Clarke, M G; Kennedy, K P; MacDonagh, R P
To develop a clinical prediction model enabling the calculation of an individual patient's life expectancy (LE) and survival probability based on age, sex, and comorbidity for use in the joint decision-making process regarding medical treatment. A computer software program was developed with a team of 3 clinicians, 2 professional actuaries, and 2 professional computer programmers. This incorporated statistical spreadsheet and database access design methods. Data sources included life insurance industry actuarial rating factor tables (public and private domain), Government Actuary Department UK life tables, professional actuarial sources, and evidence-based medical literature. The main outcome measures were numerical and graphical display of comorbidity-adjusted LE; 5-, 10-, and 15-year survival probability; in addition to generic UK population LE. Nineteen medical conditions, which impacted significantly on LE in actuarial terms and were commonly encountered in clinical practice, were incorporated in the final model. Numerical and graphical representations of statistical predictions of LE and survival probability were successfully generated for patients with either no comorbidity or a combination of the 19 medical conditions included. Validation and testing, including actuarial peer review, confirmed consistency with the data sources utilized. The evidence-based actuarial data utilized in this computer program design represent a valuable resource for use in the clinical decision-making process, where an accurate objective assessment of patient LE can so often make the difference between patients being offered or denied medical and surgical treatment. Ongoing development to incorporate additional comorbidities and enable Web-based access will enhance its use further.
Full Text Available Background: The cornerstone of mortality- and life-expectancy forecasting in developed nations, the Lee-Carter model relies on assumptions of there being a dominant singular value that captures most of the variance within a matrix of age-specific mortality rates over time and that the time trend captured by this lead singular value is constant. We revisit the model's predictive ability and trends in mortality decline among developed nations since the end of the Cold War. Objective: To understand the predictive power of the Lee-Carter model with mortality trends since 1990. Methods: Mortality data were obtained from the Human Mortality Database. Forecasts were made using R with random walk forecasts using the package forecast. Results: While Lee-Carter forecasts of life expectancy for combined sexes were accurate, sex-specific forecasts tended to somewhat overestimate for females and significantly underestimate for males. Further investigation of the trend for males shows that the first singular value continues to capture the majority of the variation in mortality since 1990, with progress along this dimension moving at a constant rate. Conclusions: Lee-Carter forecasts have significantly underestimated gains inmale life expectancy without major changes to the model's assumptions. We believe this represents more rapid progress in tackling male mortality in the G7 countries without major changes to the age pattern of these gains. Curiously, this has not affected combined-sex forecasts, potentially being offset by slight overestimation of female mortality progress. Contribution: We show that the Lee-Carter model has made inaccurate forecasts of mortality rates unrelated to violations of its underlying assumptions.
Full Text Available In this study, the relationship between life expectancy of men and women in Turkey and socio-economic variables are examined. The effect of demographic and economic factors such as the ratio of health expenditures to GDP, the ratio of elderly to employable population, the number of hospital beds per thousand people, the number of doctors per thousand patients are analyzed for a period of 1975-2009. In this study, the unit root test is initialy applied to each data set and then the cointegration test results is interpreted to determine whether a meaningful relationship exists between indicators in the long-term. Finally, the effects of the underlying factors on men and women were examined by vector error correction model. These results support that each factor has a significant effect on the life expectancy of men and women in Turkey.
Gooren, Louis J
Hormonal treatment of transgender people is becoming a normal part of medicine, though numbers of subjects remain small because of low prevalence. Information on treatment is scattered and this review brings together the latest information on treatment goals and potential side-effects of androgen treatment of female-to-male transsexual subjects. Androgen treatment of female-to-male transsexuals is usually uneventful, with a good patient compliance. Goals of hormonal treatment are elimination of secondary sex characteristics of the female sex and induction of those of the male sex. Completion takes approximately 2 years. Hormonal treatment is eventually followed by surgical ablation of breasts and removal of uterus and ovaries. Phalloplasty may be considered. Concerns are the sequelae of hypogonadism following surgery, such as loss of bone mass. Contrary to earlier expectations, there is no increase in cardiovascular disease. (Hormone-related) cancers are rare, but vaginal, cervical, endometrial carcinomas have been reported. Cancers of the breasts are of greater concern and have been found in residual mammary tissue after breast ablation. So far, androgen treatment has not raised major safety concerns. Regrets about changing sex have not been reported. Testosterone treatment of female-to-male transsexuals is effective and well tolerated.
Seifarth, Joshua E; McGowan, Cheri L; Milne, Kevin J
A sexual dimorphism in human life expectancy has existed in almost every country for as long as records have been kept. Although human life expectancy has increased each year, females still live longer, on average, than males. Undoubtedly, the reasons for the sex gap in life expectancy are multifaceted, and it has been discussed from both sociological and biological perspectives. However, even if biological factors make up only a small percentage of the determinants of the sex difference in this phenomenon, parity in average life expectancy should not be anticipated. The aim of this review is to highlight biological mechanisms that may underlie the sexual dimorphism in life expectancy. Using PubMed, ISI Web of Knowledge, and Google Scholar, as well as cited and citing reference histories of articles through August 2012, English-language articles were identified, read, and synthesized into categories that could account for biological sex differences in human life expectancy. The examination of biological mechanisms accounting for the female-based advantage in human life expectancy has been an active area of inquiry; however, it is still difficult to prove the relative importance of any 1 factor. Nonetheless, biological differences between the sexes do exist and include differences in genetic and physiological factors such as progressive skewing of X chromosome inactivation, telomere attrition, mitochondrial inheritance, hormonal and cellular responses to stress, immune function, and metabolic substrate handling among others. These factors may account for at least a part of the female advantage in human life expectancy. Despite noted gaps in sex equality, higher body fat percentages and lower physical activity levels globally at all ages, a sex-based gap in life expectancy exists in nearly every country for which data exist. There are several biological mechanisms that may contribute to explaining why females live longer than men on average, but the complexity of the
E Mohammadian akerdi
Full Text Available BACKGROUND AND OBJECTIVE: Cancers are a broad group of diseases, each having their own etiology, treatment, and prognosis. The majority of cancer patients experience a period of mental stress during their disease. Given the effective role of life expectancy in dealing with chronic diseases, such as stomach cancer, this study aimed to evaluate the effects of cognitive-behavioral group therapy on increased life expectancy of male patients with gastric cancer. METHODS: This quasi-experiment was conducted on 92 male patients with gastric cancer referring to Tuba Medical Center, Sari, Iran in 2014. Patients were randomly divided into two groups of test (n=46 and control (n=46. The two groups completed the Adult Hope Scale (AHS by Snyder in pretest stage. At the next stage, samples of the test group were exposed to 10 sessions of cognitive-behavioral group therapy (each session: 90 min, while the control group did not receive any special treatment. Both study groups completed the questionnaire again at the posttest stage, followed by the comparison of results. FINDINGS: In terms of life expectancy, mean scores of the test and control groups at the pretest stage were 37.21±4.7 and 36.26±4.73, respectively. Meanwhile, mean scores of the mentioned groups at the posttest stage were 40.02±3.87 and 36.23±4.8, respectively. A significant increase was observed in the mean scores of test and control groups at the posttest stage compared to before the intervention. Moreover, a significant difference was found between the study groups regarding life expectancy and its components (p<0.01. CONCLUSION: According to the results, cognitive-behavioral group therapy could increase life expectancy in patients with gastric cancer.
been reported previously by various authors. Though remarkable, this is simply an empirical observation. Objective: We examine best-practice life expectancy more formally by using extreme value theory. Methods: Extreme value distributions are ﬁt to the time series (1900 to 2012) of maximum life......Background: Whereas the rise in human life expectancy has been extensively studied, the evolution of maximum life expectancies, i.e., the rise in best-practice life expectancy in a group of populations, has not been examined to the same extent. The linear rise in best-practice life expectancy has...... expectancies at birth and age 65, for both sexes, using data from the Human Mortality Database and the United Nations. Conclusions: Generalized extreme value distributions offer a theoretically justiﬁed way to model best-practice life expectancies. Using this framework one can straightforwardly obtain...
This article presents an analysis of trends in mortality differentials and life expectancy by average relative earnings for male Social Security-covered workers aged 60 or older. Because average relative earnings are measured at the peak of the earnings distribution (ages 45-55), it is assumed that they act as a rough proxy for socioeconomic status. The historical literature reviewed in this analysis generally indicates that mortality differentials by socioeconomic status have not been constant over time. For this study, time trends are examined by observing how mortality differentials by average relative earnings have been changing over 29 years of successive birth cohorts that encompass roughly the first third of the 20th century. Deaths for these birth cohorts are observed at ages 60-89 from 1972 through 2001, encompassing roughly the last third of the 20th century. The large size and long span of death observations allow for disaggregation by age and year-of-birth groups in the estimation of mortality differentials by socioeconomic status. This study finds a difference in both the level and the rate of change in mortality improvement over time by socioeconomic status for male Social Security-covered workers. Average relative earnings (measured as the relative average positive earnings of an individual between ages 45 and 55) are used as a proxy for adult socioeconomic status. In general, for birth cohorts spanning the years 1912-1941 (or deaths spanning the years 1972-2001 at ages 60-89), the top half of the average relative earnings distribution has experienced faster mortality improvement than has the bottom half. Specifically, male Social Security-covered workers born in 1941 who had average relative earnings in the top half of the earnings distribution and who lived to age 60 would be expected to live 5.8 more years than their counterparts in the bottom half. In contrast, among male Social Security-covered workers born in 1912 who survived to age 60, those
Lindahl-Jacobsen, Rune; Hanson, Heidi A; Oksuzyan, Anna
PURPOSE: In Utah, the prevalence of unhealthy male risk behaviors are lower than in most other male populations, whereas women experience higher mortality risk because of higher fertility rates. Therefore, we hypothesize that the Utah sex differential in mortality would be small and less than...... in the sex differences in cohort life expectancy was approximately 2 years smaller for active Mormons in Utah than for other groups suggesting lifestyle as an important component for the overall change seen in cohort life expectancy. Sex differences in cohort life expectancy at the age of 50 years were...
Hansen, Casper Worm; Strulik, Holger
, we find that US states with higher mortality rates from cardiovascular disease prior to the 1970s experienced greater increases in adult life expectancy and higher education enrollment. Our estimates suggest that a one-standard deviation higher treatment intensity is associated with an increase...... in adult life expectancy of 0.37 years and 0.07–0.15 more years of higher education....
Lindahl-Jacobsen, Rune; Hanson, Heidi A; Oksuzyan, Anna; Mineau, Geraldine P; Christensen, Kaare; Smith, Ken R
In Utah, the prevalence of unhealthy male risk behaviors are lower than in most other male populations, whereas women experience higher mortality risk because of higher fertility rates. Therefore, we hypothesize that the Utah sex differential in mortality would be small and less than in Sweden and Denmark. Life tables from Utah, Denmark, and Sweden were used to calculate cohort life expectancies for men and women born in 1850-1910. The sex difference in cohort life expectancy was similar or larger in Utah when compared with Denmark and Sweden. The change over time in the sex differences in cohort life expectancy was approximately 2 years smaller for active Mormons in Utah than for other groups suggesting lifestyle as an important component for the overall change seen in cohort life expectancy. Sex differences in cohort life expectancy at the age of 50 years were similar for individuals actively affiliated with the Church of Jesus Christ of Latter-day Saints and for Denmark and Sweden. The hypothesis that a smaller sex difference in cohort life expectancies in Utah would be detected in relation to Denmark and Sweden was not supported. In Utah, the male-female differences in life expectancy remain substantial pointing toward biological mechanisms or other unmeasured risk factors. Copyright © 2013 Elsevier Inc. All rights reserved.
Canudas-Romo, Vladimir; DuGoff, Eva H; Wu, Albert W.
We use expert clinical and public health opinion to estimate likely changes in the prevention and treatment of important disease conditions and how they will affect future life expectancy. Focus groups were held including clinical and public health faculty with expertise in the six leading causes...
Canudas-Romo, Vladimir; García-Guerrero, Víctor Manuel; Echarri-Cánovas, Carlos Javier
OBJECTIVES: In the first decade of the 21st century, the Mexican life expectancy changed from a long trend of increase to stagnation. These changes concur with an increase in deaths by homicides that the country experienced in that decade, and an obesity epidemic that had developed over the last...... of life expectancy from 2000 to 2010. RESULTS: The apparent stagnation in life expectancy is the result of an increase in deaths by homicides and diabetes mellitus on the one hand, and the positive improvements observed in other causes of death on the other. The negative impact of homicides...... by 2 years if deaths by homicides and diabetes mellitus had been avoided....
Canudas-Romo, Vladimir; García-Guerrero, Víctor Manuel; Echarri-Cánovas, Carlos Javier
In the first decade of the 21st century, the Mexican life expectancy changed from a long trend of increase to stagnation. These changes concur with an increase in deaths by homicides that the country experienced in that decade, and an obesity epidemic that had developed over the last decades of the 20th century. We quantify the impact of causes of death on life expectancy from 2000 to 2010. Two approaches to analyse causes of death are used: the number of life years lost due to each of the causes of death in a given year, and cause-decomposition techniques for comparisons of life expectancy from 2000 to 2010. The apparent stagnation in life expectancy is the result of an increase in deaths by homicides and diabetes mellitus on the one hand, and the positive improvements observed in other causes of death on the other. The negative impact of homicides is particularly observed for ages 15 and 50, and for that of diabetes mellitus at ages above 45 years. There is little basis for optimism regarding the future scenarios of the health of the Mexican population based on the first decade of the 21st century. Male life expectancy would have increased by 2 years if deaths by homicides and diabetes mellitus had been avoided. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Botelho, Ricardo Vieira; Jardim Miranda, Bárbara Cristina; Nishikuni, Koshiro; Waisberg, Jaques
Life expectancy (LE) refers to the number of years that an individual is expected to survive. Emphasis is frequently placed on the relationship between LE and the conditions under which a population lives, but fewer studies have investigated the relationship between stress factors associated with specific professions and their effects on LE. The aim of this study is to evaluate Brazilian neurosurgeons' life expectancies (BNLEs) and compare them with those of physicians (both Brazilian and foreign) from other fields, as well as with Brazilian nondoctors. The Brazilian Society of Neurosurgery death registry was used to obtain data that compared LEs from non-neurosurgeon physicians, as described in the national and international literature. BNLEs were also compared with the LEs of Brazilian citizens. Fifty-one neurosurgeons died between 2009 and 2016. All were males. The mean age at death was 68.31 ± 17.71 years. Among all-cause mortality, the breakdown was 20% cardiovascular diseases, 39% malignancies, 10% external factors, 6% gastrointestinal disorders, 12% neurologic illnesses, and 14% unknown causes. BNLE was shorter than LE of male Brazilian citizens. LE was similar among neurosurgeons and other doctors but shorter compared with Brazilian citizens. Further research is needed to provide data that can add to and confirm these results. Copyright © 2018 Elsevier Inc. All rights reserved.
Vaupel, James W.; Canudas Romo, Vladimir
We extend Nathan Keyfitz's research on continuous change in life expectancy over time by presenting and proving a new formula for decomposing such change. The formula separates change in life expectancy over time into two terms. The first term captures the general effect of reduction in death rates...... in Sweden and Japan....
Kessing, Lars Vedel; Vradi, Eleni; Andersen, Per Kragh
OBJECTIVE: Life expectancy in patients with bipolar disorder has been reported to be decreased by 11 to 20 years. These calculations are based on data for individuals at the age of 15 years. However, this may be misleading for patients with bipolar disorder in general as most patients have a later...... onset of illness. The aim of the present study was to calculate the remaining life expectancy for patients of different ages with a diagnosis of bipolar disorder. METHODS: Using nationwide registers of all inpatient and outpatient contacts to all psychiatric hospitals in Denmark from 1970 to 2012 we...... remaining life expectancy in bipolar disorder and that of the general population decreased with age, indicating that patients with bipolar disorder start losing life-years during early and mid-adulthood. CONCLUSIONS: Life expectancy in bipolar disorder is decreased substantially, but less so than previously...
Guillermo Julián González-Pérez
Full Text Available OBJETIVO: Determinar el impacto de la violencia homicida en la esperanza de vida masculina (EVM de México y sus 32 estados durante los trienios 1998-2000 y 2008-2010, así como el grado de participación de los diferentes grupos etarios en la pérdida de años de EVM por esta causa. MÉTODOS: A partir de datos oficiales sobre defunciones y población, se construyeron tablas abreviadas de mortalidad masculina para México y sus estados en los trienios estudiados. Se calcularon la esperanza de vida temporaria masculina y los años de esperanza de vida perdidos (AEVP en el grupo etario de 15 a 75 años, por causas seleccionadas (homicidios, diabetes mellitus y accidentes de transporte y por grupos de edad en cada trienio. RESULTADOS: Entre 1998-2000 y 2008-2010 se incrementaron los AEVP por homicidio a nivel nacional y en 19 estados; en cuatro de ellos, la cifra de AEVP en 2008-2010 superó los dos años, destacándose el caso de Chihuahua, con 5,2 años. De 18 estados donde la esperanza de vida temporaria masculina disminuyó entre los dos trienios, en 14 aumentaron los AEVP por homicidio. En 2008-2010 los homicidios fueron responsables del mayor porcentaje de AEVP masculinos en el grupo etario de 20 a 44 años. Los AEVP por homicidio en el grupo de 15 a 44 años de edad se incrementaron entre ambos trienios. CONCLUSIONES: El aumento de la violencia homicida, especialmente entre los jóvenes, es un freno para el incremento de la esperanza de vida masculina en México. En varios estados, como Chihuahua y Durango, esta violencia parece ser la principal responsable del descenso de la esperanza de vida masculina entre los 15 y 75 años de edad.OBJECTIVE: To determine the impact of homicide on male life expectancy in Mexico and its 32 states during the three-year periods 1998-2000 and 2008-2010 and the weight of the different age groups in years of life expectancy lost (YLEL due to this cause. METHODS: Based on official death and population data
... What's this? Submit What's this? Submit Button NCHS Home ... expectancy at birth, at 65, and 75 years of age by sex, race and Hispanic origin Health, United States 2016, table 15 [PDF – 9.8 MB] Life ...
Leisure-time physical activity is associated with longer life expectancy, even at relatively low levels of activity and regardless of body weight, according to a study by a team of researchers led by the NCI.
Guillen, Montserrat; Vidiella-i-Anguera, Antoni
Knowledge of trends in life expectancy is of major importance for policy planning. It is also a key indicator for assessing future development of life insurance products, substantiality of existing retirement schemes, and long-term care for the elderly. This article examines the feasibility of decomposing age-gender-specific accidental and natural mortality rates. We study this decomposition by using the Lee and Carter model. In particular, we fit the Poisson log-bilinear version of this model proposed by Wilmoth and Brouhns et al. to historical (1975-1998) Spanish mortality rates. In addition, by using the model introduced by Wilmoth and Valkonen we analyze mortality-gender differentials for accidental and natural rates. We present aggregated life expectancy forecasts compared with those constructed using nondecomposed mortality rates.
Lindahl-Jacobsen, Rune; Zarulli, Virginia; Christensen, Kaare
of these environmental factors whereas small differences would reflect a lower action of the factors and approach the ‘natural’ biological level. Here we examine variability in sex differences in life expectancy in 47 historical and contemporary human populations to address our hypothesis: large sex differences in life...... that females withstand harsh environments better then males in terms of survival, partly explaining their higher life expectancy. If this hypothesis is true and females survive environmental stressors better then males then large sex differences in life expectancies could reflect the action...
Trifon I. Missov
Full Text Available BACKGROUND The gamma-Gompertz multiplicative frailty model is the most common parametric modelapplied to human mortality data at adult and old ages. The resulting life expectancy hasbeen calculated so far only numerically. OBJECTIVE Properties of the gamma-Gompertz distribution have not been thoroughly studied. The focusof the paper is to shed light onto its first moment or, demographically speaking, characterizelife expectancy resulting from a gamma-Gompertz force of mortality. The paperprovides an exact formula for gamma-Gompertz life expectancy at birth and a simplerhigh-accuracy approximation that can be used in practice for computational convenience.In addition, the article compares actual (life-table to model-based (gamma-Gompertzlife expectancy to assess on aggregate how many years of life expectancy are not captured(or overestimated by the gamma-Gompertz mortality mechanism. COMMENTS A closed-form expression for gamma-Gomeprtz life expectancy at birth contains a special(the hypergeometric function. It aids assessing the impact of gamma-Gompertz parameterson life expectancy values. The paper shows that a high-accuracy approximation canbe constructed by assuming an integer value for the shape parameter of the gamma distribution.A historical comparison between model-based and actual life expectancy forSwedish females reveals a gap that is decreasing to around 2 years from 1950 onwards.Looking at remaining life expectancies at ages 30 and 50, we see this gap almost disappearing.
Aubenque, M; Damiani, P
Using information available at the end of 1979, the authors present and analyze data on expectation of life at birth in 119 countries. Differences between developing and developed countries, trends over time, sex differentials, and limits on life expectancy are examined. The analysis reveals limits of approximately 73 years for men and 80 for women in the most developed countries. In France, which displays excessive male mortality, expectation of life increases more slowly for men. The authors attribute these sex differentials both to biological factors and to behavioral factors and ways of life.
Full Text Available Period life expectancy varies with changes in mortality, and should not be confused with the life expectancy of those alive during that period. Given past and likely future mortality changes, a recent debate has arisen on the usefulness of the period life expectancy as the leading measure of survivorship. An alternative aggregate measure of period mortality which has been seen as less sensitive to period changes, the cross-sectional average length of life (CAL has been proposed as an alternative, but has received only limited empirical or analytical examination. Here, we introduce a new measure, the average cohort life expectancy (ACLE, to provide a precise measure of the average length of life of cohorts alive at a given time. To compare the performance of ACLE with CAL and with period and cohort life expectancy, we first use population models with changing mortality. Then the four aggregate measures of mortality are calculated for England and Wales, Norway, and Switzerland for the years 1880 to 2000. CAL is found to be sensitive to past and present changes in death rates. ACLE requires the most data, but gives the best representation of the survivorship of cohorts present at a given time.
DuGoff, Eva H; Canudas-Romo, Vladimir; Buttorff, Christine
BACKGROUND: The number of people living with multiple chronic conditions is increasing, but we know little about the impact of multimorbidity on life expectancy. OBJECTIVE: We analyze life expectancy in Medicare beneficiaries by number of chronic conditions. RESEARCH DESIGN: A retrospective cohort...... study using single-decrement period life tables. SUBJECTS: Medicare fee-for-service beneficiaries (N=1,372,272) aged 67 and older as of January 1, 2008. MEASURES: Our primary outcome measure is life expectancy. We categorize study subjects by sex, race, selected chronic conditions (heart disease, cancer...... and increasing numbers of comorbid conditions. CONCLUSIONS: Social Security and Medicare actuaries should account for the growing number of beneficiaries with multiple chronic conditions when determining population projections and trust fund solvency....
Trifon I. Missov
BACKGROUND The gamma-Gompertz multiplicative frailty model is the most common parametric modelapplied to human mortality data at adult and old ages. The resulting life expectancy hasbeen calculated so far only numerically. OBJECTIVE Properties of the gamma-Gompertz distribution have not been thoroughly studied. The focusof the paper is to shed light onto its first moment or, demographically speaking, characterizelife expectancy resulting from a gamma-Gompertz force of mortality. The paperprov...
Diderichsen, S.; Andersson, J.; Johansson, E.E.; Verdonk, P.; Lagro-Janssen, T.; Hamberg, K.
Objectives: To investigate future life expectations among male and female medical students in their first and final year. Methods: The study was cross-sectional and conducted at a Swedish medical school. Out of 600 invited students, 507 (85%) answered an open-ended question about their future life, 298 (59%) first-year students and 209 (41%) last-year students. Women constituted 60% of the respondents. A mixed model design was applied; qualitative content analysis was utilized to create stati...
P.H.M. Van Baal (Pieter); F. Peters (Frederik); J.P. Mackenbach (Johan); W.J. Nusselder (Wilma)
textabstractForecasts of life expectancy (LE) have fuelled debates about the sustainability and dependability of pension and healthcare systems. Of relevance to these debates are inequalities in LE by education. In this paper, we present a method of forecasting LE for different educational groups
Hannerz, H; Borgå, P; Borritz, M
The aim of the study was to estimate life expectancies in different diagnostic groups for individuals treated as inpatients at Swedish psychiatric clinics. All individuals, older than 18 y and alive on the first of January 1983, who had been registered in the National Hospital Discharge Registry by a psychiatric clinic in 1978-82, were monitored for mortality during 1983 by using the National Cause of Death Registry. The study group consisted of 91 385 men and 77 217 women. The patients were divided into nine diagnostic groups according to the principal diagnosis registered at the latest discharge. Actuarial mathematics was used to construct life expectancy tables, which present the number of years expected to live, by gender and diagnostic group. Expectancies of life were significantly shortened for both genders and in all nine diagnostic groups (with one exception). Mental disorders in general are life shortening. This fact should be recognised in community health when setting health priorities. It should also be addressed in curricula as well as in treatment and preventive programmes.
Brønnum-Hansen, Henrik; Andersen, Otto; Kjøller, Mette
Health status of a population can be evaluated by health expectancy expressed as average lifetime in various states of health. The purpose of the study was to compare health expectancy in population groups at high, medium and low educational levels.......Health status of a population can be evaluated by health expectancy expressed as average lifetime in various states of health. The purpose of the study was to compare health expectancy in population groups at high, medium and low educational levels....
Andersson, Jenny; Johansson, Eva E.; Verdonk, Petra; Lagro-Janssen, Antoine; Hamberg, Katarina
Objectives: To investigate future life expectations among male and female medical students in their first and final year. Methods The study was cross-sectional and conducted at a Swedish medical school. Out of 600 invited students, 507 (85%) answered an open-ended question about their future life, 298 (59%) first-year students and 209 (41%) last-year students. Women constituted 60% of the respondents. A mixed model design was applied; qualitative content analysis was utilized to create statistically comparable themes and categories. Results Students’ written answers were coded, categorized and clustered into four themes: “Work”, “Family”, “Leisure” and “Quality of personal life”. Almost all students included aspects of work in their answers. Female students were more detailed than male ones in their family concerns. Almost a third of all students reflected on a future work-life balance, but considerations regarding quality of personal life and leisure were more common among last-year students. Conclusions Today’s medical students expect more of life than work, especially those standing on the doorstep of working life. They intend to balance work not only with a family but also with leisure activities. Our results reflect work attitudes that challenge the health care system for more adaptive working conditions. We suggest that discussions about work-life balance should be included in medical curricula.
DuGoff, Eva H; Canudas-Romo, Vladimir; Buttorff, Christine; Leff, Bruce; Anderson, Gerard F
The number of people living with multiple chronic conditions is increasing, but we know little about the impact of multimorbidity on life expectancy. We analyze life expectancy in Medicare beneficiaries by number of chronic conditions. A retrospective cohort study using single-decrement period life tables. Medicare fee-for-service beneficiaries (N=1,372,272) aged 67 and older as of January 1, 2008. Our primary outcome measure is life expectancy. We categorize study subjects by sex, race, selected chronic conditions (heart disease, cancer, chronic obstructive pulmonary disease, stroke, and Alzheimer disease), and number of comorbid conditions. Comorbidity was measured as a count of conditions collected by Chronic Conditions Warehouse and the Charlson Comorbidity Index. Life expectancy decreases with each additional chronic condition. A 67-year-old individual with no chronic conditions will live on average 22.6 additional years. A 67-year-old individual with 5 chronic conditions and ≥10 chronic conditions will live 7.7 fewer years and 17.6 fewer years, respectively. The average marginal decline in life expectancy is 1.8 years with each additional chronic condition-ranging from 0.4 fewer years with the first condition to 2.6 fewer years with the sixth condition. These results are consistent by sex and race. We observe differences in life expectancy by selected conditions at 67, but these differences diminish with age and increasing numbers of comorbid conditions. Social Security and Medicare actuaries should account for the growing number of beneficiaries with multiple chronic conditions when determining population projections and trust fund solvency.
Background: Whereas the rise in human life expectancy has been extensively studied, the evolution of maximum life expectancies, i.e., the rise in best-practice life expectancy in a group of populations, has not been examined to the same extent. The linear rise in best-practice life expectancy has been reported previously by various authors. Though remarkable, this is simply an empirical observation. Objective: We examine best-practice life expectancy more formally by using extreme value th...
Hjorthøj, Carsten; Stürup, Anne Emilie; McGrath, John J
was least in the Asian study and greatest in Africa. The overall weighted average life expectancy was 64·7 years (95% CI 61·1-71·3), and was lower for men than women (59·9 years, 95% CI 55·5-64·3 vs 67·6 years, 63·1-72·1). Life expectancy was lowest in Asia and Africa. Timing of publication and risk of bias...... (Africa n=1, Asia n=1, Australia n=1, Europe n=7, and North America n=3) that involved up to 247 603 patients. Schizophrenia was associated with a weighted average of 14·5 years of potential life lost (95% CI 11·2-17·8), and was higher for men than women (15·9, 13·8-18·0 vs 13·6, 11·4-15·8). Loss...
Tuljapurkar, Shripad; Coulson, Tim; Horvitz, Carol
Interest in stage-and age structured models has recently increased because they can describe quantitative traits such as size that are left out of age-only demography. Available methods for the analysis of effects of vital rates on lifespan in stage-structured models have not been widely applied because they are hard to use and interpret, and tools for age and stage structured populations are missing. We present easily interpretable expressions for the sensitivities and elasticities of life expectancy to vital rates in age-stage models, and illustrate their application with two biological examples. Much of our approach relies on trading of time and mortality risk in one stage for time and risk in others. Our approach contributes to the new framework of the study of age- and stage-structured biodemography. PMID:22664576
Abrahamsen, Bo; Osmond, Clive; Cooper, Cyrus
Osteoporosis is a chronic disease, carrying an elevated risk of fractures, morbidity, and death. Long-term treatment may be required, but the long-term risks with osteoporosis drugs remain incompletely understood. The competing risk of death may be a barrier to treating the oldest, yet this may...... not be rational if the risk of death is reduced by treatment. It is difficult to devise goal-directed long-term strategies for managing osteoporosis without firm information about residual life expectancy in treated patients. We conducted an observational study in Danish national registries tracking prescriptions...... for osteoporosis drugs, comorbid conditions, and deaths. We included 58,637 patients and 225,084 age- and sex-matched control subjects. Information on deaths until the end of 2013 was retrieved, providing a follow-up period of 10 to 17 years. In men younger than 80 years and women younger than 60 years...
van Baal, Pieter; Peters, Frederik; Mackenbach, Johan; Nusselder, Wilma
Forecasts of life expectancy (LE) have fuelled debates about the sustainability and dependability of pension and healthcare systems. Of relevance to these debates are inequalities in LE by education. In this paper, we present a method of forecasting LE for different educational groups within a population. As a basic framework we use the Li-Lee model that was developed to forecast mortality coherently for different groups. We adapted this model to distinguish between overall, sex-specific, and education-specific trends in mortality, and extrapolated these time trends in a flexible manner. We illustrate our method for the population aged 65 and over in the Netherlands, using several data sources and spanning different periods. The results suggest that LE is likely to increase for all educational groups, but that differences in LE between educational groups will widen. Sensitivity analyses illustrate the advantages of our proposed method.
Holleyman, R; Vann Jones, S
Stress and mortality are negatively correlated and it is generally accepted that certain professions are more stressful than others. Medical graduates begin as a relatively homogenous population who then choose vastly different career options making doctors an ideal population in which to try to assess whether job stress is likely to be causal to increased mortality. To establish the influence of various modifiable risk factors on the life expectancy of UK doctors. We analysed a decade of obituaries from the British Medical Journal published between January 2003 and December 2012. Data included age at death (AAD), specialty, region (deanery), marriage status and children. A total of 3068 obituaries were eligible for inclusion. Mean AAD was 78.5 years. Male sex was associated with a significantly increased AAD by an additional 3.8 years (95% CI 2.4-5.2 years, P affect life expectancy. While this does not necessarily reflect quality of life, the additional years of life gained from having extra children have a positive effect on your quantity of life. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
Brønnum-Hansen, Henrik; Eriksen, Mette Lindholm; Andersen-Ranberg, Karen
AIMS: The state old-age pension in Denmark increases to keep pace with the projected increase in average life expectancy (LE) without any regard to the social gap in LE and expected lifetime in good health. The purpose of this study was to compare changes in LE and disability-free life expectancy...... (DFLE) between groups of Danes with high, medium and low levels of education. METHODS: Nationwide register data on education and mortality were combined with data from the Surveys of Health, Ageing and Retirement in Europe (SHARE) surveys in 2006-2007, 2010-2011 and 2013-2014 and the DFLE by educational...... level was estimated by Sullivan's method for each of these three time points. RESULTS: Between 2006-2007 and 2013-2014, LE among 65-year-old men and women with a low educational level increased by 1.3 and 1.0 years, respectively, and by 1.4 and 1.3 years for highly educated men and women. The gap in LE...
Full Text Available Objectives Subjective life expectancy (SLE has been found to show a significant association with mortality. In this study, we aimed to investigate the major factors affecting SLE. We also examined whether any differences existed between SLE and actuarial life expectancy (LE in Korea. Methods A cross-sectional survey of 1000 individuals in Korea aged 20-59 was conducted. Participants were asked about SLE via a self-reported questionnaire. LE from the National Health Insurance database in Korea was used to evaluate differences between SLE and actuarial LE. Age-adjusted least-squares means, correlations, and regression analyses were used to test the relationship of SLE with four categories of predictors: demographic factors, socioeconomic factors, health behaviors, and psychosocial factors. Results Among the 1000 participants, women (mean SLE, 83.43 years; 95% confidence interval, 82.41 to 84.46 years; 48% of the total sample had an expected LE 1.59 years longer than that of men. The socioeconomic factors of household income and housing arrangements were related to SLE. Among the health behaviors, smoking status, alcohol status, and physical activity were associated with SLE. Among the psychosocial factors, stress, self-rated health, and social connectedness were related to SLE. SLE had a positive correlation with actuarial estimates (r=0.61, p<0.001. Gender, household income, history of smoking, and distress were related to the presence of a gap between SLE and actuarial LE. Conclusions Demographic factors, socioeconomic factors, health behaviors, and psychosocial factors showed significant associations with SLE, in the expected directions. Further studies are needed to determine the reasons for these results.
After including an allowance for the gap between male and female life expectancies at birth diminishing over the past 50 years in industrialized countries, the J-value model incorporating “male catch-up” has been validated against actual UK data on life expectancy. A close correspondence has also been found between forecasts for life expectancy at birth in 35 countries made by the J-value model and those produced in a recent study that applied Bayesian model averaging to 21 demographic projec...
Full Text Available It has been established that under certain mortality assumptions, the current value of the Cross-sectional Average length of Life (CAL is equal to the life expectancy for the cohort currently reaching its life expectancy. This correspondence is important, because the life expectancy for the cohort currently reaching its life expectancy, or lagged cohort life expectancy (LCLE, has been discussed in the tempo literature as a summary mortality measure of substantive interest. In this paper, we build on previous work by evaluating the extent to which the correspondence holds in actual populations. We also discuss the implications of the CAL-LCLE correspondence (or lack thereof for using CAL as a measure of cohort life expectancy, and for understanding the connection between CAL, LCLE, and underlying period mortality conditions.
Full Text Available Background: Whereas the rise in human life expectancy has been extensively studied, the evolution of maximum life expectancies, i.e., the rise in best-practice life expectancy in a group of populations, has not been examined to the same extent. The linear rise in best-practice life expectancy has been reported previously by various authors. Though remarkable, this is simply an empirical observation. Objective: We examine best-practice life expectancy more formally by using extreme value theory. Methods: Extreme value distributions are ﬁt to the time series (1900 to 2012 of maximum life expectancies at birth and age 65, for both sexes, using data from the Human Mortality Database and the United Nations. Conclusions: Generalized extreme value distributions offer a theoretically justiﬁed way to model best-practice life expectancies. Using this framework one can straightforwardly obtain probability estimates of best-practice life expectancy levels or make projections about future maximum life expectancy. Comments: Our ﬁndings may be useful for policymakers and insurance/pension analysts who would like to obtain estimates and probabilities of future maximum life expectancies.
Manchester, Joyce; Topoleski, Julie
In a continuation of long-term trends, life expectancy has been steadily increasing in the United States for the past several decades. Accompanying the recent increases, however, is a growing disparity in life expectancy between individuals with high and low income and between those with more and less education. The difference in life expectancy…
Carlier, P.; Fluchere, J.; Giraud, B.; Poizat, F.
After having recalled that the French nuclear reactors have been designed for a 40-year long life with a 30-year depreciation, the authors notice that foreign reactors which are identical or older get a 60 year operation authorization. The authors analyse the age of the nuclear reactors which are currently operating in the world, in terms of age, of country. They also discuss the license renewal process in the USA. In the next part they analyse the conditions of a life extension to 60 years. These conditions concern material monitoring, maintenance strategy for the replacement of components, the condition of installations, personnel management and behaviour. Appendices contain a table of operating reactors which are still being operated and more than 30 year old, the status of license renewal applications to the US NRC
Violanti, John M.; Hartley, Tara A.; Gu, Ja K.; Fekedulegn, Desta; Andrew, Michael E.; Burchfiel, Cecil M.
Previous epidemiological research indicates that police officers have an elevated risk of death relative to the general population overall and for several specific causes. Despite the increased risk for mortality found in previous research, controversy still exists over the life expectancy of police officers. The goal of the present study was to compare life expectancy of male police officers from Buffalo New York with the U.S. general male population utilizing an abridged life table method. On average, the life expectancy of Buffalo police officers in our sample was significantly lower than the U.S. population (mean difference in life expectancy =21.9 years; 95% CI: 14.5-29.3; ppolice officers was shorter and differences were more pronounced in younger age categories. Additionally, police officers had a significantly higher average probability of death than did males in the general population (mean difference= 0.40; 95% CI: 0.26,-0.54; ppolice officers was 21 times larger than that of the general population (Buffalo male officers vs. U.S. males = 21.7, 95% CI: 5.8-37.7). Possible reasons for shorter life expectancy among police are discussed, including stress, shift work, obesity, and hazardous environmental work exposures. PMID:24707585
Missov, Trifon; Lenart, Adam
In a population of individuals, whose mortality is governed by a Gompertz–Makeham hazard, we derive closed-form solutions to the life-expectancy integral, corresponding to the cases of homogeneous and gamma-heterogeneous populations, as well as in the presence/absence of the Makeham term. Derived...... expressions contain special functions that aid constructing high-accuracy approximations, which can be used to study the elasticity of life expectancy with respect to model parameters. Knowledge of Gompertz–Makeham life expectancies aids constructing life-table exposures....
Mackenbach, Johan P
The rise of life expectancy in Europe has been a very uneven process, both in time and space. This paper aims to identify instances in which major political conditions are likely to have influenced the rise of life expectancy, focusing on formation and dissolution of states and supranational blocs and on differences between political regimes (democratic vs. authoritarian non-communist and communist rule). Data on life expectancy, cause-specific mortality and political conditions were compiled from existing data sources. Possible relations between political conditions and life expectancy were studied by direct comparisons of changes in life expectancy in countries with different political conditions but similar starting levels of life expectancy. We found that formation and dissolution of states often went together with convergence and divergence of life expectancy, respectively, and that otherwise similar countries that did or did not become part of the Soviet bloc had distinctly different life expectancy trajectories. Democratically governed states had higher life expectancies than authoritarian states throughout the 20th century. The gap narrowed between 1920 and 1960 due to rapid catching up of infectious disease control in both non-communist and communist authoritarian states. It widened again after 1960 due to earlier and more rapid progress in democratic states against cardiovascular disease, breast cancer, motor vehicle accidents and other causes of death that have become amenable to intervention. We conclude that the history of life expectancy in Europe contains many instances in which political conditions are likely to have had a temporary or more lasting impact on population health. This suggests that there is scope for further in-depth studies of the impact of specific political determinants on the development of population health in Europe. Copyright © 2012 Elsevier Ltd. All rights reserved.
Nakagawa, Fumiyo; May, Margaret; Phillips, Andrew
The life expectancy of people living with HIV has dramatically increased since effective antiretroviral therapy has been available, and still continues to improve. Here, we review the latest literature on estimates of life expectancy and consider the implications for future research. With timely diagnosis, access to a variety of current drugs and good lifelong adherence, people with recently acquired infections can expect to have a life expectancy which is nearly the same as that of HIV-negative individuals. Modelling studies suggest that life expectancy could improve further if there were increased uptake of HIV testing, better antiretroviral regimens and treatment strategies, and the adoption of healthier lifestyles by those living with HIV. In particular, earlier diagnosis is one of the most important factors associated with better life expectancy. A consequence of improved survival is the increasing number of people with HIV who are aged over 50 years old, and further research into the impact of ageing on HIV-positive people will therefore become crucial. The development of age-specific HIV treatment and management guidelines is now called for. Analyses on cohort studies and mathematical modelling studies have been used to estimate life expectancy of those with HIV, providing useful insights of importance to individuals and healthcare planning.
Full Text Available The purpose of this paper is to investigate the influence of the status of women in society over life expectancy at birth. Based on the data of some of the socio-economic variables for 187 countries worldwide, collected by the United Nations within United Nations Development Programme – Human Development Report, we developed a regression model of life expectancy factors. Through empirical testing of the three hypotheses which refer to different aspects of the status of women in society, we found that the employment ratio between women and men has a statistically significant negative impact on life expectancy at birth, which is, at least at first glance, unexpected. At the same time, the number of teenage births per 100 women aged 15–19 as well as gender inequality has a statistically significant negative impact on life expectancy at birth.
Bijwaard, G.E.; van Poppel, F.W.A.; Ekamper, Peter; Lumey, L.H.
Background Many studies show large differences in life expectancy across the range of education, intelligence, and socio-economic status. As educational attainment, intelligence, and socio-economic status are highly interrelated, appropriate methods are required to disentangle their separate
Analysis of area mortality variations and estimation of area life tables raise methodological questions relevant to assessing spatial clustering, and socioeconomic inequalities in mortality. Existing small area analyses of US life expectancy variation generally adopt ad hoc amalgamations of counties to alleviate potential instability of mortality rates involved in deriving life tables, and use conventional life table analysis which takes no account of correlated mortality for adjacent areas or ages. The alternative strategy here uses structured random effects methods that recognize correlations between adjacent ages and areas, and allows retention of the original county boundaries. This strategy generalizes to include effects of area category (e.g. poverty status, ethnic mix), allowing estimation of life tables according to area category, and providing additional stabilization of estimated life table functions. This approach is used here to estimate stabilized mortality rates, derive life expectancies in US counties, and assess trends in clustering and in inequality according to county poverty category.
Gul Soylu Ozler
Full Text Available Aim: Halitosis is an unpleasant alteration of the halitus. The aim of the study is to assess the quality of sexual life of males with and without halitosis. Material and Method: Males between 20-50 years old; with a complaint of halitosis; married and able to complete the study were included in the study. The control group were healthy, adult, married males who have normal otorhinolaryngologic examination. The International Index of Erectile Function questionnaire(IIEF were used to assess the quality of sexual life of males with halitosis and the results were compared with a similar group of healthy men. Results: A total of 80 adult subjects completed the study. When the groups were compared in terms of age, body mass index(BMI and duration of marriage, they were similar (p=0.65, p= 0.20, p= 0.08 respectively.The halitosis group had significantly lower scores for all function domains (p=0.0001.There was no correlation between degree of halitosis and the scores of IIEF (p< 0.05. Discussion: This is the first study investigating the sexual health of males with halitosis. Halitosis not only effects oral health status but also strongly declines quality of life. The otorhinolaryngologist must not only treat halitosis but also help the patient to stand up to social and sexual problems concomitting halitosis.
Matsuyama, Y; Aida, J; Watt, R G; Tsuboya, T; Koyama, S; Sato, Y; Kondo, K; Osaka, K
This study examined whether the number of teeth contributes to the compression of morbidity, measured as a shortening of life expectancy with disability, an extension of healthy life expectancy, and overall life expectancy. A prospective cohort study was conducted. A self-reported baseline survey was given to 126,438 community-dwelling older people aged ≥65 y in Japan in 2010, and 85,161 (67.4%) responded. The onset of functional disability and all-cause mortality were followed up for 1,374 d (follow-up rate = 96.1%). A sex-stratified illness-death model was applied to estimate the adjusted hazard ratios (HRs) for 3 health transitions (healthy to dead, healthy to disabled, and disabled to dead). Absolute differences in life expectancy, healthy life expectancy, and life expectancy with disability according to the number of teeth were also estimated. Age, denture use, socioeconomic status, health status, and health behavior were adjusted. Compared with the edentulous participants, participants with ≥20 teeth had lower risks of transitioning from healthy to dead (adjusted HR, 0.58 [95% confidence interval (CI), 0.50-0.68] for men and 0.70 [95% CI, 0.57-0.85] for women) and from healthy to disabled (adjusted HR, 0.52 [95% CI, 0.44-0.61] for men and 0.58 [95% CI, 0.49-0.68] for women). They also transitioned from disabled to dead earlier (adjusted HR, 1.26 [95% CI, 0.99-1.60] for men and 2.42 [95% CI, 1.72-3.38] for women). Among the participants aged ≥85 y, those with ≥20 teeth had a longer life expectancy (men: +57 d; women: +15 d) and healthy life expectancy (men: +92 d; women: +70 d) and a shorter life expectancy with disability (men: -35 d; women: -55 d) compared with the edentulous participants. Similar associations were observed among the younger participants and those with 1 to 9 or 10 to 19 teeth. The presence of remaining teeth was associated with a significant compression of morbidity: older Japanese adults' life expectancy with disability was
Skriver, Mette Vinther; Væth, Michael; Støvring, Henrik
The standardized mortality ratio (SMR) is a widely used measure. A recent methodological study provided an accurate approximate relationship between an SMR and difference in lifetime expectancies. This study examines the usefulness of the theoretical relationship, when comparing historic mortality data in four Scandinavian populations. For Denmark, Finland, Norway and Sweden, data on mortality every fifth year in the period 1950 to 2010 were obtained. Using 1980 as the reference year, SMRs and difference in life expectancy were calculated. The assumptions behind the theoretical relationship were examined graphically. The theoretical relationship predicts a linear association with a slope, [Formula: see text], between log(SMR) and difference in life expectancies, and the theoretical prediction and calculated differences in lifetime expectancies were compared. We examined the linear association both for life expectancy at birth and at age 30. All analyses were done for females, males and the total population. The approximate relationship provided accurate predictions of actual differences in lifetime expectancies. The accuracy of the predictions was better when age was restricted to above 30, and improved if the changes in mortality rate were close to a proportional change. Slopes of the linear relationship were generally around 9 for females and 10 for males. The theoretically derived relationship between SMR and difference in life expectancies provides an accurate prediction for comparing populations with approximately proportional differences in mortality, and was relatively robust. The relationship may provide a useful prediction of differences in lifetime expectancies, which can be more readily communicated and understood.
Full Text Available This article examines the increasing life expectancy of Japanese men and women in relation to their health from 1986 to 2004. We computed healthy life expectancy for seven available time-points using the prevalence-based Sullivan method. The results showed that, for both sexes and at all ages, the gains in life expectancy prior to 1995 were mostly in years of good self-rated health, while the gains thereafter were in years of poor self-rated health. The exception was for women at age 85, among whom there was an almost continuous increase in the number of years in poor health. The proportion of life spent in different health states suggested evidence of morbidity compression until 1995, followed by an expansion of morbidity.
Full Text Available Abstract Background The health status of individuals is determined by multiple factors operating at both micro and macro levels and the interactive effects of them. Measures of health inequalities should reflect such determinants explicitly through sources of levels and combining mean differences at group levels and the variation of individuals, for the benefits of decision making and intervention planning. Measures derived recently from marginal models such as beta-binomial and frailty survival, address this issue to some extent, but are limited in handling data with complex structures. Beta-binomial models were also limited in relation to measuring inequalities of life expectancy (LE directly. Methods We propose a multilevel survival model analysis that estimates life expectancy based on survival time with censored data. The model explicitly disentangles total health inequalities in terms of variance components of life expectancy compared to the source of variation at the level of individuals in households and parishes and so on, and estimates group differences of inequalities at the same time. Adjusted distributions of life expectancy by gender and by household socioeconomic level are calculated. Relative and absolute health inequality indices are derived based on model estimates. The model based analysis is illustrated on a large Swedish cohort of 22,680 men and 26,474 women aged 6569 in 1970 and followed up for 30 years. Model based inequality measures are compared to the conventional calculations. Results Much variation of life expectancy is observed at individual and household levels. Contextual effects at Parish and Municipality level are negligible. Women have longer life expectancy than men and lower inequality. There is marked inequality by the level of household socioeconomic status measured by the median life expectancy in each socio-economic group and the variation in life expectancy within each group. Conclusion Multilevel
Auger, Nathalie; Le Serbon, Emilie; Rostila, Mikael
Sweden and Canada are known for quality of living and exceedingly high life expectancy, but recent data on how these countries compare are lacking. We measured life expectancy in Canada and Sweden during the past decade, and identified factors responsible for changes over time. We calculated life expectancy at birth for Canada and Sweden annually from 2000 to 2010, and determined the ages and causes of death responsible for the gap between the two countries using Arriaga's method. We determined how population growth, ageing, and mortality influenced the number of deaths over time. During 2000-2010, life expectancy in Canada caught up with Sweden for men, and surpassed Sweden by 0.4 years for women. Sweden lost ground owing to a slower reduction in circulatory and tumour mortality after age 65 years compared with Canada. Nonetheless, population ageing increased the number of deaths in Canada, especially for mental and nervous system disorders. In Sweden, the number of deaths decreased. In only one decade, life expectancy in Canada caught up and surpassed Sweden due to rapid improvements in circulatory and tumour mortality. Population ageing increased the number of deaths in Canada, potentially stressing the health care system more than in Sweden. © 2015 the Nordic Societies of Public Health.
Mirzada, F.; Schimberg, A.S.; Engelaer, F.M.; Bijwaard, G.E.; van Bodegom, D.; Westendorp, R.G.J.; van Poppel, F.W.A.
Practising arts has been linked to lowering stress, anxiety and blood pressure. These mechanisms are all known to affect the ageing process. Therefore, we examine the relation between long-term involvement in arts and life expectancy at age 50 (LE50), in a cohort of 12,159 male acoustic, literary
Lindahl-Jacobsen, Rune; Rau, Roland; Jeune, Bernard
Health conditions change from year to year, with a general tendency in many countries for improvement. These conditions also change from one birth cohort to another: some generations suffer more adverse events in childhood, smoke more heavily, eat poorer diets, etc., than generations born earlier...... favor forecasts that hinge on cohort differences. We use a combination of age decomposition and exchange of survival probabilities between countries to study the remarkable recent history of female life expectancy in Denmark, a saga of rising, stagnating, and now again rising lifespans. The gap between...... female life expectancy in Denmark vs. Sweden grew to 3.5 y in the period 1975-2000. When we assumed that Danish women born 1915-1945 had the same survival probabilities as Swedish women, the gap remained small and roughly constant. Hence, the lower Danish life expectancy is caused by these cohorts...
Laursen, Thomas Munk; Musliner, Katherine L; Benros, Michael E
BACKGROUND: Depression is a common psychiatric disorder, with a lifetime prevalence of 10-15% in the Danish population. Although depression is associated with excess mortality, it is not yet understood how this affects life expectancy. Our aim was to examine mortality rates and life expectancy...... in patients with unipolar depression compared to the general population, and to assess the impact of comorbid somatic illness and substance abuse. METHODS: We followed a Danish population-based cohort from 1995-2013 (N=5,103,699). The cohort included all residents in Denmark during the study period. Mortality...... rate ratios (MRRs) and life expectancy in persons with unipolar depression were calculated using survival analysis techniques. RESULTS: The overall MRR was 2.07 (95% Confidence Interval (CI): 2.05-2.09) in people with a previous unipolar depression diagnosis compared to the general Danish population...
Full Text Available BACKGROUND: In the beginning of the 1970s, Sweden was the country where both women and men enjoyed the world's longest life expectancy. While life expectancy continues to be high and increasing, Sweden has been losing ground in relation to other leading countries. METHODS: We look at life expectancy over the years 1970-2008 for men and women. To assess the relative contributions of age, causes of death, and smoking we decompose differences in life expectancy between Sweden and two leading countries, Japan and France. This study is the first to use this decomposition method to observe how smoking related deaths contribute to life expectancy differences between countries. RESULTS: Sweden has maintained very low mortality at young and working ages for both men and women compared to France and Japan. However, mortality at ages above 65 has become considerably higher in Sweden than in the other leading countries because the decrease has been faster in those countries. Different trends for circulatory diseases were the largest contributor to this development in both sexes but for women also cancer played a role. Mortality from neoplasms has been considerably low for Swedish men. Smoking attributable mortality plays a modest role for women, whereas it is substantially lower in Swedish men than in French and Japanese men. CONCLUSIONS: Sweden is losing ground in relation to other leading countries with respect to life expectancy because mortality at high ages improves more slowly than in the leading countries, especially due to trends in cardiovascular disease mortality. Trends in smoking rates may provide a partial explanation for the trends in women; however, it is not possible to isolate one single explanatory factor for why Sweden is losing ground.
Frova, Luisa; Burgio, Alessandra; Battisti, Alessandra
This paper studies gender differences in disability free life expectancy (DFLE), taking into account mortality and disability contributions. After analysing the types of disability that account for such differences, it goes on to examine temporal variability and age contributions to mortality and disability variation. The method used is an extension of Arriaga’s model proposed by Nusselder. In 2005, disability free life expectancy at age 30 was 46.23 years for men and 48.74 years for women, w...
Sepehripour, Sarvnaz; Duggineni, Sirisha; Shahsavari, Somaya; Dheansa, Baljit
Burn injuries commonly occur in vulnerable age and social groups. Previous research has shown that frailty may represent a more important marker of adverse outcome in healthcare rather than chronological age (Roberts et al., 2012). In this paper we determined the relationship between burn injury, frailty, co-morbidities and long-term survival. Retrospective data collection from patients aged 75 with burns injuries, treated and discharged at Queen Victoria Hospital. The Clinical Frailty Scale (Rockwood et al., 2005) was used to calculate frailty at the time of admission. The expected mortality age (life expectancy) of deceased patients was obtained from two survival predictors. The data shows a statistically significant correlation between frailty score and complications and a statistically significant correlation between total body surface area percentage and complications. No significant difference was found between expected and observed age of death or life expectancy amongst the deceased (p value of 0.109). Based on the data from our unit, sustaining a burn as an elderly person does not reduce life expectancy. Medical and surgical complications, immediate, early and late, although higher with greater frailty and TBSA of burn, but do not adversely affect survival in this population. Copyright © 2018 Elsevier Ltd. All rights reserved.
Full Text Available Background. Recent research suggests that the health gain from economic resources and psychological assets may be systematically larger for Whites than Blacks. Aim. This study aimed to assess whether the life expectancy gain associated with social contacts over a long follow up differs for Blacks and Whites. Methods. Data came from the Americans’ Changing Lives (ACL Study, 1986–2011. The sample was a nationally representative sample of American adults 25 and older, who were followed for up to 25 years (n = 3361. Outcome was all-cause mortality. The main predictor was social contacts defined as number of regular visits with friends, relatives, and neighbors. Baseline demographics (age and gender, socioeconomic status (education, income, and employment, health behaviors (smoking and drinking, and health (chronic medical conditions, obesity, and depressive symptoms were controlled. Race was the focal moderator. Cox proportional hazard models were used in the pooled sample and based on race. Results. More social contacts predicted higher life expectancy in the pooled sample. A significant interaction was found between race and social contacts, suggesting that the protective effect of more social contacts is smaller for Blacks than Whites. In stratified models, more social contacts predicted an increased life expectancy for Whites but not Blacks. Conclusion. Social contacts increase life expectancy for White but not Black Americans. This study introduces social contacts as another social resource that differentially affects health of Whites and Blacks.
O.H. Franco (Oscar); C.E.D. de Laet (Chris); A. Peeters (Andrea); J. Jonker (Joost); J.P. Mackenbach (Johan); W.J. Nusselder (Wilma)
textabstractBackground: Physical inactivity is a modifiable risk factor for cardiovascular disease. However, little is known about the effects of physical activity on life expectancy with and without cardiovascular disease. Our objective was to calculate the consequences of different physical
Excluding the HIV prevalence rate from the threshold candidates re-allocates a considerable number of the members of the High AIDS club, indicating that incomes, literacy, and fertility are unable to predict AIDS completely. The similarity of economic and demographic conditions in the Low Literacy and High AIDS clubs, however, raises concerns about life expectancy convergence in the future.
Dominici, Francesca; Wang, Yun; Correia, Andrew W.; Ezzati, Majid; Pope, C. Arden; Dockery, Douglas W.
Background In a previous study, we provided evidence that a decline in fine particulate matter (PM2.5) air pollution during the period between 2000 and 2007 was associated with increased life expectancy in 545 counties in the United States. In this article, we investigated which chemical constituents of PM2.5 were the main drivers of the observed association. Methods We estimated associations between temporal changes in seven major components of PM2.5 (ammonium, sulfate, nitrate, elemental carbon matter, organic carbon matter, sodium, and silicon) and temporal changes in life expectancy in 95 counties between 2002 and 2007. We included US counties that had adequate chemical components of PM2.5 mass data across all seasons. We fitted single pollutant and multiple pollutant linear models, controlling for available socioeconomic, demographic, and smoking variables and stratifying by urban and nonurban counties. Results In multiple pollutant models, we found that: (1) a reduction in sulfate was associated with an increase in life expectancy; and (2) reductions in ammonium and sodium ion were associated with increases in life expectancy in nonurban counties only. Conclusions Our findings suggest that recent reductions in long-term exposure to sulfate, ammonium, and sodium ion between 2002 and 2007 are associated with improved public health. PMID:25906366
Full Text Available The present study assessed expectations among university students (N= 474, X= 22.7, SD=5.6 years towards the possible benefits of animal-assisted interventions on quality of life. Attitudes were measured with the Improving Quality of Life scale, which is an instrument created ad hoc that demonstrated adequate psychometric properties (four easily interpretable factors, with 49% of explained variance and alphas ranging from .76 to .89. The results showed that the participants (from the departments of Social, Health or Educational Sciences had very positive attitudes (high effect sizes, ES>.80 regardless of training. The experience of sharing households with pets was associated with better expectations. These findings emphasize the high expectations that future professionals in different fields hold regarding animal-assisted interventions, and highlight the current shortcomings in training curricula. The implications of these findings for the development of animal-assisted interventions are discussed.
Modig, K; Andersson, T; Vaupel, J; Rau, R; Ahlbom, A
The purpose of this study was to explore the pattern of mortality above the age of 100 years. In particular, we aimed to examine whether Scandinavian data support the theory that mortality reaches a plateau at particularly old ages. Whether the maximum length of life increases with time was also investigated. The analyses were based on individual level data on all Swedish and Danish centenarians born from 1870 to 1901; in total 3006 men and 10 963 women were included. Birth cohort-specific probabilities of dying were calculated. Exact ages were used for calculations of maximum length of life. Whether maximum age changed over time was analysed taking into account increases in cohort size. The results confirm that there has not been any improvement in mortality amongst centenarians in the past 30 years and that the current rise in life expectancy is driven by reductions in mortality below the age of 100 years. The death risks seem to reach a plateau of around 50% at the age 103 years for men and 107 years for women. Despite the rising life expectancy, the maximum age does not appear to increase, in particular after accounting for the increasing number of individuals of advanced age. Mortality amongst centenarians is not changing despite improvements at younger ages. An extension of the maximum lifespan and a sizeable extension of life expectancy both require reductions in mortality above the age of 100 years. © 2017 The Association for the Publication of the Journal of Internal Medicine.
Bijwaard, Govert E; van Poppel, Frans; Ekamper, Peter; Lumey, L H
Many studies show large differences in life expectancy across the range of education, intelligence, and socio-economic status. As educational attainment, intelligence, and socio-economic status are highly interrelated, appropriate methods are required to disentangle their separate effects. The aim of this paper is to present a novel method to estimate gains in life expectancy specifically associated with increased education. Our analysis is based on a structural model in which education level, IQ at age 18 and mortality all depend on (latent) intelligence. The model allows for (selective) educational choices based on observed factors and on an unobserved factor capturing intelligence. Our estimates are based on information from health examinations of military conscripts born in 1944-1947 in The Netherlands and their vital status through age 66 (n = 39,798). Our empirical results show that men with higher education have lower mortality. Using structural models to account for education choice, the estimated gain in life expectancy for men moving up one educational level ranges from 0.3 to 2 years. The estimated gain in months alive over the observational period ranges from -1.2 to 5.7 months. The selection effect is positive and amounts to a gain of one to two months. Decomposition of the selection effect shows that the gain from selection on (latent) intelligence is larger than the gain from selection on observed factors and amounts to 1.0 to 1.7 additional months alive. Our findings confirm the strong selection into education based on socio-economic status and intelligence. They also show significant higher life expectancy among individuals with higher education after the selectivity of education choice has been taken into account. Based on these estimates, it is plausible therefore that increases in education could lead to increases in life expectancy.
Tareque, Md Ismail; Saito, Yasuhiko; Kawahara, Kazuo
Life expectancy (LE) at birth has increased steadily in Bangladesh since its independence. When people live longer, quality of life becomes a central issue. This study examines whether healthy life expectancy (HLE) at ages 15, 25, 35, and 45 is keeping pace with LE at those ages between 1996 and 2002. It also seeks to investigate the correlates of self-rated health (SRH) in 1996 and 2002. We used data from the World Values Survey conducted in 1996 and 2002 among individuals 15 years and older. The Sullivan method was used to compute HLE. Socio-demographic differences and their association with different states of health were examined by chi-square and Pearson's correlation tests. Multiple linear regression models were fitted to examine the correlates of SRH. The results show that perceived health improved between 1996 and 2002. For males, statistically significant increases in the expected number of years lived in good SRH were found. Proportionally, in 2002, both males and females at ages 15, 25, 35 and 45 expected more life years in good health and fewer life years in fair and poor health than did their counterparts in 1996. Comparatively, males expected fewer life years spent in good health but a much larger proportion of expected life in good health than did females. Finally, in multivariate analyses, life satisfaction was the only factor found to be significantly and positively associated with SRH for males and females in both years, although in both years the association was much more pronounced for females than for males. This study documented changes in HLE during 1996-2002. Women outlive men, but they have a lower quality of life and are more likely to live a greater part of their remaining life in poor SRH. Life satisfaction as well as other significant factors associated with SRH should be promoted, with special attention given to women, to improve healthy life expectancy and the quality of life of the Bangladeshi people.
Full Text Available Practising arts has been linked to lowering stress, anxiety and blood pressure. These mechanisms are all known to affect the ageing process. Therefore, we examine the relation between long-term involvement in arts and life expectancy at age 50 (LE50, in a cohort of 12,159 male acoustic, literary and visual artists, who were born between 1700 and 1899 in the Low Countries. We compared the life expectancy at age 50 of the various artists with the elite and middle class of that time. In the birth cohorts before 1850, acoustic (LE50:14.5-19.5 and literary artists (LE50:17.8-20.8 had a similar life expectancy at age 50 compared to the elite (LE50:18.0-19.0. Only visual artists (LE50:15.5-17.1 had a lower life expectancy at age 50 compared to the elite at that time. For the most recent birth cohorts from 1850 through 1899, the comparison between artists and the elite reversed and acoustic and literary artist had a lower life expectancy at age 50, while visual artists enjoyed a similar life expectancy at age 50. Although artists belonged to the middle socioeconomic class and lived predominantly in urban areas with poor living conditions, they had a life expectancy similar to the elite population. This is in line with observed favourable effects of practicing arts on health in the short-term. From our historical analysis, we hypothesize several mechanisms through which artistic creativity could influence the ageing process and life expectancy. These hypotheses, however, should be formally tested before any definite conclusions on effects of arts on ageing can be drawn.
Dunkel, Curtis S; Mathes, Eugene; Papini, Dennis R
Following a model that is inclusive of both dispositional and situational influences on life-history behaviors and attitudes, the effect of life expectancies on aggression and generativity was examined. Consistent with the hypotheses it was found that shorter life expectancies led to an increase in the desire to aggress and a decrease in the desire to engage in generative behaviors. The results are discussed in terms of how life history theory can be used to frame research on person-situation interactions.
Vogt, Tobias C
In the two decades since reunification, East Germans have experienced a large increase in life expectancy and a convergence with the West German mortality level. This gain in life expectancy appears even more impressive if we assume a different scenario in which the Berlin Wall did not fall, and the old East Germany still existed. This analysis takes into account that East German mortality would not have remained static without reunification. Thus, it shows how many years of life expectancy were actually added by the fall of the Berlin Wall. The analysis shows the improvements for single age groups by projecting life expectancy based on mortality levels during the 1970s and 1980s using the Lee-Carter method. I use national-level data for both sexes for East Germany before reunification. I find that, without reunification, current life expectancy at birth among East Germans would be 4.0 years lower for females and 5.7 years lower for males. I also show that older East Germans were the main demographic beneficiaries of reunification. Female and male mortality improvements in the age groups above 60 contributed up to 80% to the actual gains in life expectancy. Had the Berlin Wall not fallen, East German mortality would not have remained static but improved at a far slower rate. Thus, this counterfactual approach shows for the first time how many years of life were actually gained by reunification and how much of these gains were attributable to mortality improvements among the elderly. Copyright © 2013 S. Karger AG, Basel.
A. Peeters (Anna); J.J.M. Barendregt (Jan); F. Willekens; J.P. Mackenbach (Johan); A. Al Mamun; L.G.A. Bonneux (Luc)
textabstractBACKGROUND: Overweight and obesity in adulthood are linked to an increased risk for death and disease. Their potential effect on life expectancy and premature death has not yet been described. OBJECTIVE: To analyze reductions in life expectancy and increases in
Full Text Available The life expectancy has increased rapidly in Norway in recent decades, with about ¼ year per year. The increase has been particularly fast for men, following a temporary decline in the 1950s and 1960s. Statistics Norway’s mortality projections using the Lee-Carter method indicate further improvements in this century – about 10 years higher life expectancy at birth. This implies significant mortality declines for older persons as the mortality is now small for young people. With no deaths below age 50 the life expectancy would be only 1-2 years higher.Population projections are for several reasons important for studying population ageing, including to have knowledge about the future age structure, and to estimate the effects of possible policy changes. In addition, the mortality projections are used for several other purposes than for projecting the population, such as calculating future pensions according to the new pension system, where life expectancy improvements reduce the annual pensions.The population projections show that the population will age regardless of plausible assumptions made about the demographic components births, deaths, immigration and emigration. Policies to affect these components may only marginally affect future ageing, and in some cases in the wrong direction. The only factor that may significantly affect the future ratio of the working to the non-working population, the potential support ratio, is that people work longer. This ratio will remain at the current level if the pension age is increased from the current 67 years to 78 years at the end of the century. This may be possible if the health of old persons continues to improve.
Full Text Available Background: In most developed countries, mortality reductions in the first half of the 20th century were highly associated with changes in lifespan disparities. In the second half of the 20th century, changes in mortality are best described by a shift in the mortality schedule, with lifespan variability remaining nearly constant. These successive mortality dynamics are known as compression and shifting mortality, respectively. Objective: To understand the effect of compression and shifting dynamics on mortality changes, we quantify the gains in life expectancy due to changes in lifespan variability and changes in the mortality schedule, respectively. Methods: We introduce a decomposition method using newly developed parametric expressions of the force of mortality that include the modal age at death as one of their parameters. Our approach allows us to differentiate between the two underlying processes in mortality and their dynamics. Results: An application of our methodology to the mortality of Swedish females shows that, since the mid-1960s, shifts in the mortality schedule were responsible for more than 70Š of the increase in life expectancy. Conclusions: The decomposition method allows differentiation between both underlying mortality processes and their respective impact on life expectancy, and also determines when and how one process has replaced the other.
Laditka, Sarah B; Laditka, James N
Being oriented toward the future has been associated with better future health. We studied associations of future orientation with life expectancy and the percentage of life with disability. We used the Panel Study of Income Dynamics (n = 5249). Participants' average age in 1968 was 33.0. Six questions repeatedly measured future orientation, 1968-1976. Seven waves (1999-2011, 33,331 person-years) measured disability in activities of daily living for the same individuals, whose average age in 1999 was 64.0. We estimated monthly probabilities of disability and death with multinomial logistic Markov models adjusted for age, sex, race/ethnicity, childhood health, and education. Using the probabilities, we created large populations with microsimulation, measuring disability in each month for each individual, age 55 through death. Life expectancy from age 55 for white men with high future orientation was age 77.6 (95% confidence interval 75.5-79.0), 6.9% (4.9-7.2) of those years with disability; results with low future orientation were 73.6 (72.2-75.4) and 9.6% (7.7-10.7). Comparable results for African American men were 74.8 (72.9-75.3), 8.1 (5.6-9.3), 71.0 (69.6-72.8), and 11.3 (9.1-11.7). For women, there were no significant differences associated with levels of future orientation for life expectancy. For white women with high future orientation 9.1% of remaining life from age 55 was disabled (6.3-9.9), compared to 12.4% (10.2-13.2) with low future orientation. Disability results for African American women were similar but statistically significant only at age 80 and over. High future orientation during early to middle adult ages may be associated with better health in older age.
Brønnum-Hansen, Henrik; Baadsgaard, Mikkel
BACKGROUND: The purpose of the study was to determine trends in social inequality in mortality and life expectancy in Denmark. METHODS: The study was based on register data on educational level and mortality during the period 1981-2005 and comprised all deaths among Danes aged 30-60. Sex- and age...... with low and high educational level increased by 0.3 years. CONCLUSION: During the past 25 years, the social gap in mortality has widened in Denmark. In particular, women with a low educational level have been left behind....
Hill, Terrence D; Jorgenson, Andrew
We test whether income inequality undermines female and male life expectancy in the United States. We employ data for all 50 states and the District of Columbia and two-way fixed effects to model state-level average life expectancy as a function of multiple income inequality measures and time-varying characteristics. We find that state-level income inequality is inversely associated with female and male life expectancy. We observe this general pattern across four measures of income inequality and under the rigorous conditions of state-specific and year-specific fixed effects. If income inequality undermines life expectancy, redistribution policies could actually improve the health of states. Copyright © 2017 Elsevier Ltd. All rights reserved.
Brønnum-Hansen, Henrik; Eriksen, Mette Lindholm; Andersen-Ranberg, Karen; Jeune, Bernard
The state old-age pension in Denmark increases to keep pace with the projected increase in average life expectancy (LE) without any regard to the social gap in LE and expected lifetime in good health. The purpose of this study was to compare changes in LE and disability-free life expectancy (DFLE) between groups of Danes with high, medium and low levels of education. Nationwide register data on education and mortality were combined with data from the Surveys of Health, Ageing and Retirement in Europe (SHARE) surveys in 2006-2007, 2010-2011 and 2013-2014 and the DFLE by educational level was estimated by Sullivan's method for each of these three time points. Between 2006-2007 and 2013-2014, LE among 65-year-old men and women with a low educational level increased by 1.3 and 1.0 years, respectively, and by 1.4 and 1.3 years for highly educated men and women. The gap in LE between people with high and low levels of education remained more than 2 years. In 2006-2007, 65-year-old men with a high level of education could expect 3.2 more years without disability than men of the same age with a low level of education. In 2013-2014, the difference was 2.9 years. For women, the results were 3.7 and 3.4 years, respectively. With the persistent social inequality in LE of more than 2 years and the continuous gap between high and low educational groups in DFLE of about 3 years, a differential pension age is recommended.
von Holst, Dietrich; Hutzelmeyer, Hans; Kaetzke, Paul; Khaschei, Martin; Schönheiter, Ronald
Wild rabbits of the two sexes have separate linear rank orders, which are established and maintained by intensive fights. The social rank of individuals strongly influence their fitness: males and females that gain a high social rank, at least at the outset of their second breeding season, have a much higher lifetime fitness than subordinate individuals. This is because of two separate factors: a much higher fecundity and annual reproductive success and a 50% longer reproductive life span. These results are in contrast to the view in evolutionary biology that current reproduction can be increased only at the expense of future survival and/or fecundity. These concepts entail higher physiological costs in high-ranking mammals, which is not supported by our data: In wild rabbits the physiological costs of social positions are caused predominantly by differential psychosocial stress responses that are much lower in high-ranking than in low-ranking individuals.
Full Text Available Background: Migration selectivity is thought to shape the health profiles of Mexican immigrants. Objective: This study examines how the experience of Mexican migration to the United States affects the health process and the quality of life in old age by age at migration, specific to sex. Methods: We use 20 years of data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly to estimate the proportion of life spent disability-free prior to death across eight subgroups by sex, nativity, and age at migration among Mexican-origin elderly in the United States. Results: Female migrants are at a significant disadvantage in terms of IADL disability-free life expectancy relative to US-born women, particularly late-life migrants. Conversely, mid- and late-life male migrants exhibit an advantage in ADL disability-free life expectancy compared to their US-born counterparts. Conclusions: Foreign-born Mexican elders are not a homogeneous group. This issue merits special attention in the development of community-based long-term care programs in order to appropriately target the specific needs of different subgroups of older Mexican individuals entering their last decades of life. Contribution: This study contributes to immigrant health literature by providing a more comprehensive documentation of nativity differentials, by distinguishing subgroups of Mexican elderly by sex, nativity, and age at migration.
Majer, Istvan M; Nusselder, Wilma J; Mackenbach, Johan P; Kunst, Anton E
The goal of this study was to estimate life expectancy (LE) and LE with disability (LwD) among normal weight, overweight, and obese smokers and nonsmokers in Western Europe. Data from four waves (1998-2001) of the European Community Household Panel (ECHP) were used; a standardized multipurpose annual longitudinal survey. Self-reported health and socioeconomic information was collected repeatedly using uniform questionnaires for 66,331 individuals in nine countries. Health status was measured in terms of disability in daily activities. Multistate Markov (MSM) models were applied to obtain hazard ratios (HRs) and age-specific transition rates according to BMI and smoking status. Multistate life tables were computed using the predicted transition probabilities to estimate LE and LwD. Significant associations were observed between disability incidence and BMI (HR = 1.15 for overweight, HR = 1.64 for obese, compared to normal weight). The risk of mortality was negatively associated with overweight status among disabled (HR = 0.77). Overweight people had higher LE than people with normal-weight and obesity. Among women, overweight and obese nonsmokers expect 3.6 and 6.1 more years of LwD than normal weight persons, respectively. In contrast, daily smokers expect lower LE but a similar LwD. The same patterns were observed among people with high education and those with low education. To conclude, daily smoking is associated with mortality more than with disability, whereas obesity is associated with disability more than with mortality. The findings suggest that further tobacco control would contribute to increasing LE, while tackling the obesity epidemic is necessary to prevent an expansion of disability.
Full Text Available Women have better patient outcomes in HIV care and treatment than men in sub-Saharan Africa. We assessed--at the population level--whether and to what extent mass HIV treatment is associated with changes in sex disparities in adult life expectancy, a summary metric of survival capturing mortality across the full cascade of HIV care. We also determined sex-specific trends in HIV mortality and the distribution of HIV-related deaths in men and women prior to and at each stage of the clinical cascade.Data were collected on all deaths occurring from 2001 to 2011 in a large population-based surveillance cohort (52,964 women and 45,688 men, ages 15 y and older in rural KwaZulu-Natal, South Africa. Cause of death was ascertained by verbal autopsy (93% response rate. Demographic data were linked at the individual level to clinical records from the public sector HIV treatment and care program that serves the region. Annual rates of HIV-related mortality were assessed for men and women separately, and female-to-male rate ratios were estimated in exponential hazard models. Sex-specific trends in adult life expectancy and HIV-cause-deleted adult life expectancy were calculated. The proportions of HIV deaths that accrued to men and women at different stages in the HIV cascade of care were estimated annually. Following the beginning of HIV treatment scale-up in 2004, HIV mortality declined among both men and women. Female adult life expectancy increased from 51.3 y (95% CI 49.7, 52.8 in 2003 to 64.5 y (95% CI 62.7, 66.4 in 2011, a gain of 13.2 y. Male adult life expectancy increased from 46.9 y (95% CI 45.6, 48.2 in 2003 to 55.9 y (95% CI 54.3, 57.5 in 2011, a gain of 9.0 y. The gap between female and male adult life expectancy doubled, from 4.4 y in 2003 to 8.6 y in 2011, a difference of 4.3 y (95% CI 0.9, 7.6. For women, HIV mortality declined from 1.60 deaths per 100 person-years (95% CI 1.46, 1.75 in 2003 to 0.56 per 100 person-years (95% CI 0.48, 0.65 in
Jones, Robin L; Cesne, Axel Le
Assessment of health-related quality of life (HRQoL) is essential for holistic care. Greater efforts are required to incorporate HRQoL measures into clinical trials and daily practice. Considerable HRQoL data are available for localized soft tissue sarcomas (STS), particularly in the orthopedic setting. In future, HRQoL is expected to become increasingly important in the evaluation of palliative therapy in advanced STS. A patient-centric approach is advocated for STS management. Greater awareness of STS by nonspecialist clinicians, and timely referral to specialized sarcoma reference centers, is crucial for patient welfare. The patient is central to shared decision-making during consultations and during case review in tumor boards. The management approach to STS should be collaborative, involving a multidisciplinary team, multiple centers and patient advocacy groups.
Ziegelmann, Jochen P; Lippke, Sonia; Schwarzer, Ralf
Applying socioemotional selectivity theory to the domain of health, we examined the interplay of social-cognitive predictors of physical exercise in two groups of people who perceived their remaining lifetime as either expansive or limited (based on subjective longevity ratings). Individuals (N = 370) who were prescribed physical exercise were assessed at discharge from orthopedic rehabilitation as well as 6 and 12 months later. Multigroup structural equation modeling showed differences in latent means, interrelations of predictors, and amount of explained variance. Individuals who perceived their time as limited reported a less favorable profile on social-cognitive variables and less exercise goal attainment. We give first insights on how health self-regulation differs in these groups, and we discuss avenues for intervention based on socioemotional selectivity theory. In contrast to chronological age, subjective life expectancy can be targeted by intervention.
Murray, C J; Lopez, A D
Information on non-fatal health outcomes of disease and injury has been largely neglected in health planning because of the conceptual and definitional complexity of measuring morbidity and disability in populations. One of our major objectives was to quantify disability for inclusion in health policy debates. We analysed these health outcomes in terms of disability-free life expectancy (DFLE) and disability-adjusted life expectancy (DALE). Published and unpublished data were systematically reviewed to estimate the incidence, prevalence, and duration of 483 disabling sequelae of 107 diseases and injuries. To ensure internal consistency of these estimates, a software programme (DISMOD) was applied many times until consistent parameters were identified. The severity of disability, on a scale of 0 (perfect health) to 1 (death), was measured in a deliberate manner by the person-trade-off method. Spearman's and Pearson's correlation coefficients were used to measure disability weights among groups. Prevalence of seven classes of disability was back-calculated from the distribution of each disabling sequela across disabilities. Prevalence for each class of disability for different age-sex groups was used to calculate seven forms of DFLE and DALE based on Sullivan's method. Prevalence of most disability classes is highest in sub-Saharan Africa and lowest in established market economies. Low-severity disabilities (class I and class II) are the most common. The expectation at birth of class I disability ranges from 6.5 years in established market economies to 14.7 years in sub-Saharan Africa, and for class II disabilities, from 8.5-18.4 years. DFLE varies significantly among regions: DFLE for class I disabilities at birth ranges from 9.9 years in sub-Saharan Africa to 47.7 years in established market economies for females and DFLE for class V disabilities ranges from 43.4 years for men in sub-Saharan Africa to 74.8 years for women in established market economies. The
Trevino, Kelly M; Zhang, Baohui; Shen, Megan J; Prigerson, Holly G
The objective of this study was to examine the source of advanced cancer patients' information about their prognosis and determine whether this source of information could explain racial disparities in the accuracy of patients' life expectancy estimates (LEEs). Coping With Cancer was a prospective, longitudinal, multisite study of terminally ill cancer patients followed until death. In structured interviews, patients reported their LEEs and the sources of these estimates (ie, medical providers, personal beliefs, religious beliefs, and other). The accuracy of LEEs was calculated through a comparison of patients' self-reported LEEs with their actual survival. The sample for this analysis included 229 patients: 31 black patients and 198 white patients. Only 39.30% of the patients estimated their life expectancy within 12 months of their actual survival. Black patients were more likely to have an inaccurate LEE than white patients. A minority of the sample (18.3%) reported that a medical provider was the source of their LEEs; none of the black patients (0%) based their LEEs on a medical provider. Black race remained a significant predictor of an inaccurate LEE, even after the analysis had been controlled for sociodemographic characteristics and the source of LEEs. The majority of advanced cancer patients have an inaccurate understanding of their life expectancy. Black patients with advanced cancer are more likely to have an inaccurate LEE than white patients. Medical providers are not the source of information for LEEs for most advanced cancer patients and especially for black patients. The source of LEEs does not explain racial differences in LEE accuracy. Additional research into the mechanisms underlying racial differences in prognostic understanding is needed. Cancer 2016;122:1905-12. © 2016 The Authors. Cancer published by Wiley Periodicals, Inc. on behalf of American Cancer Society. This is an open access article under the terms of the Creative Commons
Gambone, Kirsten; Rowles, Dorothy; Szuchyt, Jamie; Deitrick, Susan; Gelband, Amy; Lu, Barbara Chris; Zohe, Dorothy; Stickney, Deborah; Fields, Susan; Chambliss, Catherine
This study examined the attitudes of male and female college students regarding maternal employment and their own career and family expectations. Perceptions of the benefits and costs associated with maternal employment were assessed through the Beliefs about the Consequences of Maternal Employment for Children (BACMEC) questionnaire (E.…
Bernstein, L M; Chapman, G B; Elstein, A S
To explore framing or editing effects and a method to debias framing in a clinical context. Clinical scenarios using multioutcome life-expectancy lotteries of equal value required choices between two supplementary drugs that either prolonged or shortened life from the 20-year beneficial effect of a baseline drug. The effects of these supplementary drugs were presented in two conditions, using a between-subjects design. In segregated editing (n = 116) the effects were presented separately from the effects of the baseline drug. In integrated editing (n = 100), effects of supplementary and baseline drugs were combined in the lottery presentation. Each subject responded to 30 problems. To explore one method of debiasing, another 100 subjects made choices after viewing both segregated and integrated editings of 20 problems (dual framing). Statistically significant preference reversals between segregated and integrated editing of pure lotteries occurred only when one framing placed outcomes in the gain domain, and the other framing placed them in the loss domain. When both editings resulted in gain-domain outcomes only, there was no framing effect. There was a related relationship of framing-effect shifts from losses to gains in mixed-lottery-choice problems. Responses to the dual framing condition did not consistently coincide with responses to either single framing. In some situations, dual framing eliminated or lessened framing effects. The results support two components of prospect theory, coding outcomes as gains or losses from a reference point, and an s-shaped utility function (concave in gain, convex in loss domains). Presenting both alternative editings of a complex situation prior to choice more fully informs the decision maker and may help to reduce framing effects. Given the extent to which preferences shift in response to alternative presentations, it is unclear which choice represents the subject's "true preferences."
Lee, Wanhyung; Hong, Kwanyoung; Lim, Sung-Shil; Yoon, Jin-Ha
Many aging workers wish to continue working as long as they can for a better life in the future. However, symptoms of pain are a key obstacle in the continuation of work among older workers. The impact of pain on work is understudied. Thus, we investigated the relationship between pain characteristics (total site and severity) and aging workers' working life expectancy scale (WoLES) in Korea. We included 1,979 participants (1,175 men and 804 women) from a well-established survey of a nationally representative population: the Korean Longitudinal Study of Ageing. A self-questionnaire was used to assess pain characteristics and WoLES. Odds ratios (ORs) and 95% confidence intervals (CIs) for the lower-WoLES group were calculated using multiple logistic regression models. Compared with the absence of pain, ORs and 95% CIs of the lower-WoLES group were increased, as follows: 1 pain site, 1.75 (1.20-2.55); 2 pain sites, 1.99 (1.32-3.03); 3 or more pain sites, 2.28 (1.51-3.42); mild pain, 1.74 (1.32-2.61); moderate pain, 2.02 (1.28-3.22); and severe pain, 2.12 (1.46-3.08). The statistical trend was significant in both total sites and severity of pain (p<0.001). There was a significant association between WoLES and both total pain sites and severity of pain, even after adjusting for potential confounding factors.
depend on the reader’s own experiences, individual feelings, personal associations or on conventions of reading, interpretive communities and cultural conditions? This volume brings together narrative theory, fictionality theory and speech act theory to address such questions of expectations...
Conclusion: Hospitalized acute coronary syndrome patients have a lower levels of life expectancy. Their life expectancy can increase through providing them with self-care education, which will lead to their independence promotion and self-esteem.
Tareque, Md Ismail; Hoque, Nazrul; Islam, Towfiqua Mahfuza; Kawahara, Kazuo; Sugawa, Makiko
Life expectancy has increased considerably throughout the world. In Bangladesh, life expectancy has increased from about 53 years in 1975 to 69 years in 2010. However, it is unknown whether the increase in life expectancy is simultaneously accompanied by an increase in disability-free life expectancy (DFLE). The purpose of the study described in this article was to explore the relationship between life expectancy and DFLE in the Rajshahi District of Bangladesh by examining the relationships between the Active Aging Index (AAI) and DFLE. The study fi ndings suggest that urban, more-educated, elderly males are more active in all aspects of life and have longer DFLE. Females are found to outlive males but are more likely to live a greater part of their remaining life with disability. Positive correlations between the AAI and DFLE suggest that older adults could enjoy more DFLE by involving themselves in active aging activities.
Canudas-Romo, Vladimir; Becker, S
one are referred to here as imbalanced. This crossover occurs when infant mortality is equal to the inverse of life expectancy at age one. This simple relation between mortality at age zero and mortality after age one divides the world into countries that have achieved the crossover in life......The single most used demographic measure to describe population health is life expectancy at birth, but life expectancies at ages other than zero are also used in the study of human longevity. Our intuition tells us that the longest life expectancy is that of a newborn. However, historically......, the expectation of life at age one (e1) has exceeded the expectation of life at birth (e0). The crossover between e0 and e1 only occurred in the developed world in the second half of the twentieth century. Life tables for populations that have not achieved this crossing between life expectancy at birth and at age...
Luy, Marc; Minagawa, Yuka
The literature suggests that women report worse health but live longer than men--a phenomenon known as the gender paradox in health and mortality. Although studies examining the paradox abound, relatively little is known about mechanisms underlying the gap. With data on healthy life expectancy from the Global Burden of Disease Study 2010, this article analyses the relationship between length of life and health among men and women in 45 more-developed countries. The proportion of life spent in poor health is used as an indicator of health. This approach accounts for gender differences in longevity and illustrates the female health disadvantage pattern more clearly. Life expectancy at birth and the proportion of life in poor health are closely related for both genders. Furthermore, the larger the female excess in longevity, the larger the female excess in the proportion of life in poor health. By focusing on the proportion of life in poor health, this analysis suggests that women's longevity advantage translates into a health disadvantages relative to men. The results indicate that women suffer from poor health not in spite of living longer, but because they live longer.
Kessing, Lars Vedel; Vradi, Eleni; McIntyre, Roger S
BACKGROUND: Accelerated aging has been proposed as a mechanism explaining the increased prevalence of comorbid general medical illnesses in bipolar disorder. AIMS: To test the hypothesis that lost life years due to natural causes starts in early and mid-adulthood, supporting the hypothesis...... of accelerated aging. METHODS: Using individual data from nationwide registers of patient with a diagnosis of bipolar disorder we calculated remaining life expectancies before age 90 years for values of age 15, 25, 35…75 years among all individuals alive in year 2000. Further, we estimated the reduction in life...... expectancy due to natural causes (physical illnesses) and unnatural causes (suicide and accidents) in relation to age. RESULTS: A total of 22,635 patients with bipolar disorder were included in the study in addition to data from the entire Danish general population of 5.4 million people. At age 15 years...
Bayati, Mohsen; Akbarian, Reza; Kavosi, Zahra
Determinants of health or health production function in health economics literature constitute noticeable issues in health promotion. This study aimed at estimating a health production function for East Mediterranean Region (EMR) based on the Grossman theoretical model. This ecological study was performed using the econometric methods. The panel data model was used in order to determine the relationship between life expectancy and socioeconomic factors. The data for 21 EMR countries between 1995 and 2007 were used. Fixed-effect-model was employed to estimate the parameters based on Hausman test. In estimating the health production function, factors such as income per capita (β=0.05, Pdeterminants of health status, proxied by life expectancy at birth. A notable result was the elasticity of life expectancy with respect to the employment rate and its significance level was different between males (β=0.13, P0.001). In order to improve the health status in EMR countries, health policymakers should focus on the factors which lie outside the healthcare system. These factors are mainly associated with economic growth and development level. Thus, the economic stabilisation policies with the aim of increasing the productivity, economic growth, and reducing unemployment play significant roles in the health status of the people of the region.
Neelam C. Poudyal; Donald G. Hodges; J.M. Bowker; H.K. Cordell
This study examined the effect of natural resource amenities on human life expectancy. Extending theexisting model of the life expectancy production function, and correcting for spatial dependence, weevaluated the determinants of life expectancy using county level data. Results indicate that after controlling
In the past 30 years, U.S. and international studies have shown that societal expectations of the 'good manager' are closely related to the male stereotype. However, it is not clear, whether this stereotype is the same for men andwomen alike in managerial positions. The results of a German study with 625 students and 376 professionals participating between 1997 and 2005 are presentedin the short note below. The main findings of the study are: 1. Female managers are expected to conform more cl...
Radivojević Biljana M.
Full Text Available This paper analyzes the connection between life expectancy according to sex and numerous factors on which its level depends on. Statistical analysis understood application of correlation and regression analysis for determining the connection strength of life expectancy and researched factors separately and then all factors together, as well as separately groups of health-medical and socio-economic factors. The analysis was carried out for a group of developed countries, medium developed, mixed group and Yugoslavia (now SCG on available data for the second half of the 20th century. Analysis results for Yugoslavia showed that the greatest influence on life expectancy of all factors together were setting aside funds for social security (p<0.05. If only health-medical factors are observed, then child mortality up to 5 years and tumor mortality are in question. With women, the greatest influence is with child mortality up to five years old among all factors (
Kessing, Lars Vedel; Vradi, Eleni; McIntyre, Roger S; Andersen, Per Kragh
Accelerated aging has been proposed as a mechanism explaining the increased prevalence of comorbid general medical illnesses in bipolar disorder. To test the hypothesis that lost life years due to natural causes starts in early and mid-adulthood, supporting the hypothesis of accelerated aging. Using individual data from nationwide registers of patient with a diagnosis of bipolar disorder we calculated remaining life expectancies before age 90 years for values of age 15, 25, 35…75 years among all individuals alive in year 2000. Further, we estimated the reduction in life expectancy due to natural causes (physical illnesses) and unnatural causes (suicide and accidents) in relation to age. A total of 22,635 patients with bipolar disorder were included in the study in addition to data from the entire Danish general population of 5.4 million people. At age 15 years, remaining life expectancy before age 90 years was decreased 12.7 and 8.9 life years, respectively, for men and women with bipolar disorder. For 15-year old boys with bipolar disorder, natural causes accounted for 58% of all lost life years and for 15-year old girls, natural causes accounted for 67% increasing to 74% and 80% for 45-year old men and women, respectively. Data concern patients who get contact to hospital psychiatry only. Natural causes of death is the most prevalent reason for lost life years already from adolescence and increases substantially during early and mid-adulthood, in this way supporting the hypothesis of accelerated aging. Early intervention in bipolar disorder should not only focus on improving outcome of the bipolar disorder but also on decreasing the risk of comorbid general medical illnesses. Copyright © 2015 Elsevier B.V. All rights reserved.
Bronikowski, Anne M.; Cords, Marina; Alberts, Susan C.; Altmann, Jeanne; Brockman, Diane K.; Fedigan, Linda M.; Pusey, Anne; Stoinski, Tara; Strier, Karen B.; Morris, William F.
We provide male and female census count data, age-specific survivorship, and female age-specific fertility estimates for populations of seven wild primates that have been continuously monitored for at least 29 years: sifaka (Propithecus verreauxi) in Madagascar; muriqui (Brachyteles hypoxanthus) in Brazil; capuchin (Cebus capucinus) in Costa Rica; baboon (Papio cynocephalus) and blue monkey (Cercopithecus mitis) in Kenya; chimpanzee (Pan troglodytes) in Tanzania; and gorilla (Gorilla beringei) in Rwanda. Using one-year age-class intervals, we computed point estimates of age-specific survival for both sexes. In all species, our survival estimates for the dispersing sex are affected by heavy censoring. We also calculated reproductive value, life expectancy, and mortality hazards for females. We used bootstrapping to place confidence intervals on life-table summary metrics (R0, the net reproductive rate; λ, the population growth rate; and G, the generation time). These data have high potential for reuse; they derive from continuous population monitoring of long-lived organisms and will be invaluable for addressing questions about comparative demography, primate conservation and human evolution. PMID:26928014
Wilk, Kelly E.
This chapter explores the work-life experiences of administrators as well as whether and how the ideal worker model affects those experiences. Departmental and supervisory differences and technology complicate administrators' work-life experiences.
Müller, Dennis W H; Lackey, Laurie Bingaman; Streich, W Jürgen; Fickel, Jörns; Hatt, Jean-Michel; Clauss, Marcus
Zoo animal husbandry aims at constantly improving husbandry, reproductive success and ultimately animal welfare. Nevertheless, analyses to determine factors influencing husbandry of different species are rare. The relative life expectancy (rLE; life expectancy (LE) as proportion of longevity) describes husbandry success of captive populations. Correlating rLE with biological characteristics of different species, reasons for variation in rLE can be detected. We analysed data of 166 901 animals representing 78 ruminant species kept in 850 facilities. The rLE of females correlated with the percentage of grass in a species' natural diet, suggesting that needs of species adapted to grass can be more easily accommodated than the needs of those adapted to browse. Males of monogamous species demonstrate higher rLE than polygamous males, which matches observed differences of sexual bias in LE in free-living populations and thus supports the ecological theory that the mating system influences LE. The third interesting finding was that rLE was higher in species managed by international studbooks when compared with species not managed in this way. Our method facilitates the identification of biological characteristics of species that are relevant for their husbandry success, and they also support ecological theory. Translating these findings into feeding recommendations, our approach can help to improve animal husbandry.
Berkel, J; de Waard, F
The mortality pattern of Seventh-Day Adventists (SDAs) in the Netherlands was assessed during a ten-year study period, 1968-1977. Of 522 deceased SDAs the causes of death of 482 could be ascertained. Standardized Mortality Ratios (SMR) for total mortality (SMR = 0,45), cancer (SMR = 0,50) and cardiovascular diseases (SMR = 0,41) as well as for various subgroups differed significantly from the total Dutch population. Mean age at death as well as life-expectation at baptism were significantly higher in SDAs, both in males and females, as compared with Dutch males and females. A health survey among a sample of the total SDA population and a group of 'friend' controls' was done in order to try to explain the differences in mortality pattern and life expectancy. It is concluded that evidence was found for the thesis that abstinence from cigarette smoking is the main factor explaining the low mortality from ischaemic heart diseases among SDAs, while presumably an appropriate (prudent) diet confers additional benefit for example on colon cancer mortality.
Wood, Brian M; Watts, David P; Mitani, John C; Langergraber, Kevin E
Demographic data on wild chimpanzees are crucial for understanding the evolution of chimpanzee and hominin life histories, but most data come from populations affected by disease outbreaks and anthropogenic disturbance. We present survivorship data from a relatively undisturbed and exceptionally large community of eastern chimpanzees (Pan troglodytes schweinfurthii) at Ngogo, Kibale National Park, Uganda. We monitored births, deaths, immigrations, and emigrations in the community between 1995 and 2016. Using known and estimated ages, we calculated survivorship curves for the whole community, for males and females separately, and for individuals ≤2 years old when identified. We used a novel method to address age estimation error by calculating stochastic survivorship curves. We compared Ngogo life expectancy, survivorship, and mortality rates to those from other chimpanzee communities and human hunter-gatherers. Life expectancy at birth for both sexes combined was 32.8 years, far exceeding estimates of chimpanzee life expectancy in other communities, and falling within the range of human hunter-gatherers (i.e., 27-37 years). Overall, the pattern of survivorship at Ngogo was more similar to that of human hunter-gatherers than to other chimpanzee communities. Maximum lifespan for the Ngogo chimpanzees, however, was similar to that reported at other chimpanzee research sites and was less than that of human-hunter gatherers. The absence of predation by large carnivores may contribute to some of the higher survivorship at Ngogo, but this cannot explain the much higher survivorship at Ngogo than at Kanyawara, another chimpanzee community in the same forest, which also lacks large carnivores. Higher survivorship at Ngogo appears to be an adaptive response to a food supply that is more abundant and varies less than that of Kanyawara. Future analyses of hominin life history evolution should take these results into account. Copyright © 2017 Elsevier Ltd. All rights
Coyle, Douglas; Stieb, Dave; Burnett, Richard T; DeCivita, Paul; Krewski, Daniel; Chen, Yue; Thun, Michael J
Air pollution and premature death are important public health concerns. Analyses have repeatedly demonstrated that airborne particles are associated with increased mortality and estimates have been used to forecast the impact on life expectancy. In this analysis, we draw upon data from the American Cancer Society (ACS) cohort and literature on utility-based measures of quality of life in relation to health status to more fully quantify the effects of air pollution on mortality in terms of quality-adjusted life expectancy. The analysis was conducted within a decision analytic model using Monte Carlo simulation techniques. Outcomes were estimated based on projections of the Canadian population. A one-unit reduction in sulfate air pollution would yield a mean annual increase in Quality-Adjusted Life Years (QALYs) of 20,960, with gains being greater for individuals with lower educational status and for males compared to females. This suggests that the impact of reductions in sulfate air pollution on quality-adjusted life expectancy is substantial. Interpretation of the results is unclear. However, the potential gains in QALYs from reduced air pollutants can be contrasted to the costs of policies to bring about such reductions. Based on a tentative threshold for the value of health benefits, analysis suggests that an investment in Canada of over 1 billion dollars per annum would be an efficient use of resources if it could be demonstrated that this would reduce sulfate concentrations in ambient air by 1 microg/m(3). Further analysis can assess the efficiency of targeting such initiatives to communities that are most likely to benefit.
Price, Hermione C; Clarke, Philip M; Gray, Alastair M; Holman, Rury R
Insurance companies often offer people with diabetes ''enhanced impaired life annuity'' at preferential rates, in view of their reduced life expectancy. To assess the appropriateness of ''enhanced impaired life annuity'' rates for individuals with type 2 diabetes. Patients. There were 4026 subjects with established type 2 diabetes (but not known cardiovascular or other life-threatening diseases) enrolled into the UK Lipids in Diabetes Study. Measurements. Estimated individual life expectancy using the United Kingdom Prospective Diabetes Study (UKPDS) Outcomes Model. Subjects were a mean (SD) age of 60.7 (8.6) years, had a blood pressure of 141/83 (17/10) mm Hg, total cholesterol level of 4.5 (0.75) mmol/L, HDL cholesterol level of 1.2 (0.29) mmol/L, with median (interquartile range [IQR]) known diabetes duration of 6 (3-11) years, and HbA(1c) of 8.0% (7.2-9.0). Sixty-five percent were male, 91% white, 4% Afro-Caribbean, 5% Indian-Asian, and 15% current smokers. The UKPDS Outcomes Model median (IQR) estimated age at death was 76.6 (73.8-79.5) years compared with 81.6 (79.4-83.2) years, estimated using the UK Government Actuary's Department data for a general population of the same age and gender structure. The median (IQR) difference was 4.3 (2.8-6.1) years, a remaining life expectancy reduction of almost one quarter. The highest value annuity identified, which commences payments immediately for a 60-year-old man with insulin-treated type 2 diabetes investing 100,000, did not reflect this difference, offering 7.4K per year compared with 7.0K per year if not diabetic. The UK Government Actuary's Department data overestimate likely age at death in individuals with type 2 diabetes, and at present, ''enhanced impaired life annuity'' rates do not provide equity for people with type 2 diabetes. Using a diabetes-specific model to estimate life expectancy could provide valuable information to the annuity industry and permit more equitable annuity rates for those with type 2
Laditka, James N; Laditka, Sarah B
Unemployment may be associated with health through factors including stress, depression, unhealthy behaviors, reduced health care, and loss of social networks. Little is known about associations of total lifetime unemployment with disability and life expectancy. People with high unemployment (≥the median) will live shorter lives with more disability than those with less unemployment. Data were nationally representative of African Americans and non-Hispanic whites, from the Panel Study of Income Dynamics (37 waves 1968-2011, n = 7,970, mean work years = 24.7). Seven waves (1999-2011, 58,268 person-years) measured disability in activities of daily living. We estimated monthly probabilities of disability and death associated with unemployment using multinomial logistic Markov models adjusted for age, sex, race/ethnicity, education, health status at baseline and throughout work life, and social support. We used the probabilities to create large populations with microsimulation, each individual having known monthly disability status, age 40 to death. We analyzed the populations to measure outcomes. Respectively for African American and white women and African American and white men, life expectancies (with 95% confidence intervals) from age 40 with low unemployment were ages: 77.1 (75.0-78.3), 80.6 (78.4-81.4), 71.4 (69.6-72.5), and 76.9 (74.9-77.9). Corresponding high unemployment results were: 73.7 (71.7-75.0), 77.5 (75.1-78.0), 68.4 (66.8-69.0), and 73.7 (71.5-74.3). The percentage of life disabled from age 40 was greater with high unemployment for the same groups, by 23.9%, 21.0%, 21.3%, and 21.1% (all p unemployment may be associated with a larger proportion of later life with disability and lower life expectancy. Copyright © 2016 Elsevier Inc. All rights reserved.
Singh, Gopal K.; Siahpush, Mohammad
This study examined the association between unemployment and life expectancy in the United States during 1990–2010. Census-based unemployment rates were linked to US county-level mortality data. Life expectancies were calculated by age, sex, race, and unemployment level during 1990–2010. Differences in life expectancy were decomposed by age and cause of death. Life expectancy was consistently lower in areas with higher unemployment rates. In 2006–2010, those in areas with high unemployment rates (≥9%) had a life expectancy of 76.9 years, compared with 80.7 years for those in areas with low unemployment rates (unemployment and life expectancy was stronger for men than for women. Life expectancy ranged from 69.9 years among black men in high unemployment areas to 90.0 years among Asian/Pacific Islander women in low unemployment areas. Disparities persisted over time. In 1990–1992, life expectancy was 4.7 years shorter in high unemployment than in low unemployment areas. In 2006–2010, the life expectancy difference between the lowest and highest unemployment areas decreased to 3.8 years. Heart disease, cancer, homicide, unintentional injuries, diabetes, HIV/AIDS, and liver cirrhosis contributed most to the lower life expectancy in high unemployment areas. High unemployment areas recorded larger gains in life expectancy than low unemployment areas, contributing to the narrowing gap during 1990–2010. PMID:27073716
Gopal K. Singh
Full Text Available This study examined the association between unemployment and life expectancy in the United States during 1990–2010. Census-based unemployment rates were linked to US county-level mortality data. Life expectancies were calculated by age, sex, race, and unemployment level during 1990–2010. Differences in life expectancy were decomposed by age and cause of death. Life expectancy was consistently lower in areas with higher unemployment rates. In 2006–2010, those in areas with high unemployment rates (≥9% had a life expectancy of 76.9 years, compared with 80.7 years for those in areas with low unemployment rates (<3%. The association between unemployment and life expectancy was stronger for men than for women. Life expectancy ranged from 69.9 years among black men in high unemployment areas to 90.0 years among Asian/Pacific Islander women in low unemployment areas. Disparities persisted over time. In 1990–1992, life expectancy was 4.7 years shorter in high unemployment than in low unemployment areas. In 2006–2010, the life expectancy difference between the lowest and highest unemployment areas decreased to 3.8 years. Heart disease, cancer, homicide, unintentional injuries, diabetes, HIV/AIDS, and liver cirrhosis contributed most to the lower life expectancy in high unemployment areas. High unemployment areas recorded larger gains in life expectancy than low unemployment areas, contributing to the narrowing gap during 1990–2010.
Aburto, José Manuel; Beltrán-Sánchez, Hiram; García-Guerrero, Victor Manuel; Canudas-Romo, Vladimir
Life expectancy in Mexico increased for more than six decades but then stagnated in the period 2000–10. This decade was characterized by the enactment of a major health care reform—the implementation of the Seguro Popular de Salud (Popular Health Insurance), which was intended to provide coverage to the entire Mexican population—and by an unexpected increase in homicide mortality. We assessed the impact on life expectancy of conditions amenable to medical service—those sensitive to public health policies and changes in behaviors, homicide, and diabetes—by analyzing mortality trends at the state level. We found that life expectancy among males deteriorated from 2005 to 2010, compared to increases from 2000 to 2005. Females in most states experienced small gains in life expectancy between 2000 and 2010. The unprecedented rise in homicides after 2005 led to a reversal in life expectancy increases among males and a slowdown among females in most states in the first decade of the twenty-first century. PMID:26733705
Aburto, José Manuel; Beltrán-Sánchez, Hiram; García-Guerrero, Victor Manuel; Canudas-Romo, Vladimir
Life expectancy in Mexico increased for more than six decades but then stagnated in the period 2000-10. This decade was characterized by the enactment of a major health care reform-the implementation of the Seguro Popular de Salud (Popular Health Insurance), which was intended to provide coverage to the entire Mexican population-and by an unexpected increase in homicide mortality. We assessed the impact on life expectancy of conditions amenable to medical service-those sensitive to public health policies and changes in behaviors, homicide, and diabetes-by analyzing mortality trends at the state level. We found that life expectancy among males deteriorated from 2005 to 2010, compared to increases from 2000 to 2005. Females in most states experienced small gains in life expectancy between 2000 and 2010. The unprecedented rise in homicides after 2005 led to a reversal in life expectancy increases among males and a slowdown among females in most states in the first decade of the twenty-first century. Project HOPE—The People-to-People Health Foundation, Inc.
Beltrán-Sánchez, Hiram; Andrade, Flávia Cristina Drumond
To estimate transition probabilities between disability states, total life expectancy, and the latter's decomposition into years spent disabled and disability-free by age, sex, and education among older adults in São Paulo, Brazil, and urban areas in Mexico. Applied a micro-simulation method (Interpolative Markov Chains) using longitudinal data. We found large between-country educational differences in incidence of and recovery from disability with higher rates in Mexico than in São Paulo, but no differences in mortality. Older adults in Mexico spent longer time being disability-free than in São Paulo for both levels of education. Males and females in São Paulo spent a larger fraction of their remaining life disabled at every age than their counterparts in urban areas in Mexico. There were educational differences in the prevalence of disability in São Paulo and urban areas in Mexico, and significant educational differences in disability incidence and recovery across sites.
Eslava-Schmalbach, Javier H; Rincón, Carlos Javier; Guarnizo-Herreño, Carol Cristina
Life expectancy is one of the measurements that have been used to monitor socioeconomic development within and among countries. During the last 30 years, life expectancy has increased worldwide mainly due to medical and technological developments. However, access to health care, new technologies and social determinants remain unevenly distributed among regions and countries in the world. To assess inequalities in life expectancy by gender and regions (departments) in Colombia between 2000 and 2009. Ecological study. Life expectancy was estimated for each Colombian department using yearly life tables from 2000 to 2009. We used data from the death registries and the estimated population series, provided by the Departamento Administrativo Nacional de Estadística (DANE). For the study period, estimates of life expectancy by departments were compared with those from Japan for the years 2000, 2006 and 2009, which is the country with the highest life expectancy in the world, and with the Colombian department with the highest life expectancy from 2000 to 2009. Compared with the highest life expectancy in the world, Colombian departments showed differences ranged between 5.7 and 21 years. We found significant differences between departments, with the largest difference being 15.3 years. Additionally, in some departments life expectancy decreased during the analyzed period. This study identified differences in life expectancy in Colombian departments suggesting inequalities in health and living conditions among them. These differences increased in some departments during the period 2000-2009.
.... For the job seeker, the expectations may be as clear as the money that will be earned and the training that will be received, as vague as wanting "good opportunity for advancement" or as difficult...
Dieckmann, Peter; Lippert, A.; Glavin, R.
In this paper we discuss scenario life savers - interventions before and during simulation scenarios that allow to create and use relevant learning opportunities, even if unexpected events happen during the conduction of the scenario. Scenario life savers are needed, when the comprehension...... or acceptance of the scenario by the participants is at stake, thus compromising learning opportunities. Scenario life savers can principally work by bringing participants back on track of the planned scenario or by adapting the conduction to their actions on the fly. Interventions can be within the logic...... of the scenario or from the "outside," not being part of the scenario itself. Scenario life savers should be anticipated during the design of scenarios and used carefully during their conduction, aiming to maximize the learning for participants. (Sim Healthcare 5: 219-225, 2010)...
Full Text Available Background: Ethnic health inequalities for males and females among the elderly have not yet been verified in multicultural societies in developing countries. The aim of this study was to assess the extent of disparities in health expectancy among the elderly from different ethnic groups using quality-adjusted life expectancy. Design: A cross-sectional community-based survey was conducted. A total of 6,511 rural elderly individuals aged ≥60 years were selected from eight different ethnic groups in the Guangxi Zhuang Autonomous Region of China and assessed for health-related quality of life (HRQoL. The HRQoL utility value was combined with life expectancy at age 60 years (LE60 data by using Sullivan's method to estimate quality-adjusted life expectancy at age 60 years (QALE60 and loss in quality-adjusted life years (QALYs for each group. Results: Overall, LE60 and QALE60 for all ethnic groups were 20.9 and 18.0 years in men, respectively, and 24.2 and 20.3 years in women. The maximum gap in QALE60 between ethnic groups was 3.3 years in males and 4.6 years in females. The average loss in QALY was 2.9 years for men and 3.8 years for women. The correlation coefficient between LE60 and QALY lost was −0.53 in males and 0.12 in females. Conclusion: Women live longer than men, but they suffer more; men have a shorter life expectancy, but those who live longer are healthier. Attempts should be made to reduce suffering in the female elderly and improve longevity for men. Certain ethnic groups had low levels of QALE, needing special attention to improve their lifestyle and access to health care.
The classic explanation that women outlive men solely due to hormonal and lifestyle differences, does not withstand a critical analysis. In developed countries, the average gap in life expectancy between the sexes is 7 years. It has widened over the last decades, despite the trend of women copying the 'unhealthy' lifestyle of men. Estrogen levels in postmenopausal women are virtually identical to estrogen levels in males and can hardly explain the discrepancy. Furthermore, testosterone got its bad reputation from one study on mentally retarded men, which has to be interpreted with caution. However, sexual size dimorphism with men being the larger sex in conjunction with the limited replication potential of human somatic cells might account for higher mortality rates in males, especially at old age. The hypothesis, as presented here, is based on the well-known concept of a cellular mitotic clock, which was discovered by Leonard Hayflick almost half a century ago. The underlying counting mechanism, namely the gradual erosion of chromosome ends (telomeres) due to the end replication problem of linear DNA molecules, was first described by Alexey Olovnikov in 1971 and with minor modifications has become a widely accepted paradigm. In a recent Lancet study, an inverse correlation between mean telomere length and mortality in people has been found. In this and two other studies, it was confirmed that males do have shorter telomeres than females at the same age. This is almost certainly a consequence of men being usually taller than women, although nobody has done an investigation yet. Clearly, a larger body requires more cell doublings, especially due to the ongoing regeneration of tissues over a lifetime. Accordingly, the replicative history of male cells might be longer than that of female cells, resulting in the exhaustion of the regeneration potential and the early onset of age-associated diseases predominantly in large-bodied males. Inherited telomere length
Leung, Michael C M; Zhang, Jie; Zhang, Junsen
This paper presents an economic model to explain the behavior of life expectancy of both sexes. It explicitly examines the relationship between the gender gap in life expectancy and the gender gap in pay. It shows that as the latter narrows over the course of economic development, the former may initially expand but will eventually shrink. Simulation results from our model accord with the behavior of life expectancy for both sexes since the 1940s in the United States.
Gao, Junke; Kakehashi, Masayuki
It is well known that Japanese people have the longest life expectancy in the world at present. Variouspoints of view which focus on causal contexts are reported. The present study used a database at theprefectural level in Japan, which included Japanese life expectancy at birth, employment types of thehousehold, medical resources, medical expenses, and nutrition indexes in 2000. The purpose of the studywas to clarify the major related factors on Japanese life expectancy. The results suggest ...
Robert M Shavelle
Full Text Available Robert M Shavelle1, David R Paculdo1, Scott J Kush1, David M Mannino2, David J Strauss11Life Expectancy Project, San Francisco, CA, USA; 2Pulmonary Epidemiology Research Laboratory, University of Kentucky School of Medicine, Division of Pulmonary and Critical Care Medicine, Lexington, KY, USARationale: Previous studies have demonstrated that chronic obstructive pulmonary disease (COPD causes increased mortality in the general population. But life expectancy and the years of life lost have not been reported.Objectives: To quantify mortality, examine how it varies with age, sex, and other risk factors, and determine how life expectancy is affected.Methods: We constructed mortality models using the Third National Health and Nutrition Examination Survey, adjusting for age, sex, race, and major medical conditions. We used these to compute life expectancy and the years of life lost. Measurements and main results: Pulmonary function testing classifi ed patients as having Global Initiative on Obstructive Lung Disease (GOLD stage 0, 1, 2, 3 or 4 COPD or restriction. COPD is associated with only a modest reduction in life expectancy for never smokers, but with a very large reduction for current and former smokers. At age 65, the reductions in male life expectancy for stage 1, stage 2, and stages 3 or 4 disease in current smokers are 0.3 years, 2.2 years, and 5.8 years. These are in addition to the 3.5 years lost due to smoking. In former smokers the reductions are 1.4 years and 5.6 years for stage 2 and stages 3 or 4 disease, and in never smokers they are 0.7 and 1.3 years.Conclusions: Persons with COPD have an increased risk of mortality compared to those who do not, with consequent reduction in life expectancy. The effect is most marked in current smokers, and this is further reason for smokers to quit.Keywords: survival, mortality, longevity, COPD
Hashimoto, Shuji; Kawado, Miyuki; Seko, Rumi; Murakami, Yoshitaka; Hayashi, Masayuki; Kato, Masahiro; Noda, Tatsuya; Ojima, Toshiyuki; Nagai, Masato; Tsuji, Ichiro
Background In Japan, life expectancy at birth is currently the highest in the world. However, recent trends in disability-free life expectancy in Japan have not been examined. Methods We used data from Japanese national surveys for the period 1995–2004. These surveys included information on activity status measured by common self-reported instruments. The numbers of expected years with and without activity limitation were estimated by using the Sullivan method. Results The numbers of expected...
Arrindell, W.A.; Veenhoven, R
Cross-national studies suggest that people are happier in feminine nations that are also economically affluent. The first objective of the present study was to replicate this finding with a quality of life index which is more comprehensive than the usual measures of subjective well-being. This
C. D. Reimers
Full Text Available Physical activity reduces many major mortality risk factors including arterial hypertension, diabetes mellitus type 2, dyslipidemia, coronary heart disease, stroke, and cancer. All-cause mortality is decreased by about 30% to 35% in physically active as compared to inactive subjects. The purpose of this paper was to synthesize the literature on life expectancy in relation to physical activity. A systematic PubMed search on life expectancy in physically active and inactive individuals was performed. In addition, articles comparing life expectancy of athletes compared to that of nonathletes were reviewed. Results of 13 studies describing eight different cohorts suggest that regular physical activity is associated with an increase of life expectancy by 0.4 to 6.9 years. Eleven studies included confounding risk factors for mortality and revealed an increase in life expectancy by 0.4 to 4.2 years with regular physical activity. Eleven case control studies on life expectancy in former athletes revealed consistently greater life expectancy in aerobic endurance athletes but inconsistent results for other athletes. None of these studies considered confounding risk factors for mortality. In conclusion, while regular physical activity increases life expectancy, it remains unclear if high-intensity sports activities further increase life expectancy.
Uchendu, Florence N
Malnutrition is a global public health problem especially in developing countries experiencing war/conflicts. War might be one of the socio-political factors influencing malnutrition in Sub-Saharan African (SSA) countries. This study aims at determining the influence of war on corruption, population (POP), number of population malnourished (NPU), food security and life expectancy (LE) in war-torn SSA countries (WTSSA) by comparing their malnutrition indicators. Fourteen countries in WTSSA were stratified into zones according to war incidences. Countries' secondary data on population (POP), NPU, Food Security Index (FSI), corruption perceptions index (CPI), Global Hunger Index (GHI) and LE were obtained from global published data. T test, multivariate and Pearson correlation analyses were performed to determine the relationship between CPI, POP, GHI, FSI, NPU, male LE (MLE) and female LE (FLE) in WTSSA at p Malnutrition indicators were similarly affected in WTSSA. Hunger influenced life expectancy. Policies promoting good governance, equity, peaceful co-existence, respect for human right and adequate food supply will aid malnutrition eradication and prevent war occurrences in Sub-Saharan African countries.
de Rezende, Leandro Fornias Machado; Rabacow, Fabiana Maluf; Viscondi, Juliana Yukari Kodaira; Luiz, Olinda do Carmo; Matsudo, Victor Keihan Rodrigues; Lee, I-Min
In Brazil, one-fifth of the population reports not doing any physical activity. This study aimed to assess the impact of physical inactivity on major noncommunicable diseases (NCDs), all-cause mortality and life expectancy in Brazil, by region and sociodemographic profile. We estimated the population attributable fraction (PAF) for physical inactivity associated with coronary heart disease, type 2 diabetes, breast cancer, colon cancer, and all-cause mortality. To calculate the PAF, we used the physical inactivity prevalence from the 2008 Brazilian Household Survey and relative risk data in the literature. In Brazil, physical inactivity is attributable to 3% to 5% of all major NCDs and 5.31% of all-cause mortality, ranging from 5.82% in the southeastern region to 2.83% in the southern region. Eliminating physical inactivity would increase the life expectancy by an average of 0.31 years. This reduction would affect mainly individuals with ≥ 15 years of schooling, male, Asian, elderly, residing in an urban area and earning ≥ 2 times the national minimum wage. In Brazil, physical inactivity has a major impact on NCDs and mortality, principally in the southeastern and central-west regions. Public policies and interventions promoting physical activity will significantly improve the health of the population.
Crimmins, Eileen M; Zhang, Yuan; Saito, Yasuhiko
To examine changes over 40 years (1970-2010) in life expectancy, life expectancy with disability, and disability-free life expectancy for American men and women of all ages. We used mortality rates from US Vital Statistics and data on disability prevalence in the community-dwelling population from the National Health Interview Survey; for the institutional population, we computed disability prevalence from the US Census. We used the Sullivan method to estimate disabled and disability-free life expectancy for 1970, 1980, 1990, 2000, and 2010. Over the 40 years, there was a steady increase in both disability-free life expectancy and disabled life expectancy. At birth, increases in disabled life and nondisabled life were equal for men (4.5 years); for women, at birth the increase in life with disability (3.6 years) exceeded the increase in life free of disability (2.7 years). At age 65 years, the increase in disability-free life was greater than the increase in disabled life. Across the life cycle, there was no compression of morbidity, but at age 65 years some compression occurred.
Radivojević Biljana M.
average amounted to about 3 years for the male and about 5 years for the female population. In Japan in 1998 it amounted to 17.1 years, namely 22.0 years respectively. However, it is interesting that all up to the seventies these indexes were almost at the same level in our country and Japan, and only after this period the differences appeared as a consequence of putting an end to the positive tendencies in differential mortality by age, even in the increase rate with the older population in Yugoslavia. On the other hand, the anticipated life expectancy for the age of 65 (for both sexes was increased by 40%, in Japan from 1970 to 1998, in contrast to an increase of 9% for 0 age. In the same period in Yugoslavia, although there was a considerably lower increase percentage, it was still more significant with newborns (above 6% for both sexes, than with population older than 65 (under 5%. Hence, such an inclination and intensity of changes resulted, in relation to Japan, in a relatively greater lagging with people aged 65 than with 0 age. The anticipated life expectancy for people aged 85 and over, in the whole observed period, increased only by 8% with the male population and 10% with the female population of Yugoslavia. Its present level is the result of small changes in the mortality rates of the oldest population. In average, people aged 85 + will live another 4.2, namely 4.4 years respectively under the assumed mortality from 1997/98. At the same time the Japanese men are expected to live another 5.4, and Japanese women another 7.2 years. Therefore, middle aged and old population in Yugoslavia has had unfavorable mortality tendencies in relation to the young population, more distinct beginning from the seventies, and especially with men. The nineties were again unfavorable for the old population, this time especially for the female population, where a slight decrease of this rate was marked. Having in mind the changes and achieved level of anticipated life expectancy in
Mohammad Reza Zarbakhsh Bahri
Full Text Available Introduction: This study aims to evaluate the effectiveness of stress management training and problem-solving training on quality of life and life expectancy of infertile women was conducted.Material and Methods: The method of this study was experimental with pretest – posttest design with a control group. population of 400 infertile women who referred to infertility center in Rasht were randomized to 250 of them were selected and the quality of life and life expectancy of the study were the 45 members of the quality of life and life expectancy lower were more randomly in three groups of 15 people, including two experimental groups and one control group were replaced. Each experimental groups were trained for 10 sessions of 90 minutes, respectively, stress management and problem-solving. Upon completion of the training program, participants were assessed again.Results: The result of present study showed that there was a significant difference between the experimental groups and control group in the scores of quality of life and life expectancy (p0.05.Conclusion: Stress management and problem solving training were effective on life expectancy and quality of life of infertile women but there was no significant difference between the effectiveness of these two methods on life expectancy and quality of life of infertile women.
Although some minimally acceptable practices are presently undertaken at most landfills to protect human health and safety and the environment, a key question remains. How much effort and resources should be expended to slow the fill-rate of a landfill? The answer depends on the performance and costs of the technical options available, the difficulty and cost of acquiring additional landfill space, and the consequences for remaining landfill lifetime of current and future actions. Toward this end, the paper (1) presents a method for projecting the remaining life of a landfill, including the alternative lifetimes associated with life extension measures; (2) presents a case study of the low-level waste landfill at Los Alamos National Lab.; and (3) illustrates a procedure for determining which measures become cost-effective to adopt as a landfill's space declines
Cockerham, William C
This paper examines the gender-related features of the health crisis in Russia which has produced the largest gender gap in life expectancy in the world. Stress and negative health lifestyles are the two most likely causes of the long-term adverse longevity pattern in Russia. However, this development cannot be clarified by a simple cause and effect explanation. This is because gender roles and gender-based normative behaviour, along with class influences, intervened to help shape outcomes. Men and women responded to the crisis along gender lines, with stress the best single explanation for a stunted longevity for females and negative health lifestyles accounting for much of the premature mortality among males. © 2012 The Author. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.
Full Text Available Abstract Background The incidence of chronic obstructive pulmonary disease (COPD and bronchial asthma began increasing in early 1960s in the population of Yokkaichi-city (Mie Prefecture, Japan. The cause of the disease was sulfur oxide air pollution, and it is known as Yokkaichi Asthma. The pollution markedly decreased by the end of 1970s; no new cases have been reported since 1988. This study aimed at examining the late effects of air pollution on the health of Yokkaichi Asthma patients. Methods Mortality rate and life expectancy of patients, registered between 1965 and 1988, were investigated from 1975 through 2000. Results Mortality rates for COPD and asthma in patients from Yokkaichi-city were significantly higher than in the whole population of Mie Prefecture. For all ages (except for males between 80 and 84 years in 1985, the life expectancy of both males and females were significantly reduced in patients from Yokkaichi-city as compared with the whole population of Mie Prefecture. The potential gains in life expectancy excluding the mortality for respiratory diseases including COPD and asthma were larger for all ages in patients from Yokkaichi-city. Conclusion Mortality and life expectancy were adversely affected in patients from Yokkaichi-city, despite the fact that the air pollution problem has been already solved.
Bolvin, M.; Chauvel, D.
The paper describes the following different tasks of the study whose aim was to extend the life time of cooling towers for French Nuclear Power plants to 40 years. The aging factors specific to cooling towers were measured and analysed with regard to the external surface, the internal surface and inside the concrete. The safety coefficient for buckling was calculated and then the stress analysis of the materials (concrete and steel) was done. A special computer program written for cooling towers was used with a model including the soil stiffness and the supports of the tower. (author)
Bynum Debra L
Full Text Available Abstract Background Estimates of life expectancy assist physicians and patients in medical decision-making. The time-delayed benefits for many medical treatments make an older adult's life expectancy estimate particularly important for physicians. The purpose of this study is to assess older adults' beliefs about physician-estimated life expectancy. Methods We performed a mixed qualitative-quantitative cross-sectional study in which 116 healthy adults aged 70+ were recruited from two local retirement communities. We interviewed them regarding their beliefs about physician-estimated life expectancy in the context of a larger study on cancer screening beliefs. Semi-structured interviews of 80 minutes average duration were performed in private locations convenient to participants. Demographic characteristics as well as cancer screening beliefs and beliefs about life expectancy were measured. Two independent researchers reviewed the open-ended responses and recorded the most common themes. The research team resolved disagreements by consensus. Results This article reports the life-expectancy results portion of the larger study. The study group (n = 116 was comprised of healthy, well-educated older adults, with almost a third over 85 years old, and none meeting criteria for dementia. Sixty-four percent (n = 73 felt that their physicians could not correctly estimate their life expectancy. Sixty-six percent (n = 75 wanted their physicians to talk with them about their life expectancy. The themes that emerged from our study indicate that discussions of life expectancy could help older adults plan for the future, maintain open communication with their physicians, and provide them knowledge about their medical conditions. Conclusion The majority of the healthy older adults in this study were open to discussions about life expectancy in the context of discussing cancer screening tests, despite awareness that their physicians' estimates could be inaccurate
Full Text Available Current climate policy and issues of energy security mean wind farms are being built at an increasing rate to meet energy demand. As wind farm development is very likely in the Mediterranean Sea, we provide an assessment of the offshore wind potential and identify expected biological effects of such developments in the region. We break new ground here by identifying potential offshore wind farm (OWF “hotspots” in the Mediterranean. Using lessons learned in Northern Europe, and small-scale experiments in the Mediterranean, we identify sensitive species and habitats that will likely be influenced by OWFs in both these hotspot areas and at a basin level. This information will be valuable to guide policy governing OWF development and will inform the industry as and when environmental impact assessments are required for the Mediterranean Sea.
Zhang, Zhong-ying; Tang, Zhe; Feng, Ming
The aim of the study is to explore the influence of hypertension on life expectancy (LE), active life expectancy (ALE) and active life expectancy/life expectancy (ALE/LE) among senior citizens in Beijin. The sample derived from Beijing multidimensional longitudinal study on aging, baseline survey consisted of 1847 elderly people aged 60 years and over dwelling in the communities from one urban district (Xuanwu), one suburban country (Daxing) and one mountainous country (Huairou) in Beijing, 2004. Cluster, stratified and randomly selected sampling technique was used and a follow-up program was carried out in 2007. The subjects were invited to fill in questionnaires at home through well-trained interviewers, together with medical history of hypertension and repeated blood pressure measurements adopted. The state of activity was defined according to whether they could perform activities of daily life (ADL). IMaCH software for multi-state life table method was used to calculate the life expectancy (LE), active life expectancy (ALE) and active life expectancy/life expectancy (ALE/LE) in people with hypertension and normal blood tension, as well as on those people with hypertension with or without cardio-cerebral disease. The study manifested that hypertensives were associated with the reduction of LE, ALE and ALE/LE compared to the normotensives. The ALE/LE was descending along with ageing, and the speed of reduction was much faster in the hypertensive group, especially within senile population. LE, ALE and LE/LE among the hypertensives with cardio-cerebral vascular diseases were shorter than the hypertensives without the disease. Difference in ALE/LE was striking in people with virile senility. Hypertension remarkably impacted the active life expectancy on senior citizens living in Beijing, especially for elderly. Hypertensives with cardio-cerebral vascular diseases exerted further influence on active life expectancy, particularly among population of virile senility
Keesom, Sarah M; Finton, Caitlyn J; Sell, Gabrielle L; Hurley, Laura M
Early-life social isolation has profound effects on adult social competence. This is often expressed as increased aggression or inappropriate displays of courtship-related behaviors. The social incompetence exhibited by isolated animals could be in part due to an altered ability to participate in communicatory exchanges. House mice (Mus musculus) present an excellent model for exploring this idea, because social isolation has a well-established influence on their social behavior, and mice engage in communication via multiple sensory modalities. Here, we tested the prediction that social isolation during early life would influence ultrasonic vocalizations (USVs) emitted by adult male mice during same-sex social encounters. Starting at three weeks of age, male mice were housed individually or in social groups of four males for five weeks, after which they were placed in one of three types of paired social encounters. Pair types consisted of: two individually housed males, two socially housed males, or an individually housed and a socially housed male ("mixed" pairs). Vocal behavior (USVs) and non-vocal behaviors were recorded from these 15-minute social interactions. Pairs of mice consisting of at least one individually housed male emitted more and longer USVs, with a greater proportional use of USVs containing frequency jumps and 50-kHz components. Individually housed males in the mixed social pairs exhibited increased levels of mounting behavior towards the socially housed males. Mounting in these pairs was positively correlated with increased number and duration of USVs as well as increased proportional use of spectrally more complex USVs. These findings demonstrate that USVs are part of the suite of social behaviors influenced by early-life social isolation, and suggest that altered vocal communication following isolation reflects reduced social competence.
Nobles, Jenna; Brown, Ryan; Catalano, Ralph
This study investigates the role of national independence and women's political participation on population health using historical lifespan data from Norway. We use time-series methods to analyze data measuring the actual length of time lived by Norwegian birth cohorts spanning a 61 year period surrounding the political emancipation of Norway from Sweden in 1905 and the establishment of a Norwegian monarchy in 1906. The use of a discrete, historical event improves our ability to interpret the population health effects of national independence and women's political participation as causal. We find a large and significant positive effect on the lifespan of Norwegian females born in the 1906 cohort. Interestingly, the effect does not extend to all living females during the Norwegian drive toward sovereignty. We conclude that the beneficial effects were likely conferred through intrauterine biological transfers and/or neonatal investments specific to the first year of life. Copyright 2010 Elsevier Ltd. All rights reserved.
Perenboom, R.J.M.; Boshuizen, H.C.; Breteler, M.M.B.; Alewijn, O.; Water, H.P.A. van de
To gain an insight into the burden of dementia in an aging society, life expectancy with dementia and its counterpart dementia-free life expectancy (DemFLE) in The Netherlands are presented. Sullivan's method was used to calculate DemFLE. For elderly living either independently or in homes for the
Jul 1, 2004 ... Results: Forty two patients were studied, their age range 13-72 ... Conclusion: The issues affecting the quality of life of male cancer ... physical adaptation to maintain good adjustment(6,7). ..... absence of state organised social support and the low .... thanks to Dr. Riro Muita who was the student collecting.
V. V. CARDOSO
Full Text Available Ovarian development, oviposition, larval eclosion, ornithine decarboxylase (ODC activity, ovarian, testis and ejaculatory apodeme measurements (length, width, and area, and the number of spermatozoa of Anastrepha fraterculus (Wiedemann were analyzed at alternating (20º/6ºC and 20º/13°C and constant (6°C; 25°C temperatures. Life span and life expectancy were also analyzed for both genders. All the results suggest that temperature, especially alternating temperatures, increase not only male and female reproductive potential but also their life span and life expectancy. These changes can be a powerful strategy triggered by A. fraterculus as a means to survive the stressful temperature conditions found in winter in the apple production region in Brazil, enabling this species to increase its population density and cause apple damage when spring begins.
CARDOSO V. V.
Full Text Available Ovarian development, oviposition, larval eclosion, ornithine decarboxylase (ODC activity, ovarian, testis and ejaculatory apodeme measurements (length, width, and area, and the number of spermatozoa of Anastrepha fraterculus (Wiedemann were analyzed at alternating (20masculine/6masculineC and 20masculine/13degreesC and constant (6degreesC; 25degreesC temperatures. Life span and life expectancy were also analyzed for both genders. All the results suggest that temperature, especially alternating temperatures, increase not only male and female reproductive potential but also their life span and life expectancy. These changes can be a powerful strategy triggered by A. fraterculus as a means to survive the stressful temperature conditions found in winter in the apple production region in Brazil, enabling this species to increase its population density and cause apple damage when spring begins.
Seaman, R; Mitchell, R; Dundas, R; Leyland, A H; Popham, F
Glasgow's low life expectancy and high levels of deprivation are well documented. Studies comparing Glasgow to similarly deprived cities in England suggest an excess of deaths in Glasgow that cannot be accounted for by deprivation. Within Scotland comparisons are more equivocal suggesting deprivation could explain Glasgow's excess mortality. Few studies have used life expectancy, an intuitive measure that quantifies the between-city difference in years. This study aimed to use the most up-to-date data to compare Glasgow to other Scottish cities and to (i) evaluate whether deprivation could account for lower life expectancy in Glasgow and (ii) explore whether the age distribution of mortality in Glasgow could explain its lower life expectancy. Sex specific life expectancy was calculated for 2007-2011 for the population in Glasgow and the combined population of Aberdeen, Dundee and Edinburgh. Life expectancy was calculated for deciles of income deprivation, based on the national ranking of datazones, using the Scottish Index of Multiple Deprivation. Life expectancy in Glasgow overall, and by deprivation decile, was compared to that in Aberdeen, Dundee and Edinburgh combined, and the life expectancy difference decomposed by age using Arriaga's discrete method. Life expectancy for the whole Glasgow population was lower than the population of Aberdeen, Dundee and Edinburgh combined. When life expectancy was compared by national income deprivation decile, Glasgow's life expectancy was not systematically lower, and deprivation accounted for over 90 % of the difference. This was reduced to 70 % of the difference when carrying out sensitivity analysis using city-specific income deprivation deciles. In both analyses life expectancy was not systematically lower in Glasgow when stratified by deprivation. Decomposing the differences in life expectancy also showed that the age distribution of mortality was not systematically different in Glasgow after accounting for deprivation
Full Text Available There has been substantial research on psychosocial and health care determinants of health disparities in the United States (US but less on the role of modifiable risk factors. We estimated the effects of smoking, high blood pressure, elevated blood glucose, and adiposity on national life expectancy and on disparities in life expectancy and disease-specific mortality among eight subgroups of the US population (the "Eight Americas" defined on the basis of race and the location and socioeconomic characteristics of county of residence, in 2005.We combined data from the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System to estimate unbiased risk factor levels for the Eight Americas. We used data from the National Center for Health Statistics to estimate age-sex-disease-specific number of deaths in 2005. We used systematic reviews and meta-analyses of epidemiologic studies to obtain risk factor effect sizes for disease-specific mortality. We used epidemiologic methods for multiple risk factors to estimate the effects of current exposure to these risk factors on death rates, and life table methods to estimate effects on life expectancy. Asians had the lowest mean body mass index, fasting plasma glucose, and smoking; whites had the lowest systolic blood pressure (SBP. SBP was highest in blacks, especially in the rural South--5-7 mmHg higher than whites. The other three risk factors were highest in Western Native Americans, Southern low-income rural blacks, and/or low-income whites in Appalachia and the Mississippi Valley. Nationally, these four risk factors reduced life expectancy at birth in 2005 by an estimated 4.9 y in men and 4.1 y in women. Life expectancy effects were smallest in Asians (M, 4.1 y; F, 3.6 y and largest in Southern rural blacks (M, 6.7 y; F, 5.7 y. Standard deviation of life expectancies in the Eight Americas would decline by 0.50 y (18% in men and 0.45 y (21% in women if these risks
Kymes, Steven M; Plotzke, Michael R; Kass, Michael A; Boland, Michael V; Gordon, Mae O
To assess the influence of expected life span on the cost-effectiveness of treating ocular hypertension to prevent primary open-angle glaucoma. We used a Markov simulation model to estimate the cost and benefit of ocular hypertension treatment over a person's remaining life. We examined the influence of age on the cost-effectiveness decision in 2 ways: (1) by evaluating specific age cohorts to assess the influence of age at the initiation of treatment; and (2) by evaluating the influence of a specific life span. At a willingness to pay $50,000/quality-adjusted life year to $100,000/quality-adjusted life year, treatment of people with a 2% or greater annual risk of developing glaucoma was cost-effective for people aged 45 years with a life expectancy of at least 18 remaining years. However, to be cost-effective, a person aged 55 years must have a life expectancy of 21 remaining years and someone aged 65 years must have a life expectancy of 23 remaining years. A person with ocular hypertension must have a life expectancy of at least 18 remaining years to justify treatment at a threshold of a 2% or greater annual risk of developing glaucoma. Persons at higher levels of risk require a life expectancy of 7 to 10 additional years to justify treatment.
Zaman, Sojib Bin; Hossain, Naznin; Mehta, Varshil; Sharmin, Shuchita; Mahmood, Shakeel Ahmed Ibne
Abstract Introduction: Gradual total health expenditure (THE) has become a major concern. It is not only the increased THE, but also its unequal growth in overall economy, found among the developing countries. If increased life expectancy is considered as a leverage for an individual’s investment in health services, it can be expected that as the life expectancy increases, tendency of health care investment will also experience a boost up. Objective: The aim of the present study wa...
Kinge, Jonas Minet; Steingrímsdóttir, Ólöf Anna; Moe, Joakim Oliu; Skirbekk, Vegard; Næss, Øyvind; Strand, Bjørn Heine
Socioeconomic inequalities in life expectancy have been shown among the middle aged and the youngest of the old individuals, but the situation in the oldest old is less clear. The aim of this study was to investigate trends in life expectancy at ages 85, 90 and 95 years by education in Norway in the period 1961-2009. This was a register-based population study including all residents in Norway aged 85 and over. Individual-level data were provided by the Central Population Register and the National Education Database. For each decade during 1961-2009, death rates by 1-year age groups were calculated separately for each sex and three educational categories. Annual life tables were used to calculate life expectancy at ages 85 (e85), 90 (e90) and 95 (e95). Educational differentials in life expectancy at each age were non-significant in the early decades, but became significant over time. For example, for the decade 2000-9, a man aged 90 years with primary education had a life expectancy of 3.4 years, while a man with tertiary education could expect to live for 3.8 years. Similar numbers in women were 4.1 and 4.5 years, respectively. Even among 95-year-old men, statistically significant differences in life expectancy were found by education in the two last decades. Education matters regarding remaining life expectancy also for the oldest old in Norway. Life expectancy at these ages is low, so a growth of 0.5 years in the life expectancy differential is sizeable. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: email@example.com.
Stewart, Susan T.; Cutler, David M.; Rosen, Allison B.
Background: While increases in obesity over the past 30 years have adversely affected population health, there have been concomitant improvements due to reductions in smoking. Better understanding of the joint effects of these trends on longevity and quality of life will help policymakers target resources more efficiently. Methods: For each year from 2005 to 2020, we forecast life expectancy and qualityadjusted life expectancy for a representative 18 year old, assuming a continuation of past...
Full Text Available The Indigenous population of Australia suffers considerable disadvantage across a wide range of socio-economic indicators, and is therefore the focus of many policy initiatives attempting to 'close the gap' between Indigenous and non-Indigenous Australians. Unfortunately, past population estimates have proved unreliable as denominators for these indicators. The aim of the paper is to contribute more robust estimates for the Northern Territory Indigenous population for the period 1966-2011, and hence estimate one of the most important of socio-economic indicators, life expectancy at birth.A consistent time series of population estimates from 1966 to 2011, based off the more reliable 2011 official population estimates, was created by a mix of reverse and forward cohort survival. Adjustments were made to ensure sensible sex ratios and consistency with recent birth registrations. Standard life table methods were employed to estimate life expectancy. Drawing on an approach from probabilistic forecasting, confidence intervals surrounding population numbers and life expectancies were estimated.The Northern Territory Indigenous population in 1966 numbered between 23,800 and 26,100, compared to between 66,100 and 73,200 in 2011. In 1966-71 Indigenous life expectancy at birth lay between 49.1 and 56.9 years for males and between 49.7 and 57.9 years for females, whilst by 2006-11 it had increased to between 60.5 and 66.2 years for males and between 65.4 and 70.8 for females. Over the last 40 years the gap with all-Australian life expectancy has not narrowed, fluctuating at about 17 years for both males and females. Whilst considerable progress has been made in closing the gap in under-five mortality, at most other ages the mortality rate differential has increased.A huge public health challenge remains. Efforts need to be redoubled to reduce the large gap in life expectancy between Indigenous and non-Indigenous Australians.
Storeng, Siri H; Krokstad, Steinar; Westin, Steinar; Sund, Erik R
Norway is experiencing a rising life expectancy combined with an increasing dependency ratio - the ratio of those outside over those within the working force. To provide data relevant for future health policy we wanted to study trends in total and healthy life expectancy in a Norwegian population over three decades (1980s, 1990s and 2000s), both overall and across gender and educational groups. Data were obtained from the HUNT Study, and the Norwegian Educational Database. We calculated total life expectancy and used the Sullivan method to calculate healthy life expectancies based on self-rated health and self-reported longstanding limiting illness. The change in health expectancies was decomposed into mortality and disability effects. During three consecutive decades we found an increase in life expectancy for 30-year-olds (~7 years) and expected lifetime in self-rated good health (~6 years), but time without longstanding limiting illness increased less (1.5 years). Women could expect to live longer than men, but the extra life years for females were spent in poor self-rated health and with longstanding limiting illness. Differences in total life expectancy between educational groups decreased, whereas differences in expected lifetime in self-rated good health and lifetime without longstanding limiting illness increased. The increase in total life expectancy was accompanied by an increasing number of years spent in good self-rated health but more years with longstanding limiting illness. This suggests increasing health care needs for people with chronic diseases, given an increasing number of elderly. Socioeconomic health inequalities remain a challenge for increasing pensioning age.
Full Text Available Introduction: Recent studies on Iranian mortality clearly underscore the role of cardiovascular diseases, unintentional injuries, and cancers as three leading causes of reduced life expectancy during the last three decades. The purpose of current study is to measure the effect of these causes on 2010 life table for Iran. Materials & Method:The number of registered death by age and sex and death distribution by cause for Iran in 2010 are obtained from death registration system operated by the Ministry of Health and to know more about the population at risk population forecast information of the Statistical Centre of Iran (SCI is used. The obtained data are analyzed using Multiple Decrement Life Table and Kitagava analysis method. Results: The results show that three leading causes of death are account for 13 years potential lost life of Iranian men and women. More detailed results indicate that cardiovascular diseases, cancers, and unintentional injuries play larger roles in this regard while men are more likely to die by unintentional injuries than women. Life expectancy of middle aged men are more affected by unintentional injuries while old aged women are more affected by cardiovascular diseases. Conclusion: Particular consideration of risk factors of cardiovascular diseases of both sexes and males death by unintentional injuries is of utmost importance in reducing mortality rate and increasing life expectancy as a result.
Brønnum-Hansen, Henrik; Juel, Knud; Davidsen, Michael
AIMS: The construct quality-adjusted life years (QALYs) combines mortality and overall health status and can be used to quantify the impact of risk factors on population health. The purpose of the study was to estimate the impact of tobacco smoking, high alcohol consumption, physical inactivity...... Health Survey 2000, and Danish EQ-5D values. RESULTS: The quality-adjusted life expectancy of 25-year-olds was 10-11 QALYs shorter for heavy smokers than for those who never smoke. The difference in life expectancy was 9-10 years. Men and women with high alcohol consumption could expect to lose about 5...... and 3 QALYs, respectively. Sedentary persons could expect to have about 7 fewer QALYs than physically active persons. Obesity shortened QALYs by almost 3 for men and 6 for women. CONCLUSIONS: Smoking, high alcohol consumption, physical inactivity, and obesity strongly reduce life expectancy and health...
Chetty, Raj; Stepner, Michael; Abraham, Sarah; Lin, Shelby; Scuderi, Benjamin; Turner, Nicholas; Bergeron, Augustin; Cutler, David
The relationship between income and life expectancy is well established but remains poorly understood. To measure the level, time trend, and geographic variability in the association between income and life expectancy and to identify factors related to small area variation. Income data for the US population were obtained from 1.4 billion deidentified tax records between 1999 and 2014. Mortality data were obtained from Social Security Administration death records. These data were used to estimate race- and ethnicity-adjusted life expectancy at 40 years of age by household income percentile, sex, and geographic area, and to evaluate factors associated with differences in life expectancy. Pretax household earnings as a measure of income. Relationship between income and life expectancy; trends in life expectancy by income group; geographic variation in life expectancy levels and trends by income group; and factors associated with differences in life expectancy across areas. The sample consisted of 1,408,287,218 person-year observations for individuals aged 40 to 76 years (mean age, 53.0 years; median household earnings among working individuals, $61,175 per year). There were 4,114,380 deaths among men (mortality rate, 596.3 per 100,000) and 2,694,808 deaths among women (mortality rate, 375.1 per 100,000). The analysis yielded 4 results. First, higher income was associated with greater longevity throughout the income distribution. The gap in life expectancy between the richest 1% and poorest 1% of individuals was 14.6 years (95% CI, 14.4 to 14.8 years) for men and 10.1 years (95% CI, 9.9 to 10.3 years) for women. Second, inequality in life expectancy increased over time. Between 2001 and 2014, life expectancy increased by 2.34 years for men and 2.91 years for women in the top 5% of the income distribution, but by only 0.32 years for men and 0.04 years for women in the bottom 5% (P income individuals varied substantially across local areas. In the bottom income
Woodard, LeChauncy D.; Landrum, Cassie R.; Urech, Tracy H.; Profit, Jochen; Virani, Salim S.; Petersen, Laura A.
Background/Objectives To validly assess quality-of-care differences among providers, performance measurement programs must reliably identify and exclude patients for whom the quality indicator may not be desirable, including those with limited life expectancy. We developed an algorithm to identify patients with limited life expectancy and examined the impact of limited life expectancy on glycemic control and treatment intensification among diabetic patients. Design We identified diabetic patients with coexisting congestive heart failure, chronic obstructive pulmonary disease, dementia, end-stage liver disease, and/or primary/metastatic cancers with limited life expectancy. To validate our algorithm, we assessed 5-year mortality among patients identified as having limited life expectancy. We compared rates of meeting performance measures for glycemic control between patients with and without limited life expectancy. Among uncontrolled patients, we examined the impact of limited life expectancy on treatment intensification within 90 days. Setting 110 Veterans Administration facilities; October 2006 – September 2007 Participants 888,628 diabetic patients Measurements Hemoglobin A1c (HbA1c) Quality measurement and performance-based reimbursement systems should acknowledge the different needs of this population. PMID:22260627
Nakagawa, Fumiyo; Lodwick, Rebecca K; Smith, Colette J
positive in 2010. The effect of altering the diagnosis rate was investigated. Results: Assuming a high rate of HIV diagnosis (median CD4 cell count at diagnosis, 432¿cells/µl), projected median age at death (life expectancy) was 75.0 years. This implies 7.0 years of life were lost on average due to HIV......Background and objectives: Effective antiretroviral therapy (ART) has contributed greatly toward survival for people with HIV, yet many remain undiagnosed until very late. Our aims were to estimate the life expectancy of an HIV-infected MSM living in a developed country with extensive access to ART...... and healthcare, and to assess the effect of late diagnosis on life expectancy. Methods: A stochastic computer simulation model of HIV infection and the effect of ART was used to estimate life expectancy and determine the distribution of potential lifetime outcomes of an MSM, aged 30 years, who becomes HIV...
Full Text Available Background: While probabilistic projection methods for projecting life expectancy exist, few account for covariates related to life expectancy. Generalized HIV/AIDS epidemics have a large, immediate negative impact on the life expectancy in a country, but this impact can be mitigated by widespread use of antiretroviral therapy (ART. Thus, projection methods for countries with generalized HIV/AIDS epidemics could be improved by accounting for HIV prevalence, the future course of the epidemic, and ART coverage. Methods: We extend the current Bayesian probabilistic life expectancy projection methods of Raftery et al. (2013 to account for HIV prevalence and adult ART coverage in countries with generalized HIV/AIDS epidemics. Results: We evaluate our method using out-of-sample validation. We ﬁnd that the proposed method performs better than the method that does not account for HIV prevalence or ART coverage for projections of life expectancy in countries with a generalized epidemic, while projections for countries without an epidemic remain essentially unchanged. Conclusions: In general, our projections show rapid recovery to pre-epidemic life expectancy levels in the presence of widespread ART coverage. After the initial life expectancy recovery, we project a steady rise in life expectancy until the end of the century. Contribution: We develop a simple Bayesian hierarchical model for long-term projections of life expectancy while accounting for HIV/AIDS prevalence and coverage of ART. The method produces well-calibrated projections for countries with generalized HIV/AIDS epidemics up to 2100 while having limited data demands.
Full Text Available Does surviving genocidal experiences, like the Holocaust, lead to shorter life-expectancy? Such an effect is conceivable given that most survivors not only suffered psychosocial trauma but also malnutrition, restriction in hygienic and sanitary facilities, and lack of preventive medical and health services, with potentially damaging effects for later health and life-expectancy. We explored whether genocidal survivors have a higher risk to die younger than comparisons without such background. This is the first population-based retrospective cohort study of the Holocaust, based on the entire population of immigrants from Poland to Israel (N = 55,220, 4-20 years old when the World War II started (1939, immigrating to Israel either between 1945 and 1950 (Holocaust group or before 1939 (comparison group; not exposed to the Holocaust. Hazard of death - a long-term outcome of surviving genocidal trauma - was derived from the population-wide official data base of the National Insurance Institute of Israel. Cox regression yielded a significant hazard ratio (HR = 0.935, CI (95% = 0.910-0.960, suggesting that the risk of death was reduced by 6.5 months for Holocaust survivors compared to non-Holocaust comparisons. The lower hazard was most substantial in males who were aged 10-15 (HR = 0.900, CI (95% = 0.842-0.962, i.e., reduced by 10 months or 16-20 years at the onset of the Holocaust (HR = 0.820, CI (95% = 0.782-0.859, i.e., reduced by18 months. We found that against all odds genocidal survivors were likely to live longer. We suggest two explanations: Differential mortality during the Holocaust and "Posttraumatic Growth" associated with protective factors in Holocaust survivors or in their environment after World War II.
Livingstone, Shona J; Levin, Daniel; Looker, Helen C; Lindsay, Robert S; Wild, Sarah H; Joss, Nicola; Leese, Graham; Leslie, Peter; McCrimmon, Rory J; Metcalfe, Wendy; McKnight, John A; Morris, Andrew D; Pearson, Donald W M; Petrie, John R; Philip, Sam; Sattar, Naveed A; Traynor, Jamie P; Colhoun, Helen M
Type 1 diabetes has historically been associated with a significant reduction in life expectancy. Major advances in treatment of type 1 diabetes have occurred in the past 3 decades. Contemporary estimates of the effect of type 1 diabetes on life expectancy are needed. To examine current life expectancy in people with and without type 1 diabetes in Scotland. We also examined whether any loss of life expectancy in patients with type 1 diabetes is confined to those who develop kidney disease. Prospective cohort of all individuals alive in Scotland with type 1 diabetes who were aged 20 years or older from 2008 through 2010 and were in a nationwide register (n=24,691 contributing 67,712 person-years and 1043 deaths). Differences in life expectancy between those with and those without type 1 diabetes and the percentage of the difference due to various causes. Life expectancy at an attained age of 20 years was an additional 46.2 years among men with type 1 diabetes and 57.3 years among men without it, an estimated loss in life expectancy with diabetes of 11.1 years (95% CI, 10.1-12.1). Life expectancy from age 20 years was an additional 48.1 years among women with type 1 diabetes and 61.0 years among women without it, an estimated loss with diabetes of 12.9 years (95% CI, 11.7-14.1). Even among those with type 1 diabetes with an estimated glomerular filtration rate of 90 mL/min/1.73 m2 or higher, life expectancy was reduced (49.0 years in men, 53.1 years in women) giving an estimated loss from age 20 years of 8.3 years (95% CI, 6.5-10.1) for men and 7.9 years (95% CI, 5.5-10.3) for women. Overall, the largest percentage of the estimated loss in life expectancy was related to ischemic heart disease (36% in men, 31% in women) but death from diabetic coma or ketoacidosis was associated with the largest percentage of the estimated loss occurring before age 50 years (29.4% in men, 21.7% in women). Estimated life expectancy for patients with type 1 diabetes in Scotland based on
Counterintuitively, faster increases in human life expectancy could lead to slower population aging. The conventional view that faster increases in human life expectancy would lead to faster population aging is based on the assumption that people become old at a fixed chronological age. A preferable alternative is to base measures of aging on people’s time left to death, because this is more closely related to the characteristics that are associated with old age. Using this alternative interpretation, we show that faster increases in life expectancy would lead to slower population aging. Among other things, this finding affects the assessment of the speed at which countries will age. PMID:25876033
Chetty, Raj; Stepner, Michael; Abraham, Sarah; Lin, Shelby; Scuderi, Benjamin; Turner, Nicholas; Bergeron, Augustin; Cutler, David
Importance The relationship between income and mortality is well established but remains poorly understood. Objectives To measure the level, temporal trend, and geographic variability in the association between income and life expectancy, and identify factors related to small area variation in this association. Design and Setting Income data for the US population were obtained from 1.4 billion de-identified tax records between 1999 and 2014. Mortality data were obtained from Social Security Administration death records. These data were used to estimate race- and ethnicity-adjusted life expectancy at 40 years of age by household income percentile, sex, and geographic area, and to evaluate factors associated with differences in life expectancy. Main Outcomes and Measures Relationship between income and life expectancy; trends in life expectancy by income group; geographic variation in life expectancy levels and trends by income group; and factors associated with differences in life expectancy across areas. Results The sample consisted of 1 408 287 218 person-year observations (mean age at which individuals were analyzed, 53.0 years; median household earnings among working individuals, $61 175 per year [mean, $97 725 per year]). Among those aged 40 to 76 years, there were 4 114 380 deaths among men (mortality rate, 596.3 per 100 000) and 2 694 808 deaths among women (mortality rate, 375.1 per 100 000). The analysis yielded four results. First, higher income was associated with greater longevity throughout the income distribution. The gap in life expectancy between the richest 1% and poorest 1% of individuals was 14.6 years (95% CI, 14.4 to 14.8 years) for men and 10.1 years (95% CI, 9.9 to 10.3 years) for women. Second, inequality in life expectancy increased over time. Between 2001 and 2014, life expectancy increased by 2.34 years for men and 2.91 years for women in the top 5% of the income distribution, but increased by only 0.32 years for men and 0.04 years for
Stephens, Alexandre S; Gupta, Leena; Thackway, Sarah; Broome, Richard A
Despite being one of the healthiest countries in the world, Australia displays substantial mortality differentials by socioeconomic disadvantage, remoteness and sex. In this study, we examined how these mortality differentials translated to differences in life expectancy between 2001 and 2012. Population-based study using mortality and estimated residential population data from Australia's largest state, New South Wales (NSW), between 2001 and 2012. Age-group-specific death rates by socioeconomic disadvantage quintile, remoteness (major cities vs regional and remote areas), sex and year were estimated via Poisson regression, and inputted into life table calculations to estimate life expectancy. Life expectancy decreased with increasing socioeconomic disadvantage in males and females. The disparity between the most and least socioeconomically deprived quintiles was 3.77 years in males and 2.39 years in females in 2012. Differences in life expectancy by socioeconomic disadvantage were mostly stable over time. Gender gaps in life expectancy ranged from 3.50 to 4.93 years (in 2012), increased with increasing socioeconomic disadvantage and decreased by ∼1 year for all quintiles between 2001 and 2012. Overall, life expectancy varied little by remoteness, but was 1.8 years higher in major cities compared to regional/remote areas in the most socioeconomically deprived regions in 2012. Socioeconomic disadvantage and sex were strongly associated with life expectancy. The disparity in life expectancy across the socioeconomic spectrum was larger in males and was stable over time. In contrast, gender gaps reduced for all quintiles between 2001 and 2012, and a remoteness effect was evident in 2012, but only for those living in the most deprived areas. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Land, K C; Guralnik, J M; Blazer, D G
A fundamental limitation of current multistate life table methodology-evident in recent estimates of active life expectancy for the elderly-is the inability to estimate tables from data on small longitudinal panels in the presence of multiple covariates (such as sex, race, and socioeconomic status). This paper presents an approach to such an estimation based on an isomorphism between the structure of the stochastic model underlying a conventional specification of the increment-decrement life table and that of Markov panel regression models for simple state spaces. We argue that Markov panel regression procedures can be used to provide smoothed or graduated group-specific estimates of transition probabilities that are more stable across short age intervals than those computed directly from sample data. We then join these estimates with increment-decrement life table methods to compute group-specific total, active, and dependent life expectancy estimates. To illustrate the methods, we describe an empirical application to the estimation of such life expectancies specific to sex, race, and education (years of school completed) for a longitudinal panel of elderly persons. We find that education extends both total life expectancy and active life expectancy. Education thus may serve as a powerful social protective mechanism delaying the onset of health problems at older ages.
Full Text Available Background: South Korea has the highest rate and highest rate of increase in suicide among developed countries. The suicide epidemic in Korea is an anomaly, and suicide rates are high for both men and women, with no signs of decreasing. Yet we do not know the extent to which suicide has reduced life expectancy in Korea. Objective: We investigated whether and to what extent the rapid increase in suicide has contributed to changes in Korean life expectancy, a key indicator of population health. Methods: We used a recently developed decomposition method that separates the contribution of suicide's effect on change in life expectancy into two parts: that due to change in the overall suicide incidence rate and that due to change in the mean age of suicide victims. Results: From 1995 to 2010, life expectancy increased by 6.5 years in Korea, with change in most causes of death contributing to its growth. We nonetheless find, as expected, that the rise in suicides reduced the increase in life expectancy from 1995 to 2010, so life expectancy in Korea is about 0.21 years lower than it would have been without the increase in suicides. Moreover, had the age of suicide victims remained stable, we project that Korea's life expectancy would be fully 0.70 years lower than it is. Conclusions: Although the growth in suicide was the largest single factor slowing the rise in Korean life expectancy, the effect would have been even larger had the age of suicide victims not increased.
Granbichler, Claudia A; Zimmermann, Georg; Oberaigner, Willi; Kuchukhidze, Giorgi; Ndayisaba, Jean-Pierre; Taylor, Alexandra; Luef, Gerhard; Bathke, Arne C; Trinka, Eugen
Studies using relative measures, such as standardized mortality ratios, have shown that patients with epilepsy have an increased mortality. Reports on more direct and absolute measure such as life expectancy are sparse. We report potential years lost and how life expectancy has changed over 40 years in a cohort of patients with newly diagnosed epilepsy. We analyzed life expectancy in a cohort of adult patients diagnosed with definite epilepsy between 1970 and 2010. Those with brain tumor as cause of epilepsy were excluded. By retrospective probabilistic record linkage, living or death status was derived from the national death registry. We estimated life expectancy by a Weibull regression model using gender, age at diagnosis, epilepsy etiology, and year of diagnosis as covariates at time of epilepsy diagnosis, and 5, 10, 15, and 20 years after diagnosis. Results were compared to the general population, and 95% confidence intervals are given. There were 249 deaths (105 women, age at death 19.0-104.0 years) in 1,112 patients (11,978.4 person-years, 474 women, 638 men). A substantial decrease in life expectancy was observed for only a few subgroups, strongly depending on epilepsy etiology and time of diagnosis: time of life lost was highest in patients with symptomatic epilepsy diagnosed between 1970 and 1980; the impact declined with increasing time from diagnosis. Over half of the analyzed subgroups did not differ significantly from the general population. This effect was reversed in the later decades, and life expectancy was prolonged in some subgroups, reaching a maximum in those with newly diagnosed idiopathic and cryptogenic epilepsy between 2001 and 2010. Life expectancy is reduced in symptomatic epilepsies. However, in other subgroups, a prolonged life expectancy was found, which has not been reported previously. Reasons may be manifold and call for further study. © 2017 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International
Chan, Moon Fai; Devi, M Kamala
The authors aim to examine the impact of demographic changes, socioeconomic inequality, and the availability of health care resources on life expectancy in Singapore, Malaysia, and Thailand. This is a cross-country study collecting annual data from 3 Southeast Asian countries from 1980 to 2008. Life expectancy is the dependent variable with demographics, socioeconomic status, and health care resources as the 3 main determinants. A structural equation model is used, and results show that the availability of more health care resources and higher levels of socioeconomic advantages are more likely to increase life expectancy. In contrast, demographic changes are more likely to increase life expectancy by way of health care resources. The authors suggest that more effort should be taken to expand and improve the coverage of health care programs to alleviate regional differences in health care use and improve the overall health status of people in these 3 Southeast Asian countries. © 2012 APJPH.
Sede, Peter I; Ohemeng, Williams
Attainment of 70 years life expectancy by 2020 is one of the millennium development goals in Nigeria. This study examined the socio-economic determinants of life expectancy in Nigeria using data from 1980-2011. Judging from the endogeneity feature of the variables, A VAR and VECM frameworks were employed. Socio-economic features were proxy by secondary school enrolment, government expenditure on health, per capita income, unemployment rate and the Naira foreign exchange rate. It was found that, the conventional socio-economic variables such as per capita income, education and government expenditure on health considered to be highly effective in determining life expectancy of developing countries are not significant in the case of Nigeria. The study however suggests that, life expectancy in Nigeria could be improved if attention is given to quality of government health expenditure, unemployment and measures to halt the depreciation of the Nigerian Naira against major foreign currency.
Canudas-Romo, Vladimir; Liu, L; Zimmerman, L
Objective: We assessed the change over time in the contribution of maternal mortality to a life expectancy calculated between ages 15 and 49, or Reproductive-Aged Life Expectancy (RALE). Our goal was to estimate the increase in RALE in developed countries over the twentieth century and the hypoth......Objective: We assessed the change over time in the contribution of maternal mortality to a life expectancy calculated between ages 15 and 49, or Reproductive-Aged Life Expectancy (RALE). Our goal was to estimate the increase in RALE in developed countries over the twentieth century....... Findings: In developed countries, five years in RALE were gained over the twentieth century, of which approximately 10%, or half a year, was attributable to reductions in maternal mortality. In sub-Saharan African countries, the possible achievable gains fluctuate between 0.24 and 1.47 years, or 6% and 44...
Westman, J; Wahlbeck, K; Laursen, T M
OBJECTIVE: To analyse mortality and life expectancy in people with alcohol use disorder in Denmark, Finland and Sweden. METHOD: A population-based register study including all patients admitted to hospital diagnosed with alcohol use disorder (1 158 486 person-years) from 1987 to 2006 in Denmark......, Finland and Sweden. RESULTS: Life expectancy was 24-28 years shorter in people with alcohol use disorder than in the general population. From 1987 to 2006, the difference in life expectancy between patients with alcohol use disorder and the general population increased in men (Denmark, 1.8 years; Finland......, 2.6 years; Sweden, 1.0 years); in women, the difference in life expectancy increased in Denmark (0.3 years) but decreased in Finland (-0.8 years) and Sweden (-1.8 years). People with alcohol use disorder had higher mortality from all causes of death (mortality rate ratio, 3.0-5.2), all diseases...
Full Text Available Abstract Background The United States health care debate has focused on the nation's uniquely high rates of lack of insurance and poor health outcomes relative to other high-income countries. Large disparities in health outcomes are well-documented in the US, but the most recent assessment of county disparities in mortality is from 1999. It is critical to tracking progress of health reform legislation to have an up-to-date assessment of disparities in life expectancy across counties. US disparities can be seen more clearly in the context of how progress in each county compares to international trends. Methods We use newly released mortality data by age, sex, and county for the US from 2000 to 2007 to compute life tables separately for each sex, for all races combined, for whites, and for blacks. We propose, validate, and apply novel methods to estimate recent life tables for small areas to generate up-to-date estimates. Life expectancy rates and changes in life expectancy for counties are compared to the life expectancies across nations in 2000 and 2007. We calculate the number of calendar years behind each county is in 2000 and 2007 compared to an international life expectancy time series. Results Across US counties, life expectancy in 2007 ranged from 65.9 to 81.1 years for men and 73.5 to 86.0 years for women. When compared against a time series of life expectancy in the 10 nations with the lowest mortality, US counties range from being 15 calendar years ahead to over 50 calendar years behind for men and 16 calendar years ahead to over 50 calendar years behind for women. County life expectancy for black men ranges from 59.4 to 77.2 years, with counties ranging from seven to over 50 calendar years behind the international frontier; for black women, the range is 69.6 to 82.6 years, with counties ranging from eight to over 50 calendar years behind. Between 2000 and 2007, 80% (men and 91% (women of American counties fell in standing against this
Wahlbeck, Kristian; Westman, Jeanette; Nordentoft, Merete
People with mental disorders evince excess mortality due to natural and unnatural deaths. The relative life expectancy of people with mental disorders is a proxy measure of effectiveness of social policy and health service provision.......People with mental disorders evince excess mortality due to natural and unnatural deaths. The relative life expectancy of people with mental disorders is a proxy measure of effectiveness of social policy and health service provision....
Luy, Marc; Wegner-Siegmundt, Christian
Background: Throughout industrialized countries, tobacco consumption is seen as the predominant driver of both the trend and the extent of gender differences in life expectancy. However, several factors raise doubts to this generalization. We hypothesize that the impact of smoking on the gender gap is context-specific and differs between populations. Methods: We decompose the gender differences in life expectancy into fractions caused by smoking and other non-biological factors for 53 industr...
Cervellati, Matteo; Sunde, Uwe
In this paper we investigate the causal effect of life expectancy on economic growth by explicitly accounting for the role of the demographic transition. In addition to focusing on issues of empirical identification, this paper emphasizes the role of the econometric specification. We present a simple theory of the economic and demographic transition where individuals' education and fertility decisions depend on their life expectancy. The theory predicts that before the demographic transition ...
Tenckhoff, E.; Erve, M.
The safety standard at a nuclear power station achieved at the time of commissioning on the basis of the state of the art during the design and construction stage has to be maintained over the entire working life of the unit. Original design life expectancy is under review in the light of new safety experience and developments. The results of such analysis can serve not only preventive maintenance purposes but also as the basis for supporting and extending the planned or approved working life; they help increase availability. A comprehensive analysis strategy to establish the actual condition and residual life expectancy of components, systems and complete units has been developed by Siemens/KWU. The results of this analysis can lead to action to extend the life expectancy of components and systems and improvements in systems and subsystems. This report quotes a number of examples. 6 figs
Firebaugh, Glenn; Acciai, Francesco; Noah, Aggie J.; Prather, Christopher; Nau, Claudia
BACKGROUND Blacks have lower life expectancy than whites in the United States. That disparity could be due to racial differences in the causes of death, with blacks being more likely to die of causes that affect the young, or it could be due to differences in the average ages of blacks and whites who die of the same cause. Prior studies fail to distinguish these two possibilities. OBJECTIVE In this study we determine how much of the 2000–10 reduction in the racial gap in life expectancy resulted from narrowing differences in the cause-specific mean age at death for blacks and whites, as opposed to changing cause-specific probabilities for blacks and whites. METHOD We introduce a method for separating the difference-in-probabilities and difference-inage components of group disparities in life expectancy. RESULTS Based on the new method, we find that 60% of the decline in the racial gap in life expectancy from 2000 to 2010 was attributable to reduction in the age component, largely because of declining differences in the age at which blacks and whites die of chronic diseases. CONCLUSION Our findings shed light on the sources of the declining racial gap in life expectancy in the United States, and help to identify where advances need to be made to achieve the goal of eliminating racial disparities in life expectancy. PMID:25580083
Full Text Available Background: Blacks have lower life expectancy than whites in the United States. That disparity could be due to racial differences in the causes of death, with blacks being more likely to die of causes that affect the young, or it could be due to differences in the average ages of blacks and whites who die of the same cause. Prior studies fail to distinguish these two possibilities. Objective: In this study we determine how much of the 2000-10 reduction in the racial gap in life expectancy resulted from narrowing differences in the cause-specific mean age at death for blacks and whites, as opposed to changing cause-specific probabilities for blacks and whites. Methods: We introduce a method for separating the difference-in-probabilities and difference-in-age components of group disparities in life expectancy. Results: Based on the new method, we find that 60Š of the decline in the racial gap in life expectancy from 2000 to 2010 was attributable to reduction in the age component, largely because of declining differences in the age at which blacks and whites die of chronic diseases. Conclusions: Our findings shed light on the sources of the declining racial gap in life expectancy in the United States, and help to identify where advances need to be made to achieve the goal of eliminating racial disparities in life expectancy.
P. K. Murthy
Full Text Available Several methods were proposed to decompose the difference between two life expectancies at birth into the contribution by different age groups. In this study an attempt has been made to compare different methods with that of Chandra Sekar (1949 method. The methodologies suggested by Arriaga, Lopez and Ruzicka and Pollard have been extended. It is shown that all the three methods and also Chandra Sekar method in their modified (symmetrical form will be seen to produce the same result as that of United Nations, Pollard, Andreev and Pressat. Finally it is suggested to use symmetric formulae of the above methods because the percent contribution of total of the interaction terms to the difference in the life expectancy at birth is observed to be very negligible.
The study seeks to raise awareness and expand knowledge about the deleterious effect of HIV/AIDS mortality on South Africa's life expectancy, a country with a relatively high HIV/AIDS prevalence rate (19. percent). Using the multiple and associated single decrement life table techniques, the study estimates the total ...
Rurup, M.L.; Pasman, H.R.W.; Kerkhof, A.J.F.M.; Deeg, D.J.H.; Onwuteaka-Philipsen, B.D.
Older people who are 'weary of life': their expectations for the future and perceived hopelessness There has been a debate for over a decade in the Netherlands about whether physicians should be allowed to provide assistance with suicide to older people who are 'weary of life'. Actual knowledge
Malhotra, Rahul; Chan, Angelique; Ajay, Shweta; Ma, Stefan; Saito, Yasuhiko
To assess variation in gender gap (female-male) in inactive life expectancy (IALE) and active life expectancy (ALE) by definition of inactivity. Inactivity, among older Singaporeans, was defined as follows: Scenario 1-health-related difficulty in activities of daily living (ADLs); Scenario 2-health-related difficulty in ADLs/instrumental ADLs (IADLs); Scenario 3-health-related difficulty in ADLs/IADLs or non-health-related non-performance of IADLs. Multistate life tables computed IALE and ALE at age 60, testing three hypotheses: In all scenarios, life expectancy, absolute and relative IALE, and absolute ALE are higher for females (Hypothesis 1 [H1]); gender gap in absolute and relative IALE expands, and in absolute ALE, it contracts in Scenario 2 versus 1 (Hypothesis 2 [H2]); gender gap in absolute and relative IALE decreases, and in absolute ALE, it increases in Scenario 3 versus 2 (Hypothesis 3 [H3]). H1 was supported in Scenarios 1 and 3 but not Scenario 2. Both H2 and H3 were supported. Definition of inactivity influences gender gap in IALE and ALE. © The Author(s) 2016.
Kogan, Lori R; McConnell, Sherry L; Schoenfeld-Tacher, Regina
This article addresses the challenges that gender performance expectations create within the veterinary profession. An investigation of veterinary students' perceptions of the essential characteristics that define successful veterinarians and veterinary students, and the gender differences within these definitions, is described. Because previous research supports the premise that the standards required for success differ for males and females, it is likely that male and female veterinary students possess different career expectations and definitions of career success. The ramifications of these differences are explored, and proposed strategies to address this issue, in the form of student support services, are discussed.
González-Pérez, Guillermo Julián; Vega-López, María Guadalupe; Souza, Edinilsa Ramos de; Pinto, Liana Wernersbach
Using official data, this study analyzed violent deaths (homicide, suicide, events of undetermined intent and deaths due to legal intervention) in Brazil and Mexico in the three-year periods 2002-2004 and 2012-14, the impact of these causes of death on life expectancy in both countries and the role of the different age groups in years of life expectancy lost (YLEL). Abridged life tables were constructed for both countries for both periods. Temporary life expectancy and YLEL between zero and 80 years by selected causes and age groups were calculated for each triennium. The leading cause of YLEL among men was homicide in both periods in Brazil (1.5 years) and in the second period in Mexico (one year). Violent deaths (VD) accounted for around 16% of YLEL in Brazil and 13% in Mexico in 2012-2014. Among women, YLEL due to homicides and suicides showed the greatest relative increase in both countries, although VD accounted for barely 3% of total YLEL. The highest percentage of YLEL due to VDwas found among the 15 to 29 year age groups in both countries and for both sexes. The increase in rates of VD in Mexico, above all among young people, has curbed further increases in life expectancy in recent years, especially among men. Likewise, the high rates of VD in Brazil in both periods have hindered the growth of life expectancy.
Full Text Available In recent years, the United States has had a relatively poor performance with respect to life expectancy compared to the other developed nations. Urban sprawl is one of the potential causes of the high rate of mortality in the United States. This study investigated cross-sectional associations between sprawl and life expectancy for metropolitan counties in the United States in 2010. In this study, the measure of life expectancy in 2010 came from a recently released dataset of life expectancies by county. This study modeled average life expectancy with a structural equation model that included five mediators: annual vehicle miles traveled (VMT per household, average body mass index, crime rate, and air quality index as mediators of sprawl, as well as percentage of smokers as a mediator of socioeconomic status. After controlling for sociodemographic characteristics, this study found that life expectancy was significantly higher in compact counties than in sprawling counties. Compactness affects mortality directly, but the causal mechanism is unclear. For example, it may be that sprawling areas have higher traffic speeds and longer emergency response times, lower quality and less accessible health care facilities, or less availability of healthy foods. Compactness affects mortality indirectly through vehicle miles traveled, which is a contributor to traffic fatalities, and through body mass index, which is a contributor to many chronic diseases. This study identified significant direct and indirect associations between urban sprawl and life expectancy. These findings support further research and practice aimed at identifying and implementing changes to urban planning designed to support health and healthy behaviors.
Hamidi, Shima; Ewing, Reid; Tatalovich, Zaria; Grace, James B.; Berrigan, David
In recent years, the United States has had a relatively poor performance with respect to life expectancy compared to the other developed nations. Urban sprawl is one of the potential causes of the high rate of mortality in the United States. This study investigated cross-sectional associations between sprawl and life expectancy for metropolitan counties in the United States in 2010. In this study, the measure of life expectancy in 2010 came from a recently released dataset of life expectancies by county. This study modeled average life expectancy with a structural equation model that included five mediators: annual vehicle miles traveled (VMT) per household, average body mass index, crime rate, and air quality index as mediators of sprawl, as well as percentage of smokers as a mediator of socioeconomic status. After controlling for sociodemographic characteristics, this study found that life expectancy was significantly higher in compact counties than in sprawling counties. Compactness affects mortality directly, but the causal mechanism is unclear. For example, it may be that sprawling areas have higher traffic speeds and longer emergency response times, lower quality and less accessible health care facilities, or less availability of healthy foods. Compactness affects mortality indirectly through vehicle miles traveled, which is a contributor to traffic fatalities, and through body mass index, which is a contributor to many chronic diseases. This study identified significant direct and indirect associations between urban sprawl and life expectancy. These findings support further research and practice aimed at identifying and implementing changes to urban planning designed to support health and healthy behaviors.
Hamidi, Shima; Ewing, Reid; Tatalovich, Zaria; Grace, James B; Berrigan, David
In recent years, the United States has had a relatively poor performance with respect to life expectancy compared to the other developed nations. Urban sprawl is one of the potential causes of the high rate of mortality in the United States. This study investigated cross-sectional associations between sprawl and life expectancy for metropolitan counties in the United States in 2010. In this study, the measure of life expectancy in 2010 came from a recently released dataset of life expectancies by county. This study modeled average life expectancy with a structural equation model that included five mediators: annual vehicle miles traveled (VMT) per household, average body mass index, crime rate, and air quality index as mediators of sprawl, as well as percentage of smokers as a mediator of socioeconomic status. After controlling for sociodemographic characteristics, this study found that life expectancy was significantly higher in compact counties than in sprawling counties. Compactness affects mortality directly, but the causal mechanism is unclear. For example, it may be that sprawling areas have higher traffic speeds and longer emergency response times, lower quality and less accessible health care facilities, or less availability of healthy foods. Compactness affects mortality indirectly through vehicle miles traveled, which is a contributor to traffic fatalities, and through body mass index, which is a contributor to many chronic diseases. This study identified significant direct and indirect associations between urban sprawl and life expectancy. These findings support further research and practice aimed at identifying and implementing changes to urban planning designed to support health and healthy behaviors.
Full Text Available Abstract Background This study aimed to examine the longitudinal contributions of four political and socioeconomic factors to the increase in life expectancy in less developed countries (LDCs between 1970 and 2004. Methods We collected 35 years of annual data for 119 LDCs on life expectancy at birth and on four key socioeconomic indicators: economy, measured by log10 gross domestic product per capita at purchasing power parity; educational environment, measured by the literacy rate of the adult population aged 15 years and over; nutritional status, measured by the proportion of undernourished people in the population; and political regime, measured by the regime score from the Polity IV database. Using linear mixed models, we analyzed the longitudinal effects of these multiple factors on life expectancy at birth with a lag of 0-10 years, adjusting for both time and regional correlations. Results The LDCs' increases in life expectancy over time were associated with all four factors. Political regime had the least influence on increased life expectancy to begin with, but became significant starting in the 3rd year and continued to increase, while the impact of the other socioeconomic factors began strong but continually decreased over time. The combined effects of these four socioeconomic and political determinants contributed 54.74% - 98.16% of the life expectancy gains throughout the lag periods of 0-10 years. Conclusions Though the effect of democratic politics on increasing life expectancy was relatively small in the short term when compared to the effects of the other socioeconomic factors, the long-term impact of democracy should not be underestimated.
Ryan J Hum
Full Text Available Improvements in life expectancy have been considerable over the past hundred years. Forecasters have taken to applying historical trends under an assumption of continuing improvements in life expectancy in the future. A linear mixed effects model was used to estimate the trends in global and regional rates of improvements in life expectancy, child, adult, and senior survival, in 166 countries between 1950 and 2010. Global improvements in life expectancy, including both child and adult survival rates, decelerated significantly over the study period. Overall life expectancy gains were estimated to have declined from 5.9 to 4.0 months per year for a mean deceleration of -0.07 months/year2; annual child survival gains declined from 4.4 to 1.6 deaths averted per 1000 for a mean deceleration of -0.06 deaths/1000/year2; adult survival gains were estimated to decline from 4.8 to 3.7 deaths averted per 1000 per year for a mean deceleration of -0.08 deaths/1000/year2. Senior survival gains however increased from 2.4 to 4.2 deaths averted per 1000 per year for an acceleration of 0.03 deaths/1000/year2. Regional variation in the four measures was substantial. The rates of global improvements in life expectancy, child survival, and adult survival have declined since 1950 despite an increase in the rate of improvements among seniors. We postulate that low-cost innovation, related to the last half-century progress in health-primarily devoted to children and middle age, is reaping diminishing returns on its investments. Trends are uneven across regions and measures, which may be due in part to the state of epidemiological transition between countries and regions and disparities in the diffusion of innovation, accessible only in high-income countries where life expectancy is already highest.
Kochanek, Kenneth D; Anderson, Robert N; Arias, Elizabeth
Life expectancy at birth has increased steadily since 1900 to a record 78.8 years in 2013. But differences in life expectancy between the white and black populations still exist, despite a decrease in the life expectancy gap from 5.9 years in 1999 to 3.6 years in 2013. Differences in the change over time in the leading causes of death for the black and white populations have contributed to this decrease in the gap in life expectancy. Between 1999 and 2013, the decrease in the life expectancy gap between the black and white populations was mostly due to greater decreases in mortality from heart disease, cancer, HIV disease, unintentional injuries, and perinatal conditions among the black population. Similarly, the decrease in the gap between black and white male life expectancy was due to greater decreases in death rates for HIV disease, cancer, unintentional injuries, heart disease, and perinatal conditions in black males. For black females, greater decreases in diabetes death rates, combined with decreased rates for heart disease and HIV disease, were the major causes contributing to the decrease in the life expectancy gap with white females. The decrease in the gap in life expectancy between the white and black populations would have been larger than 3.6 years if not for increases in death rates for the black population for aortic aneurysm, Alzheimer’s disease, and maternal conditions. For black males, the causes that showed increases in death rates over white males were hypertension, aortic aneurysm, diabetes, Alzheimer’s disease, and kidney disease, while the causes that showed increases in death rates for black females were Alzheimer’s disease, maternal conditions, and atherosclerosis. This NCHS Data Brief is the second in a series of data briefs that explore the causes of death contributing to differences in life expectancy between detailed ethnic and racial populations in the United States. The first data brief focused on the racial differences in life
Li, Kuanrong; Hüsing, Anika; Kaaks, Rudolf
Cigarette smoking, adiposity, unhealthy diet, heavy alcohol drinking and physical inactivity together are associated with about half of premature deaths in Western populations. The aim of this study was to estimate their individual and combined impacts on residual life expectancy (RLE). Lifestyle and mortality data from the EPIC-Heidelberg cohort, comprising 22,469 German adults ≥40 years and free of diabetes, cardiovascular disease and cancer at recruitment (1994-1998), were analyzed with multivariable Gompertz proportional hazards models to predict lifetime survival probabilities given specific baseline status of lifestyle risk factors. The life table method was then used to estimate the RLEs. For 40-year-old adults, the most significant loss of RLE was associated with smoking (9.4 [95% confidence interval: 8.3, 10.6] years for male and 7.3 [6.0, 8.9] years for female heavy smokers [>10 cigarettes/day]; 5.3 [3.6, 7.1] years for men and 5.0 [3.2, 6.6] years for women smoking ≤10 cigarettes/day). Other lifestyle risk factors associated with major losses of RLE were low body mass index (BMI 4 drinks/day, 3.1 [1.9, 4.0] years for men), and high processed/red meat consumption (≥120 g/day, 2.4 [1.0, 3.9] years for women). The obesity-associated loss of RLE was stronger in male never smokers, while the loss of RLE associated with low BMI was stronger in current smokers. The loss of RLE associated with low leisure time physical activity was moderate for women (1.1 [0.05, 2.1] years) and negligible for men (0.4 [-0.3, 1.2] years). The combined loss of RLE for heavy smoking, obesity, heavy alcohol drinking and high processed/red meat consumption, versus never smoking, optimal BMI (22.5 to 24.9), no/light alcohol drinking and low processed/red meat consumption, was 17.0 years for men and 13.9 years for women. Promoting healthy lifestyles, particularly no cigarette smoking and maintaining healthy body weight, should be the core component of public health approaches to
... Technical Information Service NCHS How Did Cause of Death Contribute to Racial Differences in Life Expectancy in ... National Vital Statistics System, Mortality. What causes of death influenced the difference in life expectancy between the ...
Objectives. To assess whether voting patterns in the 2016 US presidential election were correlated with long-run trends in county life expectancy. Methods. I examined county-level voting data from the 2008 and 2016 presidential elections and assessed Donald Trump’s share of the 2016 vote, change in the Republican vote share between 2008 and 2016, and changes in absolute numbers of Democratic and Republican votes. County-level estimates of life expectancy at birth were obtained for 1980 and 2014 from the Institute for Health Metrics and Evaluation. Results. Changes in county life expectancy from 1980 to 2014 were strongly negatively associated with Trump’s vote share, with less support for Trump in counties experiencing greater survival gains. Counties in which life expectancy stagnated or declined saw a 10-percentage-point increase in the Republican vote share between 2008 and 2016. Conclusions. Residents of counties left out from broader life expectancy gains abandoned the Democratic Party in the 2016 presidential election. Since coming to power, the Trump administration has proposed cuts to health insurance for the poor, social programs, health research, and environmental and worker protections, which are key determinants of population health. Health gaps likely will continue to widen without significant public investment in population health. PMID:28817322
Auger, Nathalie; Harper, Sam; Barry, Amadou D; Trempe, Normand; Daniel, Mark
Language is an important determinant of health, but analyses of linguistic inequalities in mortality are scant, especially for Canadian linguistic groups with European roots. We evaluated the life expectancy gap between the Francophone majority and Anglophone minority of Québec, Canada, both over time and across major provincial areas. Arriaga's method was used to estimate the age and cause of death groups contributing to changes in the life expectancy gap at birth between 1989-1993 and 2002-2006, and to evaluate patterns across major provincial areas (metropolitan Montréal, other metropolitan centres, and small cities/rural areas). Life expectancy at birth was greater for Anglophones, but the gap decreased over time by 1.3 years (52% decline) in men and 0.9 years (47% decline) in women, due to relatively sharper reductions in Francophone mortality from several causes, except lung cancer which countered reductions in women. The life expectancy gap in 2002-2006 was widest in other metropolitan centres (men 5.1 years, women 3.2 years), narrowest in small cities/rural areas (men 0.8 years, women 0.7 years), and tobacco-related causes were the main contributors. Only young Anglophones time, but varied across areas of Québec. Tobacco-related causes accounted for the majority of the current life expectancy gap.
Jiang, Y Y; Liu, S W; Ji, N; Zeng, X Y; Liu, Y N; Zhang, M; Wang, L M; Li, Y C; Zhou, M G
Objective: To analyze the deaths attributable to alcohol use and its impact on people's life expectancy in China in 2013. Methods: The mortality data from the Disease Surveillance Points System and alcohol use data from China Chronic Disease Surveillance (2013) were used. The deaths attributed to alcohol use and its impact on the life expectancy of Chinese residents were estimated based on the principle of comparative risk assessment by calculating population attributable fraction. Results: In 2013, alcohol use resulted in 381 200 deaths, including 97 100 hemorrhagic stroke deaths, 88 200 liver cancer deaths, 61 400 liver cirrhosis deaths and 48 700 esophageal cancer deaths, and prevented 76 500 deaths, including 68 500, 4 900 and 3 100 deaths which might be caused by ischemic heart disease, hemorrhagic stroke and diabetes respectively. If risk factor of alcohol use is removed, the people's life expectancy would rise by an average of 0.43 years, especially in western China by 0.52 years, which was 0.12 years higher than that in eastern and central China, and the life expectancy of the population in rural and urban areas would rise by 0.48 years and 0.31 years respectively. Conclusions: Although alcohol has a protective effect on reducing ischemic heart disease, stroke and diabetes deaths, alcohol use is still a risk factor influencing the mortality and life expectancy of residents in China. It is necessary to take targeted measures to reduce the health problems caused by harmful use of alcohol.
Full Text Available Background and Objectives : The main objective of this study was to investigate the relationship between scientific productivity in the field of psychiatry and life expectancy in pioneer countries. Material and Methods : A rigorous search strategy was applied on Scopus database using psychiatry terms. The search results were narrowed to 2000-2012. No language limitation was applied. Life expectancy was extracted from World Bank database using Pearson correlation. Results : The search was led to 27516 articles. The US, England and Germany were identified as leading countries in producing the psychiatry articles, respectively. Pearson correlation test results indicated that there is a direct correlation between scientific products and life expectancy index. In other words, with the increase in producing scientific articles in psychiatry field, life expectancy rises as well. Conclusion : With increase in scientific productivity, life expectancy increases and mortality rate decreases. The results of this study can serve as a guiding document in the field of health and mental health.
To assess whether voting patterns in the 2016 US presidential election were correlated with long-run trends in county life expectancy. I examined county-level voting data from the 2008 and 2016 presidential elections and assessed Donald Trump's share of the 2016 vote, change in the Republican vote share between 2008 and 2016, and changes in absolute numbers of Democratic and Republican votes. County-level estimates of life expectancy at birth were obtained for 1980 and 2014 from the Institute for Health Metrics and Evaluation. Changes in county life expectancy from 1980 to 2014 were strongly negatively associated with Trump's vote share, with less support for Trump in counties experiencing greater survival gains. Counties in which life expectancy stagnated or declined saw a 10-percentage-point increase in the Republican vote share between 2008 and 2016. Residents of counties left out from broader life expectancy gains abandoned the Democratic Party in the 2016 presidential election. Since coming to power, the Trump administration has proposed cuts to health insurance for the poor, social programs, health research, and environmental and worker protections, which are key determinants of population health. Health gaps likely will continue to widen without significant public investment in population health.
Ngongo, K N; Nante, N; Chenet, L; McKee, M
Life expectancy at birth in southern Europe is known to be greater than expected in comparison with levels of economic development. This has been attributed to the 'Mediterranean diet'. There are, however, concerns that this comparative advantage is being lost. This paper examines the factors underlying changing life expectancy in Italy since 1980. The subjects of this analysis are obtained from data on all deaths in Italy between 1980 and 1992. Change in age specific death rates is calculated from selected causes and, using the method developed by Pollard, the contribution of deaths from different causes and at different ages to changing life expectancy at birth is estimated. Between 1980 and 1992, life expectancy at birth increased by 2.70 years for men and 2.75 years for women. Death rates have fallen among children and those over 40. In contrast, death rates have increased among men aged between 20 and 39 and have increased very slightly among women aged 25-29. Falling death rates from ischaemic heart disease are continuing to contribute to increasing life expectancy. Death rates from lung and breast cancer are rising among women but are compensated for by falling death rates from other cancers. Among men, falling death rates from cancer at younger ages are being offset by increases at older ages. The rising death rate among younger men is almost entirely due to AIDS, with accidents also making a small contribution. Life expectancy in Italy has improved throughout the 1980s, largely driven by falling death rates from cardiovascular diseases. Here are, however, some worrying trends, most notably the rising death rate among young men, due almost entirely to AIDS. The changing pattern of mortality has some similarities with Spain, another Mediterranean country, but there are also important differences.
Verbeck, Teresa A.
Semi-structured interviews were conducted with 11 male collegiate student-athletes in a revenue-generating sport in an effort to better inform current academic support practitioners how to best serve this population. The inquiry focused on student-athlete perceptions of two areas: (1) perceptions regarding the expectations academic personnel have…
Daalmans, M.T.; Vissia, M.S.; Kuijpers-Jagtman, A.M.; Lagro-Janssen, A.L.M.
Aim of this study was to get more insight into the career choice, plans and expectations, and practice pattern preferences of male and female dental students in The Netherlands. A structured questionnaire was sent out to all 5th year dental students in The Netherlands in the academic year 2001/2002
Kim, Jong In; Kim, Gukbin
What is the factor that affects healthy life expectancy? Healthy life expectancy (HLE) at birth may be influenced by components of the gender inequality index (GII). Notably, this claim is not tested on the between components of the GII, such as population at least secondary education (PLSE) with ages 25 and older, labor force participation rate (LFPR) with ages 15 and older, and the HLE in the world's countries. Thus, this study estimates the associations between the PLSE, LFPR of components of the GII and the HLE. The data for the analysis of HLE in 148 countries were obtained from the World Health Organization. Information regarding the GII indicators for this study was obtained from the United Nations database. Associations between these factors and HLE were assessed using Pearson correlation coefficients and regression models. Although significant negative correlations were found between HLE and the LFPR, positive correlations were found between HLE and PLSE. Finally, the HLE predictors were used to form a model of the components of the GII, with higher PLSE as secondary education and lower LFPR as labor force (R(2) = 0.552, P <0.001). Gender inequality of the attainment secondary education and labor force participation seems to have an important latent effect on healthy life expectancy at birth. Therefore, in populations with high HLE, the gender inequalities in HLE are smaller because of a combination of a larger secondary education advantage and a smaller labor force disadvantage in male-females.
Han Lin Shang
Full Text Available Using the age- and sex-specific data of 14 developed countries, we compare the point and interval forecast accuracy and bias of ten principal component methods for forecasting mortality rates and life expectancy. The ten methods are variants and extensions of the Lee-Carter method. Based on one-step forecast errors, the weighted Hyndman-Ullah method provides the most accurate point forecasts of mortality rates and the Lee-Miller method is the least biased. For the accuracy and bias of life expectancy, the weighted Hyndman-Ullah method performs the best for female mortality and the Lee-Miller method for male mortality. While all methods underestimate variability in mortality rates, the more complex Hyndman-Ullah methods are more accurate than the simpler methods. The weighted Hyndman-Ullah method provides the most accurate interval forecasts for mortality rates, while the robust Hyndman-Ullah method provides the best interval forecast accuracy for life expectancy.
Schauer, Daniel P.; Arterburn, David E.; Livingston, Edward H.; Coleman, Karen J.; Sidney, Steve; Fisher, David; O'Connor, Patrick; Fischer, David; Eckman, Mark H.
Objective To create a decision analytic model to estimate the balance between treatment risks and benefits for severely obese patients with diabetes. Summary Background Data Bariatric surgery leads to many desirable metabolic changes, but long-term impact of bariatric surgery on life expectancy in patients with diabetes has not yet been quantified. Methods We developed a Markov state transition model with multiple Cox proportional hazards models and logistic regression models as inputs to compare bariatric surgery versus no surgical treatment for severely obese diabetic patients. The model is informed by data from three large cohorts: 1) 159,000 severely obese diabetic patients (4,185 had bariatric surgery) from 3 HMO Research Network sites, 2) 23,000 subjects from the Nationwide Inpatient Sample (NIS), and 3) 18,000 subjects from the National Health Interview Survey linked to the National Death Index. Results In our main analyses, we found that a 45 year-old female with diabetes and a BMI of 45 kg/m2 gained an additional 6.7 years of life expectancy with bariatric surgery (38.4 years with surgery vs. 31.7 without). Sensitivity analyses revealed that the gain in life expectancy decreased with increasing BMI, until a BMI of 62 kg/m2 is reached, at which point nonsurgical treatment was associated with greater life expectancy. Similar results were seen for both men and women in all age groups. Conclusions For most severely obese patients with diabetes, bariatric surgery appears to improve life expectancy; however, surgery may reduce life expectancy for the super obese with BMIs over 62 kg/m2. PMID:25844968
Steingrímsdóttir, Olöf Anna; Næss, Øyvind; Moe, Joakim Oliu; Grøholt, Else-Karin; Thelle, Dag Steinar; Strand, Bjørn Heine; Bævre, Kåre
Educational attainment and longevity are strongly related. Large population studies covering long periods to provide evidence of trends in educational inequalities regarding life expectancy are scarce though, especially prior to the 1980s. Our objective was to document changes in life expectancy by education in Norway in the period 1961-2009, and to determine whether the patterns differ between sexes. This is a register-based population study of all Norwegian residents over 34 years, with data from the National Central Population Registry and the National Education Database. For each calendar year during 1961-2009, death rates by 1 year age groups were calculated separately for each sex and three educational categories (primary, secondary and tertiary). Annual life tables were used to calculate life expectancy at age 35 (e ( 35 )) and survival probability for the three age-intervals 35-44, 45-64, and 65-90. All education groups increased their e ( 35 ) over time, but inequalities in e ( 35 ) between tertiary and primary educational categories widened 5.3 years for men and 3.2 years for women during the study period. The probability for women with primary education to survive to age 64 did not improve from 1961 to 2009. The gain in life expectancy lagged about 10 years in lower compared to higher education groups which might suggest that improvements in life sustaining factors reach different segments of the population at different times. The widening of the gap seems to have partly tapered off over the last two decades, and the changes in life expectancy should be followed carefully in the future to document the development.
Kolip, Petra; Lange, Cornelia
The gender gap in life expectancy (GGLE) varies substantially in EU 28 Member States. This paper addresses the question of whether gender inequality affects the GGLE as well as life expectancy (LE) in both genders. We conducted an ecological study and used the gender inequality index (GII) developed by the United Nations as well as the gender difference in LE in 2015. We found a correlation between GGLE and GII (r2=0.180) and between GII and LE of 0.418 (women) and 0.430 (men). Gender equality policies are still necessary and will have an effect on women's as well as men's health.
A combination of computer analysis, degree of damage and approximate conversion to residual life expectancy gives acceptable results. There is considerable uncertainty in converting degree of damage to residual life expectancy, since structural component characteristics play a major role here. Structure damages play a major part in establishing the degree of damage. Damage categories are given, together with action if operations are to continue. Exhaustion calculations to TRD 508 are to be taken as conservative and as possible evidence of trends. 14 figs., 12 refs
Johnson, Leigh F; Mossong, Joel; Dorrington, Rob E; Schomaker, Michael; Hoffmann, Christopher J; Keiser, Olivia; Fox, Matthew P; Wood, Robin; Prozesky, Hans; Giddy, Janet; Garone, Daniela Belen; Cornell, Morna; Egger, Matthias; Boulle, Andrew
Few estimates exist of the life expectancy of HIV-positive adults receiving antiretroviral treatment (ART) in low- and middle-income countries. We aimed to estimate the life expectancy of patients starting ART in South Africa and compare it with that of HIV-negative adults. Data were collected from six South African ART cohorts. Analysis was restricted to 37,740 HIV-positive adults starting ART for the first time. Estimates of mortality were obtained by linking patient records to the national population register. Relative survival models were used to estimate the excess mortality attributable to HIV by age, for different baseline CD4 categories and different durations. Non-HIV mortality was estimated using a South African demographic model. The average life expectancy of men starting ART varied between 27.6 y (95% CI: 25.2-30.2) at age 20 y and 10.1 y (95% CI: 9.3-10.8) at age 60 y, while estimates for women at the same ages were substantially higher, at 36.8 y (95% CI: 34.0-39.7) and 14.4 y (95% CI: 13.3-15.3), respectively. The life expectancy of a 20-y-old woman was 43.1 y (95% CI: 40.1-46.0) if her baseline CD4 count was ≥ 200 cells/µl, compared to 29.5 y (95% CI: 26.2-33.0) if her baseline CD4 count was <50 cells/µl. Life expectancies of patients with baseline CD4 counts ≥ 200 cells/µl were between 70% and 86% of those in HIV-negative adults of the same age and sex, and life expectancies were increased by 15%-20% in patients who had survived 2 y after starting ART. However, the analysis was limited by a lack of mortality data at longer durations. South African HIV-positive adults can have a near-normal life expectancy, provided that they start ART before their CD4 count drops below 200 cells/µl. These findings demonstrate that the near-normal life expectancies of HIV-positive individuals receiving ART in high-income countries can apply to low- and middle-income countries as well. Please see later in the article for the Editors' Summary.
Leigh F Johnson
Full Text Available Few estimates exist of the life expectancy of HIV-positive adults receiving antiretroviral treatment (ART in low- and middle-income countries. We aimed to estimate the life expectancy of patients starting ART in South Africa and compare it with that of HIV-negative adults.Data were collected from six South African ART cohorts. Analysis was restricted to 37,740 HIV-positive adults starting ART for the first time. Estimates of mortality were obtained by linking patient records to the national population register. Relative survival models were used to estimate the excess mortality attributable to HIV by age, for different baseline CD4 categories and different durations. Non-HIV mortality was estimated using a South African demographic model. The average life expectancy of men starting ART varied between 27.6 y (95% CI: 25.2-30.2 at age 20 y and 10.1 y (95% CI: 9.3-10.8 at age 60 y, while estimates for women at the same ages were substantially higher, at 36.8 y (95% CI: 34.0-39.7 and 14.4 y (95% CI: 13.3-15.3, respectively. The life expectancy of a 20-y-old woman was 43.1 y (95% CI: 40.1-46.0 if her baseline CD4 count was ≥ 200 cells/µl, compared to 29.5 y (95% CI: 26.2-33.0 if her baseline CD4 count was <50 cells/µl. Life expectancies of patients with baseline CD4 counts ≥ 200 cells/µl were between 70% and 86% of those in HIV-negative adults of the same age and sex, and life expectancies were increased by 15%-20% in patients who had survived 2 y after starting ART. However, the analysis was limited by a lack of mortality data at longer durations.South African HIV-positive adults can have a near-normal life expectancy, provided that they start ART before their CD4 count drops below 200 cells/µl. These findings demonstrate that the near-normal life expectancies of HIV-positive individuals receiving ART in high-income countries can apply to low- and middle-income countries as well. Please see later in the article for the Editors' Summary.
Gil-Herrera, Eleazar; Yalcin, Ali; Tsalatsanis, Athanasios; Barnes, Laura E; Djulbegovic, Benjamin
We present a novel knowledge discovery methodology that relies on Rough Set Theory to predict the life expectancy of terminally ill patients in an effort to improve the hospice referral process. Life expectancy prognostication is particularly valuable for terminally ill patients since it enables them and their families to initiate end-of-life discussions and choose the most desired management strategy for the remainder of their lives. We utilize retrospective data from 9105 patients to demonstrate the design and implementation details of a series of classifiers developed to identify potential hospice candidates. Preliminary results confirm the efficacy of the proposed methodology. We envision our work as a part of a comprehensive decision support system designed to assist terminally ill patients in making end-of-life care decisions.
Napolioni, Valerio; Carpi, Francesco M; Giannì, Paola; Sacco, Roberto; Di Blasio, Luca; Mignini, Fiorenzo; Lucarini, Nazzareno; Persico, Antonio M
Aging is a complex phenotype with multiple determinants but a strong genetic component significantly impacts on survival to extreme ages. The dysregulation of immune responses occurring with increasing age is believed to contribute to human morbidity and mortality. Conversely, some genetic determinants of successful aging might reside in those polymorphisms for the immune system genes regulating immune responses. Here we examined the main effects of single loci and multi-locus interactions to test the hypothesis that the adenosine deaminase (ADA) and tumor necrosis factor alpha (TNF-α) genes may influence human life-expectancy. ADA (22G>A, rs73598374) and TNF-α (-308G>A, rs1800629; -238G>A, rs361525) functional SNPs have been determined for 1071 unrelated healthy individuals from Central Italy (18-106 years old) divided into three gender-specific age classes defined according to demographic information and accounting for the different survivals between sexes: for men (women), the first class consists of individuals88 years old (>91 years old). Single-locus analysis showed that only ADA 22G>A is significantly associated with human life-expectancy in males (comparison 1 (age class 2 vs. age class 1), O.R. 1.943, P=0.036; comparison 2 (age class 3 vs. age class 2), O.R. 0.320, P=0.0056). Age- and gender-specific patterns of epistasis between ADA and TNF-α were found using Generalized Multifactor Dimensionality Reduction (GMDR). In comparison 1, a significant two-loci interaction occurs in females between ADA 22G>A and TNF-α -238G>A (Sign Test P=0.011). In comparison 2, both two-loci and three-loci interaction are significant associated with increased life-expectancy over 88 years in males. In conclusion, we report that a combination of functional SNPs within ADA and TNF-α genes can influence life-expectancy in a gender-specific manner and that males and females follow different pathways to attain longevity. Copyright © 2011 Elsevier Ltd. All rights reserved.
Love-Koh, James; Asaria, Miqdad; Cookson, Richard; Griffin, Susan
To model the social distribution of quality-adjusted life expectancy (QALE) in England by combining survey data on health-related quality of life with administrative data on mortality. Health Survey for England data sets for 2010, 2011, and 2012 were pooled (n = 35,062) and used to model health-related quality of life as a function of sex, age, and socioeconomic status (SES). Office for National Statistics mortality rates were used to construct life tables for age-sex-SES groups. These quality-of-life and length-of-life estimates were then combined to predict QALE as a function of these characteristics. Missing data were imputed, and Monte-Carlo simulation was used to estimate standard errors. Sensitivity analysis was conducted to explore alternative regression models and measures of SES. Socioeconomic inequality in QALE at birth was estimated at 11.87 quality-adjusted life-years (QALYs), with a sex difference of 1 QALY. When the socioeconomic-sex subgroups are ranked by QALE, a differential of 10.97 QALYs is found between the most and least healthy quintile groups. This differential can be broken down into a life expectancy difference of 7.28 years and a quality-of-life adjustment of 3.69 years. The methods proposed in this article refine simple binary quality-adjustment measures such as the widely used disability-free life expectancy, providing a more accurate picture of overall health inequality in society than has hitherto been available. The predictions also lend themselves well to the task of evaluating the health inequality impact of interventions in the context of cost-effectiveness analysis. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Karasek, Deborah; Goodman, Julia; Gemmill, Alison; Falconi, April; Hartig, Terry; Magganas, Aristotle; Catalano, Ralph
Male twin gestations exhibit higher incidence of fetal morbidity and mortality than singleton gestations. From an evolutionary perspective, the relatively high rates of infant and child mortality among male twins born into threatening environments reduce the fitness of these gestations, making them more vulnerable to fetal loss. Women do not perceive choosing to spontaneously abort gestations although the outcome may result from estimates, made without awareness, of the risks of continuing a pregnancy. Here, we examine whether the non-conscious decisional biology of gestation can be linked to conscious risk aversion. We test this speculation by measuring the association between household surveys in Sweden that gauge financial risk aversion in the population and the frequency of twins among live male births. We used time-series regression methods to estimate our suspected associations and Box-Jenkins modeling to ensure that autocorrelation did not confound the estimation or reduce its efficiency. We found, consistent with theory, that financial risk aversion in the population correlates inversely with the odds of a twin among Swedish males born two months later. The odds of a twin among males fell by approximately 3.5% two months after unexpectedly great risk aversion in the population. This work implies that shocks that affect population risk aversion carry implications for fetal loss in vulnerable twin pregnancies.
Wanner, R.; Brosi, S.; Duijvestijn, G.
The safety margin (i.e. the difference between the loads equipment can take and those actually imposed on components) in a reactor pressure vessel is a major factor in the life expectancy of a nuclear power station. This safety margin is reduced considerably by reductions in the toughness of equipment caused by neutron irradiation and growth of cracks. Once the minimum safety margin is infringed, the nuclear power station is at the end of its working life. 13 figs., 11 refs
Valerie Lechene; JÃƒÂƒÂÂ©rÃƒÂƒÂÂ³me Adda
This paper proposes a joint model of tobacco consumption and mortality over the life-cycle. The decision to smoke is a trade off between current utility derived from smoking and a mortality risk increasing with age. Individuals with a longer potential life expectancy have more incentive to cut back on smoking and thus self select out of smoking. Using detailed data on mortality, morbidity and smoking we are able to identify this selection effect. We empirically evaluate its importance in expl...
Full Text Available Introduction: Quality of life of individuals depends significantly on the ability to have control over everyday life, realized through the freedom to make choices from available options and self-determination. Objective: To determine the correlation between possibilities for making choices and expectations for the future with the quality of life in adults with intellectual disabilities according self-assessment and assessment by others. Methods: Descriptive, method of correlation and comparative analysis ware applied. From techniques, analysis of documents, surveys with the Quality of life questionnaire by Schalock and Keith and Questionnaire for expectations for the future by Speck, and scaling with the Scale for assessment of the opportunities for making choices by Kishi et al. Sample consisted of 130 intellectually disabled adults and 130 proxies. For establishing connection between the examined phenomena Pearson correlation coefficient (r was used, at p<0,01. Results: There is a strong correlation between the results obtained from the questionnaires about quality of life and opportunities for making choices, self-assessment r(130=0,497, p<0,01, assessment by others r(130=0,482, p<0,01. There is a correlation between the results obtained from the questionnaires about quality of life and expectations for the future, but not very strong, self-assessment r(130=0,233, p=0,008<0,01, assessment by others r(130=0,305, p<0,01. Conclusion: There is a correlation between opportunities for making choices and expectations for the future with the quality of life in adults with intellectual disabilities. To improve the quality of life in these individuals, it is necessary to design programs that will develop self-concept, abilities for self-determination and making personal choices.
Lubinski, David; Benbow, Camilla P; Kell, Harrison J
Two cohorts of intellectually talented 13-year-olds were identified in the 1970s (1972-1974 and 1976-1978) as being in the top 1% of mathematical reasoning ability (1,037 males, 613 females). About four decades later, data on their careers, accomplishments, psychological well-being, families, and life preferences and priorities were collected. Their accomplishments far exceeded base-rate expectations: Across the two cohorts, 4.1% had earned tenure at a major research university, 2.3% were top executives at "name brand" or Fortune 500 companies, and 2.4% were attorneys at major firms or organizations; participants had published 85 books and 7,572 refereed articles, secured 681 patents, and amassed $358 million in grants. For both males and females, mathematical precocity early in life predicts later creative contributions and leadership in critical occupational roles. On average, males had incomes much greater than their spouses', whereas females had incomes slightly lower than their spouses'. Salient sex differences that paralleled the differential career outcomes of the male and female participants were found in lifestyle preferences and priorities and in time allocation. © The Author(s) 2014.
Full Text Available Tzu-Yi Wu,1 Chia-Hua Chung,2 Chia-Ni Lin,3 Jing-Shiang Hwang,2 Jung-Der Wang3,4 1Institute of Economics, Academia Sinica, Taipei, Taiwan; 2Institute of Statistical Science, Academia Sinica, Taipei, Taiwan; 3Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; 4Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Background: The mortality rates for different cancers are no longer an efficient tool for making national policy. The purpose of this study were to quantify the lifetime risks, life expectancies (LEs after diagnosis, expected years of life lost (EYLL, and lifetime health care expenditures for 19 major cancers in Taiwan. Methods: A total of 831,314 patients with 19 pathologically proven cancers were abstracted from the Taiwan Cancer Registry from 1998 to 2012. They were linked to the National Mortality Registry (1998–2014 and National Health Insurance reimbursement database (1998–2013 for survival and health care costs. We estimated the cumulative incidence rate for ages 0–79 years and the lifetime survival function for patients with different cancer sites. The EYLL was calculated by subtracting the LE of each cancer cohort from that of the age- and sex-matched referents simulated from national life tables. The estimated lifetime cost was calculated by adding up the product of survival probability and mean cost at the corresponding duration-to-date after adjustment for the inflation to the year of 2013. Results: There were 5 cancers with a lifetime risk exceeding 4%: colorectal, liver, lung, and prostate in males, and breast and colorectal in females. Cancers with EYLL of >10 years were: esophageal, intrahepatic bile ducts, liver, pancreas, oral, nasopharyngeal, leukemia, lung, and gallbladder, extrahepatic bile ducts and biliary tract in males, and intrahepatic bile ducts
Stewart, Susan T.; Cutler, David M.; Rosen, Allison B.
Background Although increases in obesity over the past 30 years have adversely affected the health of the U.S. population, there have been concomitant improvements in health because of reductions in smoking. Having a better understanding of the joint effects of these trends on longevity and quality of life will facilitate more efficient targeting of health care resources. Methods For each year from 2005 through 2020, we forecasted life expectancy and quality-adjusted life expectancy for a representative 18-year-old, assuming a continuation of past trends in smoking (based on data from the National Health Interview Survey for 1978 through 1979, 1990 through 1991, 1999 through 2001, and 2004 through 2006) and past trends in body-mass index (BMI) (based on data from the National Health and Nutrition Examination Survey for 1971 through 1975, 1988 through 1994, 1999 through 2002, and 2003 through 2006). The 2003 Medical Expenditure Panel Survey was used to examine the effects of smoking and BMI on health-related quality of life. Results The negative effects of increasing BMI overwhelmed the positive effects of declines in smoking in multiple scenarios. In the base case, increases in the remaining life expectancy of a typical 18-year-old are held back by 0.71 years or 0.91 quality-adjusted years between 2005 and 2020. If all U.S. adults became nonsmokers of normal weight by 2020, we forecast that the life expectancy of an 18-year-old would increase by 3.76 life-years or 5.16 quality-adjusted years. Conclusions If past obesity trends continue unchecked, the negative effects on the health of the U.S. population will increasingly outweigh the positive effects gained from declining smoking rates. Failure to address continued increases in obesity could result in an erosion of the pattern of steady gains in health observed since early in the 20th century. PMID:19955525
Latent radiogenic cancer fatalities from reactor accidents are considered to be more important than early fatalities. However, early fatalities generally result in appreciable life shortening for the affected individual whereas latent cancer fatalities generally result in limited life shortening. In this report a mathematical model is developed to express the reduction in life expectancy from radiogenic cancer as a function of dose received. The model is then used to compare the linear model of latent radiogenic cancer incidence with several nonlinear models that have appeared in the literature. (author)
In today’s fast and globalized life style Women hold a key position in the shaping of the next generation, plays such an important part in the life of the family. Their value is beyond measure. The changing life style demands more financial steadiness, that’s why the percentage of women in the active work population has increased rapidly in many countries around the world, including ours. As a consequence, we have seen the proliferation of dual-income families where role expectations toward m...
Bai, D.S.; Chun, Y.R.; Kim, J.G.
This paper considers the design of life-test sampling plans based on failure-censored accelerated life tests. The lifetime distribution of products is assumed to be Weibull with a scale parameter that is a log linear function of a (possibly transformed) stress. Two levels of stress higher than the use condition stress, high and low, are used. Sampling plans with equal expected test times at high and low test stresses which satisfy the producer's and consumer's risk requirements and minimize the asymptotic variance of the test statistic used to decide lot acceptability are obtained. The properties of the proposed life-test sampling plans are investigated
Grace T. Cruz
Full Text Available The study provides a baseline information on the functional health transition patterns of older people and computes for the Active Life Expectancy (ALE using a multistate life table method. Findings on ALE demonstrate that females and urban residents live longer and have a greater proportion of their remaining life in active state compared to their counterparts. Health transition analysis indicates a significant proportion experiencing recovery. Age, sex, place of residence and health status/behavior indicators (self-assessed health, drinking and exercise display a significant influence on future health and mortality trajectories although surprisingly, education did not show any significant effect.
Full Text Available Abstract Background Measures of premature mortality have been used to guide debates on future health priorities and to monitor the population health status. Standard expected years of life lost (SEYLL is one of the methods used to assess the time lost due to premature death. This article affords an overview of premature mortality in Spain for the year 2008. Methods A population-based study was conducted estimating SEYLL by sex and age groups. SEYLL, a key component of the disability-adjusted life years measure of disease burden, was calculated using Princeton West standard life tables with life expectancy at birth fixed at 80 years for males and 82.5 years for females. Population data and specific death records were obtained from the official registers of the National Institute of Statistics. All data were analysed and prepared in GesMor and Epidat software packages. Results The burden of premature mortality was estimated at 2.1 million SEYLL when age at death is taken into account. Males lost 60.9% and females lost 39.1% of total SEYLL. Malignant tumors (34.5% and cardiovascular diseases (24.0% were the leading categories in terms of SEYLL. Ischaemic heart disease (8.5% and lung cancers (8.0% were the most common specific causes of SEYLL followed by cerebrovascular diseases (5.9%, colorectal cancer (4.1%, road traffic accidents (3.5%, Alzheimer and other dementias (2.9%, chronic obstructive pulmonary disease (2.8%, breast cancer (2.8% and suicides (2.6%. Conclusions In Spain, premature mortality was essentially due to chronic non-communicable diseases. Data provided in this study are relevant for a more balanced health agenda aimed at reducing the burden of premature mortality. This study also represents a first step in estimating the overall burden of disease in terms of premature death and disability.
Martin, Stephen K.; Range, Lillian M.
Examined whether illness type, pain level, and life expectancy affected reactions of undergraduates (n=160) toward a terminal illness suicide with Acquired Immune Deficiency Syndrome (AIDS) or cancer. AIDS patients were more stigmatized than cancer patients; suicide was more tolerated if victim was suffering greater pain. (Author/ABL)
Griffin, Barbara; Hesketh, Beryl; Loh, Vanessa
This study examines the construct of subjective life expectancy (SLE), or the estimation of one's probable age of death. Drawing on the tenets of socioemotional selectivity theory (Carstensen, Isaacowitz, & Charles, 1999), we propose that SLE provides individuals with their own unique mental model of remaining time that is likely to affect their…
White, Alan; McKee, Martin; de Sousa, Bruno
A feature of the health of men across Europe is their higher rates of premature mortality and shorter life expectancy at birth than women. Following the publication of the first State of Men's Health in Europe report, we sought to explore possible reasons....
Vlek, C.A.J.; Skolnik, M; Gatersleben, B.C.M.
In the context of "sustainable development", we studied which attributes are important to people's quality of life (QoL) and which changes in QoL people would expect from future economic and environmental improvements or deteriorations. About 200 adult subjects evaluated the relative importance of
Full Text Available This study compared the effects of major violent and nonviolent opposition campaigns for regime change, on predicted life expectancy at birth. The study measured life expectancy five and ten years after the campaign ended, so that deaths which occurred during the campaign would not be included in the metric, and thus enabling the study of changes made in the state on the social determinants affecting longevity, after the campaign was over. Life expectancy is one of the best reported World Development Indicators and is considered to be a good indication of the overall health and general living conditions of the state and therefore is an ideal indicator to reflect the changes made in the state following a major campaign. The results of this analysis showed that states have a hard time recovering from a major opposition campaign and initially drop behind the growth trend in the world average for predicted life expectancy at birth. But, the type of campaign that was waged and whether it was successful, greatly affects the state’s ability to recover. Encouragingly by a decade after the campaign ends, states that experienced a nonviolent campaign that was successful had caught up to the world average and inched ahead of it. This shows that on this important development indicator, new governments that were ushered into power by nonviolent social movements, had made positive changes in the state that enabled it to surpass world averages.
Full Text Available A number of industrialized nations have recently experienced some degrees of constriction in their long-standing sex differentials in life expectancy at birth. In this study we examine this phenomenon in the context of Canada’s regions between 1971 and 1991: Atlantic (Newfoundland, Nova Scotia, New Brunswick, Prince Edward Island; Quebec, Ontario, and the West (Manitoba, Saskatchewan, Alberta, British Columbia, Yukon and Northwest Territories. Decomposition analysis based on multiple decrement life tables is applied to address three questions: (1 Are there regional differentials in the degree of narrowing in the sex gap in life expectancy? (2 What is the relative contribution of major causes of death to observed sex differences in average length of life within and across regions? (3 How do the contributions of cause-of-death components vary across regions to either widen or narrow the sex gap in survival? It is shown that the magnitude of the sex gap is not uniform across the regions, though the differences are not large. The most important contributors to a narrowing of the sex gap in life expectancy are heart disease and external types of mortality (i.e., accidents, violence, and suicide, followed by lung cancer and other types of chronic conditions. In substantive terms these results indicate that over time men have been making sufficient gains in these causes of death as to narrow some of the gender gap in overall survival. Regions show similarity in these effects.
David A. Swanson
Full Text Available Census survival methods are the oldest and most widely applicable methods of estimating adult mortality, and for populations with negligible migration they can provide excellent results. The reason for this ubiquity is threefold: (1 their data requirements are minimal in that only two successive age distributions are needed; (2 the two successive age distributions are usually easily obtained from census counts; and (3 the method is straightforward in that it requires neither a great deal of judgment nor “data-fitting” techniques to implement. This ubiquity is in contrast to other methods, which require more data, as well as judgment and, often, data fitting. In this short note, the new approach we demonstrate is that life expectancy at birth can be computed by using census survival rates in combination with an identity whereby the radix of a life table is equal to 1 (l0 = 1.00. We point out that our suggested method is less involved than the existing approach. We compare estimates using our approach against other estimates, and find it works reasonably well. As well as some nuances and cautions, we discuss the benefits of using this approach to estimate life expectancy, including the ability to develop estimates of average remaining life at any age. We believe that the technique is worthy of consideration for use in estimating life expectancy in populations that experience negligible migration.
Full Text Available Census survival methods are the oldest and most widely applicable methods of estimating adult mortality, and for populations with negligible migration they can provide excellent results. The reason for this ubiquity is threefold: (1 their data requirements are minimal in that only two successive age distributions are needed; (2 the two successive age distributions are usually easily obtained from census counts; and (3 the method is straightforward in that it requires neither a great deal of judgment nor “data-fitting” techniques to implement. This ubiquity is in contrast to other methods, which require more data, as well as judgment and, often, data fitting. In this short note, the new approach we demonstrate is that life expectancy at birth can be computed by using census survival rates in combination with an identity whereby the radix of a life table is equal to 1 (l0 = 1.00. We point out that our suggested method is less involved than the existing approach. We compare estimates using our approach against other estimates, and find it works reasonably well. As well as some nuances and cautions, we discuss the benefits of using this approach to estimate life expectancy, including the ability to develop estimates of average remaining life at any age. We believe that the technique is worthy of consideration for use in estimating life expectancy in populations that experience negligible migration.
L'Abbé, E N; Steyn, M; Loots, M
Little information is available on the 20th century mortality rates of rural black South African groups, such as the Venda. The purpose of this study was to apply abridged life tables in order to estimate life expectancy from both skeletal remains and death registry information of modern South African communities. Comparisons were also made with prehistoric and contemporary groups as a means to better evaluate life expectancy for this time period. The sample consisted of 160 skeletons of known Venda origin and burial registry information for 1364 black South Africans from the Rebecca Street and Mamelodi Cemeteries in Pretoria, South Africa. Standard anthropological techniques were applied to determine sex and estimate age from the skeletal remains. The stationary and non-stationary life table models were used to analyse the data. A high rate of child mortality, low juvenile and adult mortality with a steady increase in mortality after the age of 30 years was observed for both the Venda and the cemetery samples. Throughout the 20th century, life expectancy was shown to increase for black South Africans. However, due to the widespread HIV infection/AIDS of the 21st century, infant and young adult mortality rates continue to rise at such a speed that the decline in mortality seen for South Africans in the last 50 years will most likely to be lost in the next decade due to this disease.
Vadim Nikolaevich Kabanov
Full Text Available The beginning of the 21st century was marked by the emergence of national projects in our country, which exactly correspond to the private integral indicators used by the UN in calculating the index of human capital development since 1996. The national project “Health care” is aimed at increasing life expectancy, “Education” – expanding the population’s access to knowledge, “Doubling GDP” – raising people’s income. Attaching equal importance to each indicator, the author of the article set a task to consider the economic efficiency of budgetary funds allocated to improve the nation’s health. The author assumed a proportion as the main hypotheses about the nature of correlation between life expectancy (H and expenditures on health care (G; the calculated coefficients of correlation (Pearson, r of dependence H = f(G for all RF subjects for 2003–2013 (0.49 < r < or = 0.97 confirmed the existence of correlation. The author proposed to use the slope of the straight H = f(G to x-axis as a quantitative value, indicating the economic efficiency of the transformation of budget expenditures to the increase in life expectancy. This indicator means that the achieved increase in life expectancy (Y axis motion depending on changes in budget expenditures on health (axis motion. The proposed indicator to estimate the socio-economic effectiveness of state investments in domestic health care guarantees the most objective and clear assessment, conducted on the basis of standard methods of mathematical statistics, ensuring a high accuracy of the calculations. The rate of rise in life expectancy, depending on the volume of public investment in health care, can be used for the scientific justification, for example, of the degree of Federal budget participation in the regional programs to promote national health
Brønnum-Hansen, Henrik; Duraidi, Mohammed; Qalalwa, Khaled; Jeune, Bernard
The population of Palestine comprises almost 200 000 Palestinians aged 60 or older. The purpose of the study was to estimate disability-free life expectancy for Palestinians living in the West Bank and Gaza Strip and to evaluate changes from 2006 to 2010. The study combined mortality data and prevalence of activity limitation derived from the Palestinian Family Health Surveys carried out in 2006 and 2010. Based on questions about the ability to perform five basic daily activities, disability-free life expectancy was estimated. Changes between 2006 and 2010 were decomposed into contributions from changes in mortality and disability. Life expectancy at age 60 increased from 17.1 years in 2006 to 17.3 years in 2010 for men and from 18.7 years to 19.0 years for women. Disability-free life expectancy increased significantly, by 1.3 years for 60-year-old men (from 12.8 years to 14.1 years) and 1.8 years for 60-year-old women (from 12.6 years to 14.4 years). This increase was seen in the Gaza Strip as well as in the West Bank. While the modest contribution of the mortality effect did not differ between gender and regions, the strong contributions from the disability effects varied, being greatest for women in the Gaza Strip. The significant increase in disability-free life expectancy for both genders is remarkable and, to our knowledge, not seen in other low-income countries. This change may be due to decreasing incidence of disability and greater recovery from disability as a result of better prevention, care and rehabilitation of chronic diseases. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Nosrati, Elias; Ash, Michael; Marmot, Michael; McKee, Martin; King, Lawrence P
The health gap between the top and the bottom of the income distribution is widening rapidly in the USA, but the lifespan of America's poor depends substantially on where they live. We ask whether two major developments in American society, deindustrialization and incarceration, can explain variation among states in life expectancy of those in the lowest income quartile. Life expectancy estimates at age 40 of those in the bottom income quartile were used to fit panel data models examining the relationship with deindustrialization and incarceration between 2001 and 2014 for all US states. A one standard deviation (s.d.) increase in deindustrialization (mean = 11.2, s.d. = 3.5) reduces life expectancy for the poor by 0.255 years [95% confidence interval (CI): 0.090-0.419] and each additional prisoner per 1000 residents (mean = 4.0, s.d. = 1.5) is associated with a loss of 0.468 years (95% CI: 0.213-0.723). Our predictors explain over 20% of the state-level variation in life expectancy among the poor and virtually the entire increase in the life expectancy gap between the top and the bottom income quartiles since the turn of the century. In the USA between 2001 and 2014, deindustrialization and incarceration subtracted roughly 2.5 years from the lifespan of the poor, pointing to their role as major health determinants. Future research must remain conscious of the upstream determinants and the political economy of public health. If public policy responses to growing health inequalities are to be effective, they must consider strengthening industrial policy and ending hyper-incarceration. © The Author 2017; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association
Fosse, Anette; Schaufel, Margrethe Aase; Ruths, Sabine
. CONCLUSION: Nursing home patients and their relatives wanted doctors more involved in end-of-life care. They expected doctors to acknowledge their preferences and provide guidance and symptom relief. PRACTICE IMPLICATIONS: High-quality end-of-life care in nursing homes relies on organization, funding......OBJECTIVE: Synthesize research about patients' and relatives' expectations and experiences on how doctors can improve end-of-life care in nursing homes. METHODS: We systematically searched qualitative studies in English in seven databases (Medline, Embase, PsycINFO, CINAHL, Ageline, Cochrane...... decision-makers reported uncertainty and distress when guidance from health personnel was lacking. They worried about staff shortage and emphasized doctor availability. Relatives and health personnel seldom recognized patients' ability to consent, and patients' preferences were not always recognized...
Chandra, A.; Ryu, J.J.; Karra, P.
is semi-analytical and computational, where, based on the estimated Preston constant and other material and process parameters, the scratch propensity (consisting of magnitude of scratch depth and their frequency per unit area) due to micro-motion in modular hip implants is estimated. The third phase...... views these scratches as initial notches and utilizes a mixed-mode fatigue crack propagation model to estimate the critical crack length for onset of instability. The number of loading cycles needed to reach this critical crack length is then labeled as the expected life of the implant under given...... mechanical and chemical conditions. Implications of different material and process conditions to life expectancy of orthopedic implants are discussed. It is observed that transverse micro-motion, compared to longitudinal micro-motion, plays a far more critical role in determining the implant life. Patient...
Mäki, Netta; Martikainen, Pekka; Eikemo, Terje; Menvielle, Gwenn; Lundberg, Olle; Ostergren, Olof; Jasilionis, Domantas; Mackenbach, Johan P
Healthy life expectancy is a composite measure of length and quality of life and an important indicator of health in aging populations. There are few cross-country comparisons of socioeconomic differences in healthy life expectancy. Most of the existing comparisons focus on Western Europe and the United States, often relying on older data. To address these deficiencies, we estimated educational differences in disability-free life expectancy for eight countries from all parts of Europe in the early 2000s. Long-standing severe disability was measured as a Global Activity Limitation Indicator (GALI) derived from the European Union Statistics on Income and Living Conditions (EU-SILC) survey. Census-linked mortality data were collected by a recent project comparing health inequalities between European countries (the EURO-GBD-SE project). We calculated sex-specific educational differences in disability-free life expectancy between the ages of 30 and 79 years using the Sullivan method. The lowest disability-free life expectancy was found among Lithuanian men and women (33.1 and 39.1 years, respectively) and the highest among Italian men and women (42.8 and 44.4 years, respectively). Life expectancy and disability-free life expectancy were directly related to the level of education, but the educational differences were much greater in the latter in all countries. The difference in the disability-free life expectancy between those with a primary or lower secondary education and those with a tertiary education was over 10 years for males in Lithuania and approximately 7 years for males in Austria, Finland and France, as well as for females in Lithuania. The difference was smallest in Italy (4 and 2 years among men and women, respectively). Highly educated Europeans can expect to live longer and spend more years in better health than those with lower education. The size of the educational difference in disability-free life expectancy varies significantly between countries
Leinonen, Taina; Martikainen, Pekka; Myrskylä, Mikko
The balance between the amount of time spent in work and in retirement underlies the long-term sustainability of the social security system. We examined socioeconomic differences in how increasing longevity is distributed between labor market statuses in Finland. We used register data and the Sullivan method to analyze life expectancy at age 50 spent in different labor market statuses over the period 1989-2012 and across cohorts born in 1938-1953. We projected the future mortality and labor market participation rates of partially observed cohorts. Both working life expectancy at age 50 and the share of remaining life spent in work have increased across periods following the recession of the early 1990s, and across successive cohorts. The trends were similar across the social classes, but there were large differences in the numbers of years spent in various states: for the most recent period and the youngest cohort, we find that compared with upper non-manual employees, male and female manual workers were expected to spend 3.6-3.7 fewer years in work, 1.7-4.7 fewer years in statutory retirement, and 3.2-3.9 more years in other forms of nonemployment. Our finding that the share of remaining life at age 50 spent in work is increasing implies that pressure on the welfare system is not as severe as is commonly thought. © The Author(s) 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Wang, Han-I; Aas, Eline; Howell, Debra; Roman, Eve; Patmore, Russell; Jack, Andrew; Smith, Alexandra
Acute myeloid leukemia (AML) can be diagnosed at any age and treatment, which can be given with supportive and/or curative intent, is considered expensive compared with that for other cancers. Despite this, no long-term predictive models have been developed for AML, mainly because of the complexities associated with this disease. The objective of the current study was to develop a model (based on a UK cohort) to predict cost and life expectancy at a population level. The model developed in this study combined a decision tree with several Markov models to reflect the complexity of the prognostic factors and treatments of AML. The model was simulated with a cycle length of 1 month for a time period of 5 years and further simulated until age 100 years or death. Results were compared for two age groups and five different initial treatment intents and responses. Transition probabilities, life expectancies, and costs were derived from a UK population-based specialist registry-the Haematological Malignancy Research Network (www.hmrn.org). Overall, expected 5-year medical costs and life expectancy ranged from £8,170 to £81,636 and 3.03 to 34.74 months, respectively. The economic and health outcomes varied with initial treatment intent, age at diagnosis, trial participation, and study time horizon. The model was validated by using face, internal, and external validation methods. The results show that the model captured more than 90% of the empirical costs, and it demonstrated good fit with the empirical overall survival. Costs and life expectancy of AML varied with patient characteristics and initial treatment intent. The robust AML model developed in this study could be used to evaluate new diagnostic tools/treatments, as well as enable policy makers to make informed decisions. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Dunkel, Curtis S; Mathes, Eugene
The role of the individual difference variables of mate value, short-term and long-term mating preferences, and life history strategy along with the manipulated variable of life expectancy were used to predict differences in the willingness to engage in sexually coercive behaviors. Short-term preferences and long-term preferences were correlated with the willingness to engage in sexual coercion at all life expectancies. Life history strategy was correlated with the willingness to engage in sexual coercion at only the shortest and longest life expectancies. Most importantly short-term and long-term mating preferences interacted with life expectancy to predict the willingness to engage in sexually coercive behaviors. Short life expectancies increased willingness in individuals with high short-term and low long-term preferences. The results are discussed in terms of the varying theories of sexual coercion with emphasis put on a life history approach.
Teixeira, Thiago; Nazima, Maira; Hallak, Jorge
The Amazon Rainforest is a cradle of biodiversity, where different ethnic groups have specific sexual habits. To define the average sexual quality of life of Amazonian men 18 to 69 years old, evaluate the influence of aging on their sexual function, and calculate the prevalence of premature ejaculation, delayed ejaculation, and hypoactive sexual desire disorder. A cross-sectional quantitative probability sample study was performed with a demographically representative population (N = 385), with data collected privately at participants' houses, including men who had been sexually active for a minimum of 6 months. The Male Sexual Quotient (MSQ) was used to measure sexual satisfaction and function. Statistical analysis was performed with SPSS 21.0 using the Kruskal-Wallis test (P quality of sexual life. MSQ scores. The response rate was 81.69%. The mean age was 36.00 ± 12.95 years, and most men had mixed ethnicity (63.11%), were self-employed (42.07%), had a monthly earned income of US$0 to US$460 (46.75%), and were single (36.10%). The mean MSQ score was 80.39 ± 12.14 (highly satisfied). None of the demographic characteristics showed a statistically significant influence on sexual satisfaction. The difference in quality of sexual life was statistically significant compared with age (P quality (P quality of sexual life. Sexual domains such as desire, partner satisfaction, and erection quality are related to the correlation between sexual quality of life and aging. However, the prevalence of premature ejaculation seems to be slightly higher than in other parts of the world. Teixeira T, Nazima M, Hallak J. Male Sexual Quality Of Life Is Maintained Satisfactorily Throughout Life In The Amazon Rainforest. Sex Med 2018;6:90-96. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.
Wilma J Nusselder
Full Text Available BACKGROUND: Data on mortality among homeless people are limited. Therefore, this study aimed to describe mortality patterns within a cohort of homeless adults in Rotterdam (the Netherlands and to assess excess mortality as compared to the general population in that city. METHODS: Based on 10-year follow-up of homeless adults aged ≥ 20 years who visited services for homeless people in Rotterdam in 2001, and on vital statistics, we assessed the association of mortality with age, sex and type of service used (e.g. only day care, convalescence care, other within the homeless cohort, and also compared mortality between the homeless and general population using Poisson regression. Life tables and decomposition methods were used to examine differences in life expectancy. RESULTS: During follow-up, of the 2096 adult homeless 265 died. Among the homeless, at age 30 years no significant sex differences were found in overall mortality rates and life expectancy. Compared with the general Rotterdam population, mortality rates were 3.5 times higher in the homeless cohort. Excess mortality was larger in women (rate ratio [RR] RR 5.56, 95% CI 3.95-7.82 as compared to men (RR 3.31, 95% CI 2.91-3.77, and decreased with age (RR 7.67, 95% CI 6.87-8.56 for the age group 20-44 and RR 1.63, 95% CI 1.41-1.88 for the age group 60+ years. Life expectancy at age 30 years was 11.0 (95% CI 9.1-12.9 and 15.9 (95% CI 10.3-21.5 years lower for homeless men and women compared to men and women in the general population respectively. CONCLUSION: Homeless adults face excessive losses in life expectancy, with greatest disadvantages among homeless women and the younger age groups.
Marília Regina Nepomuceno
Full Text Available OBJECTIVE To analyze conditional and unconditional healthy life expectancy among older Brazilian women. METHODS This cross-sectional study used the intercensal technique to estimate, in the absence of longitudinal data, healthy life expectancy that is conditional and unconditional on the individual’s current health status. The data used were obtained from the Pesquisa Nacional por Amostra de Domicílios (National Household Sample Survey of 1998, 2003, and 2008. This sample comprised 11,171; 13,694; and 16,259 women aged 65 years or more, respectively. Complete mortality tables from the Brazilian Institute of Geography and Statistics for the years 2001 and 2006 were also used. The definition of health status was based on the difficulty in performing activities of daily living. RESULTS The remaining lifetime was strongly dependent on the current health status of the older women. Between 1998 and 2003, the amount of time lived with disability for healthy women at age 65 was 9.8%. This percentage increased to 66.2% when the women already presented some disability at age 65. Temporal analysis showed that the active life expectancy of the women at age 65 increased between 1998-2003 (19.3 years and 2003-2008 (19.4 years. However, life years gained have been mainly focused on the unhealthy state. CONCLUSIONS Analysis of conditional and unconditional life expectancy indicated that live years gained are a result of the decline of mortality in unhealthy states. This pattern suggests that there has been no reduction in morbidity among older women in Brazil between 1998 and 2008.
Full Text Available Decomposition of a difference in life expectancies may identify ages at which the difference originates in mortality differences, or may identify age at which the difference results in different values of person-years lived (life table population. This study shows that the two approaches are orthogonally related to each other, and derives an origin-destination decomposition matrix in which summing in one direction produces Andreev's origin-decomposition results, while summing in the other direction produces destination-decomposition corresponding to directly-observed differences in nLx values.
Alvaro J. Idrovo
Full Text Available The objective of this ecological study was to ascertain the effects of physical environment on life expectancy at birth, using data from all 32 Mexican states. 50 environmental indicators with information about demography, housing, poverty, water, soils, biodiversity, forestry resources, and residues were included in exploratory factor analysis. Four factors were extracted: population vulnerability/susceptibility, and biodiversity (FC1, urbanization, industrialization, and environmental sustainability (FC2, ecological resilience (FC3, and free-plague environments (FC4. Using OLS regressions, FC2, FC3, and FC4 were found to be positively associated with life expectancy at birth, while FC1 was negatively associated. This study suggests that physical environment is an important macro-determinant of the health of the Mexican population, and highlights the usefulness of ecological concepts in epidemiological studies.
Idrovo, Alvaro J
The objective of this ecological study was to ascertain the effects of physical environment on life expectancy at birth, using data from all 32 Mexican states. 50 environmental indicators with information about demography, housing, poverty, water, soils, biodiversity, forestry resources, and residues were included in exploratory factor analysis. Four factors were extracted: population vulnerability/susceptibility, and biodiversity (FC1), urbanization, industrialization, and environmental sustainability (FC2), ecological resilience (FC3), and free-plague environments (FC4). Using OLS regressions, FC2, FC3, and FC4 were found to be positively associated with life expectancy at birth, while FC1 was negatively associated. This study suggests that physical environment is an important macro-determinant of the health of the Mexican population, and highlights the usefulness of ecological concepts in epidemiological studies.
N. Brouard; J.-M. Robine; E. Cambois
Cambois (Emmanuelle), Robin? (Jean-Marie), Brouard (Nicolas).- Life Expectancies Applied to Specific Statuses: A History of the Indicators and the Methods of Calculation Indicators of life expectancy applied to specific statuses, such as the state of health or professional status, were introduced at the end of the 1930s and are currently the object of renewed interest. Because they relate mortality to different domains (health, professional activity) applied life expectancies reflect simultan...
The objective of this ecological study was to ascertain the effects of physical environment on life expectancy at birth, using data from all 32 Mexican states. 50 environmental indicators with information about demography, housing, poverty, water, soils, biodiversity, forestry resources, and residues were included in exploratory factor analysis. Four factors were extracted: population vulnerability/susceptibility, and biodiversity (FC1), urbanization, industrialization, and environmental sust...
Egüez-Guevara, Pilar; Andrade, Flávia Cristina Drumond
Knowledge on disability's impact among older women and men in Ecuador is limited. This paper provides gender-specific estimates of disability prevalence, life expectancy with and without disability, and the factors associated with gender differences in disability at older age in Ecuador (2009-2010). Data from the Health, Well-Being, and Aging Survey (SABE) Ecuador 2009 was used. Participants were 4480 men and women aged 60 and over. Life expectancy with and without disability was calculated using the Sullivan method. Logistic regression analyses were used to explore gender differences in disability prevalence. Two disability measures, indicating limitations in activities of daily living (ADL) and instrumental activities of daily living (IADL), were used. 60-year-old women in Ecuador can expect to live 16.3 years without ADL limitations compared to 16.9 years for men. Life expectancy without IADL limitations was 12.5 years for women and 15.5 years for men. At age 60, women's length of life with ADL and IADL disability was higher (7.9 years for women vs. 4.9 years for men with ADL, and 11.7 years for women vs. 6.3 years for men with IADL). After controlling for socioeconomic characteristics, chronic conditions and lifestyle factors, gender differences in ADL disability were not statistically significant. However, older women were 58% more likely (OR=1.58, 95% CI 1.27, 1.95) to report having IADL limitations than men, even after including control variables. Interventions should tackle chronic disease, physical inactivity, and socioeconomic differences to reduce women's vulnerability to disability in older age. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
McElderry, Robert M
Surviving inhospitable periods or seasons may greatly affect fitness. Evidence of this exists in the prevalence of dormant stages in the life cycles of most insects. Here I focused on butterflies with distinct seasonal morphological types (not a genetic polymorphism) in which one morphological type, or form, delays reproduction until favorable conditions return, while the other form develops in an environment that favors direct reproduction. For two butterflies, Anaea aidea and A. andria, I tested the hypothesis that the development of each seasonal form involves a differential allocation of resources to survival at eclosion. I assayed differences in adult longevity among summer and winter forms in either a warm, active environment or a cool, calm environment. Winter form adults lived 40 times longer than summer form but only in calm, cool conditions. The magnitude of this difference provided compelling evidence that the winter form body plan and metabolic strategy (i.e. resource conservatism) favor long term survival. This research suggests that winter form adults maintain lowered metabolic rate, a common feature of diapause, to conserve resources and delay senescence while overwintering. Copyright © 2016 Elsevier Ltd. All rights reserved.
Fenelon, Andrew; Blue, Laura
We examine trends in the Hispanic longevity advantage between 1990 and 2010, focusing on the contribution of cigarette smoking. We calculate life expectancy at age 50 for Hispanics and non-Hispanic whites between 1990 and 2010. We use an indirect method to calculate the contribution of smoking to changes over time in life expectancy. Among women, the Hispanic advantage in life expectancy grows from 2.14 years in 1990 (95 % CI 1.99-2.30 years) to 3.53 years in 2010 (3.42-3.64 years). More than 40 % of this increase reflects widening differences in smoking-attributable mortality. The advantage for Hispanic men increases from 2.27 years (2.14-2.41 years) to 2.91 years (2.81-3.01 years), although smoking makes only a small contribution. Despite persistent disadvantage, US Hispanics have increased their longevity advantage over non-Hispanic whites since 1990, much of which reflects the continuing importance of cigarette smoking to the Hispanic advantage.
Izmirlian, G; Brock, D; Ferrucci, L; Phillips, C
Active life expectancy (ALE) at a given age is defined as the expected remaining years free of disability. In this study, three categories of health status are defined according to the ability to perform activities of daily living independently. Several studies have used increment-decrement life tables to estimate ALE, without error analysis, from only a baseline and one follow-up interview. The present work conducts an individual-level covariate analysis using a three-state Markov chain model for multiple follow-up data. Using a logistic link, the model estimates single-year transition probabilities among states of health, accounting for missing interviews. This approach has the advantages of smoothing subsequent estimates and increased power by using all follow-ups. We compute ALE and total life expectancy from these estimated single-year transition probabilities. Variance estimates are computed using the delta method. Data from the Iowa Established Population for the Epidemiologic Study of the Elderly are used to test the effects of smoking on ALE on all 5-year age groups past 65 years, controlling for sex and education.
Brønnum-Hansen, Henrik; Duraidi, Mohammed; Qalalwa, Khaled
into contributions from changes in mortality and disability. RESULTS: Life expectancy at age 60 increased from 17.1 years in 2006 to 17.3 years in 2010 for men and from 18.7 years to 19.0 years for women. Disability-free life expectancy increased significantly, by 1.3 years for 60-year-old men (from 12.8 years to 14...... mortality data and prevalence of activity limitation derived from the Palestinian Family Health Surveys carried out in 2006 and 2010. Based on questions about the ability to perform five basic daily activities, disability-free life expectancy was estimated. Changes between 2006 and 2010 were decomposed.......1 years) and 1.8 years for 60-year-old women (from 12.6 years to 14.4 years). This increase was seen in the Gaza Strip as well as in the West Bank. While the modest contribution of the mortality effect did not differ between gender and regions, the strong contributions from the disability effects varied...
Full Text Available Objectives: Multiple Sclerosis is an incurable and chronic disease of the central nervous system. The main purpose of this survey is to compare the character types and life expectancy of patients suffering from M. S as compared with normal people. This survey was conducted using the Persian translation of NEO-FFI (NEO-Five Factor Inventory and Herth Life Expectancy. Methods:Thirty nine people suffering from multiple sclerosis, who were hospitalized in anursing home, were chosen. As a control group there were 39 healthy people who had no background of physical or mental diseases. These people were selected from educational centre scientific and the personnel of Islamic Azad University, Science and Research Campus. Healthy people were matched to control group according, to sex, gender, marital status and education. Results: To analyze the data, T tests were used. The results of the survey show that people suffering from multiple sclerosis were significantly different from healthy people in three factors, neuroticism, extraversion and openness. For life expectancy there was no significant difference between the two groups. Discussion: Peopleaffected by Multiple Sclerosis achieve higher marks levels of the function of neuroticism compared with the healthy people. They are also agreeableness in a lower state, due to the function of openness to experience compared with the safe ones and in a lower state compared with the healthy persons.
Dávila-Cervantes, Claudio A; Pardo Montaño, Ana M
To analyze the level and trend of diabetes mellitus (DM) in Mexico, and its contribution to the changes in temporary life expectancy between 20 and 100 years of age, in the period 1990-2010. Data comes from National Mortality Vital Statistics and from the Population Census from the Mexican National Institute of Geography and Statistics (INEGI). We calculated standardized mortality rates. To analyze the impact of DM on the temporary life expectancy (80e20) we used Pollards method. Between 1990 and 2010, the standardized mortality rate for people 20 years and older increased by 224 %. The contribution of DM for men to the change in life expectancy during 1990-2000 was a reduction of 0.31 years; for women was a reduction of 0.32 years; in the period 2000-2010 the reduction continued for both men and women (0.34 and 0.12 years respectively). Mortality from DM continues to increase, especially for men, but for women a modest reduction was observed. It is essential to apply health services and programs aimed at reducing mortality from this cause, focused on prevention, early detection and timely treatment, with concrete actions on vulnerable groups.
Berec, Luděk; Maxin, Daniel
Sterilizing pathogens are commonly assumed not to affect longevity of infected individuals, and if they do then negatively. Examples abound, however, of species in which the absence of reproduction actually increases life expectancy. This happens because by decreasing the energy outlay on reproduction individuals with lowered reproduction can live longer. Alternatively, fertile individuals are more susceptible to predators or parasitoids if the latter can capitalize on mating signals of the former. Here we develop and analyze an SI epidemiological model to explore whether and to what extent does such a life expectancy prolongation due to sterilizing pathogens affect host dynamics. In particular, we are interested in an added value of increased life expectancy on the possibility of successful pest control, that is, the effect of increased lifespan and hence increased potential of the infected individuals to spread the disease on pest control effectiveness. We show that although the parameter range in which we observe an effect of increased lifespan of the sterilized individuals is not large, the effect itself can be significant. In particular, the increase in pest control effectiveness can be very dramatic when disease transmission efficiency is close to birth rate, mortality rate of susceptibles is relatively high (i.e., the species is relatively short-lived), and sterilization efficiency is relatively high. Our results thus characterize pathogens that are promising candidates for an effective pest control and that might possibly be engineered if not occurring naturally.
Lewine, Richard; Shriner, Brooke
This study examines the relationship between "vocational lost potential" and suicide risk in a mixed sample of severely and persistently mentally ill psychiatric patients. We hypothesized that increased lost potential would be associated with increased suicide risk indicator ratings and that this relationship would be moderated by patients' social class of origin. One hundred sixty-seven psychiatric patients rated a range of clinical symptoms and vocational expectations, as well as providing sociodemographic information including their parents' years of education (used as a proxy for social class of origin). Contrary to our prediction, the results suggest that individuals from higher social class who experience minimal lost potential may be at a higher risk for suicide than their counterparts with maximal lost potential; this is especially true when based on fathers' educational level. In discussing the clinical implications of our findings, we suggest that a subgroup of individuals' vocational success may depend on first addressing the cognitive conflict inherent in the phenomenon of lost potential.
The use of existing value of statistical life (VSL) estimates in benefit-cost analysis relates to relatively short changes in life expectancy. The authors' strategy for addressing this question is to briefly survey the existing economics literature.
Lallo, Carlo; Raitano, Michele
Life expectancy considerably increased in most developed countries during the twentieth century. However, the increase in longevity is neither uniform nor random across individuals belonging to various socioeconomic groups. From an economic policy perspective, the difference in mortality by socioeconomic conditions challenges the fairness of the social security systems. We focus on the case of Italy and aim at measuring differences in longevity at older ages by individuals belonging to different socioeconomic groups, also in order to assess the effective fairness of the Italian public pension system, which is based on a notional defined contribution (NDC) benefit computation formula, whose rules do not take into account individual heterogeneity in expected longevity. We use a longitudinal dataset that matches survey data on individual features recorded in the Italian module of the EU-SILC, with information on the whole working life and until death collected in the administrative archives managed by the Italian National Social Security Institute. In more detail, we follow until 2009 a sample of 11,281 individuals aged at least 60 in 2005. We use survival analysis and measure the influence of a number of events experienced in the labor market and individual characteristics on mortality. Furthermore, through Kaplan-Meier simulations of hypothetical social groups, adjusted by a Brass relational model, we estimate and compare differences in life expectancy of individuals belonging to different socioeconomic groups. Our findings confirm that socioeconomic status strongly predicts life expectancy even in old age. All estimated models show that the prevalent type of working activity before retirement is significantly associated with the risk of death, even when controlling for dozens of variables as proxies of individual demographic and socioeconomic characteristics. The risk of death for self-employed individuals is 26% lower than that of employees, and life expectancy at
Thiago Teixeira, MD, MSc
Full Text Available Introduction: The Amazon Rainforest is a cradle of biodiversity, where different ethnic groups have specific sexual habits. Aims: To define the average sexual quality of life of Amazonian men 18 to 69 years old, evaluate the influence of aging on their sexual function, and calculate the prevalence of premature ejaculation, delayed ejaculation, and hypoactive sexual desire disorder. Methods: A cross-sectional quantitative probability sample study was performed with a demographically representative population (N = 385, with data collected privately at participants’ houses, including men who had been sexually active for a minimum of 6 months. The Male Sexual Quotient (MSQ was used to measure sexual satisfaction and function. Statistical analysis was performed with SPSS 21.0 using the Kruskal-Wallis test (P < .05, and a multiple linear regression analysis was performed to investigate which factors could predict participants’ quality of sexual life. Main Outcome Measures: MSQ scores. Results: The response rate was 81.69%. The mean age was 36.00 ± 12.95 years, and most men had mixed ethnicity (63.11%, were self-employed (42.07%, had a monthly earned income of US$0 to US$460 (46.75%, and were single (36.10%. The mean MSQ score was 80.39 ± 12.14 (highly satisfied. None of the demographic characteristics showed a statistically significant influence on sexual satisfaction. The difference in quality of sexual life was statistically significant compared with age (P < .01. The domains of desire (P < .01, partner satisfaction (P = .04, and erection quality (P < .01, P = .03, P = .02 were statistically significant. Prevalences of sexual dysfunctions were 36.54% for premature ejaculation, 6.5% for delayed ejaculation, and 11.69% for hypoactive sexual desire disorder. Conclusions: Independent of age, these men have an excellent quality of sexual life. Sexual domains such as desire, partner satisfaction, and erection quality are related to the
Ara, Shihomi; Tekeşin, Cem
The main objective of this study is to estimate the monetary value of the gains of healthy days and life expectancy due to the ambient air quality standard that came into effect in 2014 by estimating the country-specific value of a life year (VOLY) and the value of the healthier and longer life (VHLL) for Turkey. Contingent valuation method is adopted to reveal individuals' willingness to pay for an improvement of health condition and the extension of their life expectancy by avoiding respiratory and lung related illnesses. VHLL is composed of two parts, WTP for an extension of one's life years (VOLY) and for an increase in the number of healthy days throughout one's life time (VHLL-VOLY). We found that close to 80% of WTP is allocated to the latter component of VHLL and only 20% is for VOLY mainly due to Islamic beliefs of the respondents. A total of 1314 observations are collected by face-to-face interviews from Afsin-Elbistan, Kutahya-Tavsanli and Ankara. The estimated VHLL and VOLY are [41,750 TL, 10,258 TL] with all the observations, [30,185 TL, 7132 TL] for Afsin-Elbistan, [31,718 TL, 7081 TL] for Kutahya-Tavsanli and [52,334 TL, 14,813 TL] for Ankara. The Inverse-U shaped relationship between Age and WTP is confirmed. The income elasticities of WTP is found to be close to 0.5 for all study areas while an Inverse-U shaped relationship between the household income and Income Elasticity of WTP is observed in the income group based analysis. Age and household income are the two prominent determinants of VHLL.
The main objective of this study is to estimate the monetary value of the gains of healthy days and life expectancy due to the ambient air quality standard that came into effect in 2014 by estimating the country-specific value of a life year (VOLY) and the value of the healthier and longer life (VHLL) for Turkey. Contingent valuation method is adopted to reveal individuals’ willingness to pay for an improvement of health condition and the extension of their life expectancy by avoiding respiratory and lung related illnesses. VHLL is composed of two parts, WTP for an extension of one’s life years (VOLY) and for an increase in the number of healthy days throughout one’s life time (VHLL-VOLY). We found that close to 80% of WTP is allocated to the latter component of VHLL and only 20% is for VOLY mainly due to Islamic beliefs of the respondents. A total of 1314 observations are collected by face-to-face interviews from Afsin-Elbistan, Kutahya-Tavsanli and Ankara. The estimated VHLL and VOLY are [41,750 TL, 10,258 TL] with all the observations, [30,185 TL, 7132 TL] for Afsin-Elbistan, [31,718 TL, 7081 TL] for Kutahya-Tavsanli and [52,334 TL, 14,813 TL] for Ankara. The Inverse-U shaped relationship between Age and WTP is confirmed. The income elasticities of WTP is found to be close to 0.5 for all study areas while an Inverse-U shaped relationship between the household income and Income Elasticity of WTP is observed in the income group based analysis. Age and household income are the two prominent determinants of VHLL. PMID:28961227
van Solinge, Hanna; Henkens, Kène
This research examined the judgemental process underlying subjective life expectancy (SLE) and the predictive value of SLE on actual mortality in older adults in the Netherlands. We integrated theoretical insights from life satisfaction research with existing models of SLE. Our model differentiates between bottom-up (objective data of any type) and top-down factors (psychological variables). The study used data from the first wave of the Netherlands Interdisciplinary Demographic Institute Work and Retirement Panel. This is a prospective cohort study among Dutch older workers. The analytical sample included 2278 individuals, assessed at age 50-64 in 2001, with vital statistics tracked through 2011. We used a linear regression model to estimate the impact of bottom-up and top-down factors on SLE. Cox proportional hazard regression was used to determine the impact of SLE on the timing of mortality, crude and adjusted for actuarial correlates of general life expectancy, family history, health and trait-like dispositions. Results reveal that psychological variables play a role in the formation of SLE. Further, the results indicate that SLE predicts actual mortality, crude and adjusted for socio-demographic, biomedical and psychological confounders. Education has an additional effect on mortality. Those with higher educational attainment were less likely to die within the follow-up period. This SES gradient in mortality was not captured in SLE. The findings indicate that SLE is an independent predictor of mortality in a pre-retirement cohort in the Netherlands. SLE does not fully capture educational differences in mortality. Particularly, higher-educated individuals underestimate their life expectancy.
Jack, Katharine M; Schoof, Valérie A M; Sheller, Claire R; Rich, Catherine I; Klingelhofer, Peter P; Ziegler, Toni E; Fedigan, Linda
Much attention has been paid to hormonal variation in relation to male dominance status and reproductive seasonality, but we know relatively little about how hormones vary across life history stages. Here we examine fecal testosterone (fT), dihydrotestosterone (fDHT), and glucocorticoid (fGC) profiles across male life history stages in wild white-faced capuchins (Cebus capucinus). Study subjects included 37 males residing in three habituated social groups in the Área de Conservacíon Guanacaste, Costa Rica. Male life history stages included infant (0 to Life history stage was a significant predictor of fT; levels were low throughout the infant and juvenile phases, doubled in subadult and subordinate adults, and were highest for alpha males. Life history stage was not a significant predictor of fDHT, fDHT:fT, or fGC levels. Puberty in white-faced capuchins appears to begin in earnest during the subadult male phase, indicated by the first significant rise in fT. Given their high fT levels and exaggerated secondary sexual characteristics, we argue that alpha adult males represent a distinctive life history stage not experienced by all male capuchins. This study is the first to physiologically validate observable male life history stages using patterns of hormone excretion in wild Neotropical primates, with evidence for a strong association between fT levels and life history stage. Copyright © 2013 Elsevier Inc. All rights reserved.
Szwarcwald, Célia Landmann; Souza Júnior, Paulo Roberto Borges de; Marques, Aline Pinto; Almeida, Wanessa da Silva de; Montilla, Dalia Elena Romero
The demographic shift and epidemiologic transition in Brazil have drawn attention to ways of measuring population health that complement studies of mortality. In this paper, we investigate regional differences in healthy life expectancy based on information from the National Health Survey (PNS), 2013. In the survey, a three-stage cluster sampling (census tracts, households and individuals) with stratification of the primary sampling units and random selection in all stages was used to select 60,202 Brazilian adults (18 years and over). Healthy life expectancies (HLE) were estimated by Sullivan's method according to sex, age and geographic region, using poor self-rated health for defining unhealthy status. Logistic regression models were used to investigate socioeconomic and regional inequalities in poor self-rated health, after controlling by sex and age. Wide disparities by geographic region were found with the worst indicators in the North and Northeast regions, whether considering educational attainment, material deprivation, or health care utilization. Life expectancy at birth for women and men living in the richest regions was 5 years longer than for those living in the less wealthy regions. Modeling the variation across regions for poor self-rated health, statistically significant effects (p < 0.001) were found for the North and Northeast when compared to the Southeast, even after controlling for age, sex, diagnosis of at least one non-communicable chronic disease, and schooling or socioeconomic class. Marked regional inequalities in HLE were found, with the loss of healthy life much higher among residents of the poorest regions, especially among the elderly. By combining data on self-rated health status and mortality in a single indicator, Healthy Life Expectancy, this study demonstrated the excess burden of poor health experienced by populations in the less wealthy regions of Brazil. To mitigate the effects of social exclusion, the development of strategies
Sato, Yukie; Rühr, Peter T; Schmitz, Helmut; Egas, Martijn; Blanke, Alexander
Males often fight with rival males for access to females. However, some males display nonfighting tactics such as sneaking, satellite behavior, or female mimicking. When these mating tactics comprise a conditional strategy, they are often thought to be explained by resource holding potential (RHP), that is, nonfighting tactics are displayed by less competitive males who are more likely to lose a fight. The alternative mating tactics, however, can also be explained by life-history theory, which predicts that young males avoid fighting, regardless of their RHP, if it pays off to wait for future reproduction. Here, we test whether the sneaking tactic displayed by young males of the two-spotted spider mite can be explained by life-history theory. We tested whether young sneaker males survive longer than young fighter males after a bout of mild or strong competition with old fighter males. We also investigated whether old males have a more protective outer skin-a possible proxy for RHP-by measuring cuticle hardness and elasticity using nanoindentation. We found that young sneaker males survived longer than young fighter males after mild male competition. This difference was not found after strong male competition, which suggests that induction of sneaking tactic is affected by male density. Hardness and elasticity of the skin did not vary with male age. Given that earlier work could also not detect morphometric differences between fighter and sneaker males, we conclude that there is no apparent increase in RHP with age in the mite and age-dependent male mating tactics in the mite can be explained only by life-history theory. Because it is likely that fighting incurs a survival cost, age-dependent alternative mating tactics may be explained by life-history theory in many species when reproduction of old males is a significant factor in fitness.
Jakovljevic, Mihajlo B; Vukovic, Mira; Fontanesi, John
Exploration of long-term health expenditure and longevity trends across three major sub-regions of Eastern Europe since 1989. 24 countries were classified as EU 2004, CIS, or SEE. European Health for All Database (HFA-DB) 1989-2012 data were processed using difference-in-difference (DiD) and data envelopment analysis (DEA). The strongest expenditure growth was recorded in EU 2004 followed by SEE and the CIS. A surprisingly similar longevity increase was present in SEE and EU 2004. In 1989, countries that joined EU in 2004 were relatively inefficient in the number of life-years gained yet had a lower life expectancy than the SEE region and was only slightly higher than the CIS region (DEA). By 2012 the revenue spent was roughly linear to additional life-year expectancies. EU 2004 members were the best performers in terms of balanced longevity increase followed by health expenditure growth. The SEE economies' longevity gains were lagging slightly behind at a far lower cost. An extrapolated CIS expenditure to longevity increase ratio has the fastest-growing long-term promise.
Full Text Available Abstract Background Life expectancy in China has been improving markedly but health gains have been uneven and there is inequality in survival chances between regions and in rural as against urban areas. This paper applies a statistical modelling approach to mortality data collected in conjunction with the 2000 Census to formally assess spatial mortality contrasts in China. The modelling approach provides interpretable summary parameters (e.g. the relative mortality risk in rural as against urban areas and is more parsimonious in terms of parameters than the conventional life table model. Results Predictive fit is assessed both globally and at the level of individual five year age groups. A proportional model (age and area effects independent has a worse fit than one allowing age-area interactions following a bilinear form. The best fit is obtained by allowing for child and oldest age mortality rates to vary spatially. Conclusion There is evidence that age (21 age groups and area (31 Chinese administrative divisions are not proportional (i.e. independent mortality risk factors. In fact, spatial contrasts are greatest at young ages. There is a pronounced rural survival disadvantage, and large differences in life expectancy between provinces.
Minicuci, N; Noale, M
To assess the effect of education on Disability Free Life Expectancy among older Italians, using a hierarchical model as indicator of disability, with estimates based on the multistate life table method and IMaCh software. Data were obtained from the Italian Longitudinal Study on Aging which considered a random sample of 5632 individuals. Total life expectancy ranged from 16.5 years for men aged 65 years to 6 years for men aged 80. The age range for women was 19.6 and 8.4 years, respectively. For both sexes, increasing age was associated with a lower probability of recovery from a mild state of disability, with a greater probability of worsening for all individuals presenting an independent state at baseline, and with a greater probability of dying except for women from a mild state of disability. A medium/high educational level was associated with a greater probability of recovery only in men with a mild state of disability at baseline, and with a lower probability of worsening in both sexes, except for men with a mild state of disability at baseline. The positive effects of high education are well established in most research work and, being a modifiable factor, strategies focused on increasing level of education and, hence strengthening access to information and use of health services would produce significant benefits.
Lílian Maria Pacola
Full Text Available OBJECTIVE: To evaluate the expectations of patients awaiting surgical treatment of lumbar canal stenosis and the association of Health-Related Quality of Life (HRQoL with symptoms of anxiety and depression. METHODS: The sample included 49 patients from a university hospital. HRQoL was assessed by the Oswestry Disability Index (ODI and 36-item Medical Outcomes Survey Short Form (SF-36 and symptoms of anxiety and depression by the Hospital Anxiety and Depression Scale (HADS. Expectations were investigated by means of questions used in international studies. Data were analyzed descriptively and by Student's t test. RESULTS: The mean time of disease progression was 34.5 months, the mean age was 58.8 years and 55.1% of the patients were women. Most patients had the expectation of improving with surgical treatment and 46.9% expected to be "much better" with regard to leg pain, walking ability, independence in activities and mental well being. The scores of anxiety and depression were respectively, 34.7% and 12.2%. We observed statistically significant differences between the groups with and without anxiety in the domains: General Health, Mental Health, and Vitality. Between the groups with and without depression there were statistically significant differences in the General Health and Mental Health domains. CONCLUSION: Patients showed great expectation to surgical treatment and the symptoms of anxiety and depression were related to some domains of HRQoL. Thus, the study contributes to broaden our knowledge and we can therefore guide the patients as to their expectations with respect to the real possibilities arising from surgery.
Vaupel, JW; Romo, VC
We extend Nathan Keyfitz research on continuous change in life expectancy over time by presenting and proving a new formula for decomposing such change. The formula separates change in life expectancy over time into two terms. The first term captures the general effect of reduction in death rates at
Bemelmans, W.J.E.; Lenthe, F. van; Hoogenveen, R.; Kunst, A.; Deeg, D.J.H.; Brandt, P.A. van den; Goldbohm, R.A.; Verschuren, W.M.M.
Background and Objective: To estimate the effects of reducing the prevalence of smoking in lower educated groups on educational differences in life expectancy. Methods: A dynamic Markov-type multistate transition model estimated the effects on life expectancy of two scenarios. A "maximum scenario"
Samanez-Larkin, Gregory R; Wagner, Anthony D; Knutson, Brian
When making decisions, individuals must often compensate for cognitive limitations, particularly in the face of advanced age. Recent findings suggest that age-related variability in striatal activity may increase financial risk-taking mistakes in older adults. In two studies, we sought to further characterize neural contributions to optimal financial risk taking and to determine whether decision aids could improve financial risk taking. In Study 1, neuroimaging analyses revealed that individuals whose mesolimbic activation correlated with the expected value estimates of a rational actor made more optimal financial decisions. In Study 2, presentation of expected value information improved decision making in both younger and older adults, but the addition of a distracting secondary task had little impact on decision quality. Remarkably, provision of expected value information improved the performance of older adults to match that of younger adults at baseline. These findings are consistent with the notion that mesolimbic circuits play a critical role in optimal choice, and imply that providing simplified information about expected value may improve financial risk taking across the adult life span.
Buscombe, Richard; Greenlees, Iain; Holder, Tim; Thelwell, Richard; Rimmer, Matt
In this study, we examined the impact of a male opponent's pre-match body language and clothing (general vs. sports-specific) on how his performances were judged by an observer. Forty male tennis players viewed videos of a male target tennis player warming up and then observed playing footage of the target. Each participant viewed the target player warming up displaying one of four combinations of body language and clothing (positive body language/tennis-specific clothing; positive body language/general sportswear; negative body language/tennis-specific clothing; negative body language/general sportswear). Participants rated the performance of the tennis player and gave their perceptions of the likely outcome of a tennis match with the target player. Analyses of variance indicated that clothing and body language had an interactive effect on both outcome expectations and ratings of performance. The findings support the contention that the initial impressions athletes form of their opponents can influence the way in which they judge the performances of opponents and their perceived likelihood of success against the same opponents.
Wang, Shaobin; Luo, Kunli
The relation between life expectancy and energy utilization is of particular concern. Different viewpoints concerned the health impacts of heating policy in China. However, it is still obscure that what kind of heating energy or what pattern of heating methods is the most related with the difference of life expectancies in China. The aim of this paper is to comprehensively investigate the spatial relations between life expectancy at birth (LEB) and different heating energy utilization in China by using spatial autocorrelation models including global spatial autocorrelation, local spatial autocorrelation and hot spot analysis. The results showed that: (1) Most of heating energy exhibit a distinct north-south difference, such as central heating supply, stalks and domestic coal. Whereas spatial distribution of domestic natural gas and electricity exhibited west-east differences. (2) Consumption of central heating, stalks and domestic coal show obvious spatial dependence. Whereas firewood, natural gas and electricity did not show significant spatial autocorrelation. It exhibited an extinct south-north difference of heat supply, stalks and domestic coal which were identified to show significant positive spatial autocorrelation. (3) Central heating, residential boilers and natural gas did not show any significant correlations with LEB. While, the utilization of domestic coal and biomass showed significant negative correlations with LEB, and household electricity shows positive correlations. The utilization of domestic coal in China showed a negative effect on LEB, rather than central heating. To improve the solid fuel stoves and control consumption of domestic coal consumption and other low quality solid fuel is imperative to improve the public health level in China in the future. Copyright © 2017 Elsevier B.V. All rights reserved.
Full Text Available The general problem of wireless sensor network nodes is the low-power batteries that significantly limit the life expectancy of a network. Nowadays the technical solutions related to energy resource management are being rapidly developed and integrated into the daily lives of people. The energy resource management systems use sensor networks for receiving and processing information during the realia time. The present paper proposes using a coordinator role mobility method for controlling the routing processes for energy balancing in nodes, which provides dynamic network reconfiguration possibilities. The method is designed to operate fully in the background and can be integrated into any exiting working system.
Lenart, Adam; Zarulli, Virginia
The role of the national health systems is to provide health for their citizens but each country achieves it up to a different degree. The health systems are heterogeneous not only in their efficiency but in their funding, organization and management too. As it is difficult to measure...... their efficiency in absolute terms, the countries can be compared with each other. The relative efficiency of health systems can be measured by the life expectancy that they provide by taking education level and their funding structure into account. Based on data coming from the HMD, GGS, OECD and WHO, data...
Telnov, V.I.; Sotnik, N.V.
A population-genetic analysis of the average life expectancy (ALE) was performed for nuclear workers at the Mayak Production Association exposed to external and internal radiation over a wide dose range and their off spring. A methodical approach was proposed to determine ALE for individuals with different genotypes and estimate ALE in the population based on genotype distribution. The analysis has revealed significant shifts in the Hp type distribution of genetic markers in the nuclear workers off spring, especially an increased proportion of Hp 2-2 at parents external g-irradiation doses over 2Gy by the conception time
Setchell, Joanna M; Wickings, E Jean; Knapp, Leslie A
We assess life history from birth to death in male mandrills (Mandrillus sphinx) living in a semifree-ranging colony in Gabon, using data collected for 82 males that attained at least the age of puberty, including 33 that reached adulthood and 25 that died, yielding data for their entire lifespan. We describe patterns of mortality and injuries, dominance rank, group association, growth and stature, and secondary sexual character expression across the male lifespan. We examine relationships among these variables and investigate potential influences on male life history, including differences in the social environment (maternal rank and group demography) and early development, with the aim of identifying characteristics of successful males. Sons of higher-ranking females were more likely to survive to adulthood than sons of low-ranking females. Adolescent males varied consistently in the rate at which they developed, and this variation was related to a male's own dominance rank. Males with fewer peers and sons of higher-ranking and heavier mothers also matured faster. However, maternal variables were not significantly related to dominance rank during adolescence, the age at which males attained adult dominance rank, or whether a male became alpha male. Among adult males, behavior and morphological development were related to a male's own dominance rank, and sons of high-ranking females were larger than sons of low-ranking females. Alpha males were always the most social, and the most brightly colored males, but were not necessarily the largest males present. Finally, alpha male tenure was related to group demography, with larger numbers of rival adult males and maturing adolescent males reducing the time a male spent as alpha male. Tenure did not appear to be related to characteristics of the alpha male himself. 2006 Wiley-Liss, Inc.
Santana Vieira, Alexsandro; Desidério Fernandes, Wedson; Fernando Antonialli-Junior, William
We investigated the changes in the behavioral repertoire over the course of life and determined the life expectancy and entropy of workers of the ant Ectatomma vizottoi. Newly emerged ants were individually marked with model airplane paint for observation of behaviors and determination of the age and life expectancy. Ants were divided into two groups: young and old workers. The 36 behaviors observed were divided into eight categories. Workers exhibit a clear division of tasks throughout their lives, with young workers performing more tasks inside the colony and old workers, outside, unlike species that have small colonies. This species also exhibits an intermediate life expectancy compared to workers of other species that are also intermediary in size. This supports the hypothesis of a relationship between size and maximum life expectancy, but it also suggests that other factors may also be acting in concert. Entropy value shows a high mortality rate during the first life intervals.
Gheorghe, Maria; Wubulihasimu, Parida; Peters, Frederik; Nusselder, Wilma; Van Baal, Pieter H M
Quality-adjusted life expectancy (QALE) has been proposed as a summary measure of population health because it encompasses multiple health domains as well as length of life. However, trends in QALE by education or other socio-economic measure have not yet been reported. This study investigates changes in QALE stratified by educational level for the Dutch population in the period 2001-2011. Using data from multiple sources, we estimated mortality rates and health-related quality of life (HRQoL) as functions of age, gender, calendar year and educational level. Subsequently, predictions from these regressions were combined for calculating QALE at ages 25 and 65. QALE changes were decomposed into effects of mortality and HRQoL. In 2001-2011, QALE increased for men and women at all educational levels, the largest increases being for highly educated resulting in a widening gap by education. In 2001, at age 25, the absolute QALE difference between the low and the highly educated was 7.4 healthy years (36.7 vs. 44.1) for men and 6.3 healthy years (39.5 vs. 45.8) for women. By 2011, the QALE difference increased to 8.1 healthy years (38.8 vs. 46.9) for men and to 7.1 healthy years (41.3 vs. 48.4) for women. Similar results were observed at age 65. Although the gap was largely attributable to widening inequalities in mortality, widening inequalities in HRQoL were also substantial. In the Netherlands, population health as measured by QALE has improved, but QALE inequalities have widened more than inequalities in life expectancy alone. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Kiiskinen, U; Vartiainen, E; Puska, P; Aromaa, A
To estimate hypertension's long-term cost and impact on life expectancy. A 19-year individual follow-up study. Subjects were categorized according to their baseline (1972) diastolic blood pressure (DBP) level into three groups: normotensive (DBP 104 mmHg). By using their social security identification numbers, we linked the subjects to a set of national registers covering hospital admissions, use of major drugs, absence due to sickness, disability pensions, and deaths. A random population sample of 10 284 men and women aged 25-59 years from the provinces of Kuopio and North Karelia in eastern Finland. The numbers of years of life and years of work lost, the cost of drugs and hospitalization, and the value of productivity lost due to disability and premature mortality. The difference in life expectancy between normotensive and severely hypertensive men was 2.7 years, of which 2.0 years was due to cardiovascular disease (CVD). Among women the corresponding differences were 2.0 and 1.5 years. Severely hypertensive men lost 2.6 years of work more than did normotensive men, of which 1.7 years was due to CVD. Among women the differences were 2.2 and 1.3 years. The mean undiscounted total costs (USA dollars at 1992 prices) were $132 500 among normotensive, $146 500 among mildly hypertensive, and $219 300 among severely hypertensive men, of which CVD accounted for 28, 39, and 43%, respectively. More than 90% of the total costs were indirect productivity losses. Among women the total costs were lower for all DBP categories, as were the shares of CVD-related costs. The proportional increase in costs on going from the lowest to the highest DBP category was, however, somewhat larger among women. On the population level, severe hypertension leads to considerable losses in terms of years of life lost, years of work lost, and costs. However, the overall impact of mild hypertension is much more limited.
Recent criticisms of the income inequality and health hypothesis have stressed the lack of consistent significant evidence for the stronger effects of income inequality among rich countries. Despite such criticisms, little attention has been devoted to the income-based criteria underlying the stratification of countries into rich/poor groups and whether trade patterns and world-system role provide an alternative means of stratifying groups. To compare income-based and trade-based criteria, 107 countries were grouped into four typologies: (I) high/low income, (II) OECD membership/non-membership, (III) core/non-core, and (IV) non-periphery/periphery. Each typology was tested separately for significant differences in the effects of income inequality between groups. Separate group comparison tests and regression analyses were conducted for each typology using Rodgers (1979) specification of income, income inequality, and life expectancy. Interaction terms were introduced into Rodgers specification to test whether group classification moderated the effects of income inequality on health. Results show that the effects of income inequality are stronger in the periphery than non-periphery (IV) (-0.76 vs -0.23; P income inequality and population health have assumed (i) income differences between countries best capture global stratification and (ii) the negative effects of income inequality are stronger in high-income countries. However, present findings emphasize (i) the importance of measuring global stratification according to trading patterns and (ii) the strong, negative effects of income inequality on life expectancy among peripheral populations.
Telnov, V. I.; Sotnik, N. V.
Average life expectancy (ALE) is a significant integrating indicator of the population health. It can be affected by many factors such as radiation and hereditary ones. A population-genetic analysis of the average life expectancy (ALE) was performed for nuclear workers at the Mayak Production. Association exposed to external and internal radiation over a wide dose range and their offspring. A methodical approach was proposed to determine ALE for individuals with different genotypes and estimate ALE in the population based on genotype distribution. The analysis of a number of genetic markers revealed significant changes in the age-specific pattern of the Hp types in workers over 60 years. Such changes were caused by both radiation and non-radiation (cardiovascular pathology) factors. In the first case ALE decreased as Hp 1-1 > Hp 2-2> Hp2-1 (radiation). In the second case, it decreased as Hp 1-1> Hp-2-1> Hp2-2 (non-radiation). analysis of genetic markers in the workers offspring indicated significant shifts in distribution of the Hp types, especially an increase in the proportion of Hp 2-2 at doses from external γ-rays over 200 cGy to parents by the time of conception. Based on the non-radiation genotype differences in ALE in this group of offspring, the preliminary calculation of ALE was carried out, which indicated its reduction by 0.52 years in comparison with the control. (Author) 21 refs
Heijink, Richard; van Baal, Pieter; Oppe, Mark; Koolman, Xander; Westert, Gert
The validity, reliability and cross-country comparability of summary measures of population health (SMPH) have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and decompose international differences in health expectancy based on health-related quality of life (HRQoL). We focused on the impact of value set choice on cross-country variation. We calculated Quality Adjusted Life Expectancy (QALE) at age 20 for 15 countries in which EQ-5D population surveys had been conducted. We applied the Sullivan approach to combine the EQ-5D based HRQoL data with life tables from the Human Mortality Database. Mean HRQoL by country-gender-age was estimated using a parametric model. We used nonparametric bootstrap techniques to compute confidence intervals. QALE was then compared across the six country-specific time trade-off value sets that were available. Finally, three counterfactual estimates were generated in order to assess the contribution of mortality, health states and health-state values to cross-country differences in QALE. QALE at age 20 ranged from 33 years in Armenia to almost 61 years in Japan, using the UK value set. The value sets of the other five countries generated different estimates, up to seven years higher. The relative impact of choosing a different value set differed across country-gender strata between 2% and 20%. In 50% of the country-gender strata the ranking changed by two or more positions across value sets. The decomposition demonstrated a varying impact of health states, health-state values, and mortality on QALE differences across countries. The choice of the value set in SMPH may seriously affect cross-country comparisons of health expectancy, even across populations of similar levels of wealth and education. In our opinion, it is essential to get more insight into the drivers of differences in health-state values across populations. This
Full Text Available Abstract Background The validity, reliability and cross-country comparability of summary measures of population health (SMPH have been persistently debated. In this debate, the measurement and valuation of nonfatal health outcomes have been defined as key issues. Our goal was to quantify and decompose international differences in health expectancy based on health-related quality of life (HRQoL. We focused on the impact of value set choice on cross-country variation. Methods We calculated Quality Adjusted Life Expectancy (QALE at age 20 for 15 countries in which EQ-5D population surveys had been conducted. We applied the Sullivan approach to combine the EQ-5D based HRQoL data with life tables from the Human Mortality Database. Mean HRQoL by country-gender-age was estimated using a parametric model. We used nonparametric bootstrap techniques to compute confidence intervals. QALE was then compared across the six country-specific time trade-off value sets that were available. Finally, three counterfactual estimates were generated in order to assess the contribution of mortality, health states and health-state values to cross-country differences in QALE. Results QALE at age 20 ranged from 33 years in Armenia to almost 61 years in Japan, using the UK value set. The value sets of the other five countries generated different estimates, up to seven years higher. The relative impact of choosing a different value set differed across country-gender strata between 2% and 20%. In 50% of the country-gender strata the ranking changed by two or more positions across value sets. The decomposition demonstrated a varying impact of health states, health-state values, and mortality on QALE differences across countries. Conclusions The choice of the value set in SMPH may seriously affect cross-country comparisons of health expectancy, even across populations of similar levels of wealth and education. In our opinion, it is essential to get more insight into the drivers
Yokoyama, Michio; Kitabatake, Takashi.
The authors reexamined the evaluation of mass gastric survey, which had previously been reported by them, from the standpoint of expectation of life and advocated new theories, the number of years of expected lifesaving and the rate of loss and gain of years. Comparison between the new evaluation and the pre-existing evaluation produces the following differences. (1) The number of years of expected lifesaving increases rapidly from the 50s to reach a peak in the 60s and to decrease from the 70s. This is more realistic and reasonable than the pre-existing method by which the higher the age, the more is gain increased. (2) The rate of loss and gain of mass gastric survey increases in each age group. In other words, the value of mass gastric survey is evaluated more highly. While the importance of mass gastric survey has recently been recognized, the number of examinees increasing, injury due to exposure to radiation has become a serious problem. Therefore, it was thought to be important to perform mass gastric survey efficiently on subjects limited based on the theory investigated from both aspects of advantage and disadvantage. (Chiba, N.)
Chang, Man-Huei; Molla, Michael T; Truman, Benedict I; Athar, Heba; Moonesinghe, Ramal; Yoon, Paula W
Healthy life expectancy (HLE) varies among demographic segments of the US population and by geography. To quantify that variation, we estimated the national and regional HLE for the US population by sex, race/ethnicity and geographic region in 2008. National HLEs were calculated using the published 2008 life table and the self-reported health status data from the National Health Interview Survey (NHIS). Regional HLEs were calculated using the combined 2007-09 mortality, population and NHIS health status data. In 2008, HLE in the USA varied significantly by sex, race/ethnicity and geographical regions. At 25 years of age, HLE for females was 47.3 years and ∼2.9 years greater than that for males at 44.4 years. HLE for non-Hispanic white adults was 2.6 years greater than that for Hispanic adults and 7.8 years greater than that for non-Hispanic black adults. By region, the Northeast had the longest HLE and the South had the shortest. The HLE estimates in this report can be used to monitor trends in the health of populations, compare estimates across populations and identify health inequalities that require attention. Published by Oxford University Press on behalf of Faculty of Public Health 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.
Because of the large number of persons who could potentially receive low doses of radiation as a result of a nuclear reactor accident, the number of fatalities from latent cancers is generally larger than the early, or prompt, fatalities. For this reason the latent cancer fatality risk of reactor accidents is perceived as being more important than the early fatality risk. In addition, there exists the temptation to add the latent cancer fatality risk to the early fatality risk for the purpose of comparing reactor accident risks to other risks that society is exposed to, such as automobile accidents, airplane accidents, hurricanes, etc. However, the impact on the individual, and society as a whole, due to latent cancer fatalities is significantly different from the impact produced by early fatalities. Early fatalities generally result in appreciable life shortening for the affected individual while latent cancer fatalities generally result in very limited life shortening. A mathematical model was developed to express the reduction in life expectancy due to latent radiogenic cancer as a function of dose received
Laditka, Sarah B; Laditka, James N
Few researchers have studied whether diabetes itself is responsible for high rates of disability or mortality, or if factors associated with diabetes contribute importantly. We estimated associations of diabetes, heart disease, obesity, and physical inactivity with life expectancy (LE), the proportion of life with disability (DLE), and disability in the last year of life. Data were from the Panel Study of Income Dynamics (1999-2011 and 1986, African American and white women and men ages 55+, n=1,980, 17,352 person-years). Activities of daily living defined disability. Multinomial logistic Markov models estimated disability transition probabilities adjusted for age, sex, race/ethnicity, education, and the health factors. Microsimulation measured outcomes. White women and men exemplify results. LE was, for women: 3.5 years less with diabetes than without (95% confidence interval, 3.1-4.0), 11.1 less (10.3-12.0) adding heart disease, 21.9 less with all factors (15.3-28.5), all pheart disease, 52.9% (38.9-66.8) with all factors, all pheart disease, obesity, and inactivity, risks that can be modified by health behaviors and medical care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Jia, Haomiao; Zack, Matthew M; Gottesman, Irving I; Thompson, William W
To examine associations between four health behaviors (smoking, physical inactivity, heavy alcohol drinking, and obesity) and three health indices (health-related quality of life, life expectancy, and quality-adjusted life expectancy (QALE)) among US adults with depression. Data were obtained from the 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System data. The EuroQol five-dimensional questionnaire (EQ-5D) health preference scores were estimated on the basis of extrapolations from the Centers for Disease Control and Prevention's healthy days measures. Depression scores were estimated using the eight-item Patient Health Questionnaire. Life expectancy estimates were obtained from US life tables, and QALE was estimated from a weighted combination of the EQ-5D scores and the life expectancy estimates. Outcomes were summarized by depression status for the four health behaviors (smoking, physical inactivity, heavy alcohol drinking, and obesity). For depressed adults, current smokers and the physically inactive had significantly lower EQ-5D scores (0.040 and 0.171, respectively), shorter life expectancy (12.9 and 10.8 years, respectively), and substantially less QALE (8.6 and 10.9 years, respectively). For nondepressed adults, estimated effects were similar but smaller. Heavy alcohol drinking among depressed adults, paradoxically, was associated with higher EQ-5D scores but shorter life expectancy. Obesity was strongly associated with lower EQ-5D scores but only weakly associated with shorter life expectancy. Among depressed adults, physical inactivity and smoking were strongly associated with lower EQ-5D scores, life expectancy, and QALE, whereas obesity and heavy drinking were only weakly associated with these indices. These results suggest that reducing physical inactivity and smoking would improve health more among depressed adults. Copyright © 2018. Published by Elsevier Inc.
Duggleby, Wendy; Thomas, Jasmine; Montford, Kelly; Thomas, Roanne; Nekolaichuk, Cheryl; Ghosh, Sunita; Cumming, Ceiwen; Tonkin, Katia
To (a) describe the types of transitions experienced by male spousal caregivers of women with breast cancer and the strategies used by male spouses to deal with these transitions and (b) examine factors related to their quality of life, including demographic variables, self-efficacy, caregiver guilt, hope, the quality of life of their partner with breast cancer, and transitions. Cross-sectional, transformational, mixed-methods approach. Participants' homes. 105 dyads of male spouses and their female partners diagnosed with stages I-III breast cancer. 600 surveys were mailed to women with breast cancer and their male partners. Significant variables were entered into a multivariate model. Male caregiver quality of life. The quality of life of male spouse participants was positively influenced by hope (p life scores reported higher hope and lower caregiver guilt scores. They reported lower quality-of-life scores if they dealt with transitions by "doing what needs to be done." Strategies to support male spouses of women with breast cancer should involve ways to foster hope, reduce feelings of guilt, and encourage male caregivers to engage more in supporting their spouses.
Evans, Grahame F; Soliman, Elsayed Z
The relationship between sense of well-being and longevity is not well-established across populations of varying levels of socioeconomic status. We sought to examine the relationship between happiness, or subjective sense of well-being and life expectancy using data from 151 countries. This analysis is based on the 2012 Happy Planet Index project conducted by the Center of Well-Being of the New Economics Foundation, based in the United Kingdom. Well-being data for each country were taken from responses to the 'Ladder of Life' question in the 2012 Gallup World Poll in which participants were asked to rate their quality of life on a scale from 1 (worst possible life) to 10 (best possible life). Life expectancy and gross domestic product data were taken from the 2011 United Nations records. Ecological footprint data were taken from Global Footprint Network records. Subjective sense of well-being was highly correlated with life expectancy (Pearson correlation r = 0.71, p ecological footprint, and population, each 1 unit of the well-being scale was associated with an increase in life expectancy of 4.0 years (95% confidence interval = 2.7-5.3). In conclusion, better sense of well-being has a strong relationship with life expectancy regardless of economic status or population size, suggesting that governments should foster happiness in order to support long-living populations.
Wohland, Pia; Rees, Phil; Nazroo, James; Jagger, Carol
We aim to develop robust estimates of disability-free life expectancy (DFLE) and healthy life expectancy (HLE) for ethnic groups in England and Wales in 2001 and to examine observed variations across ethnic groups. DFLE and HLE by age and gender for five-year age groups were computed for 16 ethnic groups by combining the 2001 Census data on ethnicity, self-reported limiting long-term illness and self-rated health using mortality by ethnic group estimated by two methods: the Standardised Illness Ratio (SIR) method and the Geographically Weighted Method (GWM). The SIR and GWM methods differed somewhat in their estimates of life expectancy (LE) at birth but produced very similar estimates of DFLE and HLE by ethnic group. For the more conservative method (GWM), the range in DFLE at birth was 10.5 years for men and 11.9 years for women, double that in LE. DFLE at birth was highest for Chinese men (64.7 years, 95% CI 64.0-65.3) and women (67.0 years, 95% CI 66.4-67.6). Over half of the ethnic minority groups (men: 10; women: 9) had significantly lower DFLE at birth than White British men (61.7 years, 95% CI 61.7-61.7) or women (64.1 years, 95% CI 64.1-64.2), mostly the Black, Asian and mixed ethnic groups. The lowest DFLE observed was for Bangladeshi men (54.3 years, 95% CI 53.7-54.8) and Pakistani women (55.1 years, 95% CI 54.8-55.4). Notable were Indian women whose LE was similar to White British women but who had 4.3 years less disability-free (95% CI 4.0-4.6). Inequalities in DFLE between ethnic groups are large and exceed those in LE. Moreover, certain ethnic groups have a larger burden of disability that does not seem to be associated with shorter LE. With the increasing population of the non-White British community, it is essential to be able to identify the ethnic groups at higher risk of disability, in order to target appropriate interventions.
Lee, Sunghee; McClain, Colleen; Webster, Noah; Han, Saram
This study examines the effect of question context created by order in questionnaires on three subjective well-being measures: life satisfaction, self-rated health, and subjective life expectancy. We conducted two Web survey experiments. The first experiment (n = 648) altered the order of life satisfaction and self-rated health: (1) life satisfaction asked immediately after self-rated health; (2) self-rated health immediately after life satisfaction; and (3) two items placed apart. We examined their correlation coefficient by experimental condition and further examined its interaction with objective health. The second experiment (n = 479) asked life expectancy before and after parental mortality questions. Responses to life expectancy were compared by order using ANOVA, and we examined interaction with parental mortality status using ANCOVA. Additionally, response time and probes were examined. Correlation coefficients between self-rated health and life satisfaction differed significantly by order: 0.313 (life satisfaction first), 0.508 (apart), and 0.643 (self-rated health first). Differences were larger among respondents with chronic conditions. Response times were the shortest when self-rated health was asked first. When life expectancy asked after parental mortality questions, respondents reported considering parents more for answering life expectancy; and respondents with deceased parents reported significantly lower expectancy, but not those whose parents were alive. Question context effects exist. Findings suggest placing life satisfaction and self-rated health apart to avoid artificial attenuation or inflation in their association. Asking about parental mortality prior to life expectancy appears advantageous as this leads respondents to consider parental longevity more, an important factor for true longevity.
Viktorov, A A; Zharinov, G M; Neklasova, N Ju; Morozova, E E
The article presents a methodical approach for prediction of life expectancy for people diagnosed with prostate cancer based on the kinetic theory of aging of living systems. The life expectancy is calculated by solving the differential equation for the rate of aging for three different stage of life - «normal» life, life with prostate cancer and life after combination therapy for prostate cancer. The mathematical model of aging for each stage of life has its own parameters identified by the statistical analysis of healthcare data from the Zharinov's databank and Rosstat CDR NES databank. The core of the methodical approach is the statistical correlation between growth rate of the prostate specific antigen level (PSA-level) or the PSA doubling time (PSA DT) before therapy, and lifespan: the higher the PSA DT is, the greater lifespan. The patients were grouped under the «fast PSA DT» and «slow PSA DT» categories. The satisfactory matching between calculations and experiment is shown. The prediction error of group life expectancy is due to the completeness and reliability of the main data source. A detailed monitoring of the basic health indicators throughout the each person life in each analyzed group is required. The absence of this particular information makes it impossible to predict the individual life expectancy.
Brønnum-Hansen, Henrik; Jonassen, Marie; Shaheen, Amira; Duraidi, Mohammed; Qalalwa, Khaled; Jeune, Bernard
The high prevalence of smoking (40%) in men living in the West Bank of the occupied Palestinian territory is a major challenge for the Palestinian health authorities. The aim of this study was to estimate life expectancy and the average lifetime with and without chronic disease in men living in the West Bank who had never smoked, were ex-smokers, or were smokers. We used a life table for the male population in the West Bank and Danish relative risk estimates for death for smokers and ex-smokers versus never smokers and data from the 2010 Palestinian Family Survey. We estimated expected life time with and without chronic disease, and the contributions from the mortality and morbidity effects to smoking-related differences in average lifetime with and without chronic disease were assessed by decomposition. The life expectancy of a Palestinian man aged 15 years who would never start smoking was 59·5 years, of which 41·1 years (95% CI 40·3-41·9) were expected to be without chronic disease. Ex-smokers could expect 57·9 years of remaining life time, 37·7 years (35·9-39·4) of which would be without chronic disease. For life-long heavy smokers, the expected lifetime was 52·6 years, of which 38·5 years (37·3-39·7) would be without chronic disease. Of the total loss of 6·9 years of life expectancy in heavy smokers, the mortality effect accounted for 2·5 years without disease and 4·4 years with disease, whereas the morbidity effect was negligible. The morbidity component of the decomposition accounted for 1·7 years with disease for moderate smokers and 2·9 years without disease for ex-smokers. The high prevalence of smoking causes a considerable loss of life-years and life time without chronic disease. We recommend that the Palestinian health authorities enforce an anti-smoking law. None. Copyright © 2018 Elsevier Ltd. All rights reserved.
A list of germanium lithium gamma ray detectors has been drawn up by a working group after investigations in various laboratories. Authors analyse the historical account of each detector and try to give an answer about some questions as: - detectors life expectation, - deficiencies and death reasons, - influence of detector type and volume. Differents parameters are also collected by the working group for future works (standard geometry, low level measurements, etc.). In the list, the characteristics of 228 detectors, collected between january 1965 and december 1977 are put together. The principal conclusions of the authors are: - with a probability of 95%, half of the detectors is dead before 6.1 years, - the average age of dead population (33% of detectors) is 3.9 years, - resolution and efficiency evolution are good indicators of possible deficiency, - the fiability of vertical cryostat is better than the other systems [fr
Bathum, L; Christiansen, L; Nybo, H
BACKGROUND: To investigate whether the frequency of carriers of mutations in the HFE gene associated with hereditary hemochromatosis diminishes with age as an indication that HFE mutations are associated with increased mortality. It is of value in the debate concerning screening for hereditary...... hemochromatosis to determine the significance of heterozygosity. METHODS: Genotyping for mutations in exons 2 and 4 of the HFE gene using denaturing gradient gel electrophoresis in 1784 participants aged 45 to 100 years from 4 population-based studies: all 183 centenarians from the Danish Centenarian Study, 601...... in the distribution of mutations in exon 2 in the different age groups. CONCLUSIONS: In a high-carrier frequency population like Denmark, mutations in HFE show an age-related reduction in the frequency of heterozygotes for C282Y, which suggests that carrier status is associated with shorter life expectancy....
Zeng, X Y; Liu, S W; Wang, L J; Zhang, M; Yin, P; Liu, Y N; Zhao, Z P; Wang, L M
Objective: To estimate the deaths (mortality) and life expectancy that attributable to high blood pressure in people from different regions and gender, in China in 2013. Methods: Data was from the 'China Chronic Disease Risk Factor Surveillance 2013' and the 'China National Mortality Surveillance 2013'. According to the comparative risk assessment theory, population attributable fraction ( PAF ) of high blood pressure by gender, urban-rural, east-central-west regions was calculated before the estimations on deaths (mortality) and life expectancy attributable to high blood pressure was made. Results: In 2013, among the Chinese people aged 25 years old and above, the mean SBP was (129.48±20.27) mmHg. High blood pressure[SBP>(115±6) mmHg]caused 20.879 million deaths and accounted for 22.78% of the total deaths. SBP, deaths, mortality rate and standardized mortality rate that attributable to high blood pressure all appeared higher in men [(131.15±18.73) mmHg, 11.517 million, 165.56/100 000 and 106.97/100 000, respectively]than in women[(127.79±21.60) mmHg, 9.362 million, 141.99/100 000 and 68.93/100 000, respectively]. SBP, deaths, mortality rate and PAF were all seen higher in rural[(130.25±20.66) mmHg, 11.234 million, 178.58/100 000 and 23.59%, respectively]than in urban[(128.58±19.77) mmHg, 9.645 million, 132.87/100 000 and 21.54%, respectively]areas. However, levels of SBP were similar in the east, central or west regions, with attributable deaths, attributable mortality rate and PAF the highest as 7.658 million 179.93/100 000, and 26.72% respectively. In 2013, among the Chinese people aged 25 years old and above, deaths caused by cardiovascular disease and chronic kidney disease attributable to high blood pressure were 19.912 million and 0.966 million, accounting for 52.31% of the total deaths due to cardiovascular diseases and 62.11% to the total chronic kidney diseases. The top three deaths attributable to high blood pressure were ischemic heart disease (6
Jonker, M F; van Lenthe, F J; Donkers, B; Mackenbach, J P; Burdorf, A
Several epidemiological studies have investigated the effect of the quantity of green space on health outcomes such as self-rated health, morbidity and mortality ratios. These studies have consistently found positive associations between the quantity of green and health. However, the impact of other aspects, such as the perceived quality and average distance to public green, and the effect of urban green on population health are still largely unknown. Linear regression models were used to investigate the impact of three different measures of urban green on small-area life expectancy (LE) and healthy life expectancy (HLE) in The Netherlands. All regressions corrected for average neighbourhood household income, accommodated spatial autocorrelation, and took measurement uncertainty of LE, HLE as well as the quality of urban green into account. Both the quantity and the perceived quality of urban green are modestly related to small-area LE and HLE: an increase of 1 SD in the percentage of urban green space is associated with a 0.1-year higher LE, and, in the case of quality of green, with an approximately 0.3-year higher LE and HLE. The average distance to the nearest public green is unrelated to population health. The quantity and particularly quality of urban green are positively associated with small-area LE and HLE. This concurs with a growing body of evidence that urban green reduces stress, stimulates physical activity, improves the microclimate and reduces ambient air pollution. Accordingly, urban green development deserves a more prominent place in urban regeneration and neighbourhood renewal programmes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Anstey, Kaarin Jane; Kingston, Andrew; Kiely, Kim Matthew; Luszcz, Mary Alice; Mitchell, Paul; Jagger, Carol
Smoking, sedentary lifestyle and obesity are risk factors for mortality and dementia. However, their impact on cognitive impairment-free life expectancy (CIFLE)has not previously been estimated. Data were drawn from the DYNOPTA dataset which was derived by harmonizing and pooling common measures from five longitudinal ageing studies. Participants for whom the Mini-Mental State Examination was available were included (N¼8111,48.6% men). Data on education, sex, body mass index, smoking and sedentary lifestyle were collected and mortality data were obtained from Government Records via data linkage.Total life expectancy (LE), CIFLE and years spent with cognitive impairment (CILE)were estimated for each risk factor and total burden of risk factors. CILE was approximately 2 years for men and 3 years for women, regardless of age. For men and women respectively, reduced LE associated with smoking was 3.82and 5.88 years, associated with obesity was 0.62 and 1.72 years and associated with being sedentary was 2.50 and 2.89 years. Absence of each risk factor was associated with longer LE and CIFLE, but also longer CILE for smoking in women and being sedentary in both sexes. Compared with participants with no risk factors, those with 2þ had shorter CIFLE of up to 3.5 years depending on gender and education level. Population level reductions in smoking, sedentary lifestyle and obesity increase longevity and number of years lived without cognitive impairment. Years lived with cognitive impairment may also increase.
Santos, Marcio Pereira
Full text: With the evolution of the norms of radiological protection in the world in last the 20 years, the life expectancy of Workers increased in direct ratio. The technological advance of the equipment that uses radiation sources and the deepening in the studies and knowledge on the ionizing radiations- e consequent deleterious effect- had contributed significantly for the reduction of the doses received for the Workers in its daily hours of working. Methods: A simple analysis of data, comparing itself the past and the gift, becomes evident that, in if treating to radiological protection, the humanity walks for a new age, which hardly will retrocede. If before the radiological protection was understood as a concern only in the practical doctors, with emphasis in the immediate effects, today already becomes gift in all the practical ones, especially in that they put into motion the planet and its wealth, in the industry. Major Values: Modernity took the man to the daily dependence of the not ionizing radiations, each time inserted of the people's day. As similar to, the radiological protection today if makes gift in diverse practical, to guarantee the cares to be taken and the fulfilment of pertinent norms. The present study it looks for to evidence that last the 20 years- marked for accidents with radioactive sources- they had been essential for a reflection of the norms of radiological protection. Thus, workers, as well as the technological sector, changed it the new reality, either demanding bigger training technician for the practical ones, attention special in security and radiological protection, or same establishing more rigid norms, through the regulating agencies. In the present work had a projection of values of life expectancy of the population, the past until the present. Analyzing Tables, as much for workers how much for the members of the public is noticed that the radiological protection offers to one better quality of life to all those involved
Epple, S.; Jung, R.; Jalba, K.; Nasui, V.
A new, freely programmable, scalable control system for academic research purposes was developed. The intention was, to have a control unit capable of handling multiple PT1000 temperature sensors at reasonable accuracy and temperature range, as well as digital input signals and providing more powerful output signals at 230V AC than conventional control units. To take full advantage of the system, control-loops are run in real time. The whole system runs independently of a personal computer. The two on-board RS232 connectors allow to connect further units to use more sensors or actuators or to connect other laboratory equipment, as required. To allow usage for long-time experiments, systematically electronic components with low failure-in-time (FIT) rate have been chosen in order to achieve high life expectancy. This paper describes the third prototype, which now provides stable measurements, and an improvement in accuracy compared to the previous designs. A rough estimation about the expected mean time between failures is given. As test case, a thermal solar system to produce hot tap water and assist heating in a single-family house was implemented. The solar fluid pump was power-controlled and several temperatures at different points in the hydraulic system were measured and used in the control algorithms. The hardware design proved suitable to test several different control strategies and their corresponding algorithms for the thermal solar system.
Williams, Elaine Fay; Ferrer, Kathleen; Lee, Marlene A; Bright, Kimberly; Williams, Keetra; Rakhmanina, Natella Y
To describe the lived experience of young adults with perinatally acquired HIV (PaHIV). With the advancement of the highly active antiretroviral treatment, PaHIV infection has transformed into a chronic lifelong illness that is faced by young adults who grew up with HIV. The known challenges that are associated with HIV are poverty, stigma and social and emotional isolation. This was a qualitative single-interview study of a convenience sample of PaHIV-infected young adults receiving care at a large metropolitan pediatric hospital. The participants had individual face-to-face interviews which were audio-taped and transcribed verbatim. Themes were developed to describe their living space, and Max Van Manen's lifeworld guide was used to describe their lived experience. Seventeen participants (eight males/nine females) were enrolled. Four major themes emerged: (i) limited social capital, especially when orphaned participants reflected on a life void of parental guidance; (ii) incomplete education and unemployment, participants described an idle existence; (iii) a harsh life, described as participants facing difficulties meeting their life's milestones; (iv) unanticipated adult issues, where participants described their limited ability to care for themselves and their children. Van Manen lifeworld themes also described the space they occupied, their memories growing up with PaHIV, their health care and relationships. Our study provides a valuable insight into the social and emotional difficulties faced by youth with PaHIV. The findings underscore the importance of extensive support and coordination of services between adult and pediatric providers to optimize long-term outcomes among young adults with PaHIV. The young adults with PaHIV require close attention and support from the healthcare providers, who can offer them a safe space to discuss lived experiences and support their ability to achieve full lives. © 2017 John Wiley & Sons Ltd.
Full Text Available Combination antiretroviral therapy (ART has significantly increased survival among HIV-positive adults in the United States (U.S. and Canada, but gains in life expectancy for this region have not been well characterized. We aim to estimate temporal changes in life expectancy among HIV-positive adults on ART from 2000-2007 in the U.S. and Canada.Participants were from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD, aged ≥20 years and on ART. Mortality rates were calculated using participants' person-time from January 1, 2000 or ART initiation until death, loss to follow-up, or administrative censoring December 31, 2007. Life expectancy at age 20, defined as the average number of additional years that a person of a specific age will live, provided the current age-specific mortality rates remain constant, was estimated using abridged life tables.The crude mortality rate was 19.8/1,000 person-years, among 22,937 individuals contributing 82,022 person-years and 1,622 deaths. Life expectancy increased from 36.1 [standard error (SE 0.5] to 51.4 [SE 0.5] years from 2000-2002 to 2006-2007. Men and women had comparable life expectancies in all periods except the last (2006-2007. Life expectancy was lower for individuals with a history of injection drug use, non-whites, and in patients with baseline CD4 counts <350 cells/mm(3.A 20-year-old HIV-positive adult on ART in the U.S. or Canada is expected to live into their early 70 s, a life expectancy approaching that of the general population. Differences by sex, race, HIV transmission risk group, and CD4 count remain.
Lant Pritchett; Martina Viarengo
This paper examines the variation across countries and evolution over time of life expectancy. Using historical data going back to the beginning of the 20th century several basic facts about the relationship between national income and life expectancy are established. The paper shows that even by examining the augmented Preston curve there is no indication that the Preston curve is “breaking down” and no indication from over 100 years of data that a very strong relationship between national i...
Gibson, Barbara E; Zitzelsberger, Hilde; McKeever, Patricia
Medical technological advances can have profound effects on people's lives by extending the life course and creating uncertain futures. This is the case for a number of persons with 'diseases of childhood' who can now survive well into adulthood with technological support. This paper draws on a Canadian qualitative study of young men with Duchenne muscular dystrophy (DMD)which examined the effects of a shifting life expectancy on personal identities. Engaging with Pierre Bourdieu's central concept of habitus, we discuss the temporal dimensions of social exclusion and marginalised identities. Participants' narrative accounts revealed how their dispositions were orientated to a shortened lifespan that exerted damaging effects regardless of actual lifespan. Compounding their material, social and symbolic isolation was a temporal isolation whereby the men had lived every day anticipating that it could be their last for as much as a decade. The findings suggest a need to re-orient medical and social discourses to serve and include adults with DMD and other conditions previously limited to childhood in their communities.
Martinez-Gonzalez, Miguel A.; Martín-Calvo, Nerea
Purpose to review the recent relevant evidence of the effects of the Mediterranean diet and lifestyle on health (2015 and first months of 2016). Recent findings Large observational prospective epidemiological studies with adequate control of confounding and two large randomized trials support the benefits of the Mediterranean dietary pattern to increase life expectancy, reduce the risk of major chronic disease, and improve quality of life and well-being. Recently, 19 new reports from large prospective studies showed –with nearly perfect consistency– strong benefits of the Mediterranean diet to reduce the risk of myocardial infarction, stroke, total mortality, heart failure and disability. Interestingly, two large and well-conducted cohorts reported significant cardiovascular benefits after using repeated measurements of diet during a long follow-up period. Besides, PREDIMED, the largest randomized trial with Mediterranean diet, recently reported benefits of this dietary pattern to prevent cognitive decline and breast cancer. Summary In the era of evidence-based medicine, the Mediterranean diet represents the gold standard in preventive medicine, probably due to the harmonic combination of many elements with antioxidant and antiinflammatory properties, which overwhelm any single nutrient or food item. The whole seems more important than the sum of its parts. PMID:27552476
lower levels of living standards and a later introduction of improvements in medicine and sanitation. This study aims to illustrate the evolution of life expectancy at birth in four different countries (England and Wales 1841-1905, France 1816-1905, Norway 1846-1905, and Sweden 1800-1905) and in the 2nd......As a result of the health transition, there have been sustained gains in the average length of life (Vallin and Meslé 2009), starting as far as more than 150 years ago in some human populations. For instance, the maximum recorded levels of life expectancy at birth illustrate a linear increase since...... 1840 (Oeppen and Vaupel 2002). During the 19th century, some few countries occupied the top 1 and 2 positions in terms of life expectancy at birth (Fig. 1). In some of these countries, such as Norway and Sweden, the average length of life was longer compared to most other European populations, despite...
Dhana, Klodian; Koolhaas, Chantal M; Berghout, Mathilde A; Peeters, Anna; Ikram, M Arfan; Tiemeier, Henning; Hofman, Albert; Nusselder, Wilma; Franco, Oscar H
We aimed to determine the contribution of specific physical activity (PA) types (i.e. walking, cycling, domestic work, sports and gardening) on total life expectancy (LE) and LE with and without cardiovascular disease (CVD). We constructed multistate life tables to calculate the effects of total PA and PA types on LE, among individuals older than 55 years from the Rotterdam Study. For the life table calculations, we used sex-specific prevalences, incident rates and hazard ratios for three transitions (healthy-to-CVD, healthy-to-death and CVD-to-death) by levels of PA and adjusted for confounders. High total PA was associated with gains in total and CVD-free LE. High cycling contributed to higher total LE in men (3.7 years) and women (2.1 years) and higher LE without CVD in men (3.1 years) and women (2.4 years). Total and CVD-free LE were increased by high domestic work in women (2.6 and 2.4 years, respectively) and high gardening in men (2.7 and 2.0 years, respectively). Higher PA levels are associated with increased LE and more years lived without CVD. Of the different PA types, cycling provided high effects in both men and women. Cycling could be more strongly encouraged in activity guidelines to maximize the population benefits of PA. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: email@example.com
Ding, X B; Tang, W W; Mao, D Q; Jiao, Y; Shen, Z Z
Objective: To analyze the premature death probability and cause-eliminated life expectancy of cardiovascular disease, cancer, chronic respiratory disease and diabetes in Chongqing residents in 2016 so as to provide recommendation for non-communicable diseases (NCDs) prevention and control in Chongqing. Methods: Death cases of Chongqing Municipality between January 1(st) and December 31(st), 2016 were reported through death case registry system of national center for disease prevention and control. Death cases were sorted by international classification of disease (ICD-10). Mortality rate, standardized mortality rate, constituent ratio, premature death probability, life expectancy, and cause-eliminated life expectancy of four major NCDs were analyzed. Results: A total of 218 004 death cases were reported in Chongqing, 2016, and the mortality rate was 731.73/100 000. Of them, a total of 179 637 death cases of the four major NCDs including cardiovascular disease, cancer, chronic respiratory disease and diabetes were reported, accounting for 82.40% of all death cases. The mortality rate and standardized mortality rate of four major NCDs was 602.95/100 000 and 455.82/100 000, respectively. The premature death probability of four major NCDs was 15.96%, and males (25.39%) had a higher premature death probability than females (10.78%). The premature death probability of cardiovascular disease, cancer, chronic respiratory disease, and diabetes were 6.01%, 8.32%, 2.05%, and 0.43%, respectively. Life expectancy would increase by 6.02, 3.19, 1.89, and 0.19 years, after eliminating cardiovascular disease, cancer, chronic respiratory disease and diabetes respectively. Conclusion: The premature death probability of major NCDs was high in Chongqing, and males had a higher premature death probability than females did. Intervention and health management of the population should be conducted according to different gender-based risk factors to reduce the premature death probability.
The number of life-history stages does not influence the androgen responsiveness to male-male interactions: sedentary and migratory black redstarts (Phoenicurus ochruros) do not elevate testosterone in response to simulated territorial intrusions.
Villavicencio, C P; Blas, J; Goymann, W
High plasma levels of testosterone at the beginning of the breeding season adjust male physiology for mating and promote territorial behavior in birds. Conversely intra-sexual competition may elicit a temporary increase in circulating testosterone. Male black redstarts (Phoenicurus ochruros) from migratory populations show the expected increase in baseline testosterone during early breeding, but circulating testosterone levels do not change in response to male-male interactions. Because sedentary populations express fewer life-history stages they may be more flexible in timing of life-history stages and more responsive to environmental modulation of hormone concentrations. Therefore, we tested whether the androgen responsiveness to male-male interactions differs between migratory (6 life-history stages) and sedentary black redstarts (3 life-history stages) during early breeding, predicting that in contrast to migratory birds, sedentary birds would modulate testosterone in response to simulated territorial intrusions (STI). In contrast to our prediction, sedentary males did not modulate post-capture testosterone levels in response to simulated territorial intrusions. Males of both populations increased testosterone after an injection of gonadotropin releasing hormone (GnRH), demonstrating that they were capable of increasing testosterone. Interestingly, in sedentary males the GnRH injection elicited a higher testosterone response in STI males than in control males. The two populations did not differ in their behavioral response to the STIs, except that sedentary males spent less time close to the decoy. In combination with previous data from black redstarts and other socially monogamous and biparental birds our current study adds to the growing evidence that current theory regarding hormone-behavior relationship needs to be refined. Copyright © 2014 Elsevier Inc. All rights reserved.
van Solinge, H.; Henkens, K.
This research examined the judgemental process underlying subjective life expectancy (SLE) and the predictive value of SLE on actual mortality in older adults in the Netherlands. We integrated theoretical insights from life satisfaction research with existing models of SLE. Our model differentiates
Bruce C. V. Campbell
Full Text Available BackgroundEndovascular thrombectomy improves functional outcome in large vessel occlusion ischemic stroke. We examined disability, quality of life, survival and acute care costs in the EXTEND-IA trial, which used CT-perfusion imaging selection.MethodsLarge vessel ischemic stroke patients with favorable CT-perfusion were randomized to endovascular thrombectomy after alteplase versus alteplase-only. Clinical outcome was prospectively measured using 90-day modified Rankin scale (mRS. Individual patient expected survival and net difference in Disability/Quality-adjusted life years (DALY/QALY up to 15 years from stroke were modeled using age, sex, 90-day mRS, and utility scores. Level of care within the first 90 days was prospectively measured and used to estimate procedure and inpatient care costs (US$ reference year 2014.ResultsThere were 70 patients, 35 in each arm, mean age 69, median NIHSS 15 (IQR 12–19. The median (IQR disability-weighted utility score at 90 days was 0.65 (0.00–0.91 in the alteplase-only versus 0.91 (0.65–1.00 in the endovascular group (p = 0.005. Modeled life expectancy was greater in the endovascular versus alteplase-only group (median 15.6 versus 11.2 years, p = 0.02. The endovascular thrombectomy group had fewer simulated DALYs lost over 15 years [median (IQR 5.5 (3.2–8.7 versus 8.9 (4.7–13.8, p = 0.02] and more QALY gained [median (IQR 9.3 (4.2–13.1 versus 4.9 (0.3–8.5, p = 0.03]. Endovascular patients spent less time in hospital [median (IQR 5 (3–11 days versus 8 (5–14 days, p = 0.04] and rehabilitation [median (IQR 0 (0–28 versus 27 (0–65 days, p = 0.03]. The estimated inpatient costs in the first 90 days were less in the thrombectomy group (average US$15,689 versus US$30,569, p = 0.008 offsetting the costs of interhospital transport and the thrombectomy procedure (average US$10,515. The average saving per patient treated with thrombectomy was US$4
Gustavo de los Campos
Full Text Available Genetic factors are believed to account for 25% of the interindividual differences in Years of Life (YL among humans. However, the genetic loci that have thus far been found to be associated with YL explain a very small proportion of the expected genetic variation in this trait, perhaps reflecting the complexity of the trait and the limitations of traditional association studies when applied to traits affected by a large number of small-effect genes. Using data from the Framingham Heart Study and statistical methods borrowed largely from the field of animal genetics (whole-genome prediction, WGP, we developed a WGP model for the study of YL and evaluated the extent to which thousands of genetic variants across the genome examined simultaneously can be used to predict interindividual differences in YL. We find that a sizable proportion of differences in YL--which were unexplained by age at entry, sex, smoking and BMI--can be accounted for and predicted using WGP methods. The contribution of genomic information to prediction accuracy was even higher than that of smoking and body mass index (BMI combined; two predictors that are considered among the most important life-shortening factors. We evaluated the impacts of familial relationships and population structure (as described by the first two marker-derived principal components and concluded that in our dataset population structure explained partially, but not fully the gains in prediction accuracy obtained with WGP. Further inspection of prediction accuracies by age at death indicated that most of the gains in predictive ability achieved with WGP were due to the increased accuracy of prediction of early mortality, perhaps reflecting the ability of WGP to capture differences in genetic risk to deadly diseases such as cancer, which are most often responsible for early mortality in our sample.
Islam, Md Shariful; Mondal, Md Nazrul Islam; Tareque, Md Ismail; Rahman, Md Aminur; Hoque, Md Nazrul; Ahmed, Md Munsur; Khan, Hafiz T A
Healthy life expectancy (HALE) at birth is an important indicator of health status and quality of life of a country's population. However, little is known about the determinants of HALE as yet globally or even country-specific level. Thus, we examined the factors that are associated with HALE at birth in low- and lower-middle-income countries. In accordance with the World Bank (WB) classification seventy-nine low- and lower-middle-income countries were selected for the study. Data on HALE, demographic, socioeconomic, social structural, health, and environmental factors from several reliable sources, such as the World Health Organization, the United Nations Development Program, Population Reference Bureau, WB, Heritage Foundation, Transparency International, Freedom House, and International Center for Prison Studies were obtained as selected countries. Descriptive statistics, correlation analysis, and regression analysis were performed to reach the research objectives. The lowest and highest HALE were observed in Sierra Leone (44.40 years) and in Sri Lanka (67.00 years), respectively. The mean years of schooling, total fertility rate (TFR), physician density, gross national income per capita, health expenditure, economic freedom, carbon dioxide emission rate, freedom of the press, corruption perceptions index, prison population rate, and achieving a level of health-related millennium development goals (MDGs) were revealed as the correlates of HALE. Among all the correlates, the mean years of schooling, TFR, freedom of the press, and achieving a level of health-related MDGs were found to be the most influential factors. To increase the HALE in low- and lower-middle-income countries, we suggest that TFR is to be reduced as well as to increase the mean years of schooling, freedom of the press, and the achievement of a level of health-related MDGs.
Full Text Available Abstract Background Information on life expectancy (LE change is of great concern for policy makers, as evidenced by discussions of the "harvesting" (or "mortality displacement" issue, i.e. how large an LE loss corresponds to the mortality results of time series (TS studies. Whereas loss of LE attributable to chronic air pollution exposure can be determined from cohort studies, using life table methods, conventional TS studies have identified only deaths due to acute exposure, during the immediate past (typically the preceding one to five days, and they provide no information about the LE loss per death. Methods We show how to obtain information on population-average LE loss by extending the observation window (largest "lag" of TS to include a sufficient number of "impact coefficients" for past exposures ("lags". We test several methods for determining these coefficients. Once all of the coefficients have been determined, the LE change is calculated as time integral of the relative risk change after a permanent step change in exposure. Results The method is illustrated with results for daily data of non-accidental mortality from Hong Kong for 1985 - 2005, regressed against PM10 and SO2 with observation windows up to 5 years. The majority of the coefficients is statistically significant. The magnitude of the SO2 coefficients is comparable to those for PM10. But a window of 5 years is not sufficient and the results for LE change are only a lower bound; it is consistent with what is implied by other studies of long term impacts. Conclusions A TS analysis can determine the LE loss, but if the observation window is shorter than the relevant exposures one obtains only a lower bound.
Katcher Brian S
Full Text Available Abstract Background A core function of local health departments is to conduct health assessments. The analysis of death certificates provides information on diseases, conditions, and injuries that are likely to cause death – an important outcome indicator of population health. The expected years of life lost (YLL measure is a valid, stand-alone measure for identifying and ranking the underlying causes of premature death. The purpose of this study was to rank the leading causes of premature death among San Francisco residents, and to share detailed methods so that these analyses can be used in other local health jurisdictions. Methods Using death registry data and population estimates for San Francisco deaths in 2003–2004, we calculated the number of deaths, YLL, and age-standardized YLL rates (ASYRs. The results were stratified by sex, ethnicity, and underlying cause of death. The YLL values were used to rank the leading causes of premature death for men and women, and by ethnicity. Results In the years 2003–2004, 6312 men died (73,627 years of life lost, and 5726 women died (51,194 years of life lost. The ASYR for men was 65% higher compared to the ASYR for women (8971.1 vs. 5438.6 per 100,000 persons per year. The leading causes of premature deaths are those with the largest average YLLs and are largely preventable. Among men, these were HIV/AIDS, suicide, drug overdose, homicide, and alcohol use disorder; and among women, these were lung cancer, breast cancer, hypertensive heart disease, colon cancer, and diabetes mellitus. A large health disparity exists between African Americans and other ethnic groups: African American age-adjusted overall and cause-specific YLL rates were higher, especially for homicide among men. Except for homicide among Latino men, Latinos and Asians have comparable or lower YLL rates among the leading causes of death compared to whites. Conclusion Local death registry data can be used to measure, rank, and
Ho, Jessica Y.; Fenelon, Andrew
Researchers have documented widening educational gradients in mortality in the United States since the 1970s. While smoking has been proposed as a key explanation for this trend, no prior study has quantified the contribution of smoking to increasing education gaps in longevity. We estimate the contribution of smoking to educational gradients in life expectancy using data on white men and women aged 50 and above from the National Longitudinal Mortality Study (N=283,430; 68,644 deaths) and the National Health Interview Survey (N=584,811; 127,226 deaths) in five periods covering the 1980s to 2006. In each period, smoking makes an important contribution to education gaps in longevity for white men and women. Smoking accounts for half the increase in the gap for white women but does not explain the widening gap for white men in the most recent period. Addressing greater initiation and continued smoking among the less educated may reduce mortality inequalities. PMID:26199287
Bahk, Jinwook; Ezzati, Majid; Khang, Young-Ho
Comparative research on health outcomes in North and South Korea offers a unique opportunity to explore political and social determinants of health. We examined the age- and cause-specific contributions to the life expectancy (LE) gap between the two Koreas. We calculated the LE at birth in 1993 and 2008 among North and South Koreans, and cause-specific contributions to the LE discrepancy between the two Koreas in 2008. The cause-specific mortality data from South Korea were used as proxies for the cause-specific mortality data in North Korea in 2008. The LE gap between the two Koreas was approximately 1 year in 1993, but grew to approximately 10 years in 2008. This discrepancy was attributable to increased gaps in mortality among children younger than 1 year and adults 55 years of age or older. The major causes of the increased LE gap were circulatory diseases, digestive diseases, infant mortality, external causes, cancers and infectious diseases. This study underscores the urgency of South Korean and international humanitarian aid programs to reduce the mortality rate of the North Korean people.
Nusselder, Wilma J.; Looman, Caspar W.N.; Mackenbach, Johan P.; Huisman, Martijn; van Oyen, Herman; Deboosere, Patrick; Gadeyne, Sylvie; Kunst, Anton E.
Objectives. We examined the contribution that specific diseases, as causes of both death and disability, make to educational disparities in disability-free life expectancy (DFLE). Methods. We used disability data from the Belgian Health Interview Survey (1997) and mortality data from the National Mortality Follow-Up Study (1991–1996) to assess education-related disparities in DFLE and to partition these differences into additive contributions of specific diseases. Results. The DFLE advantage of higher-educated compared with lower-educated persons was 8.0 years for men and 5.9 years for women. Arthritis (men, 1.3 years; women, 2.2 years), back complaints (men, 2.1 years), heart disease/stroke (men, 1.5 years; women, 1.6 years), asthma/chronic obstructive pulmonary disease (COPD) (men, 1.2 years; women, 1.5 years), and “other diseases” (men, 2.4 years) contributed the most to this difference. Conclusions. Disabling diseases, such as arthritis, back complaints, and asthma/COPD, contribute substantially to differences in DFLE by education. Public health policy aiming to reduce existing disparities in the DFLE and to improve population health should not only focus on fatal diseases but also on these nonfatal diseases. PMID:16195519
Jonker, Marcel F; D'Ippolito, Edoardo; Eikemo, Terje A; Congdon, Peter D; Nante, Nicola; Mackenbach, Johan P; Kamphuis, Carlijn B M
The evidence on the association between politics and health is scarce considering the importance of this topic for population health. Studies that investigated the effect of different political regimes on health outcomes show inconsistent results. Bayesian time-series cross-section analyses are used to examine the overall impact of regional politics on variations in Italian regional life expectancy (LE) at birth during the period 1980-2010. Our analyses control for trends in and unobserved determinants of regional LE, correct for temporal as well as spatial autocorrelation, and employ a flexible specification for the timing of the political effects. In the period from 1980 to 1995, we find no evidence that the communist, left-oriented coalitions and Christian Democratic, centre-oriented coalitions have had an effect on regional LE. In the period from 1995 onwards, after a major reconfiguration of Italy's political regimes and a major healthcare reform, we again find no evidence that the Centre-Left and Centre-Right coalitions have had a significant impact on regional LE. The presented results provide no support for the notion that different regional political regimes in Italy have had a differential effect on regional LE, even though Italian regions have had considerable and increasing autonomy over healthcare and health-related policies and expenditures.
Goodwin, C. Rory; Khattab, Mohamed H.; Sankey, Eric W.; Elder, Benjamin D.; Kosztowski, Thomas A.; Sarabia-Estrada, Rachel; Bydon, Ali; Witham, Timothy F.; Wolinsky, Jean-Paul; Gokaslan, Ziya L.; Sciubba, Daniel M.
Study Design Retrospective study. Objective Our objective was to identify preoperative prognostic factors associated with survival in patients with spinal metastasis from lung carcinoma. Methods A retrospective analysis of 26 patients diagnosed with lung carcinoma metastatic to the spinal column was performed to determine factors associated with survival. We used 3 months survival as the clinical cutoff for whether surgical intervention should be performed. We analyzed patients who survived less than 3 months compared with those who survived more than 3 months. Demographic, preoperative, operative, and postoperative factors including functional scores were collected for analysis. Results The median survival for all patients in our study was 3.5 months. We found a statistically significant difference between the group that survived less than 3 months and the group that survived greater than 3 months in terms of extrathoracic metastasis, visceral metastasis, and average postoperative modified Rankin score. Conclusion Determining which patients with lung cancer spinal metastases will benefit from surgical intervention is often dictated by the patient's predicted life expectancy. Factors associated with poorer prognosis include age, functional status, visceral metastases, and extrathoracic metastases. Although the prognosis for patients with lung cancer spinal metastases is poor, some patients may experience long-term benefit from surgical intervention. PMID:26430597
Monteverde, Malena; Novak, Beatriz
The high and increasing prevalence of overweight and obesity in Latin American and the Caribbean and the increasing prevalence of some obesity-related chronic diseases could be changing the current mortality patterns and the improvements in life expectancy of this population. The main objective of this study is to measure the effect of overweight and obesity on mortality in Mexico among elderly people (60 years and older). We use the Mexican Health and Ageing Study (MHAS, 2001 and 2003) that is a panel nationally-representative study of the population 50 years and older in Mexico. Our results show that excess body weight (defined by the two highest quintiles of Body Mass Index-BMI-) increases the risk of mortality at 60 years and older in Mexico. As much as 11% of the deaths among elderly that occurred during the period 2001-2003 in Mexico would have been avoided if overweight and obese people (individuals belonging to the highest two quintiles of BMI) had had the "ideal" weight (defined by the middle quintile, or third quintile, of BMI). At individual level, we estimate that individuals 60 years old with excess body weight (fourth and fifth quintiles of BMI) survive four years less, in average, than individuals with normal body weight (third quintile of BMI).
Jian, Wen-Shan; Huang, Chen-Ling; Iqbal, Usman; Nguyen, Phung-Anh; Hsiao, George; Li, Hsien-Chang
The purpose of the study was to probe into the changes in life expectancy associated with schooling years found by the Organization for Economic Co-operation and Development (OECD). The study was based on the OECD database from the period 2000 to 2006. The data of thirty countries were constructed to allow comparisons over time and across these countries. Panel data analysis was used to estimate the relationship of national education, as defined as school years, with life expectancy. The control factors considered were numbers of practicing physicians, practicing nurses, hospital beds, and GDP. We used fixed effects of both country and time through linear regression, the coefficient of school years in relation to life expectancy was statistically significant but negative. This finding is not in accord with the hypothesis that investing in human capital through education stimulates better health outcomes. Within developing countries, educational attainment is no longer keeping the same pace with life expectancy as before. Therefore, we suggest that an effective education policy should cover diverse topics, for example, balancing economic growth and mental hygiene, to improve national life expectancy. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
Full Text Available EnglishA number of industrialized nations have recently experienced some degrees ofconstriction in their long-standing sex differentials in life expectancy at birth. In this study weexamine this phenomenon in the context of Canada's regions between 1971 and 1991: Atlantic(Newfoundland, Nova Scotia, New Brunswick, Prince Edward Island; Quebec, Ontario, and the West(Manitoba, Saskatchewan, Alberta, British Columbia, Yukon and Northwest Territories. Decompositionanalysis based on multiple decrement life tables is applied to address three questions: (1 Are thereregional differentials in the degree of narrowing in the sex gap in life expectancy? (2 What is therelative contribution of major causes of death to observed sex differences in average length of lifewithin and across regions? (3 How do the contributions of cause-of-death components vary acrossregions to either widen or narrow the sex gap in survival? It is shown that the magnitude of the sexgap is not uniform across the regions, though the differences are not large. The most importantcontributors to a narrowing of the sex gap in life expectancy are heart disease and external types ofmortality (i.e., accidents, violence, and suicide, followed by lung cancer and other types of chronicconditions. In substantive terms these results indicate that over time men have been making sufficientgains in these causes of death as to narrow some of the gender gap in overall survival. Regions showsimilarity in these effects.FrenchCertains pays industrialisés viennent de vivre quelques constrictions dans ladifférentielle sexuelle de l'espérance de vie à la naissance. Dans cette étude,nous examinons ce phénomène dans le contexte des régions canadiennes entre1971 et 1991 : région atlantique (Terre-Neuve, Nouvelle-Écosse, Nouveau-Brunswick, île du Prince-Édouard ; le Québec, l'Ontario et l'Ouest (Manitoba,Saskatchewan, Alberta, Colombie-Britannique, Yukon et les Territoires duNord-Ouest. L'analyse de
Ho, Jessica Y
Life expectancy at birth in the United States is among the lowest of all high-income countries. Most recent studies have concentrated on older ages, finding that Americans have a lower life expectancy at age fifty and experience higher levels of disease and disability than do their counterparts in other industrialized nations. Using cross-national mortality data to identify the key age groups and causes of death responsible for these shortfalls, I found that mortality differences below age fifty account for two-thirds of the gap in life expectancy at birth between American males and their counterparts in sixteen comparison countries. Among females, the figure is two-fifths. The major causes of death responsible for the below-fifty trends are unintentional injuries, including drug overdose--a fact that constitutes the most striking finding from this study; noncommunicable diseases; perinatal conditions, such as pregnancy complications and birth trauma; and homicide. In all, this study highlights the importance of focusing on younger ages and on policies both to prevent the major causes of death below age fifty and to reduce social inequalities.
Capocaccia, R; Gatta, G; Dal Maso, L
Cancer survivorship is an increasingly important issue in cancer control. Life expectancy of patients diagnosed with breast, colon, and testicular cancers, stratified by age at diagnosis and time since diagnosis, is provided as an indicator to evaluate future mortality risks and health care needs of cancer survivors. The standard period life table methodology was applied to estimate excess mortality risk for cancer patients diagnosed in 1985-2011 from SEER registries and mortality data of the general US population. The sensitivity of life expectancy estimates on different assumptions was evaluated. Younger patients with colon cancer showed wider differences in life expectancy compared with that of the general population (11.2 years in women and 10.7 in men at age 45-49 years) than older patients (6.3 and 5.8 at age 60-64 years, respectively). Life expectancy progressively increases in patients surviving the first years, up to 4 years from diagnosis, and then starts to decrease again, approaching that of the general population. For breast cancer, the initial drop in life expectancy is less marked, and again with wider differences in younger patients, varying from 8.7 at age 40-44 years to 2.4 at ages 70-74 years. After diagnosis, life expectancy still decreases with time, but less than that in the general population, slowly approaching that of cancer-free women. Life expectancy of men diagnosed with testicular cancer at age 30 years is estimated as 45.2 years, 2 years less than cancer-free men of the same age. The difference becomes 1.3 years for patients surviving the first year, and then slowly approaches zero with increasing survival time. Life expectancy provides meaningful information on cancer patients, and can help in assessing when a cancer survivor can be considered as cured. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: firstname.lastname@example.org.
Klug, Hope; Bonsall, Michael B; Alonzo, Suzanne H
The evolution of maternal, paternal, and bi-parental care has been the focus of a great deal of research. Males and females vary in basic life-history characteristics (e.g., stage-specific mortality, maturation) in ways that are unrelated to parental investment. Surprisingly, few studies have examined the effect of this variation in male and female life history on the evolution of care. Here, we use a theoretical approach to determine the sex-specific life-history characteristics that give rise to the origin of paternal, maternal, or bi-parental care from an ancestral state of no care. Females initially invest more into each egg than males. Despite this inherent difference between the sexes, paternal, maternal, and bi-parental care are equally likely when males and females are otherwise similar. Thus, sex differences in initial zygotic investment do not explain the origin of one pattern of care over another. However, sex differences in adult mortality, egg maturation rate, and juvenile survival affect the pattern of care that will be most likely to evolve. Maternal care is more likely if female adult mortality is high, whereas paternal care is more likely if male adult mortality is high. These findings suggest that basic life-history differences between the sexes can alone explain the origin of maternal, paternal, and bi-parental care. As a result, the influence of life-history characteristics should be considered as a baseline scenario in studies examining the origin of care.
Liu, Yan; Arai, Asuna; Kanda, Koji; Lee, Romeo B; Glasser, Jay; Tamashiro, Hiko
Life expectancy (LE) is a major marker of individual survival. It also serves as a guide to highlight both the progress and the gaps in total social and societal health. Comparative LE in concert with measures of gender-specific experience, indices of empowerment and societal happiness and development offer a comparative tool to examine trends and similarities of societal progress as seen through the lens of cross-national experience. To determine the gender gaps in LE (GGLE) trends, we performed a longitudinal analysis, covering a period of 49 years (1960-2008). To examine the association of GGLE with development indices, we used the 2007 GGLE data, the newest happiness data mostly drawn from 2006; the 2006 Human Development Index (HDI) data and the 2006 Gender Empowerment Measure (GEM) data. It revealed that most of the Organization for Economic Co-operation and Development (OECD) countries had a GGLE trend that occurred in an inverted U-curve fashion. We divided them into three subgroups based on the peak years of respective GGLE. The earlier the peak year, the happier the countries, the higher the HDI and the smaller the current GGLE are. Association analysis indicates that Happiness, HDI and GEM are all negatively associated with GGLE. This pattern suggests that GGLE undergoes three phases of growth, peak and stability and decline. Japan will soon be seeing its GGLE gradually shrinking in the foreseeable future. The continuing increases in Happiness, HDI and GEM are associated with a decrease in GGLE, which should be carefully taken into consideration.
Hendi, Arun S
Several recent articles have reported conflicting conclusions about educational differences in life expectancy, and this is partly due to the use of unreliable data subject to a numerator-denominator bias previously reported as ranging from 20 % to 40 %. This article presents estimates of life expectancy and lifespan variation by education in the United States using more reliable data from the National Health Interview Survey. Contrary to prior conclusions in the literature, I find that life expectancy increased or stagnated since 1990 among all education-race-sex groups except for non-Hispanic white women with less than a high school education; there has been a robust increase in life expectancy among white high school graduates and a smaller increase among black female high school graduates; lifespan variation did not increase appreciably among high school graduates; and lifespan variation plays a very limited role in explaining educational gradients in mortality. I also discuss the key role that educational expansion may play in driving future changes in mortality gradients. Because of shifting education distributions, within an education-specific synthetic cohort, older age groups are less negatively selected than younger age groups. We could thus expect a greater concentration of mortality at younger ages among people with a high school education or less, which would be reflected in increasing lifespan variability for this group. Future studies of educational gradients in mortality should use more reliable data and should be mindful of the effects of shifting education distributions.
Full Text Available Abstract Background Non-smoking, having a normal weight and increased levels of physical activity are perhaps the three key factors for preventing cardiovascular disease (CVD. However, the relative effects of these factors on healthy longevity have not been well described. We aimed to calculate and compare the effects of non-smoking, normal weight and physical activity in middle-aged populations on life expectancy with and without cardiovascular disease. Methods Using multi-state life tables and data from the Framingham Heart Study (n = 4634 we calculated the effects of three heart healthy behaviours among populations aged 50 years and over on life expectancy with and without cardiovascular disease. For the life table calculations, we used hazard ratios for 3 transitions (No CVD to CVD, no CVD to death, and CVD to death by health behaviour category, and adjusted for age, sex, and potential confounders. Results High levels of physical activity, never smoking (men, and normal weight were each associated with 20-40% lower risks of developing CVD as compared to low physical activity, current smoking and obesity, respectively. Never smoking and high levels of physical activity reduced the risks of dying in those with and without a history of CVD, but normal weight did not. Never-smoking was associated with the largest gains in total life expectancy (4.3 years, men, 4.1 years, women and CVD-free life expectancy (3.8 and 3.4 years, respectively. High levels of physical activity and normal weight were associated with lesser gains in total life expectancy (3.5 years, men and 3.4 years, women, and 1.3 years, men and 1.0 year women, respectively, and slightly lesser gains in CVD-free life expectancy (3.0 years, men and 3.1 years, women, and 3.1 years men and 2.9 years women, respectively. Normal weight was the only behaviour associated with a reduction in the number of years lived with CVD (1.8 years, men and 1.9 years, women. Conclusions Achieving high
Full Text Available Background. Achievement motive is defined as the intention to achieve one’s goals. Achievement motive is assumed to promote clients to choices and actions toward their valuable goal, so it is an important consideration in rehabilitation. Purpose. The purpose of this study is to demonstrate the structural relationship among achievement motive on purpose in life, social participation, and role expectation of community-dwelling elderly people. Methods. Participants were community-dwelling elderly people in day-service centers. A total of 281 participants (male: 127, female: 154 answered the self-administered questionnaire in cross-sectional research. The questionnaire was comprised of demographic data and scales that evaluated achievement motive, social participation, purpose in life, and role expectation. We studied the structural relationship established by our hypothesized model via a structural equation modeling approach. Results. We checked the standardized path coefficients and the modification indices; the modified model’s statistics were a good fit: CFI = 0.984, TLI = 0.983, RMSEA = 0.050, 90% CI [0.044–0.055]. Achievement motive had a significantly direct effect on purpose in life (direct effect = 0.445, p value < 0.001, a significantly indirect effect on purpose in life via social participation or role expectation (indirect effect = 0.170, p value < 0.001 and a total effect on purpose in life (total effect = 0.615. Discussion. This result suggests that enhancing the intention to achieve one’s goals enables participants to feel a spirit of challenge with a purpose and a sense of fulfillment in their daily lives.
Sano, Nobuyuki; Kyougoku, Makoto
Background. Achievement motive is defined as the intention to achieve one's goals. Achievement motive is assumed to promote clients to choices and actions toward their valuable goal, so it is an important consideration in rehabilitation. Purpose. The purpose of this study is to demonstrate the structural relationship among achievement motive on purpose in life, social participation, and role expectation of community-dwelling elderly people. Methods. Participants were community-dwelling elderly people in day-service centers. A total of 281 participants (male: 127, female: 154) answered the self-administered questionnaire in cross-sectional research. The questionnaire was comprised of demographic data and scales that evaluated achievement motive, social participation, purpose in life, and role expectation. We studied the structural relationship established by our hypothesized model via a structural equation modeling approach. Results. We checked the standardized path coefficients and the modification indices; the modified model's statistics were a good fit: CFI = 0.984, TLI = 0.983, RMSEA = 0.050, 90% CI [0.044-0.055]. Achievement motive had a significantly direct effect on purpose in life (direct effect = 0.445, p value < 0.001), a significantly indirect effect on purpose in life via social participation or role expectation (indirect effect = 0.170, p value < 0.001) and a total effect on purpose in life (total effect = 0.615). Discussion. This result suggests that enhancing the intention to achieve one's goals enables participants to feel a spirit of challenge with a purpose and a sense of fulfillment in their daily lives.
Background Significant variation exists in published Aboriginal mortality and life expectancy (LE) estimates due to differing and evolving methodologies required to correct for inadequate recording of Aboriginality in death data, under-counting of Aboriginal people in population censuses, and unexplained growth in the Aboriginal population attributed to changes in the propensity of individuals to identify as Aboriginal at population censuses. The objective of this paper is to analyse variation in reported Australian Aboriginal mortality in terms of LE and infant mortality rates (IMR), compared with all Australians. Methods Published data for Aboriginal LE and IMR were obtained and analysed for data quality and method of estimation. Trends in reported LE and IMR estimates were assessed and compared with those in the entire Australian population. Results LE estimates derived from different methodologies vary by as much as 7.2 years for the same comparison period. Indirect methods for estimating Aboriginal LE have produced LE estimates sensitive to small changes in underlying assumptions, some of which are subject to circular reasoning. Most indirect methods appear to under-estimate Aboriginal LE. Estimated LE gaps between Aboriginal people and the overall Australian population have varied between 11 and 20 years. Latest mortality estimates, based on linking census and death data, are likely to over-estimate Aboriginal LE. Temporal LE changes by each methodology indicate that Aboriginal LE has improved at rates similar to the Australian population overall. Consequently the gap in LE between Aboriginal people and the total Australian population appears to be unchanged since the early 1980s, and at the end of the first decade of the 21st century remains at least 11–12 years. In contrast, focussing on the 1990–2010 period Aboriginal IMR declined steeply over 2001–08, from more than 12 to around 8 deaths per 1,000 live births, the same level as Australia overall in
Aubin-Horth, Nadia; Landry, Christian R; Letcher, Benjamin H; Hofmann, Hans A
Atlantic salmon (Salmo salar) undergo spectacular marine migrations before homing to spawn in natal rivers. However, males that grow fastest early in life can adopt an alternative 'sneaker' tactic by maturing earlier at greatly reduced size without leaving freshwater. While the ultimate evolutionary causes have been well studied, virtually nothing is known about the molecular bases of this developmental plasticity. We investigate the nature and extent of coordinated molecular changes that accompany such a fundamental transformation by comparing the brain transcription profiles of wild mature sneaker males to age-matched immature males (future large anadromous males) and immature females. Of the ca. 3000 genes surveyed, 15% are differentially expressed in the brains of the two male types. These genes are involved in a wide range of processes, including growth, reproduction and neural plasticity. Interestingly, despite the potential for wide variation in gene expression profiles among individuals sampled in nature, consistent patterns of gene expression were found for individuals of the same reproductive tactic. Notably, gene expression patterns in immature males were different both from immature females and sneakers, indicating that delayed maturation and sea migration by immature males, the 'default' life cycle, may actually result from an active inhibition of development into a sneaker.
Existing analyses of trends in disability free life expectancy (DFLE) are mainly at aggregate level (national or broad regional). However, major differences in DFLE, and trends in these expectancies, exist between different neighbourhoods within regions, so supporting a small area perspective. However, this raises issues regarding the stability of conventional life table estimation methods at small area scales. This paper advocates a Bayesian borrowing strength technique to model trends in mortality and disability differences across 625 small areas in London, using illness data from the 2001 and 2011 population Censuses, and deaths data for two periods centred on the Census years. From this analysis, estimates of total life expectancy and DFLE are obtained. The spatio-temporal modelling perspective allows assessment of whether significant compression or expansion of morbidity has occurred in each small area. Appropriate models involve random effects that recognise correlation and interaction effects over relevant dimensions of the observed deaths and illness data (areas, ages), as well as major spatial trends (e.g. gradients in health and mortality according to area deprivation category). Whilst borrowing strength is a primary consideration (and demonstrated by raised precision for estimated life expectancies), so also is model parsimony. Therefore, pure borrowing strength models are compared with models allowing selection of random age-area interaction effects using a spike-slab prior, and in fact borrowing strength combined with random effects selection provides better fit. Copyright © 2014 John Wiley & Sons, Ltd.
Streppel, M.T.; Boshuizen, H.C.; Ocké, M.C.; Kok, F.J.; Kromhout, D.
Study objective: To study the effect of long-term smoking on all-cause and cause-specific mortality, and to estimate the effects of cigarette and cigar or pipe smoking on life expectancy. Design: A long-term prospective cohort study. Setting: Zutphen, The Netherlands. Participants: 1373 men from the
This study examined the relationship of family background on students' academic self-efficacy and the impact of students' self-efficacy on their career and life success expectations. The study used the national dataset of the Educational Longitudinal Study of 2002 (ELS: 2002), funded by the U.S. Department of Education. Based on a path…
Rasella, Davide; Aquino, Rosana; Barreto, Mauricio Lima
Few studies have analysed the effects of income inequality on health in developing countries, particularly during economic growth, reduction of social disparities and reinforcement of the welfare and healthcare system. We evaluated the association between income inequality and life expectancy in Brazil, including the effect of social and health interventions, in the period 2000-2009. A panel dataset was created for the 27 Brazilian states over the referred time period. Multivariable linear regressions were performed using fixed-effects estimation with heteroscedasticity and serial correlation robust SEs. Models were fitted for life expectancy as a dependent variable, using the Gini index or a percentile income dispersion ratio as the main independent variable, and for demographic, socioeconomic and healthcare-related determinants as covariates. The Gini index, as the other measure of income inequality, was negatively associated with life expectancy (pincome inequality, contributing-together with PHC-to decreasing death rates in the population. Reducing income inequality may represent an important step towards improving health and increasing life expectancy, particularly in developing countries where inequalities are high.
Manuel, Douglas G; Perez, Richard; Sanmartin, Claudia; Taljaard, Monica; Hennessy, Deirdre; Wilson, Kumanan; Tanuseputro, Peter; Manson, Heather; Bennett, Carol; Tuna, Meltem; Fisher, Stacey; Rosella, Laura C
Behaviours such as smoking, poor diet, physical inactivity, and unhealthy alcohol consumption are leading risk factors for death. We assessed the Canadian burden attributable to these behaviours by developing, validating, and applying a multivariable predictive model for risk of all-cause death. A predictive algorithm for 5 y risk of death-the Mortality Population Risk Tool (MPoRT)-was developed and validated using the 2001 to 2008 Canadian Community Health Surveys. There were approximately 1 million person-years of follow-up and 9,900 deaths in the development and validation datasets. After validation, MPoRT was used to predict future mortality and estimate the burden of smoking, alcohol, physical inactivity, and poor diet in the presence of sociodemographic and other risk factors using the 2010 national survey (approximately 90,000 respondents). Canadian period life tables were generated using predicted risk of death from MPoRT. The burden of behavioural risk factors attributable to life expectancy was estimated using hazard ratios from the MPoRT risk model. The MPoRT 5 y mortality risk algorithms were discriminating (C-statistic: males 0.874 [95% CI: 0.867-0.881]; females 0.875 [0.868-0.882]) and well calibrated in all 58 predefined subgroups. Discrimination was maintained or improved in the validation cohorts. For the 2010 Canadian population, unhealthy behaviour attributable life expectancy lost was 6.0 years for both men and women (for men 95% CI: 5.8 to 6.3 for women 5.8 to 6.2). The Canadian life expectancy associated with health behaviour recommendations was 17.9 years (95% CI: 17.7 to 18.1) greater for people with the most favourable risk profile compared to those with the least favourable risk profile (88.2 years versus 70.3 years). Smoking, by itself, was associated with 32% to 39% of the difference in life expectancy across social groups (by education achieved or neighbourhood deprivation). Multivariable predictive algorithms such as MPoRT can be used
In the past three decades, the elderly population in the United States experienced increase in life expectancy (LE) and disability-free life expectancy (LE(ND)), but decrease in life expectancy with disability (LE(D)). Smoking and obesity are two major risk factors that had negative impacts on these trends. While smoking prevalence continues to decline in recent decades, obesity prevalence has been growing and is currently at a high level. This study aims to forecast the healthy life expectancy for older adults aged 55 to 85 in the US from 2011 to 2040, in relation to their smoking and obesity history. First, population-level mortality data from the Human Mortality Database (HMD) and individual-level disability data from the US National Health Interview Survey (NHIS) were used to estimate the transition rates between different health states from 1982 to 2010, using a multi-state life table (MSLT) model. Second, the estimated transition rates were fitted and projected up to 2040, using a modified Lee-Carter model that incorporates cohort smoking and obesity history from NHIS. Mortality and morbidity for both sexes will continue to decline in the next decades. Relative to 2010, men are expected to have 3.2 years gain in LE(ND) and 0.8 years loss in LE(D). For women, there will be 1.8 years gain in LE(ND) and 0.8 years loss in LE(D). By 2040, men and women are expected to spend respectively 80 % and 75 % of their remaining life expectancy between 55 and 85 disability-free. Smoking and obesity have independent negative impacts on both the survival and disability of the US older population in the coming decades, and are responsible for the present and future gender disparity in mortality and morbidity. Overall, the US older population is expected to enjoy sustained health improvements and compression of disability, largely due to decline in smoking.
Aburto, José Manuel; Wensink, Maarten Jan; Lindahl-Jacobsen, Rune
that as Norway increasingly came to resemble Sweden in terms of high life expectancy, it also came to resemble Sweden in terms of low lifespan inequality. Next, we aim to make similar decompositions for Sweden and Norway, and aim to disentangle cohort effects from the question: what can Denmark do now...... cancers and non-infectious respiratory diseases, offsetting continuous improvement in cardiovascular mortality. Before and after stagnation, life expectancy increased as disparity decreased, as the cardiovascular revolution unfolded. Comparing Denmark and its Scandinavian counterparts, we find...
Kristine Husøy Onarheim
Full Text Available BACKGROUND: The fourth Millennium Development Goal calls for a two-thirds reduction in under-5 mortality between 1990 and 2015. Under-5 mortality rate is declining, but many countries are still far from achieving the goal. Effective child health interventions that could reduce child mortality exist, but national decision-makers lack contextual information for priority setting in their respective resource-constrained settings. We estimate the potential health impact of increasing coverage of 14 selected health interventions on child mortality in Ethiopia (2011-2015. We also explore the impact on life expectancy and inequality in the age of death (Gini(health. METHODS AND FINDINGS: We used the Lives Saved Tool to estimate potential impact of scaling-up 14 health interventions in Ethiopia (2011-2015. Interventions are scaled-up to 1 government target levels, 2 90% coverage and 3 90% coverage of the five interventions with the highest impact. Under-5 mortality rate, neonatal mortality rate and deaths averted are primary outcome measures. We used modified life tables to estimate impact on life expectancy at birth and inequality in the age of death (Gini(health. Under-5 mortality rate declines from 101.0 in 2011 to 68.8, 42.1 and 56.7 per 1000 live births under these three scenarios. Prioritizing child health would also increase life expectancy at birth from expected 60.5 years in 2015 to 62.5, 64.2 and 63.4 years and reduce inequality in age of death (Gini(health substantially from 0.24 to 0.21, 0.18 and 0.19. CONCLUSIONS: The Millennium Development Goal for child health is reachable in Ethiopia. Prioritizing child health would also increase total life expectancy at birth and reduce inequality in age of death substantially (Gini(health.
Reynolds, Sandra L.; Saito, Yasuhiko; Crimmins, Eileen M.
Purpose: The purpose of this article is to estimate the effect of obesity on both the length of life and length of nondisabled life for older Americans. Design and Methods: Using data from the first 3 waves of the Asset and Health Dynamics Among the Oldest Old (AHEAD) survey, this article develops estimates of total, active, and disabled life…
Hadi, Fazal; Dato, Serena; Carpi, Francesco M; Prontera, Paolo; Crucianelli, Francesca; Renda, Federica; Passarino, Giuseppe; Napolioni, Valerio
Several recent lines of evidence are proving an important role for dopamine in the aging process and in the determination of life span. Components of the dopaminergic system may represent good candidates for longevity studies. Herein, we tested the possible association of the functional SLC6A3/DAT1 40-bp VNTR with life-expectancy in a healthy population of Central Italy (N = 993) by applying a genetic-demographic approach that takes into account the demographic information and different survival rates between sexes for modeling the survival of specific allele carriers in the population. Male carriers of S*/S* genotype showed a lower survival chance across most of the lifespan respect to the survival of DAT1*L-carriers (P = 0.021). The same analyses gave non-significant results in females. Several studies already reported significant sex differences in dopamine metabolism and its related biological pathways. Thus, we can hypothesize that the SLC6A3/DAT1 40 bp-VNTR may affect life expectancy in a sex-specific way. Moreover, it is conceivable that DAT1 S*/S* carriers, who are prone to assume "risk" type behaviors, may be dropped out of the "healthy" population by a sort of "demographic selection".
Smallegange, Isabel M; Johansson, Jacob
Many species exhibit two discrete male morphs: fighters and sneakers. Fighters are large and possess weapons but may mature slowly. Sneakers are small and have no weapons but can sneak matings and may mature quickly to start mating earlier in life than fighters. However, how differences in competitive ability and life history interact to determine male morph coexistence has not yet been investigated within a single framework. Here we integrate demography and game theory into a two-sex population model to study the evolution of strategies that result in the coexistence of fighters and sneakers. We incorporate differences in maturation time between the morphs and use a mating-probability matrix analogous to the classic hawk-dove game. Using adaptive dynamics, we show that male dimorphism evolves more easily in our model than in classic game theory approaches. Our results also revealed an interaction between life-history differences and sneaker competitiveness, which shows that demography and competitive games should be treated as interlinked mechanisms to understand the evolution of male dimorphism. Applying our approach to empirical data on bulb mites (Rhizoglyphus robini), coho salmon (Oncorhynchus kisutch), and bullhorned dung beetles (Onthophagus taurus) indicates that observed occurrences of male dimorphism are in general agreement with model predictions.
Edward, Dominic A; Fricke, Claudia; Gerrard, Dave T; Chapman, Tracey
Precise estimates of costs and benefits, the fitness economics, of mating are of key importance in understanding how selection shapes the coevolution of male and female mating traits. However, fitness is difficult to define and quantify. Here, we used a novel application of an established analytical technique to calculate individual- and population-based estimates of fitness-including those sensitive to the timing of reproduction-to measure the effects on females of increased exposure to males. Drosophila melanogaster females were exposed to high and low frequencies of contact with males, and life-history traits for each individual female were recorded. We then compared different fitness estimates to determine which of them best described the changes in life histories. We predicted that rate-sensitive estimates would be more accurate, as mating influences the rate of offspring production in this species. The results supported this prediction. Increased exposure to males led to significantly decreased fitness within declining but not stable or increasing populations. There was a net benefit of increased male exposure in expanding populations, despite a significant decrease in lifespan. The study shows how a more accurate description of fitness, and new insights can be achieved by considering individual life-history strategies within the context of population growth. © 2010 The Author(s). Evolution© 2010 The Society for the Study of Evolution.
Smallegange, I.M.; Johansson, J.
Many species exhibit two discrete male morphs: fighters and sneakers. Fighters are large and possess weapons but may mature slowly. Sneakers are small and have no weapons but can sneak matings and may mature quickly to start mating earlier in life than fighters. However, how differences in
de Keijzer, Carmen; Agis, David; Ambrós, Albert; Arévalo, Gustavo; Baldasano, Jose M; Bande, Stefano; Barrera-Gómez, Jose; Benach, Joan; Cirach, Marta; Dadvand, Payam; Ghigo, Stefania; Martinez-Solanas, Èrica; Nieuwenhuijsen, Mark; Cadum, Ennio; Basagaña, Xavier
Air pollution exposure has been associated with an increase in mortality rates, but few studies have focused on life expectancy, and most studies had restricted spatial coverage. A limited body of evidence is also suggestive for a beneficial association between residential exposure to greenness and mortality, but the evidence for such an association with life expectancy is still very scarce. To investigate the association of exposure to air pollution and greenness with mortality and life expectancy in Spain. Mortality data from 2148 small areas (average population of 20,750 inhabitants, and median population of 7672 inhabitants) covering Spain for years 2009-2013 were obtained. Average annual levels of PM 10 , PM 2.5 , NO 2 and O 3 were derived from an air quality forecasting system at 4×4km resolution. The normalized difference vegetation index (NDVI) was used to assess greenness in each small area. Air pollution and greenness were linked to standardized mortality rates (SMRs) using Poisson regression and to life expectancy using linear regression. The models were adjusted for socioeconomic status and lung cancer mortality rates (as a proxy for smoking), and accounted for spatial autocorrelation. The increase of 5μg/m 3 in PM 10 , NO 2 and O 3 or of 2μg/m 3 in PM 2.5 concentration resulted in a loss of life in years of 0.90 (95% credibility interval CI: 0.83, 0.98), 0.13 (95% CI: 0.09, 0.17), 0.20years (95% CI: 0.16, 0.24) and 0.64 (0.59, 0.70), respectively. Similar associations were found in the SMR analysis, with stronger associations for PM 2.5 and PM 10 , which were associated with an increased mortality risk of 3.7% (95% CI: 3.5%, 4.0%) and 5.7% (95% CI: 5.4%, 6.1%). For greenness, a protective effect on mortality and longer life expectancy was only found in areas with lower socioeconomic status. Air pollution concentrations were associated to important reductions in life expectancy. The reduction of air pollution should be a priority for public health
Yamamura, Eiji; Andrés, Antonio R.
Using individual-level data for China, Korea, and Japan for 2006, this research examines how life satisfaction for married males and females in East Asian countries is influenced by the age of their children. Our results show (1) the life satisfaction of females who have a child younger than 12 years old is lower than that of females with no children. (2) The greater the marginal effect of child’s age on the life satisfaction, the more developed a nation’s economic condition.
Dudel, Christian; Myrskylä, Mikko
A key concern about population aging is the decline in the size of the economically active population. Working longer is a potential remedy. However, little is known about the length of working life and how it relates to macroeconomic conditions. We use the U.S. Health and Retirement Study for 1992-2011 and multistate life tables to analyze working life expectancy at age 50 and study the impact of the Great Recession in 2007-2009. Despite declines of one to two years following the recession, in 2008-2011, American men aged 50 still spent 13 years, or two-fifths of their remaining life, working; American women of the same age spent 11 years, or one-third of their remaining life, in employment. Although educational differences in working life expectancy have been stable since the mid-1990s, racial differences started changing after the onset of the Great Recession. Our results show that although Americans generally work longer than people in other countries, considerable subpopulation heterogeneity exists. We also find that the time trends are fluctuating, which may prove troublesome as the population ages. Policies targeting the weakest performing groups may be needed to increase the total population trends.
Kessler, Matthew J; Hernández Pacheco, Raisa; Rawlins, Richard G; Ruiz-Lambrides, Angelina; Delgado, Diana L; Sabat, Alberto M
Tetanus was a major cause of mortality in the free-ranging population of rhesus monkeys on Cayo Santiago prior to 1985 when the entire colony was given its first dose of tetanus toxoid. The immediate reduction in mortality that followed tetanus toxoid inoculation (TTI) has been documented, but the long-term demographic effects of eliminating tetanus infections have not. This study uses the Cayo Santiago demographic database to construct comparative life tables 12 years before, and 12 years after, TTI. Life tables and matrix projection models are used to test for differences in: (i) survival among all individuals as well as among social groups, (ii) long-term fitness of the population, (iii) age distribution, (iv) reproductive value, and (v) life expectancy. A retrospective life table response experiment (LTRE) was performed to determine which life cycle transition contributed most to observed changes in long-term fitness of the population post-TTI. Elimination of clinical tetanus infections through mass inoculation improved the health and well-being of the monkeys. It also profoundly affected the population by increasing survivorship and long-term fitness, decreasing the differences in survival rates among social groups, shifting the population's age distribution towards older individuals, and increasing reproductive value and life expectancy. These findings are significant because they demonstrate the long-term effects of eradicating a major cause of mortality at a single point in time on survival, reproduction, and overall demography of a naturalistic population of primates. © 2014 Wiley Periodicals, Inc.
Sharma, Rashmi K; Khosla, Nidhi; Tulsky, James A; Carrese, Joseph A
Although end-of-life care preferences vary across racial/ethnic groups, little is known about how cultural values affect end-of-life care preferences among South Asian immigrants and their offspring in the US. To examine the perspectives of first- and second-generation South Asians living in the US regarding end-of-life care. Focus group study. Discussions explored participant preferences and experiences with family members facing the end of life. Twelve first-generation and 11 second-generation self-identified Asian Indians living in the mid-Atlantic region. Content analysis of focus group transcripts. First-generation participants ranged in age from 41 to 76 years and were evenly split by gender. Second-generation participants ranged in age from 23 to 36 years and included seven women and four men. All participants were highly educated, and two thirds were either studying or working in a health care field. All but two subjects were Hindu. Several themes emerged that highlighted cultural differences and challenges for this population in the context of end-of-life care: attitudes toward death and suffering; family duty; and preferences for information disclosure and decision making. Participants described cultural challenges due to the evolution of traditional roles, lack of explicit discussion between patients and family members about preferences and care expectations, and a tension between wanting to meet traditional expectations and the challenges in doing so given US social realities. Traditional cultural values, such as duty to family, greatly influenced end-of-life care preferences and retained importance across generations. Clinicians caring for Asian Indian patients at the end of life may be better able to assess care preferences after exploring the complex interplay between traditional expectations and specific social realities for each patient. Particular attention should be given to attitudes toward death and suffering, family duty, and preferences for
Richard K. Payne
Full Text Available Explores the differences in self-representation as found in the autobiographical writings of Yogi Chen, Billy Graham, and the Dalai Lama. While the latter two are widely recognized in American popular religious culture, the former is virtually invisible outside the immigrant Chinese American community. This invisibility is consistent with fact that the religious praxes of immigrant communities remain largely under-studied. However, one additional factor appears to be the mismatch between the expectations of the dominant religious culture and the immigrant culture in terms of the ways in which religious leaders represent themselves. Both Billy Graham and the Dalai Lama present themselves in very humble terms, consistent with the expectations of the Pietist background to American popular religion. Yogi Chen on the contrary tends toward a self-aggrandizing style, which although consistent with the competitive nature of premodern Tibetan religious culture is not congruent with the expectations of American popular religion.
Full Text Available Against the background of raising the retirement age to 67 years and the associated lengthening of working lifetimes in higher age groups, this article examines the question of the extent to which this political objective is covered by the health assets of the population. Here, we will first trace trends in “healthy” life expectancy among the total population for different points in time 1989, 1999 and 2009 on the basis of the data from the Socio-Economic Panel Study (SOEP and analyse these against the background of social strata indicators such as income and educational levels. Among others, one significant result is the fact that social differences have a far greater effect on healthy life expectancy than on general life expectancy and that these differences increase further over the course of time. This effect can be found particularly in men. One mandatory uniform working lifetime for all persons would however not do justice to these findings of socially highly unequally distributed life opportunities. Instead, the findings support a flexible arrangement of retirement age limits.
Duggleby, Wendy; Doell, Heather; Cooper, Dan; Thomas, Roanne; Ghosh, Sunita
The quality of life of male spouses of partners with breast cancer may determine the support they are able to give their wives. Little is known about the factors associated with their quality of life. The purpose of this study was to examine the relationship of the quality of life of male spouses of partners with breast cancer with the following factors: (a) demographic variables of male spouses and their partners, (b) levels of hope of male spouses and their partners, (c) self-efficacy and loss and grief of male spouses, and (d) quality of life of partners with breast cancer. Six hundred surveys were mailed to women with breast cancer (stage 1-3) and their male spouses. A total of 110 surveys were completed. With the use of generalized linear modeling, participating male spouses with higher quality of life scores: (a) were older (P = .01), (b) had higher hope scores (P = .01), (c) had lower feelings of guilt scores (P life scores (P Hope, self-efficacy, feelings of guilt, age, and their partners' quality of life were significantly related to quality of life of the male spouses of women with breast cancer. The findings underscore the importance of assessing for and fostering hope and self-efficacy as well as decreasing guilt in male spouses of women with breast cancer to improve their quality of life.
Hart, Sybil L
In this synthesis, we summarize studies that yielded evidence of jealousy in young infants. To shed light on this phenomenon, we present evidence that jealousy's foundation rests on history of dyadic interactions with caregivers which engender infants' expectations of exclusivity, and on maturation of sociocognitive capacities that enable infants to evaluate whether an exchange between their caregiver and another child represents a violation of that expectation. We conclude with a call for greater study of the antecedents and sequelae of both normative and atypical presentations of jealousy. In addition, we recommend approaches that address jealousy across a range of relationships, both within and beyond those which include attachment figures.
Hart, Sybil L.
In this synthesis, we summarize studies that yielded evidence of jealousy in young infants. To shed light on this phenomenon, we present evidence that jealousy’s foundation rests on history of dyadic interactions with caregivers which engender infants’ expectations of exclusivity, and on maturation of sociocognitive capacities that enable infants to evaluate whether an exchange between their caregiver and another child represents a violation of that expectation. We conclude with a call for greater study of the antecedents and sequelae of both normative and atypical presentations of jealousy. In addition, we recommend approaches that address jealousy across a range of relationships, both within and beyond those which include attachment figures. PMID:28232851
Knape, Erin Oakley
National education data indicate that young men of color and students living in poverty are not experiencing the same academic success as their female, White, or higher socioeconomic status peers, as evidenced by low reading achievement levels and high dropout rates. Of particular concern is the underachievement of Latino males, who currently have…
Guillet, Emma; Sarrazin, Philippe; Fontayne, Paul; Brustad, Robert J.
An empirical research study based upon the expectancy-value model of Eccles and colleagues (1983) investigated the effect of gender-role orientations on psychological dimensions of female athletes' sport participation and the likelihood of their continued participation in a stereotypical masculine activity. The model (Eccles et al., 1983) posits…
Buijs, Jorie; Cahen, Djuna L.; van Heerde, Marianne J.; Rauws, Erik A.; de Buy Wenniger, Lucas J. Maillette; Hansen, Bettina E.; Biermann, Katharina; Verheij, Joanne; Vleggaar, Frank P.; Brink, Menno A.; Beuers, Ulrich H. W.; van Buuren, Henk R.; Bruno, Marco J.
To evaluate the long-term outcome of autoimmune pancreatitis. Patients with at least 2 years of follow-up were included. Information was collected regarding disease characteristics, treatment outcome, diagnosed malignancies, and mortality. In addition, pancreatic function and quality of life were
Using a panel dataset on 45 sub-Saharan Africa countries (SSA), this study analyzes empirically the socioeconomic determinants of life expectancy gain (considered as an indicator of global health improvement at country level). In order to treat heterogeneity and endogeneity concerns, we use multiple estimation methods including pooling, fixed-effect, long difference and system GMM. Our analyses show that income is critical for health enhancement. Particularly, we find that GDP per capita is s...
Taramasco, C; Figueroa, K; Lazo, Y; Demongeot, J
Background The 1000s of people who die from cancer each year have become one of the leading causes of death among the Chilean population, placing it as the second cause of death in the region of Valparaiso between 1997 and 2003. Statistics have provided different measures regarding the life expectancy of cancer patients which have resulted in being useful to establish courses of action for prevention and treatment plans to follow. Methods Data was extracted from the cancer module of the Epide...
Amir Hossein Hajiazizi
Conclusion Overall, based on the results of this research, group therapy was found to reduce death anxiety and life expectancy in elderly people living in boarding houses and subsequently, improve their mental health. Due to the special emphasis of logotherapy on the present and the meaning of suffering for the elderly, it is important to use it for promoting social well-being of older people.
Mayer, Boris; Schwarz, Beate; Trommsdorff, Gisela
How is adolescents’ willingness for intergenerational support affected by parents’ expectations and parenting behavior? Does youths’ willingness for intergenerational support in turn affect parents’ well-being? The current study addresses these questions from a cross-cultural perspective, using data from connected samples of mother-adolescent dyads (N = 4162) from 14 diverse cultural contexts as part of the “Value of Children and Intergenerational Relations Study” (Trommsdorff & Nauck, 2005)....
Kaplan, Robert M.; Anderson, John P.; Kaplan, Cameron M.
Purpose: To describe the development of a model for estimating the effects of tobacco use upon Quality Adjusted Life Years (QALYs) and to estimate the impact of tobacco use on health outcomes for the United States (US) population using the model. Method: We obtained estimates of tobacco consumption from 6 years of the National Health Interview…
In situations characterized by risk and uncertainty, people frequently base their decisions on beliefs concerning the likelihood of uncertain events. Such events can be as general as success in life or as specific as winning in a lottery, success in one's job or study, or even success with starting
Full Text Available The study analyses trends in life expectancy by level of education and by occupational social class in Finland from 1981 to 2000 to assess to what extent these trends have been in accordance with the target of reducing socioeconomic differences in life expectancy set in the Government public health programme. The study is based on the census records for the population aged 35 or over, which have been linked to the death records for the years 1981 to 2000. The results show that, contrary to the public health target, the difference in the life expectancy between persons with tertiary and basic education and that between upper non-manual and manual occupational classes increased during the 1990s. Differences in the trends in mortality from alcohol-related causes of death and from other cancers than lung cancer accounted for most the increase in the socioeconomic gap among men. Different from the 1980s changes in cardiovascular mortality did not contribute to the increase in the socioeconomic gap. Among women the increase in the socioeconomic gap was mainly due to the heterogeneous group of other diseases and cancers other than lung and breast cancer
Reynolds, Megan M
Growing research on the political economy of health has begun to emphasize sociopolitical influences on cross-national differences in population health above and beyond economic growth. While this research investigates the impact of overall public health spending as a share of GDP ("health care effort"), it has for the most part overlooked the distribution of health care spending across the public and private spheres ("public sector share"). I evaluate the relative contributions of health care effort, public sector share, and GDP to the large and growing disadvantage in U.S. life expectancy at birth relative to peer nations. I do so using fixed effects models with data from 16 wealthy democratic nations between 1960 and 2010. Results indicate that public sector share has a beneficial effect on longevity net of the effect of health care effort and that this effect is nonlinear, decreasing in magnitude as levels rise. Moreover, public sector share is a more powerful predictor of life expectancy at birth than GDP per capita. This study contributes to discussions around the political economy of health, the growth consensus, and the American lag in life expectancy. Policy implications vis-à-vis the U.S. Affordable Care Act are discussed.
Full Text Available Abstract Background Expectations held by patients and health professionals may affect treatment choices and participation (by both patients and health professionals in therapeutic interventions in contemporary patient-centered healthcare environments. If patients in rehabilitation settings overestimate their discharge health-related quality of life, they may become despondent as their progress falls short of their expectations. On the other hand, underestimating their discharge health-related quality of life may lead to a lack of motivation to participate in therapies if they do not perceive likely benefit. There is a scarcity of empirical evidence evaluating whether patients’ expectations of future health states are accurate. The purpose of this study is to evaluate the accuracy with which older patients admitted for subacute in-hospital rehabilitation can anticipate their discharge health-related quality of life. Methods A prospective longitudinal cohort investigation of agreement between patients’ anticipated discharge health-related quality of life (as reported on the EQ-5D instrument at admission to a rehabilitation unit and their actual self-reported health-related quality of life at the time of discharge from this unit was undertaken. The mini-mental state examination was used as an indicator of patients’ cognitive ability. Results Overall, 232(85% patients had all assessment data completed and were included in analysis. Kappa scores ranged from 0.42-0.68 across the five EQ-5D domains and two patient cognition groups. The percentage of exact correct matches within each domain ranged from 69% to 85% across domains and cognition groups. Overall 40% of participants in each cognition group correctly anticipated all of their self-reported discharge EQ-5D domain responses. Conclusions Patients admitted for subacute in-hospital rehabilitation were able to anticipate their discharge health-related quality of life on the EQ-5D instrument
Sundberg, Louise; Agahi, Neda; Fritzell, Johan; Fors, Stefan
To enhance the understanding of the current increase in life expectancy and decreasing gender gap in life expectancy. We obtained data on underlying cause of death from the National Board of Health and Welfare in Sweden for 1997 and 2014 and used Arriaga's method to decompose life expectancy by age group and 24 causes of death. Decreased mortality from ischemic heart disease had the largest impact on the increased life expectancy of both men and women and on the decreased gender gap in life expectancy. Increased mortality from Alzheimer's disease negatively influenced overall life expectancy, but because of higher female mortality, it also served to decrease the gender gap in life expectancy. The impact of other causes of death, particularly smoking-related causes, decreased in men but increased in women, also reducing the gap in life expectancy. This study shows that a focus on overall changes in life expectancies may hide important differences in age- and cause-specific mortality. It also emphasizes the importance of addressing modifiable lifestyle factors to reduce avoidable mortality.
Peters, Frederik; Nusselder, Wilma J; Reibling, Nadine; Wegner-Siegmundt, Christian; Mackenbach, Johan P
Since 2001 the Netherlands has shown a sharp upturn in life expectancy (LE) after a longer period of slower improvement. This study assessed whether changes in healthcare expenditure (HCE) explain this reversal in trends in LE. As an alternative explanation, the impact of changes in smoking behavior was also evaluated. To quantify the contribution of changes in HCE to changes in LE, we estimated a health-production function using a dynamic panel regression approach with data on 19 OECD countries (1980-2009), accounting for temporal and spatial correlation. Smoking-attributable mortality was estimated using the indirect Peto-Lopez method. As compared to 1990-1999, during 2000-2009 LE in the Netherlands increased by 1.8 years in females and by 1.5 years in males. Whereas changes in the impact of smoking between the two periods made almost no contribution to the acceleration of the increase in LE, changes in the trend of HCE added 0.9 years to the LE increase between 2000 and 2009. The exceptional reversal in the trend of LE and HCE was not found among the other OECD countries. This study suggests that changes in Dutch HCE, and not in smoking, made an important contribution to the reversal of the trend in LE; these findings support the view that investments in healthcare are increasingly important for further progress in life expectancy.
Payne, Collin F
To estimate and compare disability-free life expectancy (DFLE) and current age patterns of disability onset and recovery from disability between the United States and countries in Latin America and the Caribbean. Disability is measured using the activities of daily living scale. Data come from longitudinal surveys of older adult populations in Costa Rica, Mexico, Puerto Rico, and the United States. Age patterns of transitions in and out of disability are modeled with a discrete-time logistic hazard model, and a microsimulation approach is used to estimate DFLE. Overall life expectancy for women aged 65 is 20.11 years in Costa Rica, 19.2 years in Mexico, 20.4 years in Puerto Rico, and 20.5 years in the United States. For men, these figures are 19.0 years in Costa Rica, 18.4 years in Mexico, 18.1 years in Puerto Rico, and 18.1 years in the United States. Proportion of remaining life spent free of disability for women at age 65 is comparable between Mexico, Puerto Rico, and the United States, with Costa Rica trailing slightly. Male estimates of DFLE are similar across the four populations. Though the older adult population of Latin America and the Caribbean lived many years exposed to poor epidemiological and public health conditions, their functional health in later life is comparable with the older adult population of the United States. © The Author(s) 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: email@example.com.
Full Text Available The search for elixir of immortality has yielded mixed results. While some of the interventions like percutaneous coronary interventions and coronary artery bypass grafting have been a huge disappointment at least as far as prolongation of life is concerned, their absolute benefit is meager and that too in very sick patients. Cardiac specific drugs like statins and aspirin have fared slightly better, being useful in patients with manifest coronary artery disease, particularly in sicker populations although even their usefulness in primary prevention is rather low. The only strategies of proven benefit in primary/primordial prevention are pursuing a healthy life-style and its modification when appropriate, like cessation of smoking, weight reduction, increasing physical activity, eating a healthy diet and bringing blood pressure, serum cholesterol, and blood glucose under control.
Andreassen, Bettina K; Myklebust, Tor Å; Haug, Erik S
Reports from cancer registries often lack clinically relevant information, which would be useful in estimating the prognosis of individual patients with urothelial carcinoma of the urinary bladder (UCB). This article presents estimates of crude probabilities of death due to UCB and the expected loss of lifetime stratified for patient characteristics. In Norway, 10,332 patients were diagnosed with UCB between 2001 and 2010. The crude probabilities of death due to UCB were estimated, stratified by gender, age and T stage, using flexible parametric survival models. Based on these models, the loss in expectation of lifetime due to UCB was also estimated for the different strata. There is large variation in the estimated crude probabilities of death due to UCB (from 0.03 to 0.76 within 10 years since diagnosis) depending on age, gender and T stage. Furthermore, the expected loss of life expectancy is more than a decade for younger patients with muscle-invasive UCB and between a few months and 5 years for nonmuscle-invasive UCB. The suggested framework leads to clinically relevant prognostic risk estimates for individual patients diagnosed with UCB and the consequence in terms of loss of lifetime expectation. The published probability tables can be used in clinical praxis for risk communication.
Hatice Imer Aras
Full Text Available Objective. To assess the quality of life (QoL in an outpatient setting among male patients dually diagnosed with schizophrenia and substance use disorder (SUD, and non-substance-using male schizophrenia patients. Methods. The study was conducted in an outpatient setting with 52 male schizophrenia patients and 49 male schizophrenia patients with SUD comorbidity, who were admitted to Bakirköy Research and Training Hospital between 1 May 2010 and 30 September 2010. The patients had been in remission for a minimum of 6 months. The subjects were re-evaluated for the persistence of the diagnosis by using the Structural Clinical Interview for DSM-IV Axis I disorders (SCID I socio-demographic data form, and the World Health Organization Quality of Life Scale Brief Version (WHOQOL-BREF and positive and negative syndrome scale (PANSS were administered to detect the factors affecting diagnostic stability and clinical course. Results. Schizophrenia patients with no SUD comorbidity had a significantly earlier age of disease onset than the comorbid group. SUD comorbidity in schizophrenia patients leads to increased rates of unemployment and homicidality. WHOQOL-Bref psychological health scores were significantly lower among patients in the comorbidity group. No statistically significant difference was identified between the groups with regard to the PANSS scores. Conclusions. It is necessary to focus on the treatment challenges for schizophrenia patients with SUD comorbidity, such as the provision of treatment in criminal justice settings, in which a high proportion of such patients are found.
Peter, C P; Perkins, E H; Peterson, W J; Walburg, H E; Makinodan, T
The effect of various immunosuppressive treatments on mean life-span and disease incidence have been studied. Significant life shortening was seen only in mice which received X-irradiation early in life and can be ascribed primarily to an increased incidence of certain malignancies. Marginal life shortening was seen in cyclophosphamide-treated animals, however, survival patterns between those and control animals did not differ until 30 months of age and the magnitude of life-shortening never approached that seen in X-irradiated animals. Thymectomy, splenectomy or cortisone treatment did not alter survival. All immunosuppressive treatments enhanced mortality due to non-neoplastic diseases, however, only a small percentage of animals die with these disease entities. With the exception of cortisone all immunosuppressive treatments increased the incidence of neoplastic disease. However, their effects on various neoplastic processes were variable and unpredictable. Four primary patterns in terms of relative immune competence, disease incidence and life expectancy were seen. Thus, immunodepression may or may not correlate with increased disease incidence, which in turn may or may not have a life-shortening effect. These findings are discussed in terms of the marked reduction of both humoral and cell-mediated immunity normally seen in aged mice and the significance of postulated immune surveillance mechanisms to survival.
A model of crack initiation and residual component life is fitted to the inspection history, inclusive of two in-service failures, of a set of gas circulator impellers at two UK power stations. The model is then used to estimate the probability of future in-service failure of each item in scenarios in which the next opportunity for inspection (i.e. detection of a developing crack) is exploited or forgone. The study takes into account in exact manner both variability and uncertainty. A novel Approximate Bayesian Computation (ABC) methodology is introduced for the quantification of uncertainty, i.e. the sampling of the posterior distribution of the parameters of the model. At the price of the discretization of this distribution, the methodology represents a quickly implemented option in problems where standard ABC rejection sampling is unacceptably inefficient. - Highlights: • A model of crack initiation and residual component life is introduced. • The model is fitted to the inspection log of a set of gas circulator impellers. • The odds of future failure are computed under different inspection schedules. • This prediction informs the choice to perform or forgo future inspection. • A novel Approximate Bayesian Computation algorithm is introduced and validated.
Babayan, Simon A; Read, Andrew F; Lawrence, Rachel A; Bain, Odile; Allen, Judith E
Humans and other mammals mount vigorous immune assaults against helminth parasites, yet there are intriguing reports that the immune response can enhance rather than impair parasite development. It has been hypothesized that helminths, like many free-living organisms, should optimize their development and reproduction in response to cues predicting future life expectancy. However, immune-dependent development by helminth parasites has so far eluded such evolutionary explanation. By manipulating various arms of the immune response of experimental hosts, we show that filarial nematodes, the parasites responsible for debilitating diseases in humans like river blindness and elephantiasis, accelerate their development in response to the IL-5 driven eosinophilia they encounter when infecting a host. Consequently they produce microfilariae, their transmission stages, earlier and in greater numbers. Eosinophilia is a primary host determinant of filarial life expectancy, operating both at larval and at late adult stages in anatomically and temporally separate locations, and is implicated in vaccine-mediated protection. Filarial nematodes are therefore able to adjust their reproductive schedules in response to an environmental predictor of their probability of survival, as proposed by evolutionary theory, thereby mitigating the effects of the immune attack to which helminths are most susceptible. Enhancing protective immunity against filarial nematodes, for example through vaccination, may be less effective at reducing transmission than would be expected and may, at worst, lead to increased transmission and, hence, pathology.
Simon A Babayan
Full Text Available Humans and other mammals mount vigorous immune assaults against helminth parasites, yet there are intriguing reports that the immune response can enhance rather than impair parasite development. It has been hypothesized that helminths, like many free-living organisms, should optimize their development and reproduction in response to cues predicting future life expectancy. However, immune-dependent development by helminth parasites has so far eluded such evolutionary explanation. By manipulating various arms of the immune response of experimental hosts, we show that filarial nematodes, the parasites responsible for debilitating diseases in humans like river blindness and elephantiasis, accelerate their development in response to the IL-5 driven eosinophilia they encounter when infecting a host. Consequently they produce microfilariae, their transmission stages, earlier and in greater numbers. Eosinophilia is a primary host determinant of filarial life expectancy, operating both at larval and at late adult stages in anatomically and temporally separate locations, and is implicated in vaccine-mediated protection. Filarial nematodes are therefore able to adjust their reproductive schedules in response to an environmental predictor of their probability of survival, as proposed by evolutionary theory, thereby mitigating the effects of the immune attack to which helminths are most susceptible. Enhancing protective immunity against filarial nematodes, for example through vaccination, may be less effective at reducing transmission than would be expected and may, at worst, lead to increased transmission and, hence, pathology.
Lee, Grace P; Storr, Carla L; Ialongo, Nicholas S; Martins, Silvia S
Adverse life events have been associated with gambling and substance use as they can serve as forms of escapism. Involvement in gambling and substance use can also place individuals in adversely stressful situations. To explore potential male-female differences in the association between addictive behavior and adverse life events among an urban cohort of adolescents. The study sample comprised of 515 adolescent participants in a randomized prevention trial. With self-reported data, four addictive behavior groups were created: nonsubstance users and nongamblers, substance users only, gamblers only, and substance users and gamblers. Multinomial logistic regression analyses with interaction terms of sex and adverse life events were conducted. Adverse life events and engaging in at least one addictive behavior were common for both sexes. Substance users and gamblers had more than twice the likelihood of nonsubstance users and nongamblers to experience any event as well as events of various domains (ie, relationship, violence, and instability). Neither relationship nor instability events' associations with the co-occurrence of substance use and gambling significantly differed between sexes. Conversely, females exposed to violence events were significantly more likely than similarly exposed males to report the co-occurrence of substance use and gambling. Findings from the current study prompt future studies to devote more attention to the development of effective programs that teach adaptive coping strategies to adolescents, particularly to females upon exposure to violence. Copyright © American Academy of Addiction Psychiatry.
People are interested in the aging phenomenon and hope that scientists are doing as much as they can to solve the mysteries of aging. However, this is not the case. A lot of knowledge is produced for local interests in curing specific disorders; aging is studied much less. Today's economy is undergoing a transition to a knowledge-based economy. Knowledge of aging should be integrated into the economies of contemporary societies. Aging research and intervention can ensure better health, primarily among middle-aged and older people, and prolong life. There are many reasons why postponing aging and rejuvenation research is not as widespread as it should be. Developed countries should create economic stimuli for such studies and intervention.
Montaño, Daniel E; Tshimanga, Mufuta; Hamilton, Deven T; Gorn, Gerald; Kasprzyk, Danuta
Slow adult male circumcision uptake is one factor leading some to recommend increased priority for infant male circumcision (IMC) in sub-Saharan African countries. This research, guided by the integrated behavioral model (IBM), was carried out to identify key beliefs that best explain Zimbabwean parents' motivation to have their infant sons circumcised. A quantitative survey, designed from qualitative elicitation study results, was administered to independent representative samples of 800 expectant mothers and 795 expectant fathers in two urban and two rural areas in Zimbabwe. Multiple regression analyses found IMC motivation among fathers was explained by instrumental attitude, descriptive norm and self-efficacy; while motivation among mothers was explained by instrumental attitude, injunctive norm, descriptive norm, self-efficacy, and perceived control. Regression analyses of beliefs underlying IBM constructs found some overlap but many differences in key beliefs explaining IMC motivation among mothers and fathers. We found differences in key beliefs among urban and rural parents. Urban fathers' IMC motivation was explained best by behavioral beliefs, while rural fathers' motivation was explained by both behavioral and efficacy beliefs. Urban mothers' IMC motivation was explained primarily by behavioral and normative beliefs, while rural mothers' motivation was explained mostly by behavioral beliefs. The key beliefs we identified should serve as targets for developing messages to improve demand and maximize parent uptake as IMC programs are rolled out. These targets need to be different among urban and rural expectant mothers and fathers.
T. F. V. Bompadre
Full Text Available Little is known about the gender differences in energetic requirements of goats in early life. In this study, we determined the energy requirements for maintenance and gain in intact male, castrated male and female Saanen goat kids using the comparative slaughter technique and provide new data on their body composition and energy efficiency. To determine the energy requirements for maintenance, we studied 21 intact males, 15 castrated males and 18 females (5.0±0.1 kg initial body weight (BW and 23±5 d of age using a split-plot design with the following main factors: three genders (intact males, castrated males, and females and three dry matter intake levels (ad libitum, 75% and 50% of ad libitum intake. A slaughter group included three kids, one for each nutritional plane, of each gender, and all three animals within a group were slaughtered when the ad libitum kid reached 15 kg in BW. Net energy requirements for gain were obtained for 17 intact males, eight castrated males and 15 females (5.1±0.4 kg BW and 23±13 d of age. Animals were fed ad libitum and slaughtered when they reached 5, 10, and 15 kg in BW. A digestion trial was performed with nine kids of each gender to determine digestible energy, metabolizable energy and energy metabolizability of the diet. Our results show no effect of gender on the energy requirements for maintenance and gain, and overall net energy for maintenance was 205.6 kJ/kg0.75 empty body weight gain (EBW (170.3 kJ/kg0.75 BW from 5 to 15 kg BW. Metabolizable energy for maintenance was calculated by iteration, assuming heat production equal to metabolizable energy intake at maintenance, and the result was 294.34 kJ/kg0.75 EBW and km of 0.70. As BW increased from 5 to 15 kg for all genders, the net energy required for gain increased from 9.5 to 12.0 kJ/g EBW gain (EWG, and assuming kg = 0.47, metabolizable energy for gain ranged from 20.2 to 25.5 kJ/g EWG. Our results indicate that it is not necessary to formulate
N P Narbut
Full Text Available This article is a logical second part of the sociological evaluation of the students’ value orientations and fears the first results of which were published in 2013 (1. Within the framework of an empirical research in the form of a survey on a sample of students at the Peoples’ Friendship University of Russia, we suggested a format for operationalization of value issues in the professional field by ‘measuring’ the student youth expectations and concerns. The results of the survey showed, in particular, that the students’ worldview seamlessly combines quite diverse considerations: prestige-image orientation and substantive arguments while choosing a specialty and educational institution; pragmatic and idealistic assessments of their own skills; adequate perception of the situation on the labor market and commitment to the ideals of personal achievements in the spirit of the ‘American Dream’; focus on learning, understanding the need of experience and confidence that even without any professional experience they can easily and quickly find a job; fears of a professional failure, loneliness and poverty and the belief that their personal qualities do guarantee them from becoming losers.
Full Text Available The ex-post retrospective analysis of the health care reform in Latvia has been performed by several authors; therefore in writing this paper, the author also considered it essential to try and predict its future prospects, specifically, to carry out an ex-ante analysis of reimbursement arrangements for medicines and medical devices in outpatient treatment (“reimbursement arrangements”. An ex-antepolicy impact analysis takes place at the beginning of the policy development process when policy planners and experts try to project, by means of various quantitative and qualitative methods, the various kinds of consequences that the society will face as a result of implementation of the policy. Taking into account the circumstances of limited state budget resources for the medicines reimbursement arrangements in Latvia, the aim of this research is to evaluate by the experts’ method the impact of the reimbursed diseases on the life expectancy, the ability to work, and the quality of life, to identify the priorities. According to the experts’ judgments the group of diagnoses “Neoplasms” gives the greatest common impact on the life expectancy, the ability to work, and quality of life, followed by the “Diseases of the circulatory system” and “Diseases of the blood and blood forming organs and certain disorders involving the immune mechanisms”.
Tod, D; Edwards, C
The purpose of this study was to examine relationships among bodybuilding dependence, muscle satisfaction, body image-related quality of life and body image-related coping strategies, and test the hypothesis that muscle dysmorphia characteristics may predict quality of life via coping strategies. Participants (294 males, Mage=20.5 years, SD=3.1) participated in a cross-sectional survey. Participants completed questionnaires assessing muscle satisfaction, bodybuilding dependence, body image-related quality of life and body image-related coping. Quality of life was correlated positively with muscle satisfaction and bodybuilding dependence but negatively with body image coping (P<0.05). Body image coping was correlated positively with bodybuilding dependence and negatively with muscle satisfaction (P<0.05). Mediation analysis found that bodybuilding dependence and muscle satisfaction predicted quality of life both directly and indirectly via body image coping strategies (as evidenced by the bias corrected and accelerated bootstrapped confidence intervals). These results provide preliminary evidence regarding the ways that muscularity concerns might influence body image-related quality of life. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Raab, Phillip A; Mackintosh, Margaret-Anne; Gros, Daniel F; Morland, Leslie A
For Veterans with posttraumatic stress disorder (PTSD), depression is a highly comorbid condition. Both conditions have been associated with decreased quality of life, and research suggests that comorbid PTSD and depression may result in worse quality of life than PTSD alone. However, research is needed to elucidate the effect of comorbidity on a broader variety of quality of life domains. In this study, we used baseline data of 158 male combat Veterans taking part in a PTSD treatment trial and examined the unique relationships between quality of life domains and PTSD symptom clusters, major depressive disorder (MDD) diagnosis, and self-reported depressive symptoms. Veterans with comorbid PTSD-MDD reported significantly worse satisfaction-related quality of life than those with PTSD alone, although this finding was largely attributable to PTSD numbing symptoms. Subsequent analyses comparing the effect of numbing symptoms to depressive symptoms revealed that depression exerted a stronger influence, although numbing symptoms were still uniquely associated with quality of life. We discuss implications for treatment and research, as well as the need to address negative affect in Veterans with PTSD.
Full Text Available Abstract Background Hitherto, a population-based analysis of the cause of death in urban areas of Western China has not been undertaken over an extended period. The aims of this study were to calculate the overall and annual cause-specific mortality rates by age and sex in urban areas of Western China from 2003 to 2012 and to evaluate the quality of the data. Methods We used Excel software, cause-of-death registrations, and International Classification of Diseases, 10th revision, codes to calculate the overall and yearly cause-specific crude mortality rates by age and sex, the Chinese age-standardized mortality rate, and life expectancies. Results In the Jiulongpo District from 2003 to 2012, there was an increase in the number of death case reports in the census-registered population, a decrease in the number of omitted deaths, and rise in the crude mortality rate. Except for 2003, the Chinese age-standardized mortality rate was the lowest in 2012 (330.83/100,000 and highest in 2005 (390.08/100,000. Life expectancy increased from 78.36 years in 2005 to 81.67 years in 2012. Conclusions With the development of its social economy, the Chinese government and public attach greater importance to cause-of-death surveillance. The quality of cause-of-death registrations has gradually increased, crude mortality rates have risen, the Chinese age-standardized mortality rate has fallen, and life expectancies have increased.
Rasmussen, Susanne R; Thomsen, Janus Laust; Kilsmark, Janni
AIMS: The intention was to investigate whether preventive health checks and health discussions are cost effective. METHODS: In a randomized trial the authors compared two intervention groups (A and B) and one control group. In 1991 2,000 30- to 49-year-old persons were invited and those who...... were given fixed appointments for health consultations. The follow-up period was six years. Analysis was carried out on the "intention to treat" principle. Outcome parameters were life years gained, and direct and total health costs (including productivity costs), discounted by 3% annually. Costs were...... in average direct (3,255 euro (3,703 euro) versus 4,186 euro) and total costs (10,409 euro (9,399 euro) versus 10,667 euro). The effect in group B is, however, better than in group A with no significant differences in costs. The results are insensitive to a range of assumptions regarding costs, effects...
Atherton, D.R.; Stevens, W.; Bruenger, F.W.; Woodbury, L.; Stover, B.J.; Smith, J.M.; Wrenn, M.E.
In the internal-emitters toxicity program at the University of Utah Radiobiology Laboratory, each experimental group carries its own specific control cohort, which is the same size as most of the individual experimental cohorts. Variations in average lifetime are observed among individual control cohorts. This may be due to external causes, genetic variances such as the occurrence of epileptic syndromes, or changes such as those that result from improved medical core or husbandry. The Stover-Eyring method was used to eliminate from control and experimental cohorts those dogs with specific diseases such as epilepsy - dogs that were at risk for too short a time for a later pathological response to occur. By the use of conventional statistical techniques, it ws shown to be reasonable to pool individual control cohorts into a much larger selected cohort that provided greater precision in the estimate of control survival and thus a more sensitive basis for the estimation of the relative life shortening in the experimental groups. The analysis suggested that control groups could be combined, and a control population of 114 beagles was proposed. Their average lifespan was 4926 +- 849 days, and the time when half the animals had died was 5000 days. 3 refs., 2 figs., 5 tabs
Streppel, Martinette T; Boshuizen, Hendriek C; Ocké, Marga C; Kok, Frans J; Kromhout, Daan
Study objective: To study the effect of long-term smoking on all-cause and cause-specific mortality, and to estimate the effects of cigarette and cigar or pipe smoking on life expectancy. Design: A long-term prospective cohort study. Setting: Zutphen, The Netherlands. Participants: 1373 men from the Zutphen Study, born between 1900 and 1920 and studied between 1960 and 2000. Measurements: Hazard ratios for the type of smoking, amount and duration of cigarette smoking, obtained from a time-dep...
Full Text Available The current paper aimed to investigate the effectiveness of psychodrama therapy in the improvement of the quality of life(QOL for opiate-dependent male patients. It was aquasi-experimental research study, using pre-and posttesting plan with a control group. A total of 30 individuals were selected among male clients with opiate dependence, who were referred to addiction treatment clinics in Kermanshah (Iran and successfully passed the detoxification programs, by a convenience sampling technique. The subjects were randomly placed into two experimental and control groups. The experimental group participated in a twelve-session psychodrama therapy plan for 6 weeks, while the control group received no intervention. In order to collect data, the SF-36 questionnaire was applied. Data analysis was performed by analysis of covariance (ANCOVA. The ANCOVA results revealed that there is a significant difference between two groups in the post-test stage. As seen from the findings, the psychodrama intervention can be used as an effective modality to enhance the quality of life among male patients with opiate dependence.
Full Text Available Introduction: Few studies have evaluated the impact of depression in terms of losses to both premature mortality and health-related quality of life (HRQOL on the overall population. Health-adjusted life expectancy (HALE is a summary measure of population health that combines both morbidity and mortality into a single summary statistic that describes the current health status of a population. Methods: We estimated HALE for the Canadian adult population according to depression status. National Population Health Survey (NPHS participants 20 years and older (n = 12 373 were followed for mortality outcomes from 1994 to 2009, based on depression status. Depression was defined as having likely experienced a major depressive episode in the previous year as measured by the Composite International Diagnostic Interview Short Form. Life expectancy was estimated by building period abridged life tables by sex and depression status using the relative risks of mortality from the NPHS and mortality data from the Canadian Chronic Disease Surveillance System (2007-2009. The Canadian Community Health Survey (2009/10 provided estimates of depression prevalence and Health Utilities Index as a measure of HRQOL. Using the combined mortality, depression prevalence and HRQOL estimates, HALE was estimated for the adult population according to depression status and by sex. Results: For the population of women with a recent major depressive episode, HALE at 20 years of age was 42.0 years (95% CI: 40.2-43.8 compared to 57.0 years (95% CI: 56.8-57.2 for women without a recent major depressive episode. For the population of Canadian men, HALE at 20 was 39.0 years (95% CI: 36.5-41.5 for those with a recent major depressive episode compared to 53.8 years (95% CI: 53.6-54.0 for those without. For the 15.0-year difference in HALE between women with and without depression, 12.3 years can be attributed to the HRQOL gap and the remaining 2.7 years to the mortality gap. The 14.8 fewer
Full Text Available Background: Excess body weight has become a major public health problem worldwide, and the burden of overweight and obesity was calculated in this work from a health economics perspective. Objective: To estimate the burden of disease attributable to overweight and obesity among males and females aged 20 years and older using years of life lost (YLL and age-standardized YLL rates (ASYLL, and to rank the leading causes of premature death. Design: A cross-sectional study took place (2010–2014 and 6,054 deaths were analyzed. Thirteen basic causes of death associated with overweight or obesity were included. The population attributable fraction (PAF, YLL, and ASYLL were calculated. Results: The overall burden attributable to overweight and obesity was 36,087 YLL, and the estimated ASYLL per 10,000 persons was 1,098 and 1,029 in males and females, respectively. Type 2 diabetes mellitus was the main cause of premature death (males, 968 ASYLL; females, 772 ASYLL. Conclusions: Overweight and obesity are major risk factors of chronic diseases that are main causes of premature death in the study population. Strategies for preventing overweight and obesity may decrease the incidence and mortality associated with these non-communicable diseases. ASYLL seems to be an indicator that is particularly well adapted to decision-making in public health.
Lorusso, Domenica; Bria, Emilio; Costantini, Anna; Di Maio, Massimo; Rosti, Giovanni; Mancuso, Annamaria
Chemotherapy side effects (CSE) have a strong impact on patients' quality of life (QOL). To assess patient perceptions of CSE, their impact on QOL and doctor-patient communication regarding these aspects, a survey was conducted among Italian cancer patients. Patients at least 18 years of age, who received chemotherapy, were administered a dedicated questionnaire to assess their point of view on five domains: expectations about CSE and impact on QOL; doctor-patient communication about CSE; treatments to reduce the impact of CSE; sexual life; family relationships/activities and employment. A total of 761 patients participated. CSE had a considerable impact on patient QOL. Nausea/vomiting was the most feared adverse effect before initiating chemotherapy and the one most commonly experienced during treatment. Patients generally reported good doctor-patient communication regarding information about CSE. In almost all cases, the oncologists prescribed an antiemetic treatment, but the incidence of nausea/vomiting was high. Cancer and CSE severely affected sexual life, daily activities and employment. CSE had a strong negative impact on QOL. Good doctor-patient communication is essential. Improving antiemetic strategies may improve QOL. Doctors' ability to inform patients about delicate issues, such as the impact of CSE on sexual life, needs to be improved. © 2016 John Wiley & Sons Ltd.
Lou, Jiunn-Horng; Chen, Sheng-Hwang; Yu, Hsing-Yi; Li, Ren-Hau; Yang, Cheng-I; Eng, Cheng-Joo
Understanding how male nursing students alleviate life stress during their academic career is conducive to their development as successful nursing professionals. This study was designed to understand the personality traits, social support, and life stresses of male nursing students. The respective influences of personality traits and social support on life stress were also explored. The study used a cross-sectional research design. A college in central Taiwan was targeted as the site for data collection. A total of 158 questionnaires were dispatched, with 145 valid copies returned (valid response rate = 91.7%). Structured questionnaires were designed to collect data on participant demographics, personality traits, social support, and life stress. Statistical methods such as descriptive statistics, one-way analysis of variance, and multiple regression analysis were applied to data analysis. Major findings of this study revealed that (a) in general, the personality traits, social support, and life stress of male nursing students scored in the medium to high range. Participants reported encountering more stress from learning and life goals than from interpersonal stress. (b) Male nursing student demographic variables (e.g., parent [father and mother considered separately] education level) and the personality traits of conscientiousness and family support, respectively, were found to impact significantly on participant life stress perceptions. And (c) the only significant predictors of life stress were support from family and education level of participant fathers and mothers, accounting for about 23.7% of variability. It is suggested that nursing students in each year of their academic career should be exposed to courses geared to reduce the life stress perceptions (especially in the areas of learning and career development) of male nursing students. Increased family support is an effective way to decrease male nursing student life stress. This study could be a
Zhang, Lu-Yao; He, Wei; Wan, Jian-Xin; Yin, Qi-Qi; Cheng, Zhen; Chen, Guan-Ming; Ji, Wen; Li, Hai; Li, Yan-Bing; Liao, Zhi-Hong
To compare the level of testosterone between type-2 diabetes mellitus (T2DM) patients and healthy controls and to investigate the status of hypogonadism and the influence of hypopgonadism on the quality of life. We collected serum total testosterone (TT), free testosterone (FT), sex hormone-binding globulin (SHBG), and other clinical data from 166 T2DM patients aged over 30 years and 186 age-matched healthy controls. We investigated the quality of life (QoL) of the two groups of subjects using the questionnaires of Androgen Deficiency in Aging Males (ADAM), Aging Male Symptoms (AMS), 36-Item Short-Form Health Survey (SF-36), and Special Quality of Life for Diabetes Mellitus (DSQL). The level of calculated FT (cFT) was remarkably lower in the T2DM patients than in the healthy controls (Pmales with hypogonadism showed significant differences from those without in age, height, systolic blood pressure, and creatinine (Phypogonadism was 51.81% in the T2DM patients, 31.58% in the 30－39 yr group, 32.50% in the 40－49 yr group, 50% in the 50－59 yr group, 69.23% in the 60－69 yr group, and 77.27% in the ≥70 yr group, elevated by 77.4% with the increase of 10 years of age (OR = 1.774, Phypogonadism. Age is a main risk factor of hypogonadism. Severer testosterone deficiency symptoms are associated with lower scores of QoL in T2DM males.
Al-Turki, Yousef Abdullah
The present study highlighted life styles related to coronary artery disease risk factors among patients attending a primary care clinic at King Khalid University Hospital, in Riyadh, Saudi Arabia. We conducted a cross-sectional study at a primary care clinic at King Khalid University Hospital, Riyadh, Saudi Arabia, during the period from 18/4/2006 to 13/6/2006. All adult male patients older than 12 years of age who attended one consultant primary care clinic were included in the study. All patients were interviewed by one consultant in family medicine during the study period. The patients were asked about dietary habits, physical activity and type of exercise, and smoking habits. Weight and height was taken for all patients by the nurse in the clinic and body mass index (BMI) were calculated for all patients. The total number of participants was 246 patients. The data were analyzed using the Statistical Package of Social Science (SPSS) version 11.5. A p value of less than 0.05 was considered statistically significant. Of the 246 male adult patients, 45.4% always consumed vegetables and fruits in their diet, 21.5% exercised on a daily basis, 51.2% exercised sometimes and 26% did not exercise at all. The type of exercise practiced by active participants was walking (76.5%) and sports (22.9%). Sports included football, basketball, swimming and other sports club activity. Only 20.7% of the participants had an ideal body weight (BMI =30). 8.9% of the participants were current smokers. Overweight and obesity is a common health problem among male adult patients attending a primary care setting. Improved dietary habits (consumption of vegetables and fruits and minimization of fat and suits) encouraging exercise and walking and helping current smokers to quit smoking are essential steps towards improving life styles in the community. It is an important health plan priority to concentrate on improving life styles in the Saudi community, to prevent cardiovascular risk
Hematti, Simin; Baradaran-Ghahfarokhi, Milad; Khajooei-Fard, Rasha; Mohammadi-Bertiani, Zohreh
Spiritual well-being in patients with an advanced cancer has been found to positively correlate with subjective well-being, lower pain levels, hope and positive mood states, high self-esteem, social competence, purpose in life, and overall quality of life. In this regard, Quran recitation is stated to be an efficient way to increase patient spirituality and also to handle life's everyday challenges. The aim of this study was to investigate the effects of listening, reading, and watching the text of the Holy Quran, called (in this study) Quran recitation, for increasing life expectancy (LE) in palliative radiotherapy patients admitted to Radiotherapy Department of Seyed alshohada Hospital, Isfahan, Iran. A questionnaire-based study was carried out on a total of 89 palliative radiotherapy patients between March 2012 and June 2012. Informed consent was obtained. The patients were requested to complete a standardized questionnaire which was designed based on the European Organization for Research and Treatment of Cancer C30 Scale Quality of Life Questionnaire (EORTC C30 Scale QLQ). A computer program (SPSS version 16.0, Chicago, IL, USA) was used, and data were analyzed by the Wilcoxon test and Spearman's rank correlation. All hypotheses were tested using a criterion level of P = 0.05. There was a significant difference for frequency and duration of Quran recitation among patients, before and after the diagnosis of their cancer (P = 0.03). Using the Spearman's rank correlation, it was found that there was a correlation between Quran recitation and subjective well-being (r = 0.352, P Quran recitation and increasing LE (r = 0.311, P Quran are useful for increasing LE in palliative radiotherapy patients admitted to Radiotherapy Department. In other words, a benefit of Quran recitation on outcome of radiotherapy for palliative radiotherapy patients was found.
Böhning, Dankmar; Karasek, Sarah; Terschüren, Claudia; Annuß, Rolf; Fehr, Rainer
Life expectancy is of increasing prime interest for a variety of reasons. In many countries, life expectancy is growing linearly, without any indication of reaching a limit. The state of North Rhine-Westphalia (NRW) in Germany with its 54 districts is considered here where the above mentioned growth in life expectancy is occurring as well. However, there is also empirical evidence that life expectancy is not growing linearly at the same level for different regions. To explore this situation further a likelihood-based cluster analysis is suggested and performed. The modelling uses a nonparametric mixture approach for the latent random effect. Maximum likelihood estimates are determined by means of the EM algorithm and the number of components in the mixture model are found on the basis of the Bayesian Information Criterion. Regions are classified into the mixture components (clusters) using the maximum posterior allocation rule. For the data analyzed here, 7 components are found with a spatial concentration of lower life expectancy levels in a centre of NRW, formerly an enormous conglomerate of heavy industry, still the most densely populated area with Gelsenkirchen having the lowest level of life expectancy growth for both genders. The paper offers some explanations for this fact including demographic and socio-economic sources. This case study shows that life expectancy growth is widely linear, but it might occur on different levels.
Santosa, Ailiana; Schröders, Julia; Vaezghasemi, Masoud; Ng, Nawi
It is unclear whether the increase in life expectancy (LE) globally is coupled with a postponement of morbidity and disability. Evidence on trends and determinants of disability-free life expectancies (DFLEs) are available in high-income countries but less in low and middle-income countries (LMICs). This study examines the levels of and inequalities in LE, disability and DFLE between men and women across different age groups aged 50 years and over in six countries with developing economies. This study utilised the cross-sectional data (n=32 724) from the WHO Study on global AGEing and adult health (SAGE) in China, Ghana, India, Mexico, the Russian Federation and South Africa in 2007-2010. Disability was measured with the activity of daily living (ADL) instrument. The DFLE was estimated using the Sullivan method based on the standard period life table and ADL-disability proportions. The disability prevalence ranged from 13% in China to 54% in India. The prevalence of disability was highest and occurred at younger age in both sexes in India. Women were more disadvantaged with higher prevalence of disability across all age groups, and the situation was worst among older women in Mexico and the Russian Federation. Though women had higher LE, their proportion of remaining LE free from disability was lower than men. There are inequalities in the levels of disability and DFLE among men and women in different age groups among people aged over 50 years in these six countries. Countermeasures to decrease intercountry and gender gaps in DFLE, including improvements in health promotion and healthcare distribution, with a gender equity focus, are needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Won, Sung-Doo; Kim, Im-Yel
Alcohol use disorder (AUD) has been conceptualized as a chronic self-regulation failure. The aim of this study was to examine the most probable pathways related to self-regulation among patients with AUD. In this study, a hypothetical model was proposed that focused on the relationship between risk factors (extrinsic life goals, emotion dysregulation) and protective factors (intrinsic life goals, self-control, and abstinence self-efficacy). Male patients with AUD (N = 188) were recruited from alcohol centers of four psychiatric hospitals between March 2015 and September 2015. All participants completed psychological assessments, including the Future Oriented Goals Scale (FOGS), the Alcohol Abstinence Self-Efficacy Scale (AASE), the Brief Self-Control Scale (BSCS), and the Difficulties in Emotion Regulation Scale (DERS) as well as sociodemographic characteristics. The final model was found to be a good fit to data. In testing indirect effects, it was shown that intrinsic life goals via emotion dysregulation, self-control, and alcohol abstinence self-efficacy decreased alcohol self-regulation failure. On the other hand, extrinsic life goals via these factors increased alcohol self-regulation failure. Conclusions/Importance: These results suggest that intrinsic goals might indirectly be the important and protective factors for AUD. Moreover, the findings implicate that self-regulation through goal setting may be necessary to alleviate symptoms and improve function among patients with AUD.
Wei, Jinling; Zhou, Haiyan; Meng, Jun; Zhang, Fan; Chen, Yunmo; Zhou, Su
In self-organized systems such as Conway’s Game of Life (CGL). Wikipedia, Conway’s game of the life, (https://en.wikipedia.org/wiki/Conway%27s-Game-of-Life)., though whether the single cell will survive or die seems unpredictable, the log–log distribution of all cells living frequency satisfies the 1/f linear law, thus meets the Self-organized Criticality(SOC) rule, which not only proves that CGL is a self-organized system, but more significantly, that the chance of living for each cell is spatial heterogeneous, and is statistical fractal. After carried out CGL, the specified iterative period which begins with a random initial condition and ends when it reaches the homeostasis, add up all the states which the living cells are marked by 1s, and the dead are marked by 0s. The resulted sum picture consisting of cells having its gray level representing the living times during the iterative process. By plotting the gray level distribution of the sum picture on log–log scale, the graph indicates the spatial living expectations distributions. Then we find the curve of the graph satisfies the Self-organized Criticality(SOC) rule, showing its linear feature in the intermediate zone, which also has name of 1/f feature. To examine its universality, we designed a more complicated self-organized cellular automata with each cell having five possible states thus the rule table becomes more complicated. As expected, the consequence shows the similar feature, and the linear feature is even more obvious when the similar experiments are carried out. To conclude, it is a new discovery of SOC from a new perspective. And with the self-organized systems expanding to other different rule tables, this feature may still be satisfied. More further, considering the natural self-organized systems of living creatures, the spatial living expectations of different phenotypes may satisfy the 1/f law, too. Though we regard this as an inspirational orientation, the supposition needs more
Papadopulos, Nikolaos A; Lellé, Jean-Daniel; Zavlin, Dmitry; Herschbach, Peter; Henrich, Gerhard; Kovacs, Laszlo; Ehrenberger, Benjamin; Kluger, Anna-Katharina; Machens, Hans-Guenther; Schaff, Juergen
Surveys on quality of life (QOL) of male-to-female (MTF) transsexuals have found low QOL scores before and increased satisfaction scores after sex-reassignment surgery (SRS). To our knowledge, many of them lack standardized questionnaires and comparisons with normative data to evaluate different vaginoplasty techniques. To analyze patient satisfaction and QOL after SRS. Forty-seven patients participated in this study. All patients had surgery with our self-developed combined technique on average 19 months before the survey. They completed a self-developed indication-specific questionnaire concerning demographic and socioeconomic issues and postoperative satisfaction. Furthermore, a standardized self-assessment questionnaire on satisfaction and QOL (Fragen zur Lebenszufriedenheit Module [FLZ M ]; Questions on Life Satisfaction Modules ) was used. The FLZ M consists of three modules (general life satisfaction, satisfaction with health, and satisfaction with body image) with scores of weighted satisfaction for each item. Results of the general and health modules were compared with normative data. Demographics, QOL, general life satisfaction, satisfaction with health, and satisfaction with body image. The self-developed indication-specific questionnaire showed that 91% experienced an improvement of QOL. All patients stated they would undergo SRS again and did not regret it at all. Patients stated their femininity significantly increased. For the FLZ M , the sum score for general life satisfaction (P patient satisfaction of this complex and non-standardized surgery. This is the first description of a new surgical technique (combined technique) for MTF SRS. QOL was assessed by a large number of patients by standardized questionnaires and could be compared with normative data. Because this is a retrospective study, we can draw only careful conclusions for pre- and postoperative changes. Our self-developed combined surgical technique seemed to have a positive influence on
Schmied, Wolfram; Barnick, Saskia; Heimann, Dierk; Schäfers, Hans-Joachim; Köllner, Volker
Physicians are expected to involve patients adequately in the decision-making process prior to surgery. To this end, it is essential to have knowledge about the potential reasons for such a decision. In this study we investigated which information sources and decision criteria are important to patients prior to aortic valve surgery. A consecutive sample of 468 patients (70.1%m, aged 66.9±14.2 years) was examined 2 years after aortic valve replacement or reconstruction with a self-developed questionnaire. Preoperative discussion with a cardiologist or a cardiac surgeon was the information source patients used most frequently and felt to be the most helpful. The most important decision criterion was quality of life, followed by life expectancy and likelihood of reoperation. Two years postoperatively, 97.3% of the patients were satisfied with their decision. Preoperative counseling by a physician plays an essential role in the decision-making process prior to cardiac surgery. Patients want to be involved in decision-making, though they do not want to bear the full responsibility.
Simone Frizell Reiter
Full Text Available To investigate psychiatric disorders, adverse social aspects and quality of life in men with epilepsy during partner's pregnancy.We used data from the Norwegian Mother and Child Cohort Study, including 76,335 men with pregnant partners. Men with epilepsy were compared to men without epilepsy, and to men with non-neurological chronic diseases.Expecting fathers in 658 pregnancies (mean age 31.8 years reported a history of epilepsy, 36.9% using antiepileptic drugs (AEDs at the onset of pregnancy. Symptoms of anxiety or depression were increased in epilepsy (7.0% and 3.9%, respectively vs. non-epilepsy (4.6% and 2.5%, respectively, p = 0.004 and 0.023, and so were new onset symptoms of depression (2.0% vs. 1.0%, p < 0.031 and anxiety (4.3% vs. 2.3%, p = 0.023. Low self-esteem (2.5% and low satisfaction with life (1.7% were more frequent among fathers with epilepsy compared to fathers without epilepsy (1.3% and 0.7%, respectively, p = 0.01 and 0.010. Adverse social aspects and life events were associated with epilepsy vs. both reference groups. Self-reported diagnoses of ADHD (2.2% and bipolar disorder (1.8% were more common in epilepsy vs. non-epilepsy (0.4% and 0.3%, respectively, p = 0.002 and 0.003 and non-neurological chronic disorders (0.5% and 0.5%, respectively, p = 0.004 and 0.018. A screening tool for ADHD symptoms revealed a higher rate compared to self-reported ADHD (9.5% vs. 2.2%, p < 0.001.Expecting fathers with epilepsy are at high risk of depression and anxiety, adverse socioeconomic aspects, low self-esteem, and low satisfaction with life. Focus on mental health in fathers with epilepsy during and after pregnancy is important. The use of screening tools can be particularly useful to identify those at risk.
One of Dickens's most renowned and enjoyable novels, Great Expectations tells the story of Pip, an orphan boy who wishes to transcend his humble origins and finds himself unexpectedly given the opportunity to live a life of wealth and respectability. Over the course of the tale, in which Pip
HervÃƒÂ© Le Bras
Full Text Available We propose an alternative way of dealing with mortality tempo. Bongaarts and Feeney have developed a model that assumes a fixed delay postponing each death. Our model, however, assumes that changes take place with the removal of a given cause of mortality. Cross-sectional risks of mortality by age and expectations of life therefore are not biased, contrary to the model of the two authors. Treating the two approaches as two particular cases of a more general process, we demonstrate that these two particular cases are the only ones that have general properties: The only model enjoying a decomposable expression is the removal model and the only model enjoying the proportionality property is the fixed delay model.
Ardo van den Hout
Full Text Available Background: A continuous-time three-state model can be used to describe change in cognitive function in the older population. State 1 corresponds to normal cognitive function, state 2 to cognitive impairment, and state 3 to dead. For statistical inference, longitudinal data are available from the UK Medical Research Council Cognitive Function and Ageing Study. Objective: The aim is statistical analysis of longitudinal multi-state data taking into account missing data and potential misclassification of state. In addition, methods for long-term prediction of the transition process are of interest, specifically when applied to the study of healthy life expectancy. Methods: Cognitive function in the older population is assumed to be stable or declining. For this reason, observed improvement of cognitive function is assumed to be caused by misclassification of either state 1 or 2. Regression models for the transition intensities are formulated to incorporate covariate information. Maximum likelihood is used for statistical inference. Results: It is shown that missing values for the state at a pre-scheduled time can easily be taken into account. Long-term prediction is explained and illustrated by the estimation of statespecific life expectancies. In addition, it is shown how microsimulation can be used to further explore predictions based on a fitted multi-state model. Conclusions: Statistical analysis of longitudinal multi-state data can take into account missing data and potential misclassification of state. With respect to long-term prediction, microsimulation is a useful tool for summarising and displaying characteristics of cognitive decline and survival. Comments: ---
Yahaya, B.; Ahmed, Y. A.; Balogun, G. I.; Agbo, S. A.
The Nigeria Research Reactor-1 (NIRR-1) is a low power miniature neutron source reactor (MNSR) located at the Centre for Energy Research and Training, Ahmadu Bello University, Zaria Nigeria. The reactor went critical with initial core excess reactivity of 3.77 mk. The NIRR-1 cold excess reactivity measured at the time of commissioning was determined to be 4.97 mk, which is more than the licensed range of 3.5-4 mk. Hence some cadmium poison worth -1.2 mk was inserted into one of the inner irradiation sites which act as reactivity regulating device in order to reduce the core excess reactivity to 3.77 mk, which is within recommended licensed range of 3.5 mk and 4.0 mk. In this present study, the burn-up calculations of the NIRR-1 fuel and the estimation of the core life time expectancy after 10 years (the reactor core expected cycle) have been conducted using the codes WIMS and CITATION. The burn-up analyses carried out indicated that the excess reactivity of NIRR-1 follows a linear decreasing trend having 216 Effective Full Power Days (EFPD) operations. The reactivity worth of top beryllium shim data plates was calculated to be 19.072 mk. The result of depletion analysis for NIRR-1 core shows that (7.9947 ± 0.0008) g of U-235 was consumed for the period of 12 years of operating time. The production of the build-up of Pu-239 was found to be (0.0347 ± 0.0043) g. The core life time estimated in this research was found to be 30.33 years. This is in good agreement with the literature
Murray, Christian J; Lipfert, Frederick W
Many publications estimate short-term air pollution-mortality risks, but few estimate the associated changes in life-expectancies. We present a new methodology for analyzing time series of health effects, in which prior frailty is assumed to precede short-term elderly nontraumatic mortality. The model is based on a subpopulation of frail individuals whose entries and exits (deaths) are functions of daily and lagged environmental conditions: ambient temperature/season, airborne particles, and ozone. This frail susceptible population is unknown; its fluctuations cannot be observed but are estimated using maximum-likelihood methods with the Kalman filter. We used an existing 14-y set of daily data to illustrate the model and then tested the assumption of prior frailty with a new generalized model that estimates the portion of the daily death count allocated to nonfrail individuals. In this demonstration dataset, new entries into the high-risk pool are associated with lower ambient temperatures and higher concentrations of particulate matter and ozone. Accounting for these effects on antecedent frailty reduces this at-risk population, yielding frail life expectancies of 5-7 days. Associations between environmental factors and entries to the at-risk pool are about twice as strong as for mortality. Nonfrail elderly deaths are seen to make only small contributions. This new model predicts a small short-lived frail population-at-risk that is stable over a wide range of environmental conditions. The predicted effects of pollution on new entries and deaths are robust and consistent with conventional morbidity/mortality times-series studies. We recommend model verification using other suitable datasets.
Full Text Available Background and purpose: Mortality Statistics and rates show the development of a country in the world. These statistics are very important for determining the distribution of risk factors of mortality (in age and gender groups, ethnicity and so on and they are useful for improving health and preventing from important diseases in future planning of countries in societies. Materials and Methods: This article is a longitudinal descriptive study. All registered deaths in Bane which occurred during 2006-2010, regardless of the cause, were collected from the department of health in Kurdistan University of Medical Sciences, and they were assigned into 21 categories based on Disease Category (ICD10 of WHO. Then the life table for every year was prepared and Life expectancy was computed for each age and sex and total lost years of life for all chapters of ICD10 were calculated. Results: Based on the ICD10, four chapters with the highest frequencies include circulatory diseases by 1008 cases (32.5%, external causes of death by 522 cases (16.7%, cancers by 480 cases (15.3%, and prenatal death by 382 cases (12.2%. Overall, these chapters include 76.4% of total death. The most years of lost life were reported for prenatal period, external causes, diseases of the circulatory system and cancers. Conclusion: Cardiovascular diseases, incidents and accidents, and cancers are the most important causes of death. Among the main reasons of death in the first group are high blood pressures, lack of movement, smoking, not consuming enough fruits, vegetables. In the second group the reasons include not obeying the traffic rules, high speed and so on. Since the sum years of lost life were the highest in the prenatal period, it is necessary to improve pregnancy care and teach mothers prior to pregnancy.
Kenny, Dianna T; Asher, Anthony
Does a combination of lifestyle pressures and personality, as reflected in genre, lead to the early death of popular musicians? We explored overall mortality, cause of death, and changes in patterns of death over time and by music genre membership in popular musicians who died between 1950 and 2014. The death records of 13,195 popular musicians were coded for age and year of death, cause of death, gender, and music genre. Musician death statistics were compared with age-matched deaths in the US population using actuarial methods. Although the common perception is of a glamorous, free-wheeling lifestyle for this occupational group, the figures tell a very different story. Results showed that popular musicians have shortened life expectancy compared with comparable general populations. Results showed excess mortality from violent deaths (suicide, homicide, accidental death, including vehicular deaths and drug overdoses) and liver disease for each age group studied compared with population mortality patterns. These excess deaths were highest for the under-25-year age group and reduced chronologically thereafter. Overall mortality rates were twice as high compared with the population when averaged over the whole age range. Mortality impacts differed by music genre. In particular, excess suicides and liver-related disease were observed in country, metal, and rock musicians; excess homicides were observed in 6 of the 14 genres, in particular hip hop and rap musicians. For accidental death, actual deaths significantly exceeded expected deaths for country, folk, jazz, metal, pop, punk, and rock.
Unsal, A.; Ayranci, U.; Tozun, M.
To determine frequency of smoking among males aged 40 and above and to evaluate its impact on health related quality of life (HRQOL). This cross-sectional study was conducted in a region of western Turkey between January, 1, and February, 30 2009. A questionnaire concerning demographics, smoking and health related quality of life (HRQOL) was filled by the subjects. Chi Square (x2) test, Student's t test, variance (ANOVA) and Spearman Correlation analyses were performed when the data were being evaluated. The frequency of smoking was 47.1%. In those smoking, the scores received from the other fields of SF-36 scale except for the emotional field were significantly lower in those not smoking. As the severity of smoking increased, physical functioning, physical body pain, general health perception, and the vitality scores showed significant decrease (p<0.05, for each domain). Smoking has a negative impact on health related quality of life. Public health education highlighting ill effects of smoking and Tobacco use need to be initiated which can be an effective preventive strategy. (author)
Stephens, Alexandre S; Purdie, Stuart; Yang, Baohui; Moore, Helen
To determine a practical approach for deriving life expectancy estimates in Australian New South Wales local government areas which display a large diversity in population sizes. Population-based study utilising mortality and estimated residential population data. 153 local government areas in New South Wales, Australia. Key performance measures of Chiang II, Silcocks, adjusted Chiang II and Bayesian random effects model methodologies of life expectancy estimation including agreement analysis of life expectancy estimates and comparison of estimate SEs. Chiang II and Silcocks methods produced almost identical life expectancy estimates across a large range of population sizes but calculation failures and excessively large SEs limited their use in small populations. A population of 25 000 or greater was required to estimate life expectancy with SE of 1 year or less using adjusted Chiang II (a composite of Chiang II and Silcocks methods). Data aggregation offered some remedy for extending the use of adjusted Chiang II in small populations but reduced estimate currency. A recently developed Bayesian random effects model utilising the correlation in mortality rates between genders, age groups and geographical areas markedly improved the precision of life expectancy estimates in small populations. We propose a hybrid approach for the calculation of life expectancy using the Bayesian random effects model in populations of 25 000 or lower permitting the precise derivation of life expectancy in small populations. In populations above 25 000, we propose the use of adjusted Chiang II to guard against violations of spatial correlation, to benefit from a widely accepted method that is simpler to communicate to local health authorities and where its slight inferior performance compared with the Bayesian approach is of minor practical significance.
Stenholm, Sari; Head, Jenny; Kivimäki, Mika; Kawachi, Ichiro; Aalto, Ville; Zins, Marie; Goldberg, Marcel; Zaninotto, Paola; Magnuson Hanson, Linda; Westerlund, Hugo; Vahtera, Jussi
Smoking, physical inactivity and obesity are modifiable risk factors for morbidity and mortality. The aim of this study was to examine the extent to which the co-occurrence of these behaviour-related risk factors predict healthy life expectancy and chronic disease-free life expectancy in four European cohort studies. Data were drawn from repeated waves of four cohort studies in England, Finland, France and Sweden. Smoking status, physical inactivity and obesity (body mass index ≥30 kg/m 2 ) were examined separately and in combination. Health expectancy was estimated by using two health indicators: suboptimal self-rated health and having a chronic disease (cardiovascular disease, cancer, respiratory disease and diabetes). Multistate life table models were used to estimate sex-specific healthy life expectancy and chronic disease-free life expectancy from ages 50 to 75 years. Compared with men and women with at least two behaviour-related risk factors, those with no behaviour-related risk factors could expect to live on average8 years longer in good health and 6 years longer free of chronic diseases between ages 50 and 75. Having any single risk factor was also associated with reduction in healthy years. No consistent differences between cohorts were observed. Data from four European countries show that persons with individual and co-occurring behaviour-related risk factors have shorter healthy life expectancy and shorter chronic disease-free life expectancy. Population level reductions in smoking, physical inactivity and obesity could increase life-years lived in good health. © The Author 2016. Published by Oxford University Press on behalf of the International Epidemiological Association.
Helleberg, Marie; May, Margaret T; Ingle, Suzanne M
smokers with never smokers were 1.70 (95% CI 1.23-2.34) and 0.92 (95% CI 0.64-1.34), respectively. Smokers had substantially higher mortality from cardiovascular disease, non-AIDS malignancies than nonsmokers [MRR 6.28 (95% CI 2.19-18.0) and 3.31 (95% CI 1.80-5.45), respectively]. [corrected]. Among 35......-year-old HIV-infected men, the loss of life-years associated with smoking and HIV was 7.9 (95% CI 7.1-8.7) and 5.9 (95% CI 4.9-6.9), respectively. The life expectancy of virally suppressed, never-smokers was 43.5 years (95% CI 41.7-45.3), compared with 44.4 years among 35-year-old men in the background......BACKGROUND: Cardiovascular disease and non-AIDS malignancies have become major causes of death among HIV-infected individuals. The relative impact of lifestyle and HIV-related factors are debated. METHODS: We estimated associations of smoking with mortality more than 1 year after antiretroviral...
Tsurugizawa, Tomokazu; Tokuda, Shinsuke; Harada, Tokiko; Takahashi, Taiki; Sadato, Norihiro
The high-dose, alcohol-induced influences on risk perception and loss aversion depend on sex. On the other hand, low-dose alcohol has less effect on risky behavior. However, the effect of low-dose alcohol on subjective valuation of gain or loss and also the effect of placebo (expectancy of alcohol) on risk perception have not been fully investigated. We investigated the effects of low-dose alcohol (0.02 g/100 ml blood alcohol concentration) and placebo effects on subjective risk perception and subjective valuation of uncertain gain and loss in females and males. Participants in the control group and the placebo group were served alcohol-free, wine-flavored beverage and participants of alcohol group were served wine (14% alcohol). The placebo group was not informed that the drink was not alcohol but the control group was informed. Then paper–pencil tasks for subjective risk perception and valuation of gain or loss were performed 45 min after drinking the beverage. The participants were asked to draw the line on a 180 mm scale for each question. The placebo effects as well as the low-dose alcohol effects were observed in subjective valuations of gain or loss. Except for effect of beverages, a gender difference was also observed for subjective likelihood. The females estimated a low-probability loss as more likely and estimated a high-probability gain as less likely than did the males. From the Stevens’ law fitting analysis, the placebo, not alcohol, significantly induced the psychophysical effect of the subjective valuation of gain or loss. These results indicate that the psychological effects of expectancy of alcohol (placebo) could be a major factor in changing the subjective valuation of gain or loss over the pharmacological effects of a small amount of alcohol (like a glass of wine). Furthermore, these results also indicate that gender differences should be taken into account when investigating pharmacological or psychological effect on decision-making. PMID
Jia, Haomiao; Zack, Matthew M; Thompson, William W
Being classified as outside the normal range for body mass index (BMI) has been associated with increased risk for chronic health conditions, poor health-related quality of life (HRQOL), and premature death. To assess the impact of BMI on HRQOL and mortality, we compared quality-adjusted life expectancy (QALE) by BMI levels. We obtained HRQOL data from the 1993-2010 Behavioral Risk Factor Surveillance System and life table estimates from the National Center for Health Statistics national mortality files to estimate QALE among U.S. adults by BMI categories: underweight (BMI overweight (BMI 25.0-29.9 kg/m(2)), obese (BMI 30.0-34.9 kg/m(2)), and severely obese (BMI ≥35.0 kg/m(2)). In 2010 in the United States, the highest estimated QALE for adults at 18 years of age was 54.1 years for individuals classified as normal weight. The two lowest QALE estimates were for those classified as either underweight (48.9 years) or severely obese (48.2 years). For individuals who were overweight or obese, the QALE estimates fell between those classified as either normal weight (54.1 years) or severely obese (48.2 years). The difference in QALE between adults classified as normal weight and those classified as either overweight or obese was significantly higher among women than among men, irrespective of race/ethnicity. Using population-based data, we found significant differences in QALE loss by BMI category. These findings are valuable for setting national and state targets to reduce health risks associated with severe obesity, and could be used for cost-effectiveness evaluations of weight-reduction interventions.
Borisenkov, Mikhail F
According to the hypothesis of circadian disruption, external factors that disturb the function of the circadian system can raise the risk of malignant neoplasm and reduce life span. Recent work has shown that the functionality of the circadian system is dependent not only on latitude of residence but also on the region's position in the time zone. The purpose of the present research was to examine the influence of latitude and time zone on cancer incidence, cancer mortality, and life expectancy at birth. A stepwise multiple regression analysis was carried out on residents of 59 regions of the European part of the Russian Federation (EPRF) using age-standardized parameters (per 100,000) of cancer incidence (CI), cancer mortality (CM), and life expectancy at birth (LE, yrs) as dependent variables. The geographical coordinates (latitude and position in the time zone) of the regions were used as independent variables, controlling for the level of economic development in the regions. The same analysis was carried out for LE in 31 regions in China. Latitude was the strongest predictor of LE in the EPRF population; it explained 48% and 45% of the variability in LE of women and men, respectively. Position within the time zone accounted for an additional 4% and 3% variability of LE in women and men, respectively. The highest values for LE were observed in the southeast of the EPRF. In China, latitude was not a predictor of LE, whereas position in the time zone explained 15% and 18% of the LE variability in women and men, respectively. The highest values of LE were observed in the eastern regions of China. Both latitude and position within the time zone were predictors for CI and CM of the EPRF population. Latitude was the best predictor of stomach CI and CM; this predictor explained 46% and 50% of the variability, respectively. Position within the time zone was the best predictor of female breast CM; it explained 15% of the variability. In most cases, CI and CM increased
Using individual-level data for China, Korea, and Japan for 2006, this research examines how the age of children influences life satisfaction for males and females in East Asian countries. Our results show that the life satisfaction of males is barely affected by a child of the relationship, whereas the life satisfaction of females with a young child is lower than that of females who do not have a child. This result holds for countries at different development stages. There is also a gender d...
Joshua C Kwekel
Full Text Available Age is a predisposing condition for susceptibility to chronic kidney disease and progression as well as acute kidney injury that may arise due to the adverse effects of some drugs. Age-related differences in kidney biology, therefore, are a key concern in understanding drug safety and disease progression. We hypothesize that the underlying suite of genes expressed in the kidney at various life cycle stages will impact susceptibility to adverse drug reactions. Therefore, establishing changes in baseline expression data between these life stages is the first and necessary step in evaluating this hypothesis. Untreated male F344 rats were sacrificed at 2, 5, 6, 8, 15, 21, 78, and 104 weeks of age. Kidneys were collected for histology and gene expression analysis. Agilent whole-genome rat microarrays were used to query global expression profiles. An ANOVA (p1.5 in relative mRNA expression, was used to identify 3,724 unique differentially expressed genes (DEGs. Principal component analyses of these DEGs revealed three major divisions in life-cycle renal gene expression. K-means cluster analysis identified several groups of genes that shared age-specific patterns of expression. Pathway analysis of these gene groups revealed age-specific gene networks and functions related to renal function and aging, including extracellular matrix turnover, immune cell response, and renal tubular injury. Large age-related changes in expression were also demonstrated for the genes that code for qualified renal injury biomarkers KIM-1, Clu, and Tff3. These results suggest specific groups of genes that may underlie age-specific susceptibilities to adverse drug reactions and disease. This analysis of the basal gene expression patterns of renal genes throughout the life cycle of the rat will improve the use of current and future renal biomarkers and inform our assessments of kidney injury and disease.
Christopher M Stone
Full Text Available The release of genetically-modified or sterile male mosquitoes offers a promising form of mosquito-transmitted pathogen control, but the insights derived from our understanding of male mosquito behaviour have not fully been incorporated into the design of such genetic control or sterile-male release methods. The importance of aspects of male life history and mating behaviour for sterile-male release programmes were investigated by projecting a stage-structured matrix model over time. An elasticity analysis of transient dynamics during sterile-male releases was performed to provide insight on which vector control methods are likely to be most synergistic. The results suggest that high mating competitiveness and mortality costs of released males are required before the sterile-release method becomes ineffective. Additionally, if released males suffer a mortality cost, older males should be released due to their increased mating capacity. If released males are of a homogenous size and size-assortative mating occurs in nature, this can lead to an increase in the abundance of large females and reduce the efficacy of the population-suppression effort. At a high level of size-assortative mating, the disease transmission potential of the vector population increases due to male releases, arguing for the release of a heterogeneously-sized male population. The female population was most sensitive to perturbations of density-dependent components of larval mortality and female survivorship and fecundity. These findings suggest source reduction might be a particularly effective complement to mosquito control based on the sterile insect technique (SIT. In order for SIT to realize its potential as a key component of an integrated vector-management strategy to control mosquito-transmitted pathogens, programme design of sterile-male release programmes must account for the ecology, behaviour and life history of mosquitoes. The model used here takes a step in this
Gettler, Lee T; Ryan, Calen P; Eisenberg, Dan T A; Rzhetskaya, Margarita; Hayes, M Geoffrey; Feranil, Alan B; Bechayda, Sonny Agustin; Kuzawa, Christopher W
Partnered fathers often have lower testosterone than single non-parents, which is theorized to relate to elevated testosterone (T) facilitating competitive behaviors and lower T contributing to nurturing. Cultural- and individual-factors moderate the expression of such psychobiological profiles. Less is known about genetic variation's role in individual psychobiological responses to partnering and fathering, particularly as related to T. We examined the exon 1 CAG (polyglutamine) repeat (CAGn) within the androgen receptor (AR) gene. AR CAGn shapes T's effects after it binds to AR by affecting AR transcriptional activity. Thus, this polymorphism is a strong candidate to influence individual-level profiles of "androgenicity." While males with a highly androgenic profile are expected to engage in a more competitive-oriented life history strategy, low androgenic men are at increased risk of depression, which could lead to similar outcomes for certain familial dynamics, such as marriage stability and parenting. Here, in a large longitudinal study of Filipino men (n=683), we found that men who had high androgenicity (elevated T and shorter CAGn) or low androgenicity (lower T and longer CAGn) showed elevated likelihood of relationship instability over the 4.5-year study period and were also more likely be relatively uninvolved with childcare as fathers. We did not find that CAGn moderated men's T responses to the fatherhood transition. In total, our results provide evidence for invested fathering and relationship stability at intermediate levels of androgenicity and help inform our understanding of variation in male reproductive strategies and the individual hormonal and genetic differences that underlie it. Copyright © 2016 Elsevier Inc. All rights reserved.
Tseng, Yolanda D.; Krishnan, Monica S.; Sullivan, Adam J.; Jones, Joshua A.; Chow, Edward; Balboni, Tracy A.
Purpose: We surveyed how radiation oncologists think about and incorporate a palliative cancer patient’s life expectancy (LE) into their treatment recommendations. Methods and Materials: A 41-item survey was e-mailed to 113 radiation oncology attending physicians and residents at radiation oncology centers within the Boston area. Physicians estimated how frequently they assessed the LE of their palliative cancer patients and rated the importance of 18 factors in formulating LE estimates. For 3 common palliative case scenarios, physicians estimated LE and reported whether they had an LE threshold below which they would modify their treatment recommendation. LE estimates were considered accurate when within the 95% confidence interval of median survival estimates from an established prognostic model. Results: Among 92 respondents (81%), the majority were male (62%), from an academic practice (75%), and an attending physician (70%). Physicians reported assessing LE in 91% of their evaluations and most frequently rated performance status (92%), overall metastatic burden (90%), presence of central nervous system metastases (75%), and primary cancer site (73%) as “very important” in assessing LE. Across the 3 cases, most (88%-97%) had LE thresholds that would alter treatment recommendations. Overall, physicians’ LE estimates were 22% accurate with 67% over the range predicted by the prognostic model. Conclusions: Physicians often incorporate LE estimates into palliative cancer care and identify important prognostic factors. Most have LE thresholds that guide their treatment recommendations. However, physicians overestimated patient survival times in most cases. Future studies focused on improving LE assessment are needed
Tseng, Yolanda D., E-mail: firstname.lastname@example.org [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Krishnan, Monica S. [Harvard Radiation Oncology Program, Boston, Massachusetts (United States); Sullivan, Adam J. [Department of Biostatistics, Harvard University, Cambridge, Massachusetts (United States); Jones, Joshua A. [Harvard Palliative Medicine Fellowship Program, Boston, Massachusetts (United States); Chow, Edward [Department of Radiation Oncology, University of Toronto, Toronto (Canada); Balboni, Tracy A. [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States)
Purpose: We surveyed how radiation oncologists think about and incorporate a palliative cancer patient’s life expectancy (LE) into their treatment recommendations. Methods and Materials: A 41-item survey was e-mailed to 113 radiation oncology attending physicians and residents at radiation oncology centers within the Boston area. Physicians estimated how frequently they assessed the LE of their palliative cancer patients and rated the importance of 18 factors in formulating LE estimates. For 3 common palliative case scenarios, physicians estimated LE and reported whether they had an LE threshold below which they would modify their treatment recommendation. LE estimates were considered accurate when within the 95% confidence interval of median survival estimates from an established prognostic model. Results: Among 92 respondents (81%), the majority were male (62%), from an academic practice (75%), and an attending physician (70%). Physicians reported assessing LE in 91% of their evaluations and most frequently rated performance status (92%), overall metastatic burden (90%), presence of central nervous system metastases (75%), and primary cancer site (73%) as “very important” in assessing LE. Across the 3 cases, most (88%-97%) had LE thresholds that would alter treatment recommendations. Overall, physicians’ LE estimates were 22% accurate with 67% over the range predicted by the prognostic model. Conclusions: Physicians often incorporate LE estimates into palliative cancer care and identify important prognostic factors. Most have LE thresholds that guide their treatment recommendations. However, physicians overestimated patient survival times in most cases. Future studies focused on improving LE assessment are needed.
Full Text Available Background: The question of work-life balance (WLB is an area where increasing attention is being paid nowadays. States, organisations and employees all have responsibility and a role to play in WLB. This article presents the important areas of the WLB by key players in this field. Purpose: The purpose of the research was to compare and analyse the differences between the actual situation and the expectations of employers and employees with regard to specific areas of WLB in Slovenia. Methodology: Data was gathered using the Computer Assisted Web Interview (CAWI method. In the first part of the research project, employers across all sectors of the economy in Slovenia were questioned and in second part focussed on employees. In order to verify the areas in which employers and employees agree and those in which there are differences in perception, multidimensional scaling (MDS was used. Results: The results of our research show that Slovenian organisations must pay more attention to flexible working time, the employees’ ability to take time off to care for family members, time and stress management workshops and paid leave for parents on a child’s first day of school. Conclusion: A significant role in WLB is played by organisations. The incorporation of WLB strategies into the strategic and financial planning of an organisation can, in fact, have positive business, economic and social effects. Employees have to express their expectations and needs, which is the only way that employers can be made aware of their problems and help with WLB. State responsibility is to encourage all social partners to shape the living environment in which employees’ can achieve a good WLB with an emphasis on gender equality
Symms, Michelle R; Rawl, Susan M; Grant, Marcia; Wendel, Christopher S; Coons, Stephen Joel; Hickey, Sara; Baldwin, Carol M; Krouse, Robert S
This secondary analysis was conducted to expand our understanding of the challenges men with ostomies face regarding intimate relationships and sexual functioning. We examined quantitative and qualitative data to examine sexual functioning, intimate relationships, and health-related quality of life (HR-QOL) among military veterans who are living with an intestinal stoma. Three Veterans Health Administration sites. Four hundred eighty-one male veterans. Case-control, mixed-methods design; cases were those who had ostomies for at least 2 months, and controls had a similar major intestinal surgical procedure that did not result in an ostomy. Quantitative and qualitative data on sexual functioning, relationships, and other dimensions of HR-QOL were collected using the modified City of Hope Quality of Life-Ostomy questionnaire. The overall response rate was 49%. Prevalence of erectile dysfunction was significantly higher among ostomates compared with controls (P ostomies reported being sexually active before surgery compared with controls (P ostomy group (P = .015). Compared with veterans with ostomies who did not resume sexual activity after surgery, those who were sexually active reported a higher total HR-QOL score and higher scores on all 4 modified City of Hope Quality of Life-Ostomy dimensions (psychological, social, physical, and spiritual well-being). Veterans with ostomies who had resumed sexual activity after their ostomy also reported that their ostomy had caused significantly less interference with social activities, less isolation, less interference with their personal relationships, and less interference with their ability to be intimate. These men also reported less difficulty adjusting to the ostomy. Results of qualitative analyses showed that problems with intimacy and sexual function are among the greatest challenges faced by ostomates. Presence of an ostomy was associated with lower rates of sexual activity and higher erectile dysfunction. The lower
Full Text Available While low vitamin D status has been shown to be associated with decreased quality of life in unhealthy populations and women, only limited data are available regarding healthy adult men. Our aim was to evaluate the associations between health-related quality of life (QoL and vitamin D status in adult men. High-tech employees aged 25–65 year were recruited from an occupational periodic examination clinic at Rambam Health Campus. QoL was assessed using the Centers for Disease Control and Prevention (CDC Health-related quality of life questionnaire (HRQOL-4. Serum 25-hydroxyvitamin D (25(OHD and Body Mass Index (BMI were measured; further information was collected about physical activity, education, sun exposure, sick-days, and musculoskeletal pain severity (visual analog scale. Three hundred and fifty-eight men were enrolled in the study; mean serum 25(OHD level was 22.1 ± 7.9 ng/mL (range 4.6–54.5 ng/mL. In a multivariate logistic regression model, 25(OHD was a significant independent determinant of self-rated health; Odds Ratio (OR for self-rated health was 0.91 (95% confidence interval (CI 0.85–0.97, p = 0.004, adjusted for age, BMI, pain severity, physical activity, and sun exposure. Every 1 ng/mL increase of 25(OHD was associated with 9% reduction in the odds of reporting self-rated health as fair or poor. Poisson regression model demonstrated an association between physically unhealthy days and 25(OHD levels (rate ratio 0.95, p < 0.001. In conclusion, serum levels of 25(OHD were associated with self-rated health and with physically unhealthy days of HRQOL in healthy high-tech male workers. Future intervention studies are required to test the impact of vitamin D supplementation on QoL.
Tepper, Sigal; Dabush, Yael; Shahar, Danit R; Endevelt, Ronit; Geva, Diklah; Ish-Shalom, Sofia
While low vitamin D status has been shown to be associated with decreased quality of life in unhealthy populations and women, only limited data are available regarding healthy adult men. Our aim was to evaluate the associations between health-related quality of life (QoL) and vitamin D status in adult men. High-tech employees aged 25-65 year were recruited from an occupational periodic examination clinic at Rambam Health Campus. QoL was assessed using the Centers for Disease Control and Prevention (CDC) Health-related quality of life questionnaire (HRQOL-4). Serum 25-hydroxyvitamin D (25(OH)D) and Body Mass Index (BMI) were measured; further information was collected about physical activity, education, sun exposure, sick-days, and musculoskeletal pain severity (visual analog scale). Three hundred and fifty-eight men were enrolled in the study; mean serum 25(OH)D level was 22.1 ± 7.9 ng/mL (range 4.6-54.5 ng/mL). In a multivariate logistic regression model, 25(OH)D was a significant independent determinant of self-rated health; Odds Ratio (OR) for self-rated health was 0.91 (95% confidence interval (CI) 0.85-0.97, p = 0.004), adjusted for age, BMI, pain severity, physical activity, and sun exposure. Every 1 ng/mL increase of 25(OH)D was associated with 9% reduction in the odds of reporting self-rated health as fair or poor. Poisson regression model demonstrated an association between physically unhealthy days and 25(OH)D levels (rate ratio 0.95, p health and with physically unhealthy days of HRQOL in healthy high-tech male workers. Future intervention studies are required to test the impact of vitamin D supplementation on QoL.
Laine, Merja K; Kujala, Urho M; Eriksson, Johan G; Wasenius, Niko S; Kaprio, Jaakko; Bäckmand, Heli M; Peltonen, Markku; Heinonen, Olli; Jula, Antti; Sarna, Seppo
The aim of this study was to assess whether a former career as an elite athlete protects from hypertension in later life. We hypothesized that vigorous physical activity during young adulthood protects against hypertension later in life. The study population (n = 3440) consists of 2037 former male elite athletes and 1403 matched controls. Of those, 599 (392 former athletes, 207 controls) participated in a clinical study in 2008. The athletes were divided into three groups: endurance, mixed and power sports. Assessment of hypertension was based on athletes' entitlement to reimbursable antihypertensive medication from the Finnish Social Insurance Institution; among the clinical study participants, this was also based on self-reported current use of antihypertensive drugs or measured hypertension. The current volume of leisure-time physical activity (LTPA) was determined by questionnaires. Among the participants, the former athletes had lower age-adjusted prevalence of hypertension than the controls [odds ratio (OR) 0.69, 95% confidence interval (CI) 0.49-0.98] and the endurance athletes had the lowest OR (OR 0.43, 95% CI 0.23-0.80). OR for the prevalence of hypertension decreased (OR 0.90, 95% CI 0.84-0.96 per 10 metabolic equivalent hours/week) when there was an increase in the volume of LTPA. The former athletes without blood pressure-lowering medication had significantly lower SBP than the controls [139.2 mmHg (SD 18.7) vs. 144.2 mmHg (SD 19.5)] (P = 0.027). A former career as an elite athlete seems to be associated with a lower prevalence of hypertension in later life. The volume of current LTPA was inversely related to prevalence of hypertension.
Salomé, F; Petitjean, F; Germain, C; Demant, J-C
Most studies on the quality of life (Qol) of patients with schizophrenia deal with objective living conditions and how they are perceived by hospitalized patients. The few studies that compare Qol for patients treated in part time services with the Qol of ambulatory patients do not show any significant difference in terms of subjective Qol. Some stu-dies evaluate the influence of psychopathology and needs (or expectations) on the subjective Qol in these groups of patients. Available data indicate that the general well-being is influenced by psychopathology (positive, negative or depressive symptoms) and unmet needs in ambulatory patients. They also show that subjective Qol in certain life domains (social relations, family relations, leisure, health, law and security) is influenced by negative symptoms, anxiety and depression in patients treated in part-time services. The aim of this study is to compare the objective and subjective Qol of patients with schizophrenia treated in part time services (day hospital and day care center) to the Qol of out-patients treated on a purely ambulatory basis (out patient clinic). We studied the Qol of 2 groups of 30 patients with schizophrenia (ICD 10 criteria) treated in various centers. The first group was made of ambulatory patients, the second one was constituted of patients treated in a day hospital or a day care center. Patients were matched for age, duration of illness, number of hospitalizations. The instruments used for rating were the following: Clinical Global Impression (CGI), Global Assessment of Functioning (GAF), Positive And Negative Symptoms Scale (PANSS), Drug Attitude Inventory (DAI-10). The Qol was measured with a french version of the Lancashire Quality Of Life Profile (LQOLP) (Salomé, Germain, Petitjean, Demant and Boyer, 2000). This instrument measures the objective Qol as well as the subjective Qol. It does possess satisfying psychometric properties and offers the possibility to establish Qol profiles. All
Taramasco, C; Figueroa, K; Lazo, Y; Demongeot, J
The 1000s of people who die from cancer each year have become one of the leading causes of death among the Chilean population, placing it as the second cause of death in the region of Valparaiso between 1997 and 2003. Statistics have provided different measures regarding the life expectancy of cancer patients which have resulted in being useful to establish courses of action for prevention and treatment plans to follow. Data was extracted from the cancer module of the Epidemiology Assistance System (SADEPI for its initials in Spanish) which stores information about cancer cases in the provinces of Valparaiso and Petorca. The survival period is defined as the difference in days between the date of occurrence and the date of death of the patient by separating the data into quartiles. The more frequent cancers in the region of Valparaiso behave similarly to global behaviours of the disease. The majority of affected patients are around 65 years of age which progressively lowers its occurrence in younger adults under the age of 45. Further efforts are required for early detection and timely access to treatment for cancer patients. Statistics are an important support in achieving this.
Shair, Syazreen Niza; Yusof, Aida Yuzi; Asmuni, Nurin Haniah
Coherent mortality forecasting models have recently received increasing attention particularly in their application to sub-populations. The advantage of coherent models over independent models is the ability to forecast a non-divergent mortality for two or more sub-populations. One of the coherent models was recently developed by  known as the product-ratio model. This model is an extension version of the functional independent model from . The product-ratio model has been applied in a developed country, Australia  and has been extended in a developing nation, Malaysia . While  accounted for coherency of mortality rates between gender and ethnic group, the coherency between states in Malaysia has never been explored. This paper will forecast the mortality rates of Malaysian sub-populations according to states using the product ratio coherent model and its independent version— the functional independent model. The forecast accuracies of two different models are evaluated using the out-of-sample error measurements— the mean absolute forecast error (MAFE) for age-specific death rates and the mean forecast error (MFE) for the life expectancy at birth. We employ Malaysian mortality time series data from 1991 to 2014, segregated by age, gender and states.
Full Text Available Household fuel combustion, especially using solid combustibles (biomass and fossil fuels, for cooking and other activities produces emissions that contribute to concentrations of indoor as well as outdoor air pollutants such as particulate matter with diameter smaller than 2.5 μm (PM2.5 that deteriorate health and likely affect life expectancy (LEX. This study investigates the impact of PM2.5 from household combustion on LEX considering several covariates while controlling for ambient PM2.5 generated by other sectors. The generalized method of moments (GMM model and the panel cointegration model were applied to a dataset of 43 Sub-Saharan Africa (SSA countries over the time period of 1995–2010. Both approaches provide similar results indicating that household PM2.5 is significantly and negatively associated with higher aggregate LEX in the long-run, and, to a greater degree for female’s. Also, among the control variables, PM2.5 from the transport sector has a greater influence on male’s LEX. Thus, efforts should be combined to reduce household PM2.5 since lower levels are associated with increased LEX.
Full Text Available The high-dose, alcohol-induced influences on risk perception and loss aversion depend on sex. On the other hand, low-dose alcohol has less effect on risky behavior. However, the effect of low-dose alcohol on subjective valuation of gain or loss and also the effect of placebo (expectancy of alcohol on risk perception have not been fully investigated. We investigated the effects of low-dose alcohol (0.02 g/100 ml blood alcohol concentration and placebo effects on subjective risk perception and subjective valuation of uncertain gain and loss in females and males. Participants in the control group and the placebo group were served alcohol-free, wine-flavored beverage and participants of alcohol group were served wine (14% alcohol. The placebo group was not informed that the drink was not alcohol but the control group was informed. Then paper-pencil tasks for subjective risk perception and valuation of gain or loss were performed 45 min after drinking the beverage. The participants were asked to draw the line on a 180 mm scale for each question. The placebo effects as well as the low-dose alcohol effects were observed in subjective valuations of gain or loss. Except for effect of beverages, a gender difference was also observed for subjective likelihood. The females estimated a low-probability loss as more likely and estimated a high-probability gain as less likely than did the males. From the Stevens' law fitting analysis, the placebo, not alcohol, significantly induced the psychophysical effect of the subjective valuation of gain or loss. These results indicate that the psychological effects of expectancy of alcohol (placebo could be a major factor in changing the subjective valuation of gain or loss over the pharmacological effects of a small amount of alcohol (like a glass of wine. Furthermore, these results also indicate that gender differences should be taken into account when investigating pharmacological or psychological effect on decision-making.
Cory, Anna-Lena; Schneider, Jutta M
Informed mating decisions are often based on social cues providing information about prospective mating opportunities. Social information early in life can trigger developmental modifications and influence later mating decisions. A high adaptive value of such adjustments is particularly obvious in systems where potential mating rates are extremely limited and have to be carried out in a short time window. Males of the sexually cannibalistic spider Argiope bruennichi can achieve maximally two copulations which they can use for one (monogyny) or two females (bigyny). The choice between these male mating tactics should rely on female availability that males might assess through volatile sex pheromones emitted by virgin females. We predict that in response to those female cues, males of A. bruennichi should mature earlier and at a smaller body size and favor a bigynous mating tactic in comparison with controls. We sampled spiders from two areas close to the Southern and Northern species range to account for differences in mate quality and seasonality. In a fully factorial design, half of the subadult males from both areas obtained silk cues of females, while the other half remained without female exposure. Adult males were subjected to no-choice mating tests and could either monopolize the female or leave her (bigyny). We found that Southern males matured later and at a larger size than Northern males. Regardless of their origin, males also shortened the subadult stage in response to female cues, which, however, had no effects on male body mass. Contrary to our prediction, the frequencies of mating tactics were unaffected by the treatment. We conclude that while social cues during late development elicit adaptive life history adjustments, they are less important for the adjustment of mating decisions. We suggest that male tactics mostly rely on local information at the time of mate search.
Background The success of health programs is influenced not only by their acceptability but also their ability to meet and respond to community expectations of service delivery. The World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have recommended medical male circumcision (MC) as an essential component of comprehensive HIV prevention programs in high burden settings. This study investigated community-level perceptions of MC for HIV prevention in Papua New Guinea (PNG), a setting where diverse traditional and contemporary forms of penile foreskin cutting practices have been described. Methods A multi-method qualitative study was undertaken in four provinces in two stages from 2009 to 2011. A total of 82 in-depth interviews, and 45 focus group discussions were completed during Stage 1. Stage 2 incorporated eight participatory workshops that were an integral part of the research dissemination process to communities. The workshops also provided opportunity to review key themes and consolidate earlier findings as part of the research process. Qualitative data analysis used a grounded theory approach and was facilitated using qualitative data management software. Results A number of diverse considerations for the delivery of MC for HIV prevention in PNG were described, with conflicting views both between and within communities. Key issues included: location of the service, service provider, age eligibility, type of cut, community awareness and potential shame amongst youth. Key to developing appropriate health service delivery models was an appreciation of the differences in expectations and traditions of unique cultural groups in PNG. Establishing strong community coalitions, raising awareness and building trust were seen as integral to success. Conclusions Difficulties exist in the implementation of new programs in a pluralistic society such as PNG, particularly if tensions arise between biomedical knowledge and medico
Tynan, Anna; Hill, Peter S; Kelly, Angela; Kupul, Martha; Aeno, Herick; Naketrumb, Richard; Siba, Peter; Kaldor, John; Vallely, Andrew
The success of health programs is influenced not only by their acceptability but also their ability to meet and respond to community expectations of service delivery. The World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) have recommended medical male circumcision (MC) as an essential component of comprehensive HIV prevention programs in high burden settings. This study investigated community-level perceptions of MC for HIV prevention in Papua New Guinea (PNG), a setting where diverse traditional and contemporary forms of penile foreskin cutting practices have been described. A multi-method qualitative study was undertaken in four provinces in two stages from 2009 to 2011. A total of 82 in-depth interviews, and 45 focus group discussions were completed during Stage 1. Stage 2 incorporated eight participatory workshops that were an integral part of the research dissemination process to communities. The workshops also provided opportunity to review key themes and consolidate earlier findings as part of the research process. Qualitative data analysis used a grounded theory approach and was facilitated using qualitative data management software. A number of diverse considerations for the delivery of MC for HIV prevention in PNG were described, with conflicting views both between and within communities. Key issues included: location of the service, service provider, age eligibility, type of cut, community awareness and potential shame amongst youth. Key to developing appropriate health service delivery models was an appreciation of the differences in expectations and traditions of unique cultural groups in PNG. Establishing strong community coalitions, raising awareness and building trust were seen as integral to success. Difficulties exist in the implementation of new programs in a pluralistic society such as PNG, particularly if tensions arise between biomedical knowledge and medico-legal requirements, compared to existing
Correia, Andrew W; Pope, C Arden; Dockery, Douglas W; Wang, Yun; Ezzati, Majid; Dominici, Francesca
In recent years (2000-2007), ambient levels of fine particulate matter (PM2.5) have continued to decline as a result of interventions, but the decline has been at a slower rate than previous years (1980-2000). Whether these more recent and slower declines of PM2.5 levels continue to improve life expectancy and whether they benefit all populations equally is unknown. We assembled a data set for 545 U.S. counties consisting of yearly county-specific average PM2.5, yearly county-specific life expectancy, and several potentially confounding variables measuring socioeconomic status, smoking prevalence, and demographic characteristics for the years 2000 and 2007. We used regression models to estimate the association between reductions in PM2.5 and changes in life expectancy for the period from 2000 to 2007. A decrease of 10 μg/m in the concentration of PM2.5 was associated with an increase in mean life expectancy of 0.35 years (SD = 0.16 years, P = 0.033). This association was stronger in more urban and densely populated counties. Reductions in PM2.5 were associated with improvements in life expectancy for the period from 2000 to 2007. Air pollution control in the last decade has continued to have a positive impact on public health.
Patrick I Chiyo
Full Text Available Factors that influence learning and the spread of behavior in wild animal populations are important for understanding species responses to changing environments and for species conservation. In populations of wildlife species that come into conflict with humans by raiding cultivated crops, simple models of exposure of individual animals to crops do not entirely explain the prevalence of crop raiding behavior. We investigated the influence of life history milestones using age and association patterns on the probability of being a crop raider among wild free ranging male African elephants; we focused on males because female elephants are not known to raid crops in our study population. We examined several features of an elephant association network; network density, community structure and association based on age similarity since they are known to influence the spread of behaviors in a population. We found that older males were more likely to be raiders than younger males, that males were more likely to be raiders when their closest associates were also raiders, and that males were more likely to be raiders when their second closest associates were raiders older than them. The male association network had sparse associations, a tendency for individuals similar in age and raiding status to associate, and a strong community structure. However, raiders were randomly distributed between communities. These features of the elephant association network may limit the spread of raiding behavior and likely determine the prevalence of raiding behavior in elephant populations. Our results suggest that social learning has a major influence on the acquisition of raiding behavior in younger males whereas life history factors are important drivers of raiding behavior in older males. Further, both life-history and network patterns may influence the acquisition and spread of complex behaviors in animal populations and provide insight on managing human
Full Text Available Abstract Background Pelargonium is one of the most popular garden plants in the world. Moreover, it has a considerable economic importance in the ornamental plant market. Conventional cross-breeding strategies have generated a range of cultivars with excellent traits. However, gene transfer via Agrobacterium tumefaciens could be a helpful tool to further improve Pelargonium by enabling the introduction of new genes/traits. We report a simple and reliable protocol for the genetic transformation of Pelargonium spp. and the production of engineered long-life and male sterile Pelargonium zonale plants, using the pSAG12::ipt and PsEND1::barnase chimaeric genes respectively. Results The pSAG12::ipt transgenic plants showed delayed leaf senescence, increased branching and reduced internodal length, as compared to control plants. Leaves and flowers of the pSAG12::ipt plants were reduced in size and displayed a more intense coloration. In the transgenic lines carrying the PsEND1::barnase construct no pollen grains were observed in the modified anther structures, which developed instead of normal anthers. The locules of sterile anthers collapsed 3–4 days prior to floral anthesis and, in most cases, the undeveloped anther tissues underwent necrosis. Conclusion The chimaeric construct pSAG12::ipt can be useful in Pelargonium spp. to delay the senescence process and to modify plant architecture. In addition, the use of engineered male sterile plants would be especially useful to produce environmentally friendly transgenic plants carrying new traits by preventing gene flow between the genetically modified ornamentals and related plant species. These characteristics could be of interest, from a commercial point of view, both for pelargonium producers and consumers.
Dubey, Manisha; Ram, Usha; Ram, Faujdar
Under the prevailing conditions of imbalanced life table and historic gender discrimination in India, our study examines crossover between life expectancies at ages zero, one and five years for India and quantifies the relative share of infant and under-five mortality towards this crossover. We estimate threshold levels of infant and under-five mortality required for crossover using age specific death rates during 1981-2009 for 16 Indian states by sex (comprising of India's 90% population in 2011). Kitagawa decomposition equations were used to analyse relative share of infant and under-five mortality towards crossover. India experienced crossover between life expectancies at ages zero and five in 2004 for menand in 2009 for women; eleven and nine Indian states have experienced this crossover for men and women, respectively. Men usually experienced crossover four years earlier than the women. Improvements in mortality below ages five have mostly contributed towards this crossover. Life expectancy at age one exceeds that at age zero for both men and women in India except for Kerala (the only state to experience this crossover in 2000 for men and 1999 for women). For India, using life expectancy at age zero and under-five mortality rate together may be more meaningful to measure overall health of its people until the crossover. Delayed crossover for women, despite higher life expectancy at birth than for men reiterates that Indian women are still disadvantaged and hence use of life expectancies at ages zero, one and five become important for India. Greater programmatic efforts to control leading causes of death during the first month and 1-59 months in high child mortality areas can help India to attain this crossover early.
Full Text Available Under the prevailing conditions of imbalanced life table and historic gender discrimination in India, our study examines crossover between life expectancies at ages zero, one and five years for India and quantifies the relative share of infant and under-five mortality towards this crossover.We estimate threshold levels of infant and under-five mortality required for crossover using age specific death rates during 1981-2009 for 16 Indian states by sex (comprising of India's 90% population in 2011. Kitagawa decomposition equations were used to analyse relative share of infant and under-five mortality towards crossover.India experienced crossover between life expectancies at ages zero and five in 2004 for menand in 2009 for women; eleven and nine Indian states have experienced this crossover for men and women, respectively. Men usually experienced crossover four years earlier than the women. Improvements in mortality below ages five have mostly contributed towards this crossover. Life expectancy at age one exceeds that at age zero for both men and women in India except for Kerala (the only state to experience this crossover in 2000 for men and 1999 for women.For India, using life expectancy at age zero and under-five mortality rate together may be more meaningful to measure overall health of its people until the crossover. Delayed crossover for women, despite higher life expectancy at birth than for men reiterates that Indian women are still disadvantaged and hence use of life expectancies at ages zero, one and five become important for India. Greater programmatic efforts to control leading causes of death during the first month and 1-59 months in high child mortality areas can help India to attain this crossover early.
Kim, Jong In; Kim, Gukbin
Population is aging rapidly in Europe. Older age life expectancy (OLE) can be influenced by country-level depth of credit information (DCI) as an indicator of financial crisis, gross national income (GNI) per capita, and gender inequality index (GII). These factors are key indicators of socio-ecological inequality. They can be used to develop strategies to reduce country-level health disparity. The objective of this study was to confirm the relationship between socio-ecological factors and OLE in Europe. Data were obtained from World Bank, WHO, and UN database for 34 Europe countries. Associations between socio-ecological factors and OLE were assessed with Pearson correlation coefficients and three regression models. These models assumed that appropriate changes in country-level strategies of healthy aging would produce changes in GNI per capital as personal perspective, GII in social environment perspective, and DCI in public policy perspective to implement socio-ecological changes. Hierarchal linear regression was used for final analysis. Although OLE (women and men) had significant negative correlation with GII (gender inequality index, r = - 0.798, p = 0.001), it had positive correlations with GNI (gross national income per capita, r = 0.834, p = 0.001) and DCI (depth of credit information index, r = 0.704, p = 0.001) levels caused by financial crisis. Higher levels GNI and DCI but lower GII were found to be predictors of OLE (women and men) (R 2 = 0.804, p effect on OLE levels. Thus, country-level strategies of successful aging in Europe should target socio-ecological factors such as GII, GNI, and DCI value.
Ian R Hambleton
Full Text Available We describe trends in life expectancy at birth (LE and between-country LE disparities since 1965, in Latin America and the Caribbean.LE trends since 1965 are described for three geographical sub-regions: the Caribbean, Central America, and South America. LE disparities are explored using a suite of absolute and relative disparity metrics, with measurement consensus providing confidence to observed differences. LE has increased throughout Latin America and the Caribbean. Compared to the Caribbean, LE has increased by an additional 6.6 years in Central America and 4.1 years in South America. Since 1965, average reductions in between-country LE disparities were 14% (absolute disparity and 23% (relative disparity in the Caribbean, 55% and 51% in Central America, 55% and 52% in South America.LE in Latin America and the Caribbean is exceeding 'minimum standard' international targets, and is improving relative to the world region with the highest human longevity. The Caribbean, which had the highest LE and the lowest between-country LE disparities in Latin America and the Caribbean in 1965-70, had the lowest LE and the highest LE disparities by 2005-10. Caribbean Governments have championed a collaborative solution to the growing burden of non-communicable disease, with 15 territories signing on to the Declaration of Port of Spain, signalling regional commitment to a coordinated public-health response. The persistent LE inequity between Caribbean countries suggests that public health interventions should be tailored to individual countries to be most effective. Between- and within-country disparity monitoring for a range of health metrics should be a priority, first to guide country-level policy initiatives, then to contribute to the assessment of policy success.
Skevington, Suzanne M.; McCrate, Farah M.
Abstract Background and objectives Fulfilling patient expectations is central to defining a good quality of life (QoL) in health. The WHOQOL‐BREF was developed using novel, person‐centred methods and is a generic patient‐reported outcomes measure (PROM). However, without robust psychometric performance, PROMs cannot be relied upon to assess individuals. This study investigated the WHOQOL‐BREF (UK), with this use in mind. Design Cross sectional with nested repeated measures. Setting and participants Twenty‐seven disease groups or health conditions and healthy people were recruited at 38 UK sites, in a wide range of settings (n = 4628). Interventions ‘Treatment as usual’; new and alternative interventions. Outcome measures WHOQOL‐BREF (UK); SF‐36. Results Respondent burden was low, as acceptability and feasibility were high. Internal consistency was excellent (0.92) and test–retest reliability good. Distinctive QoL profiles were found for diverse conditions. Musculoskeletal, psychiatric and cardiovascular patients reported the poorest QoL and also improved most during treatment. Overall, QoL was good, and best for healthy groups, supporting discriminant validity. Compared with the SF‐36, WHOQOL physical and psychological domains showed good concurrent validity, although social was weak. Small or moderate effect sizes confirmed responsiveness to change in specified domains for certain conditions and interventions. Age had a small impact on reporting QoL. Discussion and conclusion The WHOQOL‐BREF is found to be a high quality patient‐centred generic tool suited to individual assessment in clinics, for research, and audit. PMID:21281412
Glei, Dana A; Goldman, Noreen; Ryff, Carol D; Weinstein, Maxine
We evaluate the variability in estimates of self-reported physical limitations by age across four nationally representative surveys in the US. We consider its implications for determining whether, as previous literature suggests, the US estimates reveal limitations at an earlier age than in three countries with similar life expectancy: England, Taiwan, and Costa Rica. Based on cross-sectional data from seven population-based surveys, we use local mean smoothing to plot self-reported limitations by age for each of four physical tasks for each survey, stratified by sex. We find substantial variation in the estimates in the US across four nationally-representative surveys. For example, one US survey suggests that American women experience a walking limitation 15 years earlier than their Costa Rican counterparts, while another US survey implies that Americans have a 4-year advantage. Differences in mode of survey may account for higher prevalence of limitations in the one survey that used a self-administered mail-in questionnaire than in the other surveys that used in-person or telephone interviews. Yet, even among US surveys that used the same mode, there is still so much variability in estimates that we cannot conclude whether Americans have better or worse function than their counterparts in the other countries. Seemingly minor differences in question wording and response categories may account for the remaining inconsistency. If minor differences in question wording can result in such extensive variation in the estimates within a given population, then lack of comparability is likely to be an even greater problem when examining results across countries that do not share the same language or culture. Despite the potential utility of self-reported physical function within a survey sample, our findings imply that absolute estimates of population-level prevalence of self-reported physical limitations are unlikely to be strictly comparable across countries-or even
Lee, Sunghee; Smith, Jacqui
Subjective life expectancy (SLE) has been suggested as a predictor of mortality and mortality-related behaviors. Although critical for culturally diverse societies, these findings do not consider cross-cultural methodological comparability. Culture-specific reporting heterogeneity is a well-known phenomenon introducing biases, and research on this issue with SLE is not established. Using data from the Health and Retirement Study, we examined reporting heterogeneity in SLE focusing on item nonresponse, focal points, and reports over time for five ethnic-cultural groups: non-Hispanic Whites, non-Hispanic Blacks, non-Hispanic other races, English-interviewed Hispanics, and Spanish-interviewed Hispanics. On item nonresponse, Spanish-interviewed Hispanics said, "I don't know," to SLE significantly more than any other groups. Nearly half of the respondents chose 0, 50, or 100, making them focal points. However, the focal points differed: 50 for Whites, 100 for Blacks, and 0 for Spanish-interviewed Hispanics. The relationship of SLE measured at two time points was higher for Whites than minorities. Moreover, those who said "I don't know" to SLE showed higher subsequent mortality than those who gave an answer. SLE was not a significant mortality predictor for Hispanics. Overall, SLE is not free from culture-specific reporting heterogeneity. This warrants further research about its culture-relevant measurement mechanisms. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: email@example.com.
Hu, Yannan; van Lenthe, Frank J; Mackenbach, Johan P
Whether income inequality is related to population health is still open to debate. We aimed to critically assess the relationship between income inequality and mortality in 43 European countries using comparable data between 1987 and 2008, controlling for time-invariant and time-variant country-level confounding factors. Annual data on income inequality, expressed as Gini index based on net household income, were extracted from the Standardizing the World Income Inequality Database. Data on life expectancy at birth and age-standardized mortality by cause of death were obtained from the Human Lifetable Database and the World Health Organization European Health for All Database. Data on infant mortality were obtained from the United Nations World Population Prospects Database. The relationships between income inequality and mortality indicators were studied using country fixed effects models, adjusted for time trends and country characteristics. Significant associations between income inequality and many mortality indicators were found in pooled cross-sectional regressions, indicating higher mortality in countries with larger income inequalities. Once the country fixed effects were added, all associations between income inequality and mortality indicators became insignificant, except for mortality from external causes and homicide among men, and cancers among women. The significant results for homicide and cancers disappeared after further adjustment for indicators of democracy, education, transition to national independence, armed conflicts, and economic freedom. Cross-sectional associations between income inequality and mortality seem to reflect the confounding effects of other country characteristics. In a European context, national levels of income inequality do not have an independent effect on mortality.
Terashima, Mikiko; Read Guernsey, Judith; Andreou, Pantelis
Although efforts have been made to articulate rural-urban health inequalities in recent years, results have been inconsistent due to different geographical scales used in these studies. Small-area level investigations of health inequalities will likely show more detailed pictures of health inequalities among diverse rural communities, but they are difficult to conduct, particularly in a small population region. The objectives of this study were: 1) to compare life expectancy at birth for females and males across small-areas classified by locally defined settlement types for a small province in Canada; 2) to assess whether any of the settlement types explains variations in life expectancy over and above the extent of socioeconomic disadvantage and social isolation; and 3) to examine variations in life expectancies within a (larger) area unit used as the basis of health inequality investigations in previous studies. Seven settlement types were determined for the 'community' units based on population per-kilometre-road density and settlement forms. Mean life expectancies at birth for both genders were compared by settlement type, both for the entire province and within the Halifax Regional Municipality--the province's only census designated metropolitan area, but also contains rural settlements. Linear regression analyses were conducted to assess the statistical associations between life expectancy and the settlement types, adjusting for indicators of community-level deprivation. While types of communities considered as 'rural' generally had lower life expectancy for both genders, the effects of living in any settlement type were attenuated once adjusted for socioeconomic deprivation and social isolation. An exception was the village and settlement cluster type, which had additionally negative effects on health for females. There were some variations observed within the Halifax Regional Municipality, suggesting the importance of further investigating a variety of
Sato, Y.; Rühr, P.T.; Schmitz, H.; Egas, M.; Blanke, A.
Males often fight with rival males for access to females. However, some males display nonfighting tactics such as sneaking, satellite behavior, or female mimicking. When these mating tactics comprise a conditional strategy, they are often thought to be explained by resource holding potential (RHP),
This study aims at examining gender differences in the experience of work-family interference and perceived job-life satisfaction in a group of Iranian employees. The participants in the study consist of 387 Iranian male and female employees from a variety of organizations. The results of t tests and multiple regression analysis using EQS 6.1…
Stephens, Alexandre S; Purdie, Stuart; Yang, Baohui; Moore, Helen
Objective To determine a practical approach for deriving life expectancy estimates in Australian New South Wales local government areas which display a large diversity in population sizes. Design Population-based study utilising mortality and estimated residential population data. Setting 153 local government areas in New South Wales, Australia. Outcome measures Key performance measures of Chiang II, Silcocks, adjusted Chiang II and Bayesian random effects model methodologies of life expectan...
Liu, Yan; Arai, Asuna; Obayashi, Yoshihide; Kanda, Koji; Boostrom, Eugene; Lee, Romeo B; Tamashiro, Hiko
This study analyzed the trend of gender gaps in life expectancy (GGLE) in Japan between 1947 and 2010, and explored the correlations of GGLE with gender mortality ratio and social development indices. Using GGLE and social indices data collected from the official websites, we carried out trends analysis of GGLE by calculating segmented average growth rates for different periods. We explored the association between GGLE and all-cause mortality; and between GGLE and Human Development Index (HDI) while controlling for time trend, by computing the generalized additive models based on the software R (version 2.15). Japan's GGLE increased in a fluctuating fashion. Across 53 years, the average growth rates varied widely: 0.14% (1947-1956), 1.43% (1956-1974), 1.06% (1974-2004) and -0.60% (2004-2010) (overall average 0.87%). The value of GGLE peaked to 7.00 years in 2004, and then has slowly declined (6.75 years in 2010). Age-adjusted all-cause gender mortality ratio had a statistically positive association with GGLE (PJapan could be partly explained by increased disease-specific mortality ratios (male/female), especially those involving chronic bronchitis and emphysema, diseases of the liver, suicide and cancer. The recent decline of GGLE might imply that Japanese women have been catching up with the lifestyle of men, resulting in similar mortality patterns. This calls for gender-sensitive approaches to developing policies and programs that will help sustain healthy lifestyles to combat smoking and alcohol intake, and social support to prevent suicide. © 2012 Japan Geriatrics Society.
Leandro de Moraes Kohl
Full Text Available OBJECTIVES: The six-minute walk test has been widely used to evaluate functional capacity and predict mortality in several populations. Thus, the aim of this study was to evaluate the prognostic value of the six-minute walk test for the life expectancy of end-stage renal disease patients. METHODS: Patients over 18 years old who underwent hemodialysis for at least six months were included. Patients with hemodynamic instability, smoking, chronic obstructive pulmonary disease, physical incapacity and acute myocardial stroke in the preceding three months were excluded. RESULTS: Fifty-two patients (54% males; 36+11 years old were followed for 144 months. The distance walked in the six-minute walk test was a survival predictor for end-stage renal disease patients. In the multivariate analysis, for each 100 meters walked with a 100-meter increment, the hazard ratio was 0.53, with a 95% confidence interval of 0.37-0.74. There was a positive correlation between the distance walked in the six-minute walk test and peak oxygen consumption (r = 0.508. In the multivariate analysis, each year of dialysis treatment represented a 10% increase in death probability; in the severity index analysis, each point on the scale represented an 11% increase in the death risk. CONCLUSIONS: We observed that survival increased approximately 5% for every 100 meters walked in the six-minute walk test, demonstrating that the test is a viable option for evaluating the functional capacity in patients with end-stage renal disease.
Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015
Kassebaum, N.J.; Arora, Megha; Barber, R.M.; Bhutta, Zulfiqar; Brown, J.; Carter, Austin; Casey, Daniel C.; Charlson, Fiona J.; Coates, M.; Coggeshall, M.S.; Geleijnse, J.M.
Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development,
Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015 : a systematic analysis for the Global Burden of Disease Study 2015
Kassebaum, Nicholas J.; Arora, Megha; Barber, Ryan M.; Bhutta, Zulfigar A.; Carter, Austin; Casey, Daniel C.; Charlson, Fiona J.; Coates, Matthew M.; Coggeshall, Megan; Cornaby, Leslie; Dandona, Lalit; Dicker, Daniel J.; Erskine, Holly E.; Ferrari, Alize J.; Fitzmaurice, Christina; Foreman, Kyle; Forouzanfar, Mohammad H.; Fullman, Nancy; Gething, Peter W.; Goldberg, Ellen M.; Graetz, Nicholas; Haagsma, Juanita A.; Johnson, Catherine; Kemmer, Laura; Khalil, Ibrahim A.; Kinfu, Yohannes; Kutz, Michael J.; Kyu, Hmwe H.; Leung, Janni; Liang, Xiaofeng; Lim, Stephen S.; Lim, Stephen S.; Lozano, Rafael; Mensah, George A.; Mikesell, Joe; Mokdad, Ali H.; Mooney, Meghan D.; Naghavi, Mohsen; Nguyen, Grant; Nsoesie, Elaine; Pigott, David M.; Pinho, Christine; Rankin, Zane; Reinig, Nikolas; Salomon, Joshua A.; Sandar, Logan; Amare, Azmeraw T.; Hoek, Hans W.; Singh, Abhishek; Tura, Abera Kenay
Background Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and
Fukumura, Tomoe; Yoshita, Katsushi; Tabata, Masaji
The purpose of this study was to understand the actual state of life hours (working time, sleep time, and time of meal intake) and dietary habits of male shift work employees, and to elucidate the impact of working arrangements and dietary habits on their physical condition and health problems. The subjects were 187 male employees (aged 18-64 years) working for an industrial company in Toyama prefecture. We used a self-administered questionnaire to assess dietary habit, lifestyle habits, and life hours at the time of a periodic health examination in April 2013. The subjects were grouped based on their working condition (i.e., day shift, late shift, and late-night shift) into two groups of day shift (n = 107) and shiftwork (n = 80). The proportion of time spent sleeping and feeding was determined in half hour increments, and the incidences of skipping meals (breakfast, lunch and dinner) and midnight snack intake were calculated for each working condition. We also examined the association between the frequency of eating and physical condition for each working condition. The state of life hours of the shiftwork group during the day was similar to that of the day shift group. However, the workers' state of life hours, incidences of skipping meals, and midnight snack intake varied considerably when working at the other shift times. In the shiftwork group, regardless of the working patterns, the BMI and % body fat of the group that ate more than three times a day were significantly lower than those of the group that ate less than twice a day. The results of the present study suggest that it is difficult to ensure the time and opportunity for meals for shift workers. We consider that it is necessary to prevent them skipping of meals, and to support a proper dietary intake during the night.
Full Text Available Despite improving healthcare, the gap in mortality between people with serious mental illness (SMI and general population persists, especially for younger age groups. The electronic database from a large and comprehensive secondary mental healthcare provider in London was utilized to assess the impact of SMI diagnoses on life expectancy at birth.People who were diagnosed with SMI (schizophrenia, schizoaffective disorder, bipolar disorder, substance use disorder, and depressive episode/disorder before the end of 2009 and under active review by the South London and Maudsley NHS Foundation Trust (SLAM in southeast London during 2007-09 comprised the sample, retrieved by the SLAM Case Register Interactive Search (CRIS system. We estimated life expectancy at birth for people with SMI and each diagnosis, from national mortality returns between 2007-09, using a life table method.A total of 31,719 eligible people, aged 15 years or older, with SMI were analyzed. Among them, 1,370 died during 2007-09. Compared to national figures, all disorders were associated with substantially lower life expectancy: 8.0 to 14.6 life years lost for men and 9.8 to 17.5 life years lost for women. Highest reductions were found for men with schizophrenia (14.6 years lost and women with schizoaffective disorders (17.5 years lost.The impact of serious mental illness on life expectancy is marked and generally higher than similarly calculated impacts of well-recognised adverse exposures such as smoking, diabetes and obesity. Strategies to identify and prevent causes of premature death are urgently required.
Wells, Kevin Eugene; Morgan, Grant; Worrell, Frank C.; Sumnall, Harry; McKay, Michael Thomas
The goal of the present study is to examine the stability of time attitudes profiles across a one-year period as well as the association between time attitudes profiles and several variables. These variables include attitudes towards alcohol, context of alcohol use, consumption of a full drink, and subjective life expectancy. We assessed the…
Streppel, M.T.; Ocke, M.C.; Boshuizen, H.C.; Kok, F.J.; Kromhout, D.
Background: Light to moderate alcohol intake lowers the risk of cardiovascular mortality, but whether this protective effect can be attributed to a specific type of beverage remains unclear. Moreover, little is known about the effects of long-term alcohol intake on life expectancy. Methods: The
Chan, Moon Fai
This study aimed to examine the impact of health care resources, socioeconomic status, and demographic changes on life expectancy in Indonesia, Philippines, and Vietnam. This was a cross-country study to collect annual data (1980-2008) from each target country. Life expectancy was the dependent variable and health care resources, socioeconomic status, and demographics were the 3 main determinants. Structural equation modeling was employed, and the results indicate that the availability of more health care resources (Indonesia: coefficient = .47, P = .008; Philippines: coefficient = .48, P = .017; Vietnam: coefficient = .48, P = .004) and higher levels of socioeconomic advantages (Indonesia: coefficient = .41, P = .014; Vietnam: coefficient = .34, P = .026) are more likely to increase life expectancy. In contrast, demographic changes are more likely to increase life expectancy because of the wide range of health care resources. These findings suggest that more effort, particularly during economic downturns, should be put into removing the barriers that impede access to health care services and increasing preventive care for the population that currently has less access to health care in communities where there is a shortage of medical resources. © 2013 APJPH.
Kim, Jong In; Kim, Gukbin
The remaining years of healthy life expectancy (RYH) at age 65 years can be calculated as RYH (65) = healthy life expectancy-aged 65 years. This study confirms the associations between socioeconomic indicators and the RYH (65) in 148 countries. The RYH data were obtained from the World Health Organization. Significant positive correlations between RYH (65) in men and women and the socioeconomic indicators national income, education level, and improved drinking water were found. Finally, the predictors of RYH (65) in men and women were used to build a model of the RYH using higher socioeconomic indicators (R(2 )= 0.744, p educational attainment, national income level, and improved water quality influenced the RYH at 65 years. Therefore, policymaking to improve these country-level socioeconomic factors is expected to have latent effects on RYH in older age. © The Author(s) 2016.
Scheidell, Joy D; Kumar, Pritika C; Campion, Taylor; Quinn, Kelly; Beharie, Nisha; McGorray, Susan P; Khan, Maria R
Child sexual abuse is associated with substance use and sexual risk behaviors during adolescence and adulthood, but no known studies have documented associations across the life course in a nationally representative U.S. We used the National Longitudinal Study of Adolescent to Adult Health to measure associations between child sexual abuse and substance use and sexual risk behaviors during adolescence, young adulthood, and adulthood among males and females (n = 11,820). Approximately 10% of females and 7% of males reported child sexual abuse. Associations with substance use were strongest during adolescence and lessened over time. Increased odds of sexual risk among those with a history of child sexual abuse remained consistent through the life course. Significant gender differences existed for some associations (e.g., adulthood multiple partners: males adjusted odds ratio (AOR) = 1.73, 95%CI:1.18, 2.53; females AOR = 1.11, 95%CI:0.79, 1.56). Trauma-informed prevention interventions should address child sexual abuse among both males and females to prevent substance use and sexual risk behavior throughout the life course.
Hauck, K; Martin, S; Smith, P C
The WHO Commission on the Social Determinants of Health set out an impressive collection of policy proposals on the social determinants of health. However, a serious weakness for securing implementation is the difficulty for policymakers in identifying priorities for action. The objective of this study is to determine a small set of the most influential determinants using existing data and an empirical approach. 45 Indicators from the World Bank's World Development Indicators are selected to measure attainment for the determinants proposed by the Commission. Panel data models of life expectancy at birth for 54 low-income countries over the years 1990-2012 (1188 country-years) are estimated. Each determinant is subjected to a robustness test using Extreme Bound Analysis, to determine the stability of its estimated impact on life expectancy. For 20 robust and significant determinants the magnitude of association with life expectancy is determined. The largest average increases in life expectancy at 14.5 months per capita is associated with a one standard deviation reduction in HIV prevalence among children, followed by advances in gender equality at 9.4 months. Improvements in life expectancy between 6 and 9 months are associated with agricultural production, political stability, access to clean water and sanitation, good governance, and primary school enrolment. Improvements below 6 months are associated with increases in private health expenditure and overseas development assistance, and control of armed conflict and HIV prevalence among men. There is no evidence that national income, public spending on healthcare and education, secondary schooling, terms of international trade, employment, debt service and relief, out-of-pocket expenditures, agricultural ex- or imports, lifestock production, foreign investment, urbanization or environmental degradation are robustly associated with population health. Results provide support for the relevance of some proposed
Laursen, Thomas Munk; Wahlbeck, Kristian; Hällgren, Jonas; Westman, Jeanette; Ösby, Urban; Alinaghizadeh, Hassan; Gissler, Mika; Nordentoft, Merete
Objective Excess mortality from diseases and medical conditions (natural death) in persons with psychiatric disorders has been extensively reported. Even in the Nordic countries with well-developed welfare systems, register based studies find evidence of an excess mortality. In recent years, cardiac mortality and death by diseases of the circulatory system has seen a decline in all the Nordic countries, but a recent paper indicates that women and men in Denmark, Finland, and Sweden, who had been hospitalised for a psychotic disorder, had a two to three-fold increased risk of dying from a cardiovascular disease. The aim of this study was to compare the mortality by diseases of the circulatory system among patients with bipolar disorder or schizophrenia in the three Nordic countries Denmark, Sweden, and Finland. Furthermore, the aim was to examine and compare life expectancy among these patients. Cause specific Standardized Mortality Rates (SMRs) were calculated for each specific subgroup of mortality. Life expectancy was calculated using Wiesler’s method. Results The SMR for bipolar disorder for diseases of the circulatory system was approximately 2 in all countries and both sexes. SMR was slightly higher for people with schizophrenia for both genders and in all countries, except for men in Denmark. Overall life expectancy was much lower among persons with bipolar disorder or schizophrenia, with life expectancy being from 11 to 20 years shorter. Conclusion Our data show that persons in the Nordic countries with schizophrenia or bipolar disorder have a substantially reduced life expectancy. An evaluation of the reasons for these increased mortality rates should be prioritized when planning healthcare in the coming years. PMID:23826212
Sharma, Rashmi K.; Prigerson, Holly G.; Penedo, Frank J.; Maciejewski, Paul K.
Background Patient gender plays a significant role in patient-physician communication, patient illness understanding and aggressiveness of end of life (EoL) care. However, little is known about the extent to which gender differences in the effects of EoL discussions on EoL care contribute to gender differences in EoL care. The present study aims to determine if gender differences exist in receipt of intensive care unit (ICU) care near death and in the association between EoL discussions and receipt of ICU EoL care. Methods Multi-site, prospective, cohort study of patients (N=353) with metastatic cancers, identified as terminally ill at study enrollment and interviewed a median of 4.1 months before their deaths. Postmortem chart reviews and caregiver interviews documented ICU stays in the las