoking, alcohol, diet, and air pollution

How feasible is the life expectancy target in the Saudi Arabian vision for 2030?

Over the period 2016-2030, Saudi Arabia seeks to increase life expectancy at birth by 6 years. The main aim was to analyse the feasibility of this gain using the demographic literature. The demographic literature on recorded high gains in life expectancy and the determinants of these gains were reviewed. The findings were examined considering the Saudi Arabian context. Explanations covered demographic and behavioural factors, inequalities, health care delivery system, public health provision, health-related policies and advancements in science and technology. However, the crucial factor is the country's position in the "cardiovascular revolution" (which combines smoking prevalence, obesity, lifestyle and related policies). In countries where life expectancy is in the 70s, average yearly gains are less than 0.31 years, much lower that the Saudi Arabian target of 0.43 years. For Saudi Arabia, an average yearly gain of about half this is achievable provided the fundamental drivers of life expectancy are addressed.

Health Convergence Between East and West Germany as Reflected in Long-Term Cause-Specific Mortality Trends: To What Extent was it Due to Reunification?

The sizeable mortality gap between the German Democratic Republic (East Germany) and the pre-unified Federal Republic of Germany (West Germany) narrowed rapidly after the two states were unified. Despite extensive research, the mechanisms underlying the convergence process are still not fully understood. Significant changes to coding practices and the system of data collection introduced in East Germany shortly after reunification have further complicated the ability of researchers to interpret mortality trends. Our aim is to assess the role of German reunification in the convergence process in light of the evolution of long-term mortality trends by causes of death. Compared to previous studies, we rely on much more detailed mortality data, which we first adjust for notable distortions. We propose an upward correction of cancer mortality, as well as corrections that account for obvious changes in the items selected within the ICD chapter of circulatory diseases. We identify three distinct processes that took place in East Germany around the time of reunification: (1) a sustained reduction in mortality that started before reunification; (2) a temporary increase in mortality in 1990–1991 that was related to the abrupt social transition, as reflected by socially sensitive causes such as accidents, alcohol-related diseases, and acute myocardial infarction; and (3) a reunification-driven process of convergence that was mostly caused by the accelerated decline in mortality from cerebrovascular and chronic heart diseases. Mortality improvements observed in the GDR starting in the 1980s might be interpreted as the first signs of a cardiovascular revolution. Shifts in individual behaviour likely started before reunification, whereas the real progress in medical care occurred later with the implementation of the Western system of health care. We therefore conclude that German reunification per se did not initiate the convergence process, but rather reinforced and accelerated trends that were already apparent.

Between \u2018Pioneers\u2019 of the Cardiovascular Revolution and Its \u2018Late Followers\u2019: Mortality Changes in the Czech Republic and Poland Since 1968

After several decades of stagnation, mortality in most Central European countries started to decrease after 1989. The Czech Republic and Poland were the first former Communist countries in this region to experience a rapid and sustained increase in life expectancy. This study focuses on the trends in cause-of-death mortality that have contributed to the recent progress in these two countries. The analysis is based on the cause-of-death time series (1968–2013) reconstructed in accordance with the 10th ICD revision, which makes the data fully comparable over the full period under study. Actual trends in cause-specific mortality are presented, and age, sex and causes of death components of life expectancy changes are disentangled. In both countries, the reduction in cardiovascular mortality at adult and old ages was crucial for the increase in life expectancy after 1991. Results are discussed in the context of institutional changes that occurred after the fall of Communism, such as the reorientation of health policies and the emergence of non-governmental organizations. Changes in health-related attitudes and behaviours as well as structural changes in societies, notably the rising share of persons with tertiary education, are also discussed.

Life expectancy and education: evidence from the cardiovascular revolution

In this study we investigate the causal impact of increasing adult longevity on higher education. We exploit the fourth stage of the epidemiological transition, i.e. the unexpected decline of deaths from heart attack and stroke in the 1970s as a large positive health shock that affected predominantly old age mortality. Using a differences-in-differences estimation strategy we find across U.S. states that the cardiovascular revolution led to an increase in adult life expectancy by about 2 years, which caused higher education enrollment to increase by 7 percentage points, i.e. 30 percent of the observed increase from 1970 to 2000. Our findings are robust to the inclusion of state-specific health trends and a host of confounding variables. They suggest large effects of improving longevity on higher education enrollment.

The cardiovascular revolution and economic performance in the OECD countries

We find strong evidence that variation in cardiovascular mortality from year 2000 to year 2012 helps to explain variation in income per capita across the OECD countries. Most of the source of variation, however, comes from Eastern Europe. Better diffusion of surgical and therapeutic treatments since the year 2000 has demonstrably benefitted those still in the labor force in these relatively poor nations.

Life Expectancy and Education: Evidence from the Cardiovascular Revolution

This paper exploits the unexpected decline of deaths from cardiovascular diseases since the 1970s as a large positive health shock that affected predominantly old-age mortality; i.e., the fourth stage of the epidemiological transition. Using a differences-in-differences estimation strategy, we find that U.S. states with higher levels of cardiovascular-disease mortality prior the 1970s experienced greater increases in adult life expectancy and higher education enrollment. Our estimates suggest that the cardiovascular revolution caused an increase in life expectancy of 1.5 years and an increase in education enrollment of 9 percentage points, i.e. 52 percent of the observed increase from 1960 to 2000.

Life Expectancy and Education: Evidence from the Cardiovascular Revolution

This paper exploits the unexpected decline of deaths from cardiovascular diseases since the 1970s as a large positive health shock that affected predominantly old-age mortality; i.e., the fourth stage of the epidemiological transition. Using a differences-in-differences estimation strategy, we find that U.S. states with higher levels of cardiovascular-disease mortality prior the 1970s experienced greater increases in adultlife expectancy and higher education enrollment. Our estimates suggest that the cardiovascular revolution caused an increase in life expectancy of 1.5 years and an increase in education enrollment of 9 percentage points, i.e. 52 percent of the observed increase from 1960 to 2000.

Disease and Development: A Reply to Bloom, Canning, and Fink

Previous articleNext article No AccessDisease and Development: A Reply to Bloom, Canning, and FinkDaron Acemoglu and Simon JohnsonDaron AcemogluMassachusetts Institute of Technology Search for more articles by this author and Simon JohnsonMassachusetts Institute of Technology Search for more articles by this author PDFPDF PLUSFull TextSupplemental Material Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Journal of Political Economy Volume 122, Number 6December 2014 Article DOIhttps://doi.org/10.1086/677190 Views: 799Total views on this site Citations: 25Citations are reported from Crossref © 2014 by The University of Chicago. All rights reserved.PDF download Crossref reports the following articles citing this article:Leah Bevis, Kichan Kim, David Guerena Soil zinc deficiency and child stunting: Evidence from Nepal, Journal of Health Economics 53 (Oct 2022): 102691.https://doi.org/10.1016/j.jhealeco.2022.102691Koichi Futagami, Miho Sunaga Risk aversion and longevity in an overlapping generations model, Journal of Macroeconomics 72 (Jun 2022): 103415.https://doi.org/10.1016/j.jmacro.2022.103415Rainer Kotschy Health improvements impact income inequality, The Journal of the Economics of Ageing 22 (Jun 2022): 100385.https://doi.org/10.1016/j.jeoa.2022.100385Masagus M. Ridhwan, Peter Nijkamp, Affandi Ismail, Luthfi M.Irsyad The effect of health on economic growth: a meta-regression analysis, Empirical Economics 122 (Apr 2022).https://doi.org/10.1007/s00181-022-02226-4Lei He, Zhengqi Wang The interaction effects of rising life expectancy and the public pension burden on aggregate savings and economic growth, Portuguese Economic Journal 115 (Mar 2022).https://doi.org/10.1007/s10258-022-00208-zMehmet Top, Songul Cinaroglu Cluster analysis of health systems in Europe according to life expectancy at birth, The International Journal of Health Planning and Management 36, no.66 (Jul 2021): 2162–2181.https://doi.org/10.1002/hpm.3283Maria Kuecken, Josselin Thuilliez, Marie-Anne Valfort Disease and Human Capital Accumulation: Evidence from the Roll Back Malaria Partnership in Africa, The Economic Journal 131, no.637637 (Dec 2020): 2171–2202.https://doi.org/10.1093/ej/ueaa134Alistair Dieppe, Atsushi Kawamoto, Yoki Okawa, Cedric Okou, Jonathan Temple What Explains Productivity Growth, (Jun 2021): 39–96.https://doi.org/10.1596/978-1-4648-1608-6_ch2Rainer Kotschy Health dynamics shape life-cycle incomes, Journal of Health Economics 75 (Jan 2021): 102398.https://doi.org/10.1016/j.jhealeco.2020.102398David E. 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The Recent Mortality Decline in Russia: Beginning of the Cardiovascular Revolution?

The health situation in Russia has often been characterized as a long‐running crisis. From the 1960s until the beginning of the 2000s, the declining life expectancy trend was substantially interrupted only twice: once in the mid‐1980s as a result of Gorbachev's anti‐alcohol campaign, and again at the end of the 1990s as a result of the “rebound” effect following the dramatic rise in mortality associated with the acute socioeconomic crisis. In both cases, the progress made proved to be short‐lived. A third mortality decline in Russia began in 2003 and is still ongoing. We investigate the components and driving forces of this new development, in particular the role played by cardiovascular diseases. Using cause‐specific mortality data, we identify the main features of the recent improvements and compare these features with those observed in selected European countries, specifically France, Poland, and Estonia. Our aim is to gauge whether the features of the improvements in these countries are similar to those of the recent advancements made in Russia. Although the recent improvements in Russia have features in common with initial stages of prior mortality declines in other countries and may support optimism about the future, a return to mortality stagnation cannot be ruled out.

Case fatality of acute myocardial infarction: an emerging gender gap

There has been a cardiovascular revolution since the 1970s in many industrialized countries with rapidly declining mortality rates especially for coronary heart disease (CHD). This has been most striking for men. A slower decline in out-of hospital mortality for women below 55 has been demonstrated in Finland. This, and indications of increasing incidence of CHD in the younger segments of the female populations may be pointing at a shift in the incidence and mortality pattern of this disorder. These findings should be taken seriously, reminding us that younger women are not protected against coronary heart disease.

Mortality in Europe: The Divergence between East and West

After a period of general convergence, the 1960s were marked by the divergence between the life expectancies of eastern European countries, where all progress came to a halt, and those of the rest of Europe where health care made large strides. A hierarchical analysis of age-specific mortality patterns shows that this divergence goes together with the development of very different patterns of age at death; in the countries of eastern Europe, and especially in the USSR, excess mortality at adult ages is spectacularly high.Cause-specific analysis reveals the decisive role played by two kinds of diseases. On the one hand, “man-made diseases” (alcoholism, smoking, car accidents, etc.) have continued to increase in the east, whereas they were curbed in the west starting in the 1960s. On the other hand, eastern Europe was unable to join the cardiovascular revolution that had enabled the west to increase its life expectancy levels. The considerable divergence between eastern and western Europe should not hide the differences that still remain among western countries. Indeed, mortality patterns are changing in the west, and the traditional opposition between north and south is undergoing radical transformations.

Mortality in Europe: the Divergence Between East and West

After a period of general convergence, the 1960s were marked by the divergence between the life expectancies of eastern European countries, where all progress came to a halt, and those of the rest of Europe where health care made large strides. A hierarchical analysis of age-specific mortality patterns shows that this divergence goes together with the development of very different patterns of age at death; in the countries of eastern Europe, and especially in the USSR, excess mortality at adult ages is spectacularly high.Cause-specific analysis reveals the decisive role played by two kinds of diseases. On the one hand, “man-made diseases” (alcoholism, smoking, car accidents, etc.) have continued to increase in the east, whereas they were curbed in the west starting in the 1960s. On the other hand, eastern Europe was unable to join the cardiovascular revolution that had enabled the west to increase its life expectancy levels. The considerable divergence between eastern and western Europe should not hide the differences that still remain among western countries. Indeed, mortality patterns are changing in the west, and the traditional opposition between north and south is undergoing radical transformations.