Potential Years Of Life Lost Rate Research Articles

Liver cancer in China: the analysis of mortality and burden of disease trends from 2008 to 2021

BackgroundLiver cancer is one of the most common cancers in China. To understand the basic death situation and disease burden change trend, we analyze the death information of liver cancer among Chinese residents from 2008 to 2021.MethodsData was collected from the Cause-of-Death Surveillance dataset of the National Cause-of-Death Surveillance System from 2008 to 2021. Excel 2016 was used for data entry and to calculate the Crude Mortality Rate (CMR), Age-Standardized Mortality Rate (ASMR), Potential Years of Life Lost (PYLL), and Potential Years of Life Lost Rate (PYLLR). SPSS 25.0 was used to statistically analyze CMR, ASMR, PYLL, and other indicators. Annual percent change (APC) and average APC(AAPC) was used for trend analysis and tested by t tests. Joinpoint 4.9.1.0 was used to calculate APC and AAPC. Age-Period-Cohort model was used to assess the effects of age, period, and birth cohort on liver cancer mortality.ResultsFrom 2008 to 2021, 491,701 liver cancer deaths were reported in the National Disease Surveillance Points System. The ASMR of liver cancer in Chinese residents decreased from 27.58/100,000 in 2008 to 17.95/100,000 in 2021 at an average annual rate of 3.40% (t = -5.10, P < 0.001). The mortality rate was higher in males than in females (all P < 0.001) and higher in rural areas than in urban areas (all P < 0.001). The mortality rate of liver cancer varied significantly among eastern, central, and western China (all P < 0.001). The PYLLR of liver cancer in Chinese residents decreased from 2.89‰ in 2008 to 2.06‰ in 2021 at an average annual rate of 2.40% (t = -5.10, P < 0.001). Males had a lower PYLLR than females, decreasing at average annual rates of 2.20% (t = -5.40, P < 0.001) and 2.90% (t = -8.40, P < 0.001), respectively. Urban areas had a lower PYLLR than rural areas, decreasing at average annual rate of 3.30% (t = -4.00, P < 0.001) and 2.50% (t = -11.60, P < 0.001), respectively. Eastern, central, and western China decreased at average annual rates of 3.40%, 2.30%, and 2.10%, respectively (t = -7.80, -3.60, -7.10, P < 0.001 for all). The risk of China liver cancer mortality increased with age, decreased with birth cohort.ConclusionsThe mortality and disease burdens of liver cancer in China decreased yearly and were higher in males and in people living in rural areas, with significant differences among those living in eastern, central, and western China.

Years of Potential Life Lost due to COVID-19 according to race/color and gender in Brazil between 2020 and 2021.

Mortality caused by the COVID-19 pandemic has impacted indicators of Years of Potential Life Lost (YPLL) worldwide. This study aimed to estimate the YPLL due to mortality caused by COVID-19, according to sex, age group, and race/color in Brazil, from March 2020 to December 2021. Deaths caused by COVID-19 were characterized, in which the rates and ratios of standardized YPLL rates, the average number of years of potential life lost (ANYPLL), and the average age at death (AAD) were estimated and compared. Overall, 13,776,969.50 potential years of life were lost, which resulted in an average loss of 22.5 potential years not lived. A greater loss of potential years of life was identified in men (58.12%) and in the age groups from 0 to 59 years in the black (58.92%) and indigenous (63.35%) populations, while in the age groups of 60 years and over, a greater loss of YPLL was observed in the white (45.89%) and yellow (53.22%) populations. Women recorded the highest ADD, with the exception of indigenous women. White men (1.63), brown men (1.59), and black men (1.61) had the highest rates when compared to white women. Although COVID-19 has a greater impact on the elderly, it was the black and indigenous populations under the age of 60 who had the greatest loss of potential years of life.

Cancer mortality and premature deaths among hairdressers in Brazil

Hairdresser is an occupation classified by the International Agency for Research on Cancer as probably carcinogenic (Group 2A) for lung and bladder cancer, but evidence is accumulating on its association with other cancer types. To our knowledge, this is the first study aimed to compare the cancer mortality and premature mortality between hairdressers and other workers in Brazil. Methods: In this exploratory study, information on deaths by selected cancers that occurred in Brazil, from 1996 to 2020, among workers aged 20-70y, with identified occupation was gathered from the Brazilian Mortality Information System. Sociodemographic characteristics, sex-specific mortality ratio, and Years of Potential Life Lost (YPLL) were compared between hairdressers, service workers, and general workers. We used logistic regression models to estimate crude (ORC) and adjusted (ORADJ) odds ratios. Models were adjusted by age, educational level, and ethnicity. We also used Poisson regression models to compare the YPLL rates across the occupational groups. Results: From 1996 to 2020, 23 557 deaths occurred among hairdressers, 576 428 among service workers, and 13 332 996 among general workers in Brazil. Higher mortality ORs and YPLL were observed for several types of cancer among hairdressers, compared to service and general workers, especially for women. Hairdressers' mortality was significantly higher among whites, women, younger workers, and those who completed high school. Female hairdressers had significantly higher odds of dying from cancer of the digestive, respiratory, reproductive, urinary, and hematological systems, both in crude and adjusted models. For male hairdressers, higher odds were found only for urinary tract and bladder cancer, while other significant associations indicated lower mortality than the comparison groups. YPLL analyses revealed significant premature deaths among Brazilian hairdressers. In women, this was more evident among those who died of neoplasms of salivary glands, bones and articular cartilages, and acute lymphoid leukemia; in men, tongue, pharynx, and thyroid. Conclusions: Our results suggest that Brazilian female hairdressers are more likely to die from several cancers, with potential consequences on premature deaths. Causal associations to occupational risks, such as exposure to chemicals, should be investigated by observational epidemiologic studies. Meanwhile, it is important to promote public policies, regulations, and Occupational Safety and Health (OSH) strategies to protect hairdressers’ health, mitigate occupational risks, and ensure safe workplaces.

A Comprehensive 16-Year Analysis of National Center for Health Statistics Data on the Top Three Causes of Death Before Age 75 by Sex, Race, and Hispanic Origin.

This study aimed to conduct a comprehensive 16-year analysis of years of potential life lost (YPLL) due to leading causes of death in the United States, focusing on disparities by sex, race/ethnicity, and specific causes of death using the National Center for Health Statistics (NCHS) data. Data from the NCHS spanning 2000-2016 were included. Age-adjusted YPLL rates per 100,000 population were analyzed, stratified by sex, race/ethnicity, and leading causes of death, including malignant neoplasms, heart disease, and cerebrovascular diseases. Over 16 years, the total YPLL rate was 7,036.2 per 100,000 population. Males had a higher YPLL rate (8,852.5 per 100,000) than females (5,259.9 per 100,000). Among racial/ethnic groups, Black/African Americans had the highest YPLL rate (10,896.8 per 100,000), followed by American Indian/Alaska Natives (7,310.0 per 100,000), Hispanics/Latinos (5,256.8 per 100,000), and Asians/Pacific Islanders (3,279.7 per 100,000). Leading causes included malignant neoplasms (1,451.6 per 100,000), heart diseases (1,055.4 per 100,000), and cerebrovascular diseases (182.3 per 100,000). This analysis spanning 16 years highlights notable disparities in YPLLrates among different demographic groups. These differences are evident in the YPLL rates for males, which are higher than those for females. The YPLL rate is most pronounced among Black/African Americans, followed by American Indian/Alaska Natives, Hispanics/Latinos, and Asians/Pacific Islanders. The primary contributors to YPLL are malignant neoplasms, heart diseases, and cerebrovascular diseases. These findings emphasize the importance of addressing these disparities to enhance public health outcomes and mitigate the premature loss of life.Despite progress, disparities persist, highlighting the need for targeted interventions and further research.

Disease burden and health risk to rural communities of northeastern India from indoor cooking-related exposure to parent, oxygenated and alkylated PAHs

Exposure to a total of 51 targeted and non-targeted polycyclic aromatic hydrocarbons (PAHs) and their oxygenated and alkylated derivatives associated with size-segregated aerosol was investigated in rural kitchens using liquefied petroleum gas (LPG), mixed biomass (MB) and firewood (FW) fuels in northeastern India. The averaged PM10-associated parent-, alkylated-, and oxygenated-PAHs concentrations increased notably from LPG (257, 54, and 116 ng m−3) to MB (838, 119, and 272 ng m−3) to FW-using kitchens (2762, 225, and 554 ng m−3), respectively. PAHs were preferentially associated with the PM1 fraction with contributions increasing from 80 % in LPG to 86 % in MB and 90 % in FW-using kitchens, which in turn was dominated by <0.25 μm particles (54–75 % of the total). A clear profile of enrichment of low-molecular weight PAHs in cleaner fuels (LPG) and a contrasting enrichment of high-molecular weight PAHs in biomass-based fuels was noted. The averaged internal dose of Benzo[a]pyrene equivalent was the lowest in the case of LPG (19 ng m−3), followed by MB (161 ng m−3) and the highest in FW users (782 ng m−3). Estimation of incremental lifetime cancer risk (ILCR) from PAH exposure revealed extremely high cancer risk in biomass users (factors of 8–40) compared to LPG. The potential years of life lost (PYLL) and PYLL rate averaged across kitchen categories was higher for lung cancer (PYLL: 10.55 ± 1.04 years; PYLL rate: 204 ± 426) compared to upper respiratory tract cancer (PYLL: 10.02 ± 0.05 years; PYLL rate: 4 ± 7), and the PYLL rates for biomass users were higher by factors of 9–56 as compared to LPG users. These findings stress the need for accelerated governmental intervention to ensure a quick transition from traditional biomass-based fuels to cleaner alternatives for the rural population of northeastern India.

Fatal, non-fatal burden of cancer in the elderly in China, 2005–2016: a nationwide registry-based study

BackgroundAs populations age, cancer burden becomes increasingly conspicuous. This study quantified the cancer burden of the elderly (≥ 60 years) in China, based on the China Cancer Registry Annual Report to provide epidemiological evidence for cancer prevention and control.MethodsData on cancer cases and deaths among the elderly aged ≥ 60 years were collected from the China Cancer Registry Annual Report, 2008–2019. Potential years of life lost (PYLL) and disability-adjusted life years (DALY) were calculated to analyze fatalities and the non-fatal burden. The time trend was analyzed using the Joinpoint model.ResultsFrom 2005 to 2016, the PYLL rate of cancer in the elderly was stable between 45.34‰ and 47.62‰, but the DALY rate for cancer decreased at an average annual rate of 1.18% (95% CI: 0.84–1.52%). The non-fatal cancer burden in the rural elderly was higher than that of the urban elderly. Lung, gastric, liver, esophageal, and colorectal cancers were the main cancers causing the cancer burden in the elderly, and accounted for 74.3% of DALYs. The DALY rate of lung cancer in females in the 60–64 age group increased (annual percentage change [APC] = 1.14%, 95% CI: 0.10–1.82%). Female breast cancer was one of the top five cancers in the 60–64 age group, with DALY rates that also increased (APC = 2.17%, 95% CI: 1.35–3.01%). With increasing age, the burden of liver cancer decreased, while that of colorectal cancer rose.ConclusionsFrom 2005 to 2016, the cancer burden in the elderly in China decreased, mainly reflected in the non-fatal burden. Female breast and liver cancer were a more serious burden in the younger elderly, while colorectal cancer burden was mainly observed in the older elderly.

Understanding population exposure to size-segregated aerosol and associated trace elements during residential cooking in northeastern India: Implications for disease burden and health risk

Mass-size distribution of respirable aerosol and 13 associated trace elements (TEs) were investigated in rural kitchens using liquefied petroleum gas (LPG), firewood and mixed biomass fuels across three northeastern Indian states. The averaged PM10 (particulate matter with aerodynamic diameter ≤ 10 μm) and ΣTE concentrations were 403 and 30 μg m−3 for LPG, 2429 and 55 μg m−3 for firewood, and 1024 and 44 μg m−3 for mixed biomass-using kitchens. Mass-size distributions were tri-modal with peaks in the ultrafine (0.05–0.08 μm), accumulation (0.20–1.05 μm), and coarse (3.20–4.57 μm) modes. Respiratory deposition, estimated using the multiple path particle dosimetry model, ranged from 21 % to 58 % of the total concentration across fuel types and population age categories. Head, followed by pulmonary and tracheobronchial, was the most vulnerable deposition region, and children were the most susceptible age group. Inhalation risk assessment of TEs revealed significant non-carcinogenic as well as carcinogenic risk, especially for biomass fuel users. The potential years of life lost (PYLL) was the highest for chronic obstructive pulmonary disease (COPD: 15.9 ± 3.8 years) followed by lung cancer (10.3 ± 0.3 years) and pneumonia (10.1 ± 0.1 years), while the PYLL rate was also highest for COPD, with Cr(VI) being the major contributor. Overall, these findings reveal the significant health burden faced by the northeastern Indian population from indoor cooking using solid biomass fuels.

Excess mortality from COVID 19 in Costa Rica: a registry based study using Poisson regression

Official death toll related to COVID-19 has been considerably underestimated in reports from some Latin American countries. This study aimed to analyze the mortality associated with the COVID-19 pandemic in Costa Rica between March 2020 and December2021. A registry based study based on 2017-2021 data from the National Institute of Statistics and Census was designed (N=128,106). Excess deaths were defined by the WHO as "the difference in the total number of deaths in a crisis compared to those expected under normal conditions"; and were estimated using a Poisson regression, and mortality and years of potential life lost (YPLL) rates were calculated. The COVID-19 pandemic represented 15% of the deaths in Costa Rica between March 2020 and December 2021. The mortality rate related to COVID-19 was 83 per 100,000 person-years. Between March and July 2020 (low-incidence period), observed number of deaths was 9%-lower than expected, whereas it was 15% and 24% higher than expected between July 2020 and March 2021 (high incidence period - no vaccination), and between March 2021 and December 2021 (high incidence period - progressive vaccination) respectively. Between July 2020 and December 2021, excess deaths observed and COVID-19 deaths reported were comparable (7461 and 7620 respectively). Nevertheless, there were more deaths than expected for conditions that predispose to COVID-19 deaths. YPLL and mortality rates increased with age, but significant excess deaths were observed in all age-groups older than 30-39 years. No large differences were noted by districts' socioeconomic characteristics although excess death rate was lower in rural compared to urban areas. Reporting of deaths was only slightly underestimated. In the pre-vaccination period, mortality rate and YPLL rates increased with age, being highest in people aged 60 years or older and justifying the decision to initially prioritize vaccination of older individuals. The study was supported by the University of Costa Rica and the Agencia Costarricense de Investigaciones Biomédicas - Fundación Inciensa.

Systemic sclerosis mortality trends in Spain from 1980 to 2019: age-period-cohort and joinpoint analysis.

Systemic sclerosis (SSc) is an autoimmune chronic rheumatic disease with a high mortality rate, which continues to be a challenge for clinicians today. To assess changes in mortality trends in the Spanish SSc population between 1980 and 2019, taking into account the independent effects of sex, age, time period and birth cohort. SSc death records and mid-year population data were collected from the National Statistics Institute. Age-standardized mortality rates were calculated for the overall population and for each sex (male, female) and age group (5-year groups). Significant changes in mortality trends were identified by joinpoint regressions. An age-period-cohort (APC) analysis and potential years of life lost (PYLL) analysis were performed to identify the burden of SSc. Age-standardized mortality rates due to SSc increased from 1.87 (95% CI 1.00-3.02) per 1 000 000 inhabitants between 1980 and 1984, to 2.47 (95% CI 1.74-3.02) per 1 000 000 inhabitants between 2015 and 2019. The relative risk of mortality fell in all groups in cohorts born after 1990. The PYLL rates showed a gradual rise for both sexes. There was an increase in overall SSc mortality in Spain during the 39 years evaluated, although there was a progressive drop for men.

Analysis of death causes of residents in poverty-stricken Areas in 2020: take Liangshan Yi Autonomous Prefecture in China as an example

BackgroundContinuous surveillance of death can measure health status of the population, reflect social development of a region, thus promote health service development in the region and improve the health level of local residents. Liangshan Yi Autonomous Prefecture was a poverty-stricken region in Sichuan province, China. While at the end of 2020, as the announcement of its last seven former severely impoverished counties had shaken off poverty, Liangshan declared victory against poverty. Since it is well known that the mortality and cause of death structure will undergo some undesirable changes as the economy develops, this study aimed to reveal the distribution of deaths, as well as analyze the latest mortality and death causes distribution characteristics in Liangshan in 2020, so as to provide references for the decision-making on health policies and the distribution of health resources in global poverty-stricken areas.MethodsLiangshan carried out the investigation on underreporting deaths among population in its 11 counties in 2018, and combined with the partially available data from underreporting deaths investigation data in 2020 and the field experience, we have estimated the underreporting rates of death in 2020 using capture-recapture (CRC) method. The crude mortality rate, age-standardized mortality rate, proportion and rank of the death causes, potential years of life lost (PYLL), average years of life lost (AYLL), potential years of life lost rate (PYLLR), standardized potential years of life lost (SPYLL), premature mortality from non-communicable diseases (premature NCD mortality), life expectancy and cause-eliminated life expectancy were estimated and corrected.ResultsIn 2020, Liangshan reported a total of 16,850 deaths, with a crude mortality rate of 608.75/100,000 and an age-standardized mortality rate of 633.50/100,000. Male mortality was higher than female mortality, while 0-year-old mortality of men was lower than women’s. The former severely impoverished counties’ age-standardized mortality and 0-year-old mortality were higher than those of the non-impoverished counties. The main cause of death spectrum was noncommunicable diseases (NCDs), and the premature NCD mortality of four major NCDs were 14.26% for the overall population, 19.16% for men and 9.27% for women. In the overall population, the top five death causes were heart diseases (112.07/100,000), respiratory diseases (105.85/100,000), cerebrovascular diseases (87.03/100,000), malignant tumors (73.92/100,000) and injury (43.89/100,000). Injury (64,216.78 person years), malignant tumors (41,478.33 person years) and heart diseases (29,647.83 person years) had the greatest burden on residents in Liangshan, and at the same time, the burden of most death causes on men were greater than those on women. The life expectancy was 76.25 years for overall population, 72.92 years for men and 80.17 years for women, respectively, all higher than the global level (73.3, 70.8 and 75.9 years).ConclusionsTaking Liangshan in China as an example, this study analyzed the latest death situation in poverty-stricken areas, and proposed suggestions on the formulation of health policies in other poverty-stricken areas both at home and abroad.

Premature mortality attributable to COVID-19: potential years of life lost in 17 countries around the world, January\u2013August 2020

BackgroundUnderstanding the impact of the burden of COVID-19 is key to successfully navigating the COVID-19 pandemic. As part of a larger investigation on COVID-19 mortality impact, this study aims to estimate the Potential Years of Life Lost (PYLL) in 17 countries and territories across the world (Australia, Brazil, Cape Verde, Colombia, Cyprus, France, Georgia, Israel, Kazakhstan, Peru, Norway, England & Wales, Scotland, Slovenia, Sweden, Ukraine, and the United States [USA]).MethodsAge- and sex-specific COVID-19 death numbers from primary national sources were collected by an international research consortium. The study period was established based on the availability of data from the inception of the pandemic to the end of August 2020. The PYLL for each country were computed using 80 years as the maximum life expectancy.ResultsAs of August 2020, 442,677 (range: 18–185,083) deaths attributed to COVID-19 were recorded in 17 countries which translated to 4,210,654 (range: 112–1,554,225) PYLL. The average PYLL per death was 8.7 years, with substantial variation ranging from 2.7 years in Australia to 19.3 PYLL in Ukraine. North and South American countries as well as England & Wales, Scotland and Sweden experienced the highest PYLL per 100,000 population; whereas Australia, Slovenia and Georgia experienced the lowest. Overall, males experienced higher PYLL rate and higher PYLL per death than females. In most countries, most of the PYLL were observed for people aged over 60 or 65 years, irrespective of sex. Yet, Brazil, Cape Verde, Colombia, Israel, Peru, Scotland, Ukraine, and the USA concentrated most PYLL in younger age groups.ConclusionsOur results highlight the role of PYLL as a tool to understand the impact of COVID-19 on demographic groups within and across countries, guiding preventive measures to protect these groups under the ongoing pandemic. Continuous monitoring of PYLL is therefore needed to better understand the burden of COVID-19 in terms of premature mortality.

Mortality trend and analysis of potential years of life lost due to leukemia and lymphoma in Brazil and Mato Grosso.

To estimate the mortality trend and to analyze the potential years of life lost (PYLL) due to leukemias and lymphomas in Brazil and Mato Grosso, from 2001 to 2019. Time-series study on deaths from leukemias and lymphomas with data obtained from the Mortality Information System. Trends were calculated by age group by the Joinpoint regression method, using calendar year as regressor variable, estimated annual percentage change (APC) and mean annual percentage change, considering 95% confidence intervals. PYLL rates were collected from the Cancer Mortality Atlas. In Brazil, the mortality rate trend remained stable for both diseases in the period: leukemias (APC=0.2; 95%CI 0.0-0.3) and lymphomas (APC=0.2; 95%CI 0.4-0.1). In Mato Grosso state, the rate for leukemias was also stable (APC=0.3; 95%CI 1.0-1.6). For lymphomas, the trend was ascendant (APC=2.3; 95%CI 0.5-4.2), but descending among people younger than 59 years. For leukemias, PYLL rates were 64 and 65/100,000 in Brazil and Mato Grosso, respectively. For lymphomas, 27 and 22/100,000, respectively, with the highest rates found among males. The behavior of mortality rates from leukemia and lymphoma in Mato Grosso was different from that observed nationally, with an upward trend for lymphomas and no differences between age groups for both diseases. PYLL rates for leukemias were similar, while for lymphomas they were higher among men and lower in Mato Grosso when compared to Brazil.

Years of potential life lost among the population: Is YPLL analysis a helpful tool?

Mortality is one of the key determinants of the demographic development of the Republic of Srpska (RS). In the last 20 years, there has been an increase in the mortality rate, especially in the older population. Years of potential life lost (YPLL) were used in this study as a measure of the premature mortality of the population of the RS. The reference age limit is set at 70 years of age, therefore, premature mortality refers to all deaths in the age range from 0 to 69 years. The time frame includes a period of 20 years (1998-2018). The subject of the research is the YPLL analysis of the population of the RS, with a special emphasis on the causes of death. The study aims to determine the differences in YPLL according to gender and cause of death, as well as to indicate the factors influencing differential premature mortality. The results of the research indicate a decrease in YPLL by about 40%. Higher YPLL rates were registered in males. Differentiation according to the cause of death showed low values of YPLL in non-communicable diseases, while high rates were recorded in violent deaths. The decrease in the YPLL rate is a consequence of the reduction of infant mortality and violent deaths, while high values in males are a consequence of the influence of risk factors. Reducing these factors can have a significant impact on reducing YPLL rates among the population of the RS.

Years of potential life lost due to AIDS in female, in Southern Brazil: a descriptive study, 2007-2017.

to describe the years of potential life lost (YPLL) due to AIDS among the female population and analyze its association with race/skin color and social vulnerability indicators in Porto Alegre, capital city of the state of Rio Grande do Sul, Brazil. this was a descriptive study that took into consideration AIDS deaths in female between 2007 and 2017; data were obtained from the Mortality Information System; crude values and YPLL rates per 1,000 deaths were calculated, taking into consideration health districts and race/skin color. of the 1,539 deaths, approximately 51,000 years of potential life were estimated, representing 86.5 years lost/1,000 female; it could be seen a higher proportion of deaths among female of White race/ skin color (53.4%); however, a higher rate of YPLL was found among female of Black and mixed race/skin color living in regions of greater vulnerability. the results suggest the impact of racial inequalities on the decrease in years of potential life due to AIDS deaths.

Potential years of life lost due to PM2.5-bound toxic metal exposure: Spatial patterns across 60 cities in China

To clarify the spatial patterns of disease burden caused by toxic metals in fine particulate matter (PM2.5) across China, annual concentration levels of typical toxic metals in PM2.5 over 60 cities of China were retrieved. Then, potential years of life lost (PYLL) attributable to toxic metal (As, Cd, Cr (VI), Mn, and Ni) exposure was calculated from health risk assessments and lifetable estimates. The results show that Cr(VI) and As were the most polluted metals and greatly exceeded the recommended annual values in the National Ambient Air Quality Standard of China. PYLL for each death (mean ± standard deviation) of 19.8 ± 4.5 years was observed for lung cancer, followed closely by COPD and pneumonia. Furthermore, the PYLL rate (years per 100,000 people) attributable to exposure to these toxic metals was 457 (male: 505, female: 402) years for different cities; therein, Cr(VI) contributed the highest PYLL among these toxic metals, with a proportion of 72.7% (male: 75.3%, female: 69.5%), followed by As of 16.4% (male: 13.8%, female: 19.8%). The concentration level and PYLL both showed large spatial variability, of which the top-ranking cities were observed to be affected by well-developed metal-related industries and coal-powered industrial sectors.

53. Sex and Race Disparities in Premature Mortality among People with HIV: A 21-Year Observational Cohort Study

BackgroundSince the availability of antiretroviral therapy, mortality rates among people with HIV (PWH) have decreased; however, this trend may fail to quantify premature deaths among PWH. We assessed trends and disparities in all-cause and premature mortality by sex, HIV risk factor, and race, among PWH receiving care at the Vanderbilt Comprehensive Care Clinic from January 1998 – December 2018.MethodsWe examined mortality trends across calendar eras using person-time from clinic entry to date of death or December 31, 2018. We compared mortality rates by demographic and clinical factors and calculated adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CI) using multivariable Poisson regression. For individuals who died, years of potential life lost (YPLL) were obtained from the expected years of life remaining by referencing US sex-specific period life tables at age and year of death; age-adjusted YPLL (aYPLL) rates were also calculated. We examined patient factors associated with YPLL using multivariable linear regression. ResultsAmong the 6,531 individuals (51% non-Hispanic [NH] White race, 40% NH Black race, 21% female) included, 956 (14.6%) died. Mortality rates dramatically decreased during the study period (Figure). After adjusting for calendar era, age, injection drug use, hepatitis C virus (HCV), year of HIV diagnosis, history of AIDS-defining illness, CD4 cell count, and HIV RNA at clinic entry, only female sex (aIRR=1.32, 95% CI: 1.13–1.55 vs. males) but not NH Black race (aIRR=1.02, 95% CI: 0.88–1.17 vs. NH White race) was associated with increased mortality. In contrast, aYPLL per 1,000-person years was significantly higher for both female and NH Black PWH (Table 1). In adjusted models including CD4 cell count, HIV RNA, HCV, and year of clinic entry, higher YPLL remained associated with NH Black race, female sex regardless of HIV risk factor, and younger age at HIV diagnosis (Table 2). ConclusionDespite marked improvement over time, sex disparities in mortality as well as sex and race disparities in YPLL remained among PWH in care in this cohort. YPLL is a useful measure for examining persistent gaps in longevity and premature mortality among PWH.Disclosures Peter F. Rebeiro, PhD, MHS, Gilead (Other Financial or Material Support, Single Honorarium for an Expert Panel)

Potential life years lost to COVID-19 in 17 countries during the pandemic period, up to August 2020

BackgroundCOVID-19 pandemic is affecting populations and regions in different ways. In this study, we assess the Potential Years of Life Lost (PYLL) to COVID-19 across different regions.MethodsWe used age-group and sex-specific weekly COVID-19 deaths (from January to August 2020) from national primary sources of 17 countries from the C-MOR consortium (Australia, Brazil, Cape Verde, Colombia, Cyprus, France, Georgia, Israel, Kazakhstan, Peru, Norway, England & Wales, Scotland, Slovenia, Sweden, Ukraine, and the United States). PYLL were calculated by summing up the numbers of deaths in each age group multiplied by the remaining years of life up to age 80. Age-standardized PYLL rates (per 100,000 population), using the World (WHO 2000-2025) Standard population as the reference population, were estimated to facilitate comparison across countries.ResultsCountries in South America displayed the highest PYLL rates (567-1,377 PYLL/100,000). Countries in Asia & Middle East (besides Kazakhstan), Australia, and some European countries (Georgia, Norway, and Slovenia) observed <50 PYLL/100,000. Furthermore, the male to female PYLL rate ratio was above one in all countries [1.3 (Ukraine) - 14.4 (Cyprus)], besides Georgia (ratio = 0.5).ConclusionsSouth America, and males were found to be the most affected by COVID-19. Ongoing monitoring of the COVID-19 mortality impact is essential in order to assess health system performances, control measures, and identify vulnerable populations. Differences in mortality burden among populations will help public health officials in their efforts to minimize the COVID-19 mortality burden on a local, and on a global level.Key messages Up to August 2020, COVID-19 was a cause of premature mortality in all the participating countries, with South America and males to be more affected.The timing of the pandemic, seasonal trends, the control measures enforced, and underlying social conditions are probable explanations for the differences observed among countries.

The trend and burden of cardiovascular death in Anhui Province from 2013 to 2018

Objective To understand the characteristics and life loss of cardiovascular diseases (CVDs) among residents in Anhui Province. Methods The data of 24 surveillance points in Anhui Province from 2013 to 2018 in the national death information registration management system was collected. The mortality of CVDs was analyzed, and the change trend of CVDs mortality was tested by annual percent change (APC). Potential years of life lost (PYLL), potential years of life lost rate (PYLLR) and average years of life lost (AYLL) were used for disease burden assessment. Results From 2013 to 2018, the standardized mortality rate of CVDs in Anhui Province was 260.36/100 000, showing a decreasing trend year by year (APC%=-2.53%). The CVDs mortality rate was higher in men than in women, and higher in rural areas than in urban. And it is the highest in Northern Anhui, followed by central Anhui, and the lowest in southern Anhui. CVDs were the first cause of in the whole population (48.58%), with PYLLR of 12.86‰ and AYLL of 11.13 years. PYLLR was the highest in cerebral hemorrhage (4.69 ‰) and ischemic heart disease (4.28 ‰). AYLL ranked the top three in chronic rheumatic heart disease, cerebral hemorrhage and ischemic heart disease. Conclusion The prevention and control of CVDs in Anhui Province has received some achievement, but the burden of disease is still heavy, the prevention and control of high-risk groups should be strengthened.

Years of potential life lost due to premature death of cardiovascular diseases among residents in Suzhou from 1987 to 2017

From 1987 to 2017, cardiovascular disease (CVD) had been ranking the first cause of death in Suzhou, and the mortality rate showed an upward trend annual percentage changes (APC=0.62%, P=0.001), while the standardized mortality rate showed a downward trend (APC=-2.65%, P<0.001). The probability of premature death of CVD declined consistently from 7.06% in 1987 to 2.00% in 2017 (APC=-4.45%, P<0.001). When the life expectancy was set at 70, the potential years of life lost rate (PYLLR) decreased from 6.35‰ in 1987 to 3.30‰ in 2017, and the standardized PYLLR decreased from 7.30‰ to 2.68‰. When the life expectancy was set at 75, the PYLLR decreased from 10.12‰ to 5.19‰, and the standardized PYLLR decreased from 11.44‰ to 3.88‰. With the increase of years, all PYLLR and standardized PYLLR showed a significantly downward trend (APC=-2.51%--3.89%, P<0.001).

Long-term trends of potential years of life lost due to main causes of death in the Slovak population, 2004-2013.

The aim of this study was to evaluate trends of potential years of life lost (PYLL) rates in the Slovak population and analyze the average annual percent change (AAPC) of PYLL rates regarding the most common causes of death between 2004 and 2013. National mortality and demographic data were obtained from the Statistical Office of the Slovak Republic, and 378,535 causes of death within the period were analyzed. The PYLL values in both genders and each disease category were added up across all age groups to form annual values. For the trend analysis, the AAPC indicator was proposed. The PYLL rate is age-standardized and expressed as a sum of all deaths per 100,000. In the period 2004-2013, the highest mean PYLL rates were observed in neoplasms in the whole population (2,103 per 100,000), as well as in females (2,088 per 100,000), with a permanent high significant increase of AAPC of PYLL in both genders. The second highest mean PYLL rate in the ten-year period was related to circulatory system diseases in total (1,922 per 100,000) as well as in females (1,449 per 100,000). In males, circulatory system diseases had the highest PYLL rate (2,397 per 100,000). The PYLL rates trend regarding external causes of morbidity and mortality showed the most notable decrease in the assessed period and the AAPC of PYLL showed significant negative values both in males (-2.5%; p < 0.001) and females (-4%; p < 0.001). Our results should contribute in developing intervention programs aimed at reducing the burden of premature mortality since the main causes of premature death are associated to well-known and preventable risk factors.