Objectives: This study was to examine the influences of community characteristics on the mortality rates. Community characteristics included socioeconomic environmental characteristics, health care resources, and health lifestyle practice. Methods: This study used secondary data whose units of analyses were 249 administrative districts. Mortality rates were estimated with hierarchical regression models entered in the order of (1) socioeconomic environmental characteristics, (2) health care resources, and (3) health lifestyle practice. Results: About 70% of mortality rate was explained by socioeconomic environmental characteristics, health care resources, and health lifestyle practice. In particular, socioeconomic environmental characteristics showed the strongest impact on mortality rate. Among socioeconomic characteristics, community with lower rate of households headed with college or more, lower number of inhabitants per on-premise license, higher rate of population in poverty, and rural region showed higher mortality rate. Among health care resources, community with higher number of inhabitants per doctor and lower number of inhabitants per hospital bed showed higher mortality rate. Among health lifestyle practice, community with higher current smoking rate and lower moderate physical activity practice rate showed higher mortality rate. Conclusions: The results suggest that policy makers should take into account socioeconomic environmental characteristics of community in developing community-based health promotion rather than focusing on lifestyle changes of residents.
Fang, Jia-Ying;Dong, Hong-Li;Wu, Ku-Sheng;Du, Pei-Ling;Xu, Zhen-Xi;Lin, Kun
Asian Pacific Journal of Cancer Prevention
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제16권14호
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pp.5829-5834
/
2015
Objective: To describe and analyze the epidemiological characteristics of lung cancer mortality in China from 1991 to 2013, forecast the future five-year trend and provide scientific evidence for prevention and management of lung cancer. Materials and Methods: Mortality data for lung cancer in China from 1991 to 2013 were used to describe epidemiological characteristics. Trend surface analysis was applied to analyze the geographical distribution of lung cancer. Four models, curve estimation, time series modeling, gray modeling (GM) and joinpoint regression, were performed to forecast the trend for the future. Results: Since 1991 the mortality rate of lung cancer increased yearly. The rate for males was higher than that for females and rates in urban areas were higher than in rural areas. In addition, our results showed that the trend will continue to increase in the ensuing 5 years. The mortality rate increased from age 45-50 and peaked in the group of 85 years old. Geographical analysis indicated that people living in northeast China provinces and the coastal provinces in eastern China had a higher mortality rate for lung cancer than those living in the centre or western Chinese provinces. Conclusions: The standardized mortality rate of lung cancer has constantly increased from 1991 to 2013, and been predicted to continue in the ensuing 5 years. Further efforts should be concentrated on education of the general public to increase prevention and early detection. Much better prevention and management is needed in high mortality areas (northeastern and eastern parts of China) and high risk populations (45-50-year-olds).
Kutikhin, Anton G.;Yuzhalin, Arseniy E.;Brailovskiy, Valeriy V.;Zhivotovskiy, Alexey S.;Magarill, Yuri A.;Brusina, Elena B.
Asian Pacific Journal of Cancer Prevention
/
제13권10호
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pp.5189-5193
/
2012
Kemerovo is an industrial region of the Russian Federation characterized by highly developed mining, chemical, metallurgical and power industries. Many of the factories were closed down due to the socioeconomical crisis in the early 90's, and economic potential of the survivors has also decreased significantly. Paradoxically, this has led to the improvement of the ecological situation in the region and elimination of exposure to many chemical carcinogens. This factor, in combination with the improvement of oncological care, might be expected to have lead to a decline of cancer incidence and mortality in the region. To assess trends of cancer incidence and mortality in Kemerovo Region, we therefore carried out an analysis of relevant epidemiological data during 1991-2010. In fact, a significant increase of cancer incidence overall was revealed during 2001-2010. Male cancer incidence was significantly higher than female cancer incidence. Regarding gastric cancer incidence, statistically significant differences during 2001-2010 were found only for men, and male incidence exceeded female incidence. Concerning colorectal cancer incidence, it was lower during 2001-2005 and 2006-2010 as compared to the period of 1991-1996. Lung cancer incidence was significantly higher during 1991-2000 compared to 2001-2010. Among urban populations, cancer incidence was higher in comparison with rural population, but a gradual steady convergence of trends of cancer incidence among urban and rural populations was noted. Lung cancer, breast cancer, colorectal cancer, non-melanoma skin cancer, and gastric cancer are the most prevalent cancer forms in Kemerovo Region. There were no differences in cancer mortality between 2001-2005 and 2006-2010; however, male cancer mortality exceeded female cancer mortality. A similar situation was observed for gastric cancer, colorectal cancer, and lung cancer. Cancer mortality among urban populations exceeded mortality among rural population, for both genders. We suggest that these data can be used for development of modern programs of cancer prevention and early diagnostics in industrial regions of Siberia.
Objectives: While recent studies showed that coffee consumption reduced the risk of all-cause mortality, no study has examined the effect of coffee consumption on all-cause mortality related to sleep disorders. We aimed to examine whether sleep-related disorders would differently affect the association between coffee consumption and the risk of all-cause mortality among 8,075 adults aged 40 to 69 years. Methods: In a prospective cohort study, the study participants were biennially followed up for 12 years from 2001 to 2012. On each follow-up visit, the participants underwent comprehensive tests including anthropometric examinations, interviewer-administered questionnaires, and biochemical tests. Coffee consumption frequency and the amount were measured using a semi-quantitative food frequency questionnaire. Using death certificate data from Korean National Statistical Office, the vital status of each study participant was identified. Sleep-related disorders were examined with interviewer-administered questionnaires. We estimated Hazard ratios and the corresponding 95% confidence intervals from Cox Proportional Hazard models. Multivariable models were established after adjusting for center, total caloric intake, age, gender, body mass index, physical activity, education, smoking, drinking, hypertension, diabetes, total cholesterol, c-reactive protein, energy-adjusted food groups of refined grains, vegetables, fruits, meat, fish, and dairy. Results: Compared with those who had no coffee consumption, participants who had about three cups of coffee per day showed a reduced risk of all-cause mortality, after adjusting for covariates. Those who had a sleep-related disorder showed no significant effect of coffee consumption on the risk of all-cause mortality, whereas those who had no sleep-related disorders showed significantly reduced risk of all-cause mortality. Conclusions: Our findings suggested that approximately three cups of coffee per day would be beneficial to reduce the risk of all-cause mortality only among adults with no sleep-related disorders. Coffee consumption should be prudent for those with sleep-related symptoms.
The objective of this study was to investigate the calf death and analyse the causes of the mortality by based on medical records and autopsy findings during 10 years in a large dairy farm. Total of 1,361 calf born and 146 calf dead during the invested period. Mortality rate was 10.7% and showed the big difference by year-specific mortality from 2.8% (4 calves) to 19.2% (28 calves). The highest rate of mortality was 1 week age (18.5%, 27 calves) and followed by 2 week age (11.6%, 17 calves) and mortality of more old calf tended to be reduced. The death less than 4 weeks and 8 weeks of age of the entire mortality accounted for 41.1% (60/146 calves) and 70.0% (102/146 calves), respectively. Causes of calf death were digestive diseases (53.4%), respiratory diseases (17.1%), musculoskeletal disease (8.2%), and systemic disease (8.2%) in order. Specific causes of calf death was highest in enteritis (43.2%), followed by pneumonia (14.4%), sepsis (8.2%) and fractures (3.4%). Seasonally, most of calf death happened in winter (48.6%) and then fall (21.2%). This results showed that enteritis and pneumonia are the main reason of calf death but other reasons were involved in calf death on the based on autopsy finding. On going research relating factors of calf mortality is needed.
In this paper, an attempt has been made to examine the pattern of mortality in Korea during 1970~80. By applying the age-sex specific mortality rates quoted from 1978~79 life tables for Korea published by NBOS, EPB to those of the West pattern of regional model life tables and the far eastern pattern of model life tables for developing countries, life expectancy at birth were calculated. Also the author reviewed the trends of death rates, life expectancy and cause of death using vital registration data and other materials. Summarized results are as follows; 1. Crude death rates in Korea was reduced to one fifth in the 1983 compared to that in 1920's. Life expectancy also improved to almost double in 1985 compared to 1920's. But the difference in the life expectancy between male and female increased during that period and it was recorded as 6.4 years in 1985. This discrepancy was mainly due to the different tempo of decreasing in mortality level by sex, particularly, for the age 40 and above. 2. For the pattern of mortality in Korea, it showed that female mortality could accounted closer to the West pattern model life tables. There were high similarity between actual pattern prevalent in Korea and West pattern. And its coefficient of variance was also very low. However for the case of male, it was difficult to find the exact model life tables for explaining the actual situation on the male mortality pattern which means exist considerable dissimilarity in older ages. The Far eastern pattern of U.N. model life tables show better results than West pattern, however, the deviation of the pattern to actual was severe. Also in Far eastern pattern, high coefficient of variance was existed. Furthermore it was found in the paper that the mortality level of Korean male for the age 40 and above were much higher than that of Far eastern pattern which was reflected the high mortality of the male adult in Far east region. 3. The analysis of cause of death showed that circulatory disease such as cerebrovascular disease and hypertensive disease accounted for the leading cause of death in Korea for the age 40 and above. There should he paid special attention to chronic retrogressive diseases for the older age groups. For younger age groups, injury and poisoning were reported as important cause of death.
Lee, Sang Ah;Park, Eun-Cheol;Shin, Jaeyong;Ju, Yeong Jun;Lee, Hoo-Yeon
보건행정학회지
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제29권2호
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pp.237-244
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2019
Background: Weekend admission is known for having association with increased mortality attributed by poor quality of care and severe patients. We investigated the association between hospital admission on weekends and the in-hospital mortality rates of patients with cardiovascular disease. Furthermore, we examined this association stratified by admission via emergency room or not. Methods: We analyzed claim data provided by the Health Insurance Review & Assessment in 2013. In total, 80,817 cardiovascular patients were included in this study, which treated in-hospital mortality (early and during total length of stay) as a dependent variable. A generalized linear mixed effects model was used. We conducted subgroup analyses stratified by admission via emergency room or not. Results: Patients who admitted on weekend showed higher in-hospital mortality both early (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.23-1.78) and during total length of stay (OR, 1.17; 95% CI, 1.02-1.33) compared to those admitted on weekdays. Patients who were admitted to the hospital on a weekend by emergency room were more likely to experience early in-hospital mortality compared to those admitted on weekdays. Furthermore, we found that patients not admitted to the hospital through the emergency department were more likely to experience both early and total length of stay in-hospital mortality. Conclusion: Our study shows higher in-hospital mortality rates for cardiovascular patients admitted on weekends. Efforts to improve the quality of care on weekend are important to mitigate the 'weekend effect' and improve patient outcomes.
Background: External-cause mortality is an important public health issue worldwide. Considering its significance to workers' health and inequalities across industries, we aimed to describe the state of external-cause mortality and investigate its difference by industry in Republic of Korea based on data for 2018. Methods: Data obtained from the Statistics Korea and Korean Employment Information System were used. External causes of death were divided into three categories (suicide, transport accident, and others), and death occurred during employment period or within 90 days after unemployment was regarded as workers' death. We calculated age- and sex-standardized mortalities per 100,000, standardized mortality ratios (SMRs) compared to the general population and total workers, and mortality rate ratios (RRs) across industries using information and communication as a reference. Correlation analyses between income, education, and mortality were conducted. Results: Age- and sex-standardized external-cause mortality per 100,000 in all workers was 29.4 (suicide: 16.2, transport accident: 6.6, others: 6.6). Compared to the general population, all external-cause and suicide SMRs were significantly lower; however, there was no significant difference in transport accidents. When compared to total workers, wholesale, transportation, and business facilities management showed higher SMR for suicide, and agriculture, forestry, and fishing, mining and quarrying, construction, transportation and storage, and public administration and defense showed higher SMR for transport accidents. A moderate to strong negative correlation was observed between education level and mortality (both age- and sex-standardized mortality rates and SMR compared to the general population). Conclusion: Inequalities in external-cause mortalities from suicide, transport accidents, and other causes were found. For reducing the differences, improved policies are needed for industries with higher mortalities.
da Costa, Joao Cordeiro;Manso, Maria Conceicao;Gregorio Susana;Leite, Marcia;Pinto, Joao Moreira
Tuberculosis and Respiratory Diseases
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제85권4호
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pp.349-357
/
2022
Background: The most consistently identified mortality determinants for the new coronavirus 2019 (COVID-19) infection are aging, male sex, cardiovascular/respiratory diseases, and cancer. They were determined from heterogeneous cohorts that included patients with different disease severity and previous conditions. The main goal of this study was to determine if activities of daily living (ADL) dependence measured by Barthel's index could be a predictor for COVID-19 mortality. Methods: A prospective cohort study was performed with a consecutive sample of 340 COVID-19 patients representing patients from all over the northern region of Portugal from October 2020 to March 2021. Mortality risk factors were determined after controlling for demographics, ADL dependence, admission time, comorbidities, clinical manifestations, and delay-time for diagnosis. Central tendency measures were used to analyze continuous variables and absolute numbers (proportions) for categorical variables. For univariable analysis, we used t test, chi-square test, or Fisher exact test as appropriate (α=0.05). Multivariable analysis was performed using logistic regression. IBM SPSS version 27 statistical software was used for data analysis. Results: The cohort included 340 patients (55.3% females) with a mean age of 80.6±11.0 years. The mortality rate was 19.7%. Univariate analysis revealed that aging, ADL dependence, pneumonia, and dementia were associated with mortality and that dyslipidemia and obesity were associated with survival. In multivariable analysis, dyslipidemia (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.17-0.71) was independently associated with survival. Age ≥86 years (pooled OR, 2.239; 95% CI, 1.100-4.559), pneumonia (pooled OR, 3.00; 95% CI, 1.362-6.606), and ADL dependence (pooled OR, 6.296; 95% CI, 1.795-22.088) were significantly related to mortality (receiver operating characteristic area under the curve, 82.1%; p<0.001). Conclusion: ADL dependence, aging, and pneumonia are three main predictors for COVID-19 mortality in an elderly population.
BACKGROUND/OBJECTIVES: The long-term health impacts of dietary sugar have begun to be reported. The committee on the 2020 Dietary Reference Intakes for Koreans for sugar intended to update the scientific evidence on the association of added sugar intake with health outcomes, including mortality. This study evaluated the evidence on the association of dietary sugar with the all-cause and cardiovascular disease mortality from cohort studies. SUBJECTS/METHODS: The PubMed and ScienceDirect databases were searched until July 2021. The search terms were based on multiple combinations of keywords, such as added sugar, beverage, and mortality, included in the title or abstract. Two authors independently assessed the eligibility criteria of study selection and extracted the information from each selected article for this systematic review. RESULTS: The literature search identified 276 articles. Seventeen cohort studies met the inclusion criteria and were included in this systematic review. This study extracted information on the cohort and participants, dietary assessment methods, exposure and its comparison groups, health outcomes, and risk measures. Five articles reported added sugar intake, and 15 articles reported the food sources of the added sugar in the association with mortality. Increased mortality was observed in higher added sugar intake and a lower intake of less than 5% of energy, while higher discrepancies between gender, age groups, and countries were noted. In addition, nutritious sugary foods and beverages did not increase mortality. CONCLUSIONS: A 'U' or 'J' shaped relationship between the added sugar intake and mortality was estimated. The observed discrepancy indicated the need for more evidence to establish the dose-response relationship for Koreans.
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