Mortality Experience Research Articles

Trends and patterns of violence-related mortality in Nigeria: evidence from a 16-year analysis of secondary data

BackgroundNigeria is one of the most terrorised countries due to terrorist attacks and violent clashes. There have been many fatalities resulting from this violence, which started in the late 1960s...

Construction of experience life-tables for the algerian survivor pension beneficiaries

The objective of this paper is to construct periodic life tables based on the mortality experience of the Algerian survivor pension beneficiaries. Usually, the mortality of retirees is lower than that of the global population, essentially due to better living conditions and access to health care. Also, we aim to verify if mortality is different between the categories of survivor pensioners and to adapt the actuarial life tables accordingly, which may result in actuarial valuations more adapted to the risk function of each subpopulation. To this end, we compare three parametric models i.e., the Gompertz model, the Kannisto model, and the Heligman & Pollard model. Results show a significant difference between the life expectancy of the survivor pension beneficiaries and that of the direct retirees and between the categories of survivor pensioners.

Benefits of Investing on Mother and Child Healthcare in Tanzania

Purpose: Maternal and child healthcare play crucial role in reducing global mortality rates, with a significant impact on the overall burden of disease. The Sustainable Development Goal 3 aims to reduce the global maternal mortality ratio to less than 70 per 100,000 live births, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births by 2030. Sub-Saharan Africa, including Tanzania, carries a high burden of mortality rates and experiences a significant share of maternal and child deaths, exacerbating the global figures. The average prevalence of below 5 years mortality in SSA between 2010 and 2018 was 4.10% according to Ahinkorah (2021). Recognizing the severity of this issue, the government of Tanzania through the Development Agenda 2025, Draft health policy 2020 and the current Health Sector strategic plan 2021-2026 plans to reduce infant and maternal mortality rates through mother and child healthcare investment. The Health Sector Strategic Plan focuses on strengthening the health systems in the country and aims to sustain the achievements made in enhancing the health of reproductive, maternal, newborn, children, and adolescent populations. This study sought to assess the benefits of investing on mother and child healthcare in Tanzania. The study was guided by the investment commodity theory developed by the economist John Maynard Keynes in 1936. The study evaluated the current status of mother and child health indicators, the benefits of investing in mother and child health on overall health outcomes and identified the existing gaps and challenges in the provision, access and utilization of mother and child healthcare services in Tanzania.
 Methodology: The study was a desktop review-based study which relied on existing published information, data, and literature.
 Findings: The study found out that there have been improvements in certain areas of mother and child health indicators but maternal and child mortality rates remain high. Health interventions such as vaccination programs, improved access to healthcare services, and the use of maternal and child health insurance cards showed positive effects on reducing child mortality, improving child health outcomes, and enhancing maternal healthcare utilization. The significant gaps and challenges in the provision, access, and utilization of mother and child healthcare services include disparities in access to healthcare services based on factors such as education level and wealth status, inadequate healthcare infrastructure, long distances to health facilities, sociocultural barriers, and financial constraints.
 Unique contribution to theory, practice and policy: The study recommends strengthening of healthcare infrastructure, enhancing access to maternal and child healthcare services, especially for vulnerable populations, promoting health education and raising awareness about maternal and child healthcare practices, addressing the shortage of skilled healthcare professionals, improving data collection and use and monitoring of maternal and child health indicators, addressing socio-cultural barriers that hinder access and utilization of healthcare services and increasing investment in mother and child health care programs through allocate adequate resources.

Melancholic Grief and the Psychic Experience of Reproductive Loss in Emma Tammi’s The Wind (2018)

Horror films directed by women are uniquely suited to problematize the psychic experience of reproductive loss. This article analyzes Emma Tammi’s The Wind (2018) to understand how the film’s horrific representations of interior spaces (the body, the mind, and the home) reflect the psychic experience of melancholic grief associated with reproductive loss. The film functions to problematize the affective complacency that demands that good mothers conceal their negative feelings of loss, animosity, and jealousy. In the context of the maternal experience of infant mortality, the “mask of motherhood” perpetuates the psychic antagonisms of ambivalence and melancholic guilt associated with losing a child. Toward that end, a critical discourse analysis of The Wind and related paratexts considers how the spatial relations between the interior homestead and exterior landscape serve to reflect the monstrous experience of melancholic grief. The resulting analysis provides a feminist approach to understanding melancholic grief and identifies horror films as important discursive spaces for developing alternative representations of mother’s psychic experiences of loss.

Use of days alive without life support and similar count outcomes in randomised clinical trials – an overview and comparison of methodological choices and analysis methods

BackgroundDays alive without life support (DAWOLS) and similar outcomes that seek to summarise mortality and non-mortality experiences are increasingly used in critical care research. The use of these outcomes is challenged by different definitions and non-normal outcome distributions that complicate statistical analysis decisions.MethodsWe scrutinized the central methodological considerations when using DAWOLS and similar outcomes and provide a description and overview of the pros and cons of various statistical methods for analysis supplemented with a comparison of these methods using data from the COVID STEROID 2 randomised clinical trial. We focused on readily available regression models of increasing complexity (linear, hurdle-negative binomial, zero–one-inflated beta, and cumulative logistic regression models) that allow comparison of multiple treatment arms, adjustment for covariates and interaction terms to assess treatment effect heterogeneity.ResultsIn general, the simpler models adequately estimated group means despite not fitting the data well enough to mimic the input data. The more complex models better fitted and thus better replicated the input data, although this came with increased complexity and uncertainty of estimates. While the more complex models can model separate components of the outcome distributions (i.e., the probability of having zero DAWOLS), this complexity means that the specification of interpretable priors in a Bayesian setting is difficult.Finally, we present multiple examples of how these outcomes may be visualised to aid assessment and interpretation.ConclusionsThis summary of central methodological considerations when using, defining, and analysing DAWOLS and similar outcomes may help researchers choose the definition and analysis method that best fits their planned studies.Trial registrationCOVID STEROID 2 trial, ClinicalTrials.gov: NCT04509973, ctri.nic.in: CTRI/2020/10/028731.

Impact of cancer and other causes of death on mortality of cancer patients: A study based on Japanese population-based registry data.

Cancer registry data provide a very important source of information for improving our understanding of the epidemiology of various cancers. In this work, we estimated the 5-year crude probabilities of death from cancer and from other causes for five common cancers, namely stomach, lung, colon-rectum, prostate and breast, in Japan, using population-based registry data. Based on data on 344 676 patients diagnosed with one of these cancers between 2006 and 2008 in 21 prefectures participating in the Monitoring of Cancer Incidence in Japan (MCIJ) and followed-up for at least 5 years, we used a flexible excess hazard model to compute the crude probabilities of death for different combinations of sex, age and stage at diagnosis. For tumours diagnosed at the distant stage, as well as for regional lung tumours, the vast majority of deaths at 5 years in cancer patients were attributable to the disease itself (although this proportion was only around 60% in older prostate cancer patients). For localised and most regional tumours, the impact of other causes of death on the total mortality increased with age at diagnosis, especially for localised breast, colorectal and gastric cancer. By allowing the partition of the mortality experience of cancer patients into a cancer- and an other-cause-specific component, crude probability of death estimates provide insight into how the impact of cancer on mortality might differ among populations with different background mortality risks. This might be useful for informing discussions between clinicians and patients about treatment options.

Modelling socio-economic mortality at neighbourhood level

AbstractIn this study, we quantify the relationship between socio-economic status and life expectancy and identify combinations of socio-economic variables that are particularly useful for explaining mortality differences between neighbourhoods in England. We achieve this by examining socio-economic variation in mortality experiences across small areas in England known as lower layer super output areas (LSOAs). We then consider 12 socio-economic variables that are known to have a strong association with mortality. We estimate the relationship between those variables and mortality rates using a random forest algorithm. Based on the resulting estimate, we then create a new socio-economic mortality index – the Longevity Index for England (LIFE). The index is constructed in a way that eliminates the impact of care homes that might artificially increase mortality rates in LSOAs with care homes compared to LSOAs that do not contain a care home. Using mortality data for different age groups, we make the index age-dependent and investigate the impact of specific socio-economic characteristics on the age-specific mortality risk. We compare the explanatory power of the LIFE index to the English Index of Multiple Deprivation (IMD) as predictors of mortality. While we find that the IMD can explain regional mortality differences to some extent, the LIFE index has significantly greater explanatory power for mortality differences between regions. Our empirical results also indicate that income deprivation amongst the elderly and employment deprivation are the most significant socio-economic factors for explaining mortality variation across LSOAs in England.

Association of Race and Poverty Status With DNA Methylation–Based Age

The Dunedin Pace of Aging Calculated From the Epigenome (DunedinPACE) measure is a newly constructed DNA methylation (DNAm) biomarker associated with morbidity, mortality, and adverse childhood experiences in several cohorts with European ancestry. However, there are few studies of the DunedinPACE measure among socioeconomically and racially diverse cohorts with longitudinal assessments. To investigate the association of race and poverty status with DunedinPACE scores in a socioeconomically diverse middle-aged cohort of African American and White participants. This longitudinal cohort study used data from the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) study. HANDLS is a population-based study of socioeconomically diverse African American and White adults aged 30 to 64 years at baseline in Baltimore, Maryland, with follow-up approximately every 5 years. The current study was restricted to 470 participants with blood samples at 2 time points: August 14, 2004, to June 22, 2009 (visit 1), and June 23, 2009, to September 12, 2017 (visit 2). Genome-wide DNAm was assessed at visit 1 (chronological age, 30-64 years) and visit 2. Data were analyzed from March 18, 2022, to February 9, 2023. DunedinPACE scores were estimated for each participant at 2 visits. DunedinPACE scores are values scaled to a mean of 1, interpretable with reference to a rate of 1 year of biological aging per 1 year of chronological aging. Linear mixed-model regression analysis was used to examine the trajectories of DunedinPACE scores by chronological age, race, sex, and poverty status. Among 470 participants, the mean (SD) chronological age at visit 1 was 48.7 (8.7) years. Participants were balanced by sex (238 [50.6%] were men and 232 [49.4%] were women), race (237 [50.4%] African American and 233 [49.6%] White), and poverty status (236 [50.2%] living below poverty level and 234 [49.8%] living above poverty level). The mean (SD) time between visits was 5.1 (1.5) years. Overall, the mean (SD) DunedinPACE score was 1.07 (0.14), representing a 7% faster pace of biological aging than chronological aging. Linear mixed-effects regression analysis revealed an association between the 2-way interaction between race and poverty status (White race and household income below poverty level: β = 0.0665; 95% CI, 0.0298-0.1031; P < .001) and significantly higher DunedinPACE scores and an association between quadratic age (age squared: β = -0.0113; 95% CI, -0.0212 to -0.0013; P = .03) and significantly higher DunedinPACE scores. In this cohort study, household income below poverty level and African American race were associated with higher DunedinPACE scores. These findings suggest that the DunedinPACE biomarker varies with race and poverty status as adverse social determinants of health. Consequently, measures of accelerated aging should be based on representative samples.

MP61-04 LIFE EXPECTANCY AND THE CHOICE OF RADICAL PROSTATECTOMY

You have accessJournal of UrologyCME1 Apr 2023MP61-04 LIFE EXPECTANCY AND THE CHOICE OF RADICAL PROSTATECTOMY Roderick Clark and Steven Narod Roderick ClarkRoderick Clark More articles by this author and Steven NarodSteven Narod More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003319.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: In deciding upon radical prostatectomy for a prostate cancer patient, urologists are asked to consider a patient’s life expectancy as well as tumour aggressiveness. NCCN recommends observation or non-surgical management for men with low- or intermediate-risk cancer who have a life expectancy of less than ten years. It is unclear how life expectancy calculated at diagnosis accurately reflects the actual mortality experience. The objective of this study is to determine the proportion of men who are over the age of 65 at the time of surgery who die of prostate cancer versus other causes within 10-years. METHODS: We performed a population-based, retrospective cohort study using data from the Surveillance, Epidemiology and End-Results (SEER) program. Our study included 35,035 men with prostate cancer diagnosed between the years 1992 -1997 who were between the ages 60-80 at the time of diagnosis. RESULTS: Of the men in the study, 13,383 (38.2%) died within ten years of diagnosis. Of these, 2,689 (20%) died of prostate cancer and 9,773 (73%) died of another cause (921 missing data). Of the 2689 men who died of prostate cancer within 10-years of diagnosis, 38.6% had a radical prostatectomy. Of the 9773 men who died of another cause within 10-years of diagnosis, 38.6% had a radical prostatectomy. CONCLUSIONS: After stratifying by age of diagnosis, the proportions of men who did and who did not have a radical prostatectomy varied little by the actual ten-year mortality experience of the groups. We should either improve our mortality estimation methods for patients being considered for radical prostatectomy or re-evaluate the clinical utility of recommending this as part of the assessment before surgery. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e853 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Roderick Clark More articles by this author Steven Narod More articles by this author Expand All Advertisement PDF downloadLoading ...

Philippa Koch. The Course of God’s Providence: Religion, Health, and the Body in Early America.

Illness and religion were two of the most important factors that shaped eighteenth-century lives. Philippa Koch’s new book examines the intersection of these two phenomena—specifically, the intersection of Protestant theology and devotional practice with the almost constant experience of illness, injury, and childbirth, and the ever-present possibility of death. The book asks: how did eighteenth-century people use religion to understand their experience? The answer, according to Koch, is an understanding of illness and suffering rooted in a Providential worldview: Ill-health, both of an individual or a society, is part of God’s larger plan. Koch traces this worldview through a series of chapters that consider ministerial writings on health and disease; laypeople’s own narratives of illness; illness as a collective problem to be solved; and the experience of childbirth and infant mortality. The book offers new and useful perspectives on many familiar topics. For instance, Koch retells the familiar story of Cotton Mather and smallpox inoculation but takes this as a chapter in religious history rather than the history of medicine. She argues that Mather saw a commitment to public health as a Christian obligation. As a minister, he was required to heal communities and bodies as well as looking after individual souls. Advocating for inoculation was a way of enacting God’s plan and healing spiritual as well as physical corruption.

Mortality in rural coastal Kenya measured using the Kilifi Health and Demographic Surveillance System: a 16-year descriptive analysis.

Background: The Kilifi Health and Demographic Surveillance System (KHDSS) was established in 2000 to define the incidence and prevalence of local diseases and evaluate the impact of community-based interventions. KHDSS morbidity data have been reported comprehensively but mortality has not been described. This analysis describes mortality in the KHDSS over 16 years. Methods: We calculated mortality rates from 2003-2018 in four intervals of equal duration and assessed differences in mortality across these intervals by age and sex. We calculated the period survival function and median survival using the Kaplan-Meier method and mean life expectancies using abridged life tables. We estimated trend and seasonality by decomposing a time series of monthly mortality rates. We used choropleth maps and random-effects Poisson regression to investigate geographical heterogeneity. Results: Mortality declined by 36% overall between 2003-2018 and by 59% in children aged <5 years. Most of the decline occurred between 2003 and 2006. Among adults, the greatest decline (49%) was observed in those aged 15-54 years. Life expectancy at birth increased by 12 years. Females outlived males by 6 years. Seasonality was only evident in the 1-4 year age group in the first four years. Geographical variation in mortality was ±10% of the median value and did not change over time. Conclusions: Between 2003 and 2018, mortality among children and young adults has improved substantially. The steep decline in 2003-2006 followed by a much slower reduction thereafter suggests improvements in health and wellbeing have plateaued in the last 12 years. However, there is substantial inequality in mortality experience by geographical location.

Seasonal mortality amongst UK occupational pension scheme members 2000–2016

Abstract Mortality at older ages varies by season, increasing the uncertainty associated with modelling and projecting mortality at older ages and ultimately contributing to pension providers’ overall risk. As the population ages, it becomes more important to understand variations in seasonal mortality between pensioners and to identify those most vulnerable to seasonal mortality differences. Using data from the Self-Administered Pension Schemes mortality investigation of the Continuous Mortality Investigation of the Institute and Faculty of Actuaries, UK, this paper investigates variations in seasonal mortality amongst members of UK occupational pension schemes over the period 2000–2016. Results are also compared with the corresponding population of England and Wales. For the oldest age groups (80+), which are most affected by seasonality, females are more vulnerable to seasonal differences in mortality for each pensioner group relative to males. Following a long-term decline in the winter-summer mortality gap the gap increased over the period, particularly for female pensioners and dependants. Seasonality remains a feature of UK mortality at older ages and risk management for pension schemes should consider seasonality when analysing overall mortality experience.

WINO, MIŁOŚĆ, HEDONIZM, MIASTO I „ODGŁOS WIOSEŁ ŁODZI CHARONA”1. ŚWIAT POSŁAŃ I PIEŚNI CARLA MICHAELA BELLMANA

In the satirical works mentioned above, Carl Michael Bellman shows an unscripted image of the world and man of the Enlightenment in Sweden. In fact, the author showed the difficult condition of mortality. In the collection of works analyzed in this essay, the Swedish poet repeatedly pointed out problems that are permanently embedded in the human condition and provoke various behaviors in order to survive in the space of powerlessness of the human experience of mortality. This entire realistic world of Bellman’s texts turns out to be extremely pessimistic, because it exposes the true condition of reality, which is defined by endless loneliness, sadness and death. The second half of the 18th century revealed the pathological nature of the Swedish city functioning in the era of “moral corruption, political decay, economic ruin and desperate revelries that helped to forget about the unbearable everyday life”. In the collection of his Epistles and Songs, the Swedish poet repeatedly pointed out problems that are permanently embedded in the human condition and provoke various behaviors in order to survive in the space of powerlessness of the human experience of mortality. Bellman’s clear aversion to predetermined social rules, conventions, internal models and patterns that limit personal freedom echoes the assumptions of Cyrenaic philosophy, according to which, apart from antipathy to the rules of social functioning, bodily pleasures are the most important and are a manifestation of pure good. The author does not avoid describing the disease and the disintegration of the body as a result of it (Epistle No. 30), and a meticulous description of the changing parts of the body affected by the disease and disintegration. According to the author, to alleviate this condition, the only consolation is a sip of wine and waiting for death in full reconciliation with the absolutely just laws of nature. The author lists representatives of various social classes, enumerates their merits, titles, wealth, and psychological types, in order to make it clear in the refrain that everyone, without exception, will face the same final act of existence – “one path written for us” – death.

Introduction to Fatal Years 30 Years Later: New Research On Child Mortality in the Past Special Issue

Abstract2021 marked the 30-year anniversary of the publication Fatal Years: Child Mortality in the late Nineteenth-Century United States, a pioneering work in historical demography by Samuel H. Preston and Michael R. Haines. This special issue showcases the current state of historical mortality studies through a collection of articles originally presented at two commemorative sessions at the 2021 meeting of the Social Science History Association. It provides new and more nuanced evidence on several of the major themes of Fatal Years in terms of the mortality experience and includes studies of a wide range of contexts, from North America, to Ireland, England and Wales, and continental Europe. They all bring new evidence and leverage the dramatic development that has taken place in availability of large-scale micro-level data in the 30 years since Fatal Years was published. This introduction first provides some background to the collection and then summarizes the main findings from the different articles included. Preston and Haines provide a coda to this collection with a short reflection article on researching and writing Fatal Years.

Hospital Mortality and Trainee Experiences: How General Medical Council Survey Findings Correlate With Summary Hospital-Level Mortality Indicator.

This study aimed to investigate whether components of junior doctor satisfaction are associated with patient mortality within the United Kingdom. We conducted a cross-sectional study of publicly available data (the General Medical Council [GMC] National Survey and the Summary Hospital-level Mortality Indicator [SHMI]) pertaining to subjective physician trainee satisfaction and patient mortality within 80 United Kingdom-based healthcare institutions. The direction and strength of correlation between components of the GMC National Survey and relative patient mortality as described by the SHMI were calculated. Additional outcomes included mean GMC survey scores for reported domains and mean SHMI by healthcare institution. SHMI for included healthcare institutions ranged from 0.69 to 1.21 (mean [SD], 1.01 [0.1]). Mean GMC domain scores ranged between 44.61 and 88.62 (mean [SD], 71.16 [10.84]). Statistically significant correlations were observed for clinical supervision, clinical supervision out of hours, rota design, overall satisfaction, and teamwork. After application of Bonferroni correction, statistically significant correlations remained for both clinical supervision and clinical supervision out of hours. There is a significant association between components of subjective trainee satisfaction and patient mortality within the United Kingdom. Further investigation to examine these relationships, perhaps to target intervention, may prevent avoidable patient harm.

There is the Beach, There is the Ocean

My work investigates our complex cultural relationship with Nature with a capital "N", in particular the fantasy of tropical space: a collage of impressions and desires which ossify into a psychological 'elsewhere' that is in fact no place at all. By making images that simultaneously trigger and violate romantic tropes, I attempt to reverse the gaze of the tourist back onto itself. This essay describes the process by which I became a tropical tourist at the age of six, the year that I found my father’s heart-attacked body on our kitchen floor. This early experience of mortality, coupled with yearly family trips to the beach, created the representational code by which I now work out poetic relationships with desire and loss.

Subjective Well-Being and Active Life Expectancy in Japan: Evidence From a Longitudinal Study.

Existing research has suggested that older adults in Japan enjoy phenomenal physical health status, but they have poor subjective well-being (SWB). Limited empirical evidence exists, however, on how physical health and SWB intersect and are linked to the lives of older men and women in Japan. Using the concept of health expectancy, this study examines the role of SWB, as measured by life satisfaction, in the mortality and morbidity experiences of Japanese adults aged 65 years and older. We used the nationally representative Nihon University Japanese Longitudinal Study of Aging, 1999-2009. Our measurement of morbidity is disability, based on difficulty in activities in daily living (ADLs) and instrumental ADLs. We use the Interpolation of Markov Chains approach to compute life expectancy (LE), LE without disability (active LE), and LE with differing severity of disability for those who are satisfied with life and for those who are not. We documented significant differences in LE and active LE by the state of life satisfaction among older adults in Japan. Men and women who are satisfied with life are expected to live longer and spend more years without having disability compared to those who are not satisfied. We found no differences in the length of life with disability of differing severity by the state of life satisfaction. Our results highlight the important role of SWB at older ages in Japan, because it is directly related to the physical health of its aging population. Fully understanding the health of the older population requires research that focuses on both objective and subjective dimensions of well-being.

Reduced Vascular Disease Mortality Associated with Improved 5‐Year Survival in an AD Cohort Followed for 25 years

AbstractBackgroundIt is important to monitor all‐cause and cause‐specific mortality in AD cohorts to assess impacts of new therapies and advances in management of co‐morbidities.MethodWe compared all‐cause and cause‐specific morality in four cohorts of Alzheimer’s disease (AD) patients ≥ 65 years old followed in an academic memory center from 1995‐2019. Patients’ clinical and neuropsychological histories were obtained from an electronic data base. Vital status and cause of death through 2019 were ascertained using the National Death Index (NDI). Cohorts were defined based on enrollment date (1995‐1999, 2000‐2004, 2005‐2009, 2010‐2014). Hazard ratios (HRs) for five‐year all‐cause and cause‐specific mortality were compared across cohorts using Cox proportional hazards and competing risks regression, adjusting for age, sex, education, duration of symptoms at baseline, history of vascular disease, and baseline MMSE score.Result713 patients met selection criteria, and 686 deaths occurred within five years of baseline. Mean age at baseline was 78.7 ±6.5 and mean age at death was 82.2 ± 6.4 years. AD/Dementia accounted for proportionally more deaths over time: 39%, 46%, 55%, and 58% of deaths in Cohorts 1‐4 respectively. All‐cause mortality was significantly lower in Cohort 4 than in Cohorts 1‐3 (HR Cohort 2vs1 = .99±.10, p = .97; HR Cohort 3vs1 = .95±.09, p = .62; HR Cohort 4vs1 = .63±.07; p = . &lt;001). There was a temporal trend toward reduced CVD mortality (HR Cohort 2vs1 = .69±.14; p = .06; HR Cohort 3vs1 = .67±.13; p = .04; HR Cohort 4vs1 = .40 ±.10; p = .001).ConclusionThe increasing proportion of AD deaths and increased survival in Cohort 4 is likely due to decreases in CVD mortality. The mortality experience of Cohort 4 can serve as a benchmark for future trends, particularly as new therapies are approved and impacts of the Sars‐CoV2 epidemic are observed.

Mortality among mine and mill workers exposed to respirable crystalline silica.

BackgroundMillions of workers are potentially exposed to respirable crystalline silica (RCS) which has been associated with several diseases. We updated the mortality experience of a cohort of 2,650 mine and mill workers at four manufacturing facilities to assess cause-specific mortality risks associated with estimated cumulative RCS exposure.MethodsStudy eligibility was defined as any employee who had ≥1 year of service by 2000, with work history experience available from 1945 through 2004. Vital status and cause of death were ascertained from 1945 through 2015. RCS exposure was estimated across plant-, department-, job-, and time-dependent categories using historic industrial hygiene sampling data and professional judgment. Associations between cumulative RCS (mg/m3-years) and cause-specific mortality were examined using Cox proportional hazard regression models.ResultsIn the exposure-response analysis defined on quartiles of cumulative RCS exposure, no increasing trend (ptrend = 0.37) in lung cancer mortality (n = 116 deaths) was observed (Hazard ratio (HR) = 1.00 (referent), 1.20, 1.85, 0.92). Mortality risk for non-malignant respiratory disease was increased across quartiles (HR = 1.00, 1.35, 1.89, 1.70; ptrend = 0.15), based on 83 deaths. Non-malignant renal disease mortality was increased across quartiles (HR = 1.00, 6.64, 3.79, 3.29; ptrend = 0.11), based on 26 deaths.ConclusionsAfter nearly seven decades of follow-up, the exposure-response analyses showed no evidence of a positive trend for lung cancer, and limited evidence of a trend for non-malignant respiratory disease, and non-malignant renal disease mortality as a result of cumulative RCS exposure in this occupational cohort.

Association of socioeconomic deprivation with life expectancy and all-cause mortality in Spain, 2011–2013

Life tables summarise a population’s mortality experience during a time period. Sex- and age-specific life tables are needed to compute various cancer survival measures. However, mortality rates vary according to socioeconomic status. We present sex- and age-specific life tables based on socioeconomic status at the census tract level in Spain during 2011–2013 that will allow estimating cancer relative survival estimates and life expectancy measures by socioeconomic status. Population and mortality data were obtained from the Spanish Statistical Office. Socioeconomic level was measured using the Spanish Deprivation Index by census tract. We produced sex- and age-specific life expectancies at birth by quintiles of deprivation, and life tables by census tract and province. Life expectancy at birth was higher among women than among men. Women and men in the most deprived census tracts in Spain lived 3.2 and 3.8 years less than their counterparts in the least deprived areas. A higher life expectancy in the northern regions of Spain was discovered. Life expectancy was higher in provincial capitals than in rural areas. We found a significant life expectancy gap and geographical variation by sex and socioeconomic status in Spain. The gap was more pronounced among men than among women. Understanding the association between life expectancy and socioeconomic status could help in developing appropriate public health programs. Furthermore, the life tables we produced are needed to estimate cancer specific survival measures by socioeconomic status. Therefore, they are important for cancer control in Spain.