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Lifespan is reduced by approximately 15 years in individuals suffering from severe mental illnesses such as schizophrenia spectrum disorders. Contributing to this is an increased prevalence of metabolic syndrome, an assortment of factors that confer risk of diabetes type 2 and cardiovascular disease. Body Mass Index (BMI) is predictive of metabolic syndrome. Previous research indicates that the BMI of incarcerated individuals not suffering from a major mental disorder increase during incarceration, especially amongst females. However, information on the development of BMI during forensic psychiatric care is scarcer, and follow-up periods have been short. Thus, the authors extracted data from the Swedish National Forensic Psychiatric Register regarding the longitudinal development of BMI in 3389 individuals who received court mandated forensic psychiatric care in Sweden during 2009-2020. A significant increase in BMI by 1.1% per year was observed during the first four years of care. After this, changes were no longer significant. Factors associated with a larger increase in BMI were female gender, being prescribed antipsychotics, young age at admission, receiving outpatient care, and access to an external support person. There was an inverse association between BMI and symptom severity. Substantial heterogeneity was observed in longitudinal changes in individual BMI and in comparisons between individuals receiving care at different clinics.

Lifespan is reduced by approximately 15 years in individuals suffering from severe mental illnesses such as schizophrenia spectrum disorders. Contributing to this is an increased prevalence of metabolic syndrome, an assortment of factors that confer risk of diabetes type 2 and cardiovascular disease. Body Mass Index (BMI) is predictive of metabolic syndrome. Previous research indicates that the BMI of incarcerated individuals not suffering from a major mental disorder increase during incarceration, especially amongst females. However, information on the development of BMI during forensic psychiatric care is scarcer, and follow-up periods have been short. Thus, the authors extracted data from the Swedish National Forensic Psychiatric Register regarding the longitudinal development of BMI in 3389 individuals who received court mandated forensic psychiatric care in Sweden during 2009-2020. A significant increase in BMI by 1.1% per year was observed during the first four years of care. After this, changes were no longer significant. Factors associated with a larger increase in BMI were female gender, being prescribed antipsychotics, young age at admission, receiving outpatient care, and access to an external support person. There was an inverse association between BMI and symptom severity. Substantial heterogeneity was observed in longitudinal changes in individual BMI and in comparisons between individuals receiving care at different clinics.

Lifespan is reduced by approximately 15 years in individuals suffering from severe mental illnesses such as schizophrenia spectrum disorders. Contributing to this is an increased prevalence of metabolic syndrome, an assortment of factors that confer risk of diabetes type 2 and cardiovascular disease. Body Mass Index (BMI) is predictive of metabolic syndrome. Previous research indicates that the BMI of incarcerated individuals not suffering from a major mental disorder increase during incarceration, especially amongst females. However, information on the development of BMI during forensic psychiatric care is scarcer, and follow-up periods have been short. Thus, the authors extracted data from the Swedish National Forensic Psychiatric Register regarding the longitudinal development of BMI in 3389 individuals who received court mandated forensic psychiatric care in Sweden during 2009-2020. A significant increase in BMI by 1.1% per year was observed during the first four years of care. After this, changes were no longer significant. Factors associated with a larger increase in BMI were female gender, being prescribed antipsychotics, young age at admission, receiving outpatient care, and access to an external support person. There was an inverse association between BMI and symptom severity. Substantial heterogeneity was observed in longitudinal changes in individual BMI and in comparisons between individuals receiving care at different clinics.

Producción Científica, Deep decarbonization paths to the 1.5 °C or 2 °C temperature stabilization futures require a rapid reduction in coal-fired power plants, but many countries are continuing to build new ones. Coal-fired plants are also a major contributor to air pollution related health impacts. Here, we couple an integrated human-earth system model (GCAM) with an air quality model (TM5-FASST) to examine regional health co-benefits from cancelling new coal- fired plants worldwide. Our analysis considers the evolution of pollutants control based on coal plants vintage and regional policies. We find that cancelling all new proposed projects would decrease air pollution related premature mortality between 101,388–213,205 deaths (2–5%) in 2030, and 213,414–373,054 (5–8%) in 2050, globally, but heavily concentrated in developing Asia. These health co-benefits are comparable in magnitude to the values obtained by implementing the Nationally Determined Contributions (NDCs). Furthermore, we estimate that strengthening the climate target from 2 °C to 1.5 °C would avoid 326,351 additional mortalities in 2030, of which 251,011 (75%) are attributable to the incremental coal plant shutdown., Supported by Basque Government (BERC 2018-2021; PRE_2017_2_0139) and the Spanish State Research Agency through María de Maeztu Excellence Unit accreditation 2018-2022 (MDM-2017-0714). Ministry of Science, Innovation and Universities (RTI2018-099858- A-100 and RTI2018-093352-B-I00); the Ministry of the Economy and Competitiveness of Spain (PID2019-106822RB-I00); and the project LO- COMOTION H2020-LC-CLA-2018-2 (No 821105).

Lifespan is reduced by approximately 15 years in individuals suffering from severe mental illnesses such as schizophrenia spectrum disorders. Contributing to this is an increased prevalence of metabolic syndrome, an assortment of factors that confer risk of diabetes type 2 and cardiovascular disease. Body Mass Index (BMI) is predictive of metabolic syndrome. Previous research indicates that the BMI of incarcerated individuals not suffering from a major mental disorder increase during incarceration, especially amongst females. However, information on the development of BMI during forensic psychiatric care is scarcer, and follow-up periods have been short. Thus, the authors extracted data from the Swedish National Forensic Psychiatric Register regarding the longitudinal development of BMI in 3389 individuals who received court mandated forensic psychiatric care in Sweden during 2009-2020. A significant increase in BMI by 1.1% per year was observed during the first four years of care. After this, changes were no longer significant. Factors associated with a larger increase in BMI were female gender, being prescribed antipsychotics, young age at admission, receiving outpatient care, and access to an external support person. There was an inverse association between BMI and symptom severity. Substantial heterogeneity was observed in longitudinal changes in individual BMI and in comparisons between individuals receiving care at different clinics.

Background: Higher levels of socioeconomic deprivation have been consistently associated with increased risk of premature mortality, but a detailed analysis by causes of death is lacking in Belgium. We aim to investigate the association between area deprivation and all-cause and cause-specific premature mortality in Belgium over the period 1998–2019. Methods: We used the 2001 and 2011 Belgian Indices of Multiple Deprivation to assign statistical sectors, the smallest geographical units in the country, into deprivation deciles. All-cause and cause-specific premature mortality rates, population attributable fraction, and potential years of life lost due to inequality were estimated by period, sex, and deprivation deciles. Results: Men and women living in the most deprived areas were 1.96 and 1.78 times more likely to die prematurely compared to those living in the least deprived areas over the period under study (1998–2019). About 28% of all premature deaths could be attributed to socioeconomic inequality and about 30% of potential years of life lost would be averted if the whole population of Belgium faced the premature mortality rates of the least deprived areas. Conclusion: Premature mortality rates have declined over time, but inequality has increased due to a faster pace of decrease in the least deprived areas compared to the most deprived areas. As the causes of death related to poor lifestyle choices contribute the most to the inequality gap, more effective, country-level interventions should be put in place to target segments of the population living in the most deprived areas as they are facing disproportionately high risks of dying., SCOPUS: ar.j, info:eu-repo/semantics/published

Lifespan is reduced by approximately 15 years in individuals suffering from severe mental illnesses such as schizophrenia spectrum disorders. Contributing to this is an increased prevalence of metabolic syndrome, an assortment of factors that confer risk of diabetes type 2 and cardiovascular disease. Body Mass Index (BMI) is predictive of metabolic syndrome. Previous research indicates that the BMI of incarcerated individuals not suffering from a major mental disorder increase during incarceration, especially amongst females. However, information on the development of BMI during forensic psychiatric care is scarcer, and follow-up periods have been short. Thus, the authors extracted data from the Swedish National Forensic Psychiatric Register regarding the longitudinal development of BMI in 3389 individuals who received court mandated forensic psychiatric care in Sweden during 2009-2020. A significant increase in BMI by 1.1% per year was observed during the first four years of care. After this, changes were no longer significant. Factors associated with a larger increase in BMI were female gender, being prescribed antipsychotics, young age at admission, receiving outpatient care, and access to an external support person. There was an inverse association between BMI and symptom severity. Substantial heterogeneity was observed in longitudinal changes in individual BMI and in comparisons between individuals receiving care at different clinics.

Background: Air pollution has been linked to mortality, but there are few studies examining the association with different exposure time windows spanning across several decades. The evidence for the effects of green space and mortality is contradictory.Objective: We investigated all-cause mortality in relation to exposure to particulate matter (PM2.5 and PM10), black carbon (BC), nitrogen dioxide (NO2), ozone (O3) and greenness (normalized difference vegetation index NDVI) across different exposure time windows.Methods: The exposure assessment was based on a combination of the Danish Eulerian Hemispheric Model and the Urban Background Model for the years 1990, 2000 and 2010. The analysis included a complete case dataset with 9,135 participants from the third Respiratory Health in Northern Europe study (RHINE III), aged 40-65 years in 2010, with mortality follow-up to 2021. We performed Cox proportional hazard models, adjusting for potential confounders.Results: Altogether, 327 (3.6 %) persons died in the period 2010-2021. Increased exposures in 1990 of PM2.5, PM10, BC and NO2 were associated with increased all-cause mortality hazard ratios of 1.40 (95 % CI1.04-1.87 per 5 mu g/m3), 1.33 (95 % CI: 1.02-1.74 per 10 mu g/m3), 1.16 (95 % CI: 0.98-1.38 per 0.4 mu g/m3) and 1.17 (95 % CI: 0.92-1.50 per 10 mu g/m3), respectively. No statistically significant associations were observed between air pollution and mortality in other time windows. O3 showed an inverse association with mortality, while no association was observed between greenness and mortality. Adjusting for NDVI increased the hazard ratios for PM2.5, PM10, BC and NO2 exposures in 1990. We did not find significant interactions between greenness and air pollution metrics.Conclusion: Long term exposure to even low levels of air pollution is associated with mortality. Opening up for a long latency period, our findings indicate that air pollution exposures over time may be even more harmful than anticipated.

Background: Air pollution has been linked to mortality, but there are few studies examining the association with different exposure time windows spanning across several decades. The evidence for the effects of green space and mortality is contradictory.Objective: We investigated all-cause mortality in relation to exposure to particulate matter (PM2.5 and PM10), black carbon (BC), nitrogen dioxide (NO2), ozone (O3) and greenness (normalized difference vegetation index NDVI) across different exposure time windows.Methods: The exposure assessment was based on a combination of the Danish Eulerian Hemispheric Model and the Urban Background Model for the years 1990, 2000 and 2010. The analysis included a complete case dataset with 9,135 participants from the third Respiratory Health in Northern Europe study (RHINE III), aged 40-65 years in 2010, with mortality follow-up to 2021. We performed Cox proportional hazard models, adjusting for potential confounders.Results: Altogether, 327 (3.6 %) persons died in the period 2010-2021. Increased exposures in 1990 of PM2.5, PM10, BC and NO2 were associated with increased all-cause mortality hazard ratios of 1.40 (95 % CI1.04-1.87 per 5 mu g/m3), 1.33 (95 % CI: 1.02-1.74 per 10 mu g/m3), 1.16 (95 % CI: 0.98-1.38 per 0.4 mu g/m3) and 1.17 (95 % CI: 0.92-1.50 per 10 mu g/m3), respectively. No statistically significant associations were observed between air pollution and mortality in other time windows. O3 showed an inverse association with mortality, while no association was observed between greenness and mortality. Adjusting for NDVI increased the hazard ratios for PM2.5, PM10, BC and NO2 exposures in 1990. We did not find significant interactions between greenness and air pollution metrics.Conclusion: Long term exposure to even low levels of air pollution is associated with mortality. Opening up for a long latency period, our findings indicate that air pollution exposures over time may be even more harmful than anticipated.

Background: Air pollution has been linked to mortality, but there are few studies examining the association with different exposure time windows spanning across several decades. The evidence for the effects of green space and mortality is contradictory.Objective: We investigated all-cause mortality in relation to exposure to particulate matter (PM2.5 and PM10), black carbon (BC), nitrogen dioxide (NO2), ozone (O3) and greenness (normalized difference vegetation index NDVI) across different exposure time windows.Methods: The exposure assessment was based on a combination of the Danish Eulerian Hemispheric Model and the Urban Background Model for the years 1990, 2000 and 2010. The analysis included a complete case dataset with 9,135 participants from the third Respiratory Health in Northern Europe study (RHINE III), aged 40-65 years in 2010, with mortality follow-up to 2021. We performed Cox proportional hazard models, adjusting for potential confounders.Results: Altogether, 327 (3.6 %) persons died in the period 2010-2021. Increased exposures in 1990 of PM2.5, PM10, BC and NO2 were associated with increased all-cause mortality hazard ratios of 1.40 (95 % CI1.04-1.87 per 5 mu g/m3), 1.33 (95 % CI: 1.02-1.74 per 10 mu g/m3), 1.16 (95 % CI: 0.98-1.38 per 0.4 mu g/m3) and 1.17 (95 % CI: 0.92-1.50 per 10 mu g/m3), respectively. No statistically significant associations were observed between air pollution and mortality in other time windows. O3 showed an inverse association with mortality, while no association was observed between greenness and mortality. Adjusting for NDVI increased the hazard ratios for PM2.5, PM10, BC and NO2 exposures in 1990. We did not find significant interactions between greenness and air pollution metrics.Conclusion: Long term exposure to even low levels of air pollution is associated with mortality. Opening up for a long latency period, our findings indicate that air pollution exposures over time may be even more harmful than anticipated.

2023 Acuerdos transformativos CRUE, Aim To estimate the potential cost of lost labour productivity due to cancer-related premature mortality in Europe (EU-27 plus Norway, Switzerland, Iceland and United Kingdom) from 2018 to 2040. Methods Deaths and years of potential productive life lost due to 23 types of cancer were estimated for 2018–2040, for 31 European countries. The data were analysed by age groups, by sex and by year. Projected productivity costs were estimated by calculating gross earnings by country, gender and age group using the Human Capital Approach, adjusting for projected labour force participation and unemployment rates. Various data sources were used. Sensitivity analyses were conducted. Results Between 2018 and 2040, cancer is expected to cause around eight million premature deaths (58% male). The cumulative projected productivity costs in this respect are €1.3 trillion, representing an annual average of €58.7 billion, or 0.43% of the EU-27 gross domestic product. Labour productivity costs are projected to decrease by 6% from 2018 to 2040. The highest cost region is Western Europe, where Germany and France will experience the highest cumulative losses (€288 and €192 billion, respectively). The most costly cancers, in terms of total costs related to productivity losses, are of the lung and colorectum (€264.4 and €116.3 billion, respectively). In terms of average productivity cost per death, the most costly forms of cancer are Hodgkin lymphoma (€301,157) and melanoma (€260,522). Conclusion The novel information presented could help national policymakers anticipate possible areas for cost savings. Action should be taken on disease prevention, on reducing mortality and on delaying the age of death due to Hodgkin lymphoma, brain cancer, leukaemia and melanoma. Furthermore, the study findings enhance our understanding of macroeconomic variables and could be useful in determining a re-allocation of health expenditures., Asociación de Economía de la Salud (España), Universidad Complutense de Madrid, Ministerio de Educación, Cultura y Deporte, Depto. de Economía Aplicada, Pública y Política, Fac. de Ciencias Económicas y Empresariales, TRUE, pub, APC financiada por la UCM

Background: Survival in patients with end-stage kidney disease (ESKD) on renal replacement therapy (RRT) is less than that of the general population of the same age, and depends on patient factors, the medical care received, and the type of RRT used. The objective of this study is to analyze the factors associated with survival in patients undergoing RRT. Methods: We conducted a retrospective observational study of adult patients with an incident of ESKD on RRT in Andalusia from 1 January 2008 to 31 December 2018. Patient characteristics, nephrological care received, and survival from the beginning of RRT were evaluated. A survival model for the patient was developed according to the variables studied. Results: A total of 11,551 patients were included. Median survival was 6.8 years (95% CI (6.6; 7.0)). After starting RRT, survival at one year and five years was 88.7% (95% CI (88.1; 89.3)) and 59.4% (95% CI (58.4; 60.4)), respectively. Age, initial comorbidity, diabetic nephropathy, and a venous catheter were independent risk factors. However, non-urgent initiation of RRT and follow-up in consultations for more than six months had a protective effect. It was identified that renal transplantation (RT) was the most influential independent factor in patient survival, with a risk ratio of 0.13 (95% CI (0.11; 0.14)). Conclusions: The receiving of a kidney transplant was the most beneficial modifiable factor in the survival of incident patients on RRT. We consider that the mortality of the renal replacement treatment should be adjusted, taking into account both modifiable and nonmodifiable factors to achieve a more precise and comparable interpretation.

Background: Obesity is a serious public health concern worldwide, and nearly 40% of all adults in the United States and 21% in Sweden are now living with obesity. Efforts focusing mainly on weight loss have fallen short in reducing obesity prevalence. There is a great need for improved insight into what factors may promote a healthy weight, thereby avoiding the adverse health outcomes linked to obesity. Primary weight maintenance is a prevention strategy that emphasizes keeping a long-term stable weight in the non-obese range. Aim: The overall aims of this thesis were to improve understanding of the patterns of obesity and obesity-related mortality among rural adults in Central New York State (U.S.) and Västerbotten County (Sweden), and to explore factors that are related to primary weight maintenance. Material and methods: Data from U.S. health surveys and health examinations in Sweden were used to compare twenty-year (1989-2009) trends in body mass index (BMI) and obesity using multi-factor analysis of variance. The association between obesity and risk of 1) premature all-cause death, and 2) premature circulatory death, was compared between the U.S. and Sweden using proportional hazards regression. In 2009, a longitudinal questionnaire of attitudes, behaviors and perceptions regarding weight maintenance was administered to U.S. subjects. Associations between ten-year weight change and survey variables were tested using multiple linear regression, separately for sex and age strata. To gain a deeper understanding of influences, facilitators and barriers to healthy eating and physical activity, a qualitative interview study was conducted with U.S. women aged 26-35, with data analyzed by qualitative content analysis. Results: Over twenty years, BMI increased for both men and women in all age strata in both countries, and those with no university education consistently had higher BMI than their university-educated counterparts. BMI increased more for younger groups (ag, Zoom link: https://umu.zoom.us/j/67748741045

Background: Obesity is a serious public health concern worldwide, and nearly 40% of all adults in the United States and 21% in Sweden are now living with obesity. Efforts focusing mainly on weight loss have fallen short in reducing obesity prevalence. There is a great need for improved insight into what factors may promote a healthy weight, thereby avoiding the adverse health outcomes linked to obesity. Primary weight maintenance is a prevention strategy that emphasizes keeping a long-term stable weight in the non-obese range. Aim: The overall aims of this thesis were to improve understanding of the patterns of obesity and obesity-related mortality among rural adults in Central New York State (U.S.) and Västerbotten County (Sweden), and to explore factors that are related to primary weight maintenance. Material and methods: Data from U.S. health surveys and health examinations in Sweden were used to compare twenty-year (1989-2009) trends in body mass index (BMI) and obesity using multi-factor analysis of variance. The association between obesity and risk of 1) premature all-cause death, and 2) premature circulatory death, was compared between the U.S. and Sweden using proportional hazards regression. In 2009, a longitudinal questionnaire of attitudes, behaviors and perceptions regarding weight maintenance was administered to U.S. subjects. Associations between ten-year weight change and survey variables were tested using multiple linear regression, separately for sex and age strata. To gain a deeper understanding of influences, facilitators and barriers to healthy eating and physical activity, a qualitative interview study was conducted with U.S. women aged 26-35, with data analyzed by qualitative content analysis. Results: Over twenty years, BMI increased for both men and women in all age strata in both countries, and those with no university education consistently had higher BMI than their university-educated counterparts. BMI increased more for younger groups (ag, Zoom link: https://umu.zoom.us/j/67748741045

AIMS: To evaluate the association of cardiovascular health (CVH), measured by Life's Essential 8 score, with the risk of premature mortality and to determine the patterns of CVH-related differences in life expectancy among people with and without type 2 diabetes (T2D). MATERIALS AND METHODS: This prospective study included 309,789 participants (age 56.6 ± 8.1 years; 46% men) enroled in the UK Biobank. The Life's Essential 8 composite measure consists of four health behaviours (diet, physical activity, nicotine exposure, and sleep) and four health factors (BMI, non-HDL cholesterol, blood glucose, and blood pressure), and the maximum CVH score was 100 points. CVH was categorised into low, moderate, and high groups. Premature death was defined as death before the age of 75. Cox proportional hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated, and life expectancy was estimated. RESULTS: During a median follow-up of 12.7 years, 13,683 cases of premature death were documented. Compared to participants with low CVH, the multivariable HRs (95% CIs) of premature death were 0.59 (0.56-0.62) and 0.42 (0.39-0.45) for the moderate and high CVH groups, respectively. This association was stronger in participants with T2D compared with those without T2D. At the age of 50 years, compared to low CVH groups, high CVH was associated with a gain of 9.79 (9.70-9.87) and 5.58 (5.48-5.67) additional life years for men with and without T2D, respectively. The corresponding life gain for women with and without T2D was 24.21 (24.13-24.27) and 10.18 (10.10-10.27), respectively. CONCLUSIONS: Maintaining an ideal Life's Essential 8 score may provide more benefits for people with T2D than for those without T2D, including a lower risk of premature death and an increased lifespan.

Chronic kidney disease is the non-communicable disease with the highest growth in morbidity and mortality. Renal transplantation (RT) is the first option of renal replacement in end-stage kidney disease (ESKD) and dialysis is an alternative. However, there is no objective quantification of the impact of both options on a patient’s overall survival. The purpose of our study is to assess the potential years of life lost by patients on renal replacement therapy. Methods: Retrospective study cohort conducted from 2008 to 2018 based on autonomic data registry. Results: 11,551 patients included who received renal replacement therapy (RRT) in a range of age from 15 to 94 years. The mean age at the time of onset was 62.7 years, 95% confidence interval (95% CI) (62.4; 63.0). The mortality rate of RRT patients was 42.2%, 95% CI (41.5; 43.3) and the mean age at death was 72.7 years, 95% CI (72.4; 73.1). The number of patients with ESKD treated with RT was 3776, 32.7% of the total, 95% CI (31.8; 33.5). The total amount of years of potential life lost (YPLL) in the entire cohort was 77,831.3 years, 48,010.1 years in men, and 29,821.2 years in women. The mean number of YPLL per patient with RRT was 6.74 years in both sexes, 6.95 years in women, and 6.61 years in men. The mean number of potential years of life lost in dialysis patients was 9.0 years in both sexes, 8.8 years in men, and 9.2 years in women, while among kidney transplant recipients this figure decreased to 2.2 years in both men and women. Conclusions: End-stage chronic kidney disease in renal replacement therapy by dialysis causes an average of 9.0 years of life potentially lost for each patient on dialysis treatment, while having received a kidney transplant reduces this figure by 75.6%.

Background: Air pollution has been linked to mortality, but there are few studies examining the association with different exposure time windows spanning across several decades. The evidence for the effects of green space and mortality is contradictory.Objective: We investigated all-cause mortality in relation to exposure to particulate matter (PM2.5 and PM10), black carbon (BC), nitrogen dioxide (NO2), ozone (O3) and greenness (normalized difference vegetation index NDVI) across different exposure time windows.Methods: The exposure assessment was based on a combination of the Danish Eulerian Hemispheric Model and the Urban Background Model for the years 1990, 2000 and 2010. The analysis included a complete case dataset with 9,135 participants from the third Respiratory Health in Northern Europe study (RHINE III), aged 40-65 years in 2010, with mortality follow-up to 2021. We performed Cox proportional hazard models, adjusting for potential confounders.Results: Altogether, 327 (3.6 %) persons died in the period 2010-2021. Increased exposures in 1990 of PM2.5, PM10, BC and NO2 were associated with increased all-cause mortality hazard ratios of 1.40 (95 % CI1.04-1.87 per 5 mu g/m3), 1.33 (95 % CI: 1.02-1.74 per 10 mu g/m3), 1.16 (95 % CI: 0.98-1.38 per 0.4 mu g/m3) and 1.17 (95 % CI: 0.92-1.50 per 10 mu g/m3), respectively. No statistically significant associations were observed between air pollution and mortality in other time windows. O3 showed an inverse association with mortality, while no association was observed between greenness and mortality. Adjusting for NDVI increased the hazard ratios for PM2.5, PM10, BC and NO2 exposures in 1990. We did not find significant interactions between greenness and air pollution metrics.Conclusion: Long term exposure to even low levels of air pollution is associated with mortality. Opening up for a long latency period, our findings indicate that air pollution exposures over time may be even more harmful than anticipated.

[Abstract] Exposure to ambient air pollution increases mortality and morbidity, leading disabilities, and premature deaths. Air pollution has been identified as a leading cause of global disease burden, especially in low- and middle-income countries in 2015 (Global Burden of Diseases, Injuries and Risk Factors Study, 2015). This study explores the relation between mortality rates and particulate matter (PM) concentrations in the 50 Spanish regions for the period 2002-2017. Moreover, we estimated the premature deaths due to PM in Spain according to welfare and production losses in 2017. Random-effects models were developed to evaluate the relation between mortality rates and PM concentrations. The economic cost of premature deaths was assessed using the Willingness to Pay approach to quantify welfare losses and the Human Capital method to estimate production losses. PM10 concentrations are positively related to mortality due to respiratory diseases and stroke. Based on 10,342 premature deaths in 2017, losses in welfare amount to EUR 36,227 million (3.1% of Spanish GDP). The economic value of current and future production losses reached EUR 229 million (0.02% of GDP). From a social perspective, air pollution is a public health concern that greatly impacts health and quality of life. Results highlight the need to implement or strengthen regulatory, fiscal, and health public policies to substantially benefit the population’s health by reducing their exposure to air pollution., [Resumen] La exposición a la contaminación atmosférica aumenta la mortalidad y la morbilidad, lo que conduce a la discapacidad y a la muerte prematura. La contaminación del aire se identificó como una de las principales causas de la carga mundial de enfermedades, sobre todo en países de ingresos bajos y medianos en el 2015 (Global Burden of Diseases, Injuries and Risk Factors Study, 2015). Este artículo explora la relación entre las tasas de mortalidad y la concentración de material particulado (PM) en las 50 regiones españolas desde el 2002 hasta el 2017. Además, se realizó una estimación de las muertes prematuras provocadas por PM en España en términos de bienestar y pérdidas de producción en el 2017. Se desarrollaron modelos de efectos aleatorios para estudiar la relación entre las tasas de mortalidad y las concentraciones de PM. El costo económico de las muertes prematuras se evaluó usando el enfoque “disposición a pagar” para monetizar las pérdidas de bienestar y el método del capital humano para estimar las pérdidas de producción. Las concentraciones de PM10 están positivamente asociadas con la mortalidad por enfermedades respiratorias y accidente cerebrovascular. Con base en 10.342 muertes prematuras en el 2017, las pérdidas en el bienestar social ascendieron a EUR 36.227 millones (3,1% del PIB español). El valor económico de las pérdidas de producción presentes y futuras llegó a EUR 229 millones (0,02% del PIB). Desde un punto de vista social, la contaminación del aire es un problema de salud pública que tiene un gran impacto en la salud y en la calidad de vida. Los resultados ponen de manifiesto la necesidad de implementar o de fortalecer políticas públicas regulatorias, fiscales y de salud para obtener beneficios sustanciales para la salud con la reducción de la exposición, [Resumo] A exposição à poluição do ar ambiente aumenta a mortalidade e a morbidade, levando a incapacidades e mortes prematuras. A poluição do ar foi identificada como uma das principais causas da carga global de doenças, principalmente em países de baixa e média renda em 2015 (Global Burden of Diseases, Injuries and Risk Factors Study, 2015). Este artigo explora a relação entre as taxas de mortalidade e a concentração de material particulado (PM) nas 50 regiões espanholas de 2002 a 2017. Além disso, foi realizada uma estimativa das mortes prematuras causadas por PM na Espanha em termos de bem-estar e perdas de produção em 2017. Modelos de efeitos aleatórios foram desenvolvidos para estudar a relação entre as taxas de mortalidade e as concentrações de PMP. O custo econômico das mortes prematuras foi avaliado usando a abordagem “disposição a pagar” para monetizar as perdas de bem-estar e o método do capital humano para estimar as perdas de produção. As concentrações de PM10 estão positivamente associadas à mortalidade por doenças respiratórias e acidente vascular cerebral. Com base em 10.342 mortes prematuras em 2017, as perdas no bem-estar social subiram para EUR 36,227 bilhões (3,1% do PIB espanhol). O valor econômico das perdas de produção presentes e futuras atingiu os EUR 229 milhões (0,02% do PIB). Do ponto de vista social, a poluição do ar é um problema de saúde pública que tem grande impacto na saúde e na qualidade de vida. Os resultados evidenciam a necessidade de implementar ou fortalecer políticas públicas regulatórias, fiscais e de saúde para obter benefícios substanciais à saúde com a redução da exposição

Background: Air pollution has been linked to mortality, but there are few studies examining the association with different exposure time windows spanning across several decades. The evidence for the effects of green space and mortality is contradictory.Objective: We investigated all-cause mortality in relation to exposure to particulate matter (PM2.5 and PM10), black carbon (BC), nitrogen dioxide (NO2), ozone (O3) and greenness (normalized difference vegetation index NDVI) across different exposure time windows.Methods: The exposure assessment was based on a combination of the Danish Eulerian Hemispheric Model and the Urban Background Model for the years 1990, 2000 and 2010. The analysis included a complete case dataset with 9,135 participants from the third Respiratory Health in Northern Europe study (RHINE III), aged 40-65 years in 2010, with mortality follow-up to 2021. We performed Cox proportional hazard models, adjusting for potential confounders.Results: Altogether, 327 (3.6 %) persons died in the period 2010-2021. Increased exposures in 1990 of PM2.5, PM10, BC and NO2 were associated with increased all-cause mortality hazard ratios of 1.40 (95 % CI1.04-1.87 per 5 mu g/m3), 1.33 (95 % CI: 1.02-1.74 per 10 mu g/m3), 1.16 (95 % CI: 0.98-1.38 per 0.4 mu g/m3) and 1.17 (95 % CI: 0.92-1.50 per 10 mu g/m3), respectively. No statistically significant associations were observed between air pollution and mortality in other time windows. O3 showed an inverse association with mortality, while no association was observed between greenness and mortality. Adjusting for NDVI increased the hazard ratios for PM2.5, PM10, BC and NO2 exposures in 1990. We did not find significant interactions between greenness and air pollution metrics.Conclusion: Long term exposure to even low levels of air pollution is associated with mortality. Opening up for a long latency period, our findings indicate that air pollution exposures over time may be even more harmful than anticipated.

Chronic kidney disease is the non-communicable disease with the highest growth in morbidity and mortality. Renal transplantation (RT) is the first option of renal replacement in end-stage kidney disease (ESKD) and dialysis is an alternative. However, there is no objective quantification of the impact of both options on a patient’s overall survival. The purpose of our study is to assess the potential years of life lost by patients on renal replacement therapy. Methods: Retrospective study cohort conducted from 2008 to 2018 based on autonomic data registry. Results: 11,551 patients included who received renal replacement therapy (RRT) in a range of age from 15 to 94 years. The mean age at the time of onset was 62.7 years, 95% confidence interval (95% CI) (62.4; 63.0). The mortality rate of RRT patients was 42.2%, 95% CI (41.5; 43.3) and the mean age at death was 72.7 years, 95% CI (72.4; 73.1). The number of patients with ESKD treated with RT was 3776, 32.7% of the total, 95% CI (31.8; 33.5). The total amount of years of potential life lost (YPLL) in the entire cohort was 77,831.3 years, 48,010.1 years in men, and 29,821.2 years in women. The mean number of YPLL per patient with RRT was 6.74 years in both sexes, 6.95 years in women, and 6.61 years in men. The mean number of potential years of life lost in dialysis patients was 9.0 years in both sexes, 8.8 years in men, and 9.2 years in women, while among kidney transplant recipients this figure decreased to 2.2 years in both men and women. Conclusions: End-stage chronic kidney disease in renal replacement therapy by dialysis causes an average of 9.0 years of life potentially lost for each patient on dialysis treatment, while having received a kidney transplant reduces this figure by 75.6%.

Background: Obesity is a serious public health concern worldwide, and nearly 40% of all adults in the United States and 21% in Sweden are now living with obesity. Efforts focusing mainly on weight loss have fallen short in reducing obesity prevalence. There is a great need for improved insight into what factors may promote a healthy weight, thereby avoiding the adverse health outcomes linked to obesity. Primary weight maintenance is a prevention strategy that emphasizes keeping a long-term stable weight in the non-obese range. Aim: The overall aims of this thesis were to improve understanding of the patterns of obesity and obesity-related mortality among rural adults in Central New York State (U.S.) and Västerbotten County (Sweden), and to explore factors that are related to primary weight maintenance. Material and methods: Data from U.S. health surveys and health examinations in Sweden were used to compare twenty-year (1989-2009) trends in body mass index (BMI) and obesity using multi-factor analysis of variance. The association between obesity and risk of 1) premature all-cause death, and 2) premature circulatory death, was compared between the U.S. and Sweden using proportional hazards regression. In 2009, a longitudinal questionnaire of attitudes, behaviors and perceptions regarding weight maintenance was administered to U.S. subjects. Associations between ten-year weight change and survey variables were tested using multiple linear regression, separately for sex and age strata. To gain a deeper understanding of influences, facilitators and barriers to healthy eating and physical activity, a qualitative interview study was conducted with U.S. women aged 26-35, with data analyzed by qualitative content analysis. Results: Over twenty years, BMI increased for both men and women in all age strata in both countries, and those with no university education consistently had higher BMI than their university-educated counterparts. BMI increased more for younger groups (ag, Zoom link: https://umu.zoom.us/j/67748741045

Background: Obesity is a serious public health concern worldwide, and nearly 40% of all adults in the United States and 21% in Sweden are now living with obesity. Efforts focusing mainly on weight loss have fallen short in reducing obesity prevalence. There is a great need for improved insight into what factors may promote a healthy weight, thereby avoiding the adverse health outcomes linked to obesity. Primary weight maintenance is a prevention strategy that emphasizes keeping a long-term stable weight in the non-obese range. Aim: The overall aims of this thesis were to improve understanding of the patterns of obesity and obesity-related mortality among rural adults in Central New York State (U.S.) and Västerbotten County (Sweden), and to explore factors that are related to primary weight maintenance. Material and methods: Data from U.S. health surveys and health examinations in Sweden were used to compare twenty-year (1989-2009) trends in body mass index (BMI) and obesity using multi-factor analysis of variance. The association between obesity and risk of 1) premature all-cause death, and 2) premature circulatory death, was compared between the U.S. and Sweden using proportional hazards regression. In 2009, a longitudinal questionnaire of attitudes, behaviors and perceptions regarding weight maintenance was administered to U.S. subjects. Associations between ten-year weight change and survey variables were tested using multiple linear regression, separately for sex and age strata. To gain a deeper understanding of influences, facilitators and barriers to healthy eating and physical activity, a qualitative interview study was conducted with U.S. women aged 26-35, with data analyzed by qualitative content analysis. Results: Over twenty years, BMI increased for both men and women in all age strata in both countries, and those with no university education consistently had higher BMI than their university-educated counterparts. BMI increased more for younger groups (ag, Zoom link: https://umu.zoom.us/j/67748741045

Background: Obesity is a serious public health concern worldwide, and nearly 40% of all adults in the United States and 21% in Sweden are now living with obesity. Efforts focusing mainly on weight loss have fallen short in reducing obesity prevalence. There is a great need for improved insight into what factors may promote a healthy weight, thereby avoiding the adverse health outcomes linked to obesity. Primary weight maintenance is a prevention strategy that emphasizes keeping a long-term stable weight in the non-obese range. Aim: The overall aims of this thesis were to improve understanding of the patterns of obesity and obesity-related mortality among rural adults in Central New York State (U.S.) and Västerbotten County (Sweden), and to explore factors that are related to primary weight maintenance. Material and methods: Data from U.S. health surveys and health examinations in Sweden were used to compare twenty-year (1989-2009) trends in body mass index (BMI) and obesity using multi-factor analysis of variance. The association between obesity and risk of 1) premature all-cause death, and 2) premature circulatory death, was compared between the U.S. and Sweden using proportional hazards regression. In 2009, a longitudinal questionnaire of attitudes, behaviors and perceptions regarding weight maintenance was administered to U.S. subjects. Associations between ten-year weight change and survey variables were tested using multiple linear regression, separately for sex and age strata. To gain a deeper understanding of influences, facilitators and barriers to healthy eating and physical activity, a qualitative interview study was conducted with U.S. women aged 26-35, with data analyzed by qualitative content analysis. Results: Over twenty years, BMI increased for both men and women in all age strata in both countries, and those with no university education consistently had higher BMI than their university-educated counterparts. BMI increased more for younger groups (ag, Zoom link: https://umu.zoom.us/j/67748741045

Background: Survival in patients with end-stage kidney disease (ESKD) on renal replacement therapy (RRT) is less than that of the general population of the same age, and depends on patient factors, the medical care received, and the type of RRT used. The objective of this study is to analyze the factors associated with survival in patients undergoing RRT. Methods: We conducted a retrospective observational study of adult patients with an incident of ESKD on RRT in Andalusia from 1 January 2008 to 31 December 2018. Patient characteristics, nephrological care received, and survival from the beginning of RRT were evaluated. A survival model for the patient was developed according to the variables studied. Results: A total of 11,551 patients were included. Median survival was 6.8 years (95% CI (6.6; 7.0)). After starting RRT, survival at one year and five years was 88.7% (95% CI (88.1; 89.3)) and 59.4% (95% CI (58.4; 60.4)), respectively. Age, initial comorbidity, diabetic nephropathy, and a venous catheter were independent risk factors. However, non-urgent initiation of RRT and follow-up in consultations for more than six months had a protective effect. It was identified that renal transplantation (RT) was the most influential independent factor in patient survival, with a risk ratio of 0.13 (95% CI (0.11; 0.14)). Conclusions: The receiving of a kidney transplant was the most beneficial modifiable factor in the survival of incident patients on RRT. We consider that the mortality of the renal replacement treatment should be adjusted, taking into account both modifiable and nonmodifiable factors to achieve a more precise and comparable interpretation.

Deep decarbonization paths to the 1.5 °C or 2 °C temperature stabilization futures require a rapid reduction in coal-fired power plants, but many countries are continuing to build new ones. Coal-fired plants are also a major contributor to air pollution related health impacts. Here, we couple an integrated human-earth system model (GCAM) with an air quality model (TM5-FASST) to examine regional health co-benefits from cancelling new coal-fired plants worldwide. Our analysis considers the evolution of pollutants control based on coal plants vintage and regional policies. We find that cancelling all new proposed projects would decrease air pollution related premature mortality between 101,388–213,205 deaths (2–5%) in 2030, and 213,414–373,054 (5–8%) in 2050, globally, but heavily concentrated in developing Asia. These health co-benefits are comparable in magnitude to the values obtained by implementing the Nationally Determined Contributions (NDCs). Furthermore, we estimate that strengthening the climate target from 2 °C to 1.5 °C would avoid 326,351 additional mortalities in 2030, of which 251,011 (75%) are attributable to the incremental coal plant shutdown.

When parents are unable to raise their children or to meet the minimum acceptable standards for their care, this can lead to involvement with child welfare services. In some cases, children are separated from their families and taken into out-of-home care (OHC). For good reason, prior research has primarily focused on the lifelong development of these children, and there is now extensive evidence showing that the experience of placement in OHC is predictive of worse outcomes in almost every dimension of adult life [1,2,3,4,5,6]. It is nonetheless likely that the treatment of OHC as a risk factor at the level of the individual child greatly underestimates the scope of the issue from a public health perspective. Here, we argue that gaining more knowledge about the familial circumstances under which the child welfare services enter—and, in many cases, later on exit—the scene would not only facilitate the understanding of why experiences of OHC tend to leave such long-lasting marks on children, but also how they reflect and contribute to inequalities at the population level.

IMPORTANCE Children who are placed in out-of-home care may have poorer outcomes in adulthood, on average, compared with their peers, but the direction and magnitude of these associations need clarification. OBJECTIVE To estimate associations between being placed in out-of-home care in childhood and adolescence and subsequent risks of experiencing a wide range of social and health outcomes in adulthood following comprehensive adjustments for preplacement factors. DESIGN, SETTING, PARTICIPANTS This cohort and cosibling study of all children born in Finland between 1986 and 2000 (N = 855622) monitored each person from their 15th birthday either until the end of the study period (December 2018) or until they migrated, died, or experienced the outcome of interest. Cox and Poisson regression models were used to estimate associations with adjustment for measured confounders (from linked population registers) and unmeasured familial confounders (using sibling comparisons). Data were analyzed from October 2020 to August 2021. EXPOSURES Placement in out-of-home care up to age 15 years. MAIN OUTCOMES AND MEASURES Through national population, patient, prescription drug, cause of death, and crime registers, 16 specific outcomes were identified across the following categories: psychiatric disorders; low socioeconomic status; injuries and experiencing violence; and antisocial behaviors, suicidality, and premature mortality. RESULTS A total of 30127 individuals (3.4%) were identified who had been placed in out-of-home care for a median (interquartile range) period of 1.3 (0.2-5.1) years and 2 (1-3) placement episodes before age 15 years. Compared with their siblings, individuals who had been placed in out-of-home care were 1.4 to 5 times more likely to experience adverse outcomes in adulthood (adjusted hazard ratio [aHR] for those with a fall-related injury, 1.40; 95% CI, 1.25-1.57 and aHR for those with an unintentional poisoning injury, 4.79; 95% CI, 3.56-6.43, respectively). The

Carotenoids are abundant pigments mainly contained in vegetables and fruits, and show antioxidant properties by quenching free radicals in human body. Few studies have investigated associations between serum carotenoid levels and premature mortality. The objective of this study was to investigate the association between serum carotenoid level and premature mortality in a Japanese population. This study included 446 Japanese adults (174 men, aged of 40–64) recruited as participants in the Japan Collaborative Cohort (JACC) Study. Serum carotenoid level was measured by high-performance liquid chromatography. Premature mortality was defined as death before 65 years old during the follow-up period. Premature mortality was ascertained in 60 men (34.5%) and 65 women (23.9%). In men, compared to the 1st tertile of serum b-cryptoxanthin and provitamin A, those who were in the 3rd tertile had lower risks of premature all-cause mortality (OR, 95% CI: 0.19, 0.07–0.47 for b-cryptoxanthin, and 0.24, 0.09–0.61 for provitamin A). In women, compared to the 1st tertile of serum b-cryptoxanthin, those who were in the 3rd tertile had higher risks of premature all-cause mortality (OR, 95% CI: 1.94, 1.00–4.03). These significant associations were observed in analyses for premature cancer mortality. We found significant associations between higher levels of serum b-cryptoxanthin and provitamin A and lower risks of premature mortality among Japanese men, while a different directional association was found in women. Although these findings suggest roles of serum carotenoids on premature mortality, further studies are needed to validate this association in other populations.

Introduction: Noncommunicable diseases have emerged as the main causes of death in the world, representing in 2019, 73.6% of all deaths from all causes and in Cuba 81.5%. Premature mortality from cardiovascular diseases turned out to be 34.7% of the total number of premature deaths globally. Objective: To describe mortality from ischemic heart, cerebrovascular and hypertensive diseases in Cuba, in the 2011- 2020 decade. Material and Methods: A descriptive longitudinal ecological study of annual mortality from ischemic heart, cerebrovascular and hypertensive diseases in Cuba was carried out in the 2011-2020 decade. Crude mortality rates for these diseases were taken into account. The statistical yearbooks published by the Directorate of Medical Records and Health Statistics of the Ministry of Public Health for those years were the source of information. Results: The annual mortality rates from ischemic heart, cerebrovascular and hypertensive diseases in Cuba showed overall increasing trends in the 2011- 2020 decade, more pronounced in the case of hypertensive diseases. An increase in premature mortality rates from these diseases was observed. Conclusions: Arterial hypertension constitutes a severe health problem in Cuba, both as a cause of death and as a risk factor attributable to mortality from ischemic heart and cerebrovascular diseases., Introducción: Las enfermedades no transmisibles se han erigido como las principales causas de muerte en el mundo, representando en 2019, 73,6 % del total de defunciones por todas las causas y en Cuba 81,5 %. La mortalidad prematura por enfermedades cardiovasculares, resultó ser 34,7 % del total de fallecidos prematuramente a nivel global. Objetivo: Describir la mortalidad por enfermedades isquémicas del corazón, cerebrovasculares e hipertensivas en Cuba, en el decenio 2011-2020. Material y Métodos: Se realizó un estudio ecológico longitudinal descriptivo de la mortalidad anual por enfermedades isquémicas del corazón, cerebrovasculares e hipertensivas en Cuba, en el decenio 2011-2020. Se tuvieron en cuenta, las tasas de mortalidad brutas por esas dolencias. Los anuarios estadísticos publicados por la Dirección de Registros Médicos y Estadísticas de Salud, del Ministerio de Salud Pública de esos años, fueron la fuente de información. Resultados: Las tasas de mortalidad anual por las enfermedades isquémicas del corazón, cerebrovasculares e hipertensivas en Cuba mostraron globalmente tendencias al incremento en el decenio 2011-2020, más pronunciada en el caso de las enfermedades hipertensivas. Se observó un incremento en las tasas de mortalidad prematura por dichas enfermedades. Conclusiones: La hipertensión arterial constituye un severo problema de salud en Cuba, tanto como causa de muerte, como factor de riesgo atribuible para la mortalidad por enfermedades isquémicas del corazón y cerebrovasculares.

Carotenoids are abundant pigments mainly contained in vegetables and fruits, and show antioxidant properties by quenching free radicals in human body. Few studies have investigated associations between serum carotenoid levels and premature mortality. The objective of this study was to investigate the association between serum carotenoid level and premature mortality in a Japanese population. This study included 446 Japanese adults (174 men, aged of 40–64) recruited as participants in the Japan Collaborative Cohort (JACC) Study. Serum carotenoid level was measured by high-performance liquid chromatography. Premature mortality was defined as death before 65 years old during the follow-up period. Premature mortality was ascertained in 60 men (34.5%) and 65 women (23.9%). In men, compared to the 1st tertile of serum b-cryptoxanthin and provitamin A, those who were in the 3rd tertile had lower risks of premature all-cause mortality (OR, 95% CI: 0.19, 0.07–0.47 for b-cryptoxanthin, and 0.24, 0.09–0.61 for provitamin A). In women, compared to the 1st tertile of serum b-cryptoxanthin, those who were in the 3rd tertile had higher risks of premature all-cause mortality (OR, 95% CI: 1.94, 1.00–4.03). These significant associations were observed in analyses for premature cancer mortality. We found significant associations between higher levels of serum b-cryptoxanthin and provitamin A and lower risks of premature mortality among Japanese men, while a different directional association was found in women. Although these findings suggest roles of serum carotenoids on premature mortality, further studies are needed to validate this association in other populations.

Smrtnost mladih u Srbiji je problem koji se često zanemaruje. U radu se kvantifikuje prevremeni mortalitet u Srbiji i to ukupan prevremeni mortalitet, kao i mortalitet izazvan pandemijom COVID-19 i aeroza-gađenjem sitnim PM2.5 česticama. Rezultati pokazuju da Srbija izgubi preko pola miliona godina potencijalnog života godišnje. Aerozaga-đenje PM2.5 najviše utiče na vojvođanske opštine. U radu su date preporuke u vidu promene paradigme kada je u pitanju populaciona politika (umesto pronatalitetne, na onu koja zdravlje stavlja u fokus populacione politike), revizije strateških dokumenata, fokusiranje na prevenciju i otvaranje podataka kao jeftinog načina da se podstakne istraživanje, informiše i edukuje šira javnost., Premature mortality in Serbia is a problem that is often overlooked. The paper quan-tifies the premature mortality in Serbia, the total premature mortality, as well as the mortality caused by the COVID-19 pandemic and PM2.5 air pollution. Detailed mor-tality (vital statistics based) data is combined with remote sensing data of PM2.5 es-timate how affected are the municipalities of Serbia by air pollution. The results show that Serbia loses over half a million years of potential life per year. Premature mortality due to PM2.5 air pollution is most prominent in municipalities of Vojvodina (North Banat). Results indicate that the initial year of pandemic does not paint a full picture when it comes to premature mortality caused by COVID-19. The paper offers recom-mendations in the form of a needed paradigm shift when it comes to population pol-icy (instead of a pronatalist one – to one that focuses on improvement of public health as a population policy), revision of strategic documents, focus on prevention and open-ing data as a cheap way to encourage research, inform and educate the public.

Deep decarbonization paths to the 1.5 °C or 2 °C temperature stabilization futures require a rapid reduction in coal-fired power plants, but many countries are continuing to build new ones. Coal-fired plants are also a major contributor to air pollution related health impacts. Here, we couple an integrated human-earth system model (GCAM) with an air quality model (TM5-FASST) to examine regional health co-benefits from cancelling new coal-fired plants worldwide. Our analysis considers the evolution of pollutants control based on coal plants vintage and regional policies. We find that cancelling all new proposed projects would decrease air pollution related premature mortality between 101,388–213,205 deaths (2–5%) in 2030, and 213,414–373,054 (5–8%) in 2050, globally, but heavily concentrated in developing Asia. These health co-benefits are comparable in magnitude to the values obtained by implementing the Nationally Determined Contributions (NDCs). Furthermore, we estimate that strengthening the climate target from 2 °C to 1.5 °C would avoid 326,351 additional mortalities in 2030, of which 251,011 (75%) are attributable to the incremental coal plant shutdown.

Smrtnost mladih u Srbiji je problem koji se često zanemaruje. U radu se kvantifikuje prevremeni mortalitet u Srbiji i to ukupan prevremeni mortalitet, kao i mortalitet izazvan pandemijom COVID-19 i aeroza-gađenjem sitnim PM2.5 česticama. Rezultati pokazuju da Srbija izgubi preko pola miliona godina potencijalnog života godišnje. Aerozaga-đenje PM2.5 najviše utiče na vojvođanske opštine. U radu su date preporuke u vidu promene paradigme kada je u pitanju populaciona politika (umesto pronatalitetne, na onu koja zdravlje stavlja u fokus populacione politike), revizije strateških dokumenata, fokusiranje na prevenciju i otvaranje podataka kao jeftinog načina da se podstakne istraživanje, informiše i edukuje šira javnost., Premature mortality in Serbia is a problem that is often overlooked. The paper quan-tifies the premature mortality in Serbia, the total premature mortality, as well as the mortality caused by the COVID-19 pandemic and PM2.5 air pollution. Detailed mor-tality (vital statistics based) data is combined with remote sensing data of PM2.5 es-timate how affected are the municipalities of Serbia by air pollution. The results show that Serbia loses over half a million years of potential life per year. Premature mortality due to PM2.5 air pollution is most prominent in municipalities of Vojvodina (North Banat). Results indicate that the initial year of pandemic does not paint a full picture when it comes to premature mortality caused by COVID-19. The paper offers recom-mendations in the form of a needed paradigm shift when it comes to population pol-icy (instead of a pronatalist one – to one that focuses on improvement of public health as a population policy), revision of strategic documents, focus on prevention and open-ing data as a cheap way to encourage research, inform and educate the public.

Recently, oil and natural gas (O&NG) production activities in the Denver-Julesburg Basin have expanded rapidly. Associated nonmethane hydrocarbon (NMHC) emissions contribute to photochemical formation of ground-level ozone and include benzene as well as other hazardous air pollutants. Using positive matrix factorization (PMF) and chemical mass balance (CMB) methods, we estimate how much O&NG activities and other sources contribute to morning NMHC mixing ratios measured from 2013 to mid-2016 at a site in Platteville, CO, in the Denver-Julesburg Basin, and at a contrasting site in downtown Denver. A novel adjoint sensitivity analysis method is then used to estimate corresponding contributions to ozone and ozone-linked mortality in the Denver region. Average 6-9 am NMHC mixing ratios in Platteville were seven times higher than those in Denver in 2013 but four times higher in 2016. CMB estimates that O&NG activities contributed to the Platteville (Denver) site an average of 96% (56%) of NMHC on a carbon basis while PMF indicated 92% (33%). Average vehicle-related contributions of NMHC are estimated as 41% by CMB and 53% by PMF in Denver. Estimates of the fractional contribution to potential ozone and ozone-linked mortality from O&NG activities are smaller while those from vehicles are larger than the NMHC contributions. CMB (PMF) indicate that greater than 78% (40%) of annual average benzene in Denver is attributable to vehicle emissions while greater than 75% (67%) of benzene in Platteville is attributable to O&NG activities.

Objectives: The study aims to make use of individual data to estimate the impact on premature mortality due to both existing commuter bicycling and the potential impact due to increased physical activity through shifting transport mode from car commuting to bicycling. Methods: Using registry data on home and work addresses for the population of Stockholm County the shortest bicycling route on a network of bicycle paths and roads was retrieved. Travel survey data were used to establish current modes of commuting. The relation between duration of bicycling and distance bicycled within the general population in 2015 was established as a basis for identifying individuals that currently drive a car to work but were estimated to have the physical capacity to bicycle to work within 30 min. Within this mode-shift scenario from car-to-bike the duration of bicycling per week was estimated, both among current and potential bicycle commuters. The health impact assessment (HIA) on mortality due to bicycle commuting physical activity was estimated using the same relative risk as within the WHO Health Economic Assessment Tool. Results: The current number of bicycle commuters were 53 000, and the scenario estimated an additional 111 000. Their mean bicycle distances were 4.5 and 3.4 km, respectively. On average these respective amounts of physical activity reduced the yearly mortality by 16% and 12%, resulting in 11.3 and 16.2 fewer preterm deaths per year. Conclusion: The HIA of transferring commuting by car to bicycle estimated large health benefits due to increased physical activity., FAAP

Deep decarbonization paths to the 1.5 °C or 2 °C temperature stabilization futures require a rapid reduction in coal-fired power plants, but many countries are continuing to build new ones. Coal-fired plants are also a major contributor to air pollution related health impacts. Here, we couple an integrated human-earth system model (GCAM) with an air quality model (TM5-FASST) to examine regional health co-benefits from cancelling new coal-fired plants worldwide. Our analysis considers the evolution of pollutants control based on coal plants vintage and regional policies. We find that cancelling all new proposed projects would decrease air pollution related premature mortality between 101,388–213,205 deaths (2–5%) in 2030, and 213,414–373,054 (5–8%) in 2050, globally, but heavily concentrated in developing Asia. These health co-benefits are comparable in magnitude to the values obtained by implementing the Nationally Determined Contributions (NDCs). Furthermore, we estimate that strengthening the climate target from 2 °C to 1.5 °C would avoid 326,351 additional mortalities in 2030, of which 251,011 (75%) are attributable to the incremental coal plant shutdown.

Germany has set itself the goal of reducing the premature mortality of under 70-year-old men to 190/100,000 and of women to 100/100,000 (age-standardized) by 2030. This is in line with the targets of the United Nations (UN) Sustainable Development Goals (SDG) (2015-2030) to reduce premature mortality by 34% for both men and women during this period.For the years 2010 to 2018, the premature mortality of 0-69-year-old men and women was calculated and standardized to the European population. On this basis, two linear trend calculations were made and compared with each other: 1. with the data of the target for Germany up to the year 2030, and 2. with the real figures achieved so far.The goal of reducing premature mortality by 34% within 15 years can, according to the current trend, only be achieved to 13.5% for men and 5.2% for women. Conclusions will be drawn from this as to how premature mortality can be reduced more significantly., Deutschland hat sich das Ziel gesetzt, die vorzeitige Sterblichkeit der unter 70-jährigen Männer auf 190/100.000 und der Frauen auf 100/100.000 (altersstandardisiert) bis zum Jahr 2030 zu senken. Das entspricht den Zielstellungen der Nachhaltigen Entwicklungsziele (SDG) der Vereinten Nationen (UN) (2015-2030), die vorzeitige Sterblichkeit in diesem Zeitraum um 34% für Männer und Frauen zu senken.Für die Jahre 2010 bis 2018 wurde die vorzeitige Sterblichkeit der unter 70-jährigen Männer und Frauen berechnet und auf die Europa-Bevölkerung standardisiert. Auf dieser Grundlage wurden zwei lineare Trendberechnungen vorgenommen und miteinander verglichen: 1. Mit den Daten der Zielstellung für Deutschland bis zum Jahr 2030 und 2. mit den bisher real erreichten Zahlen.Das Ziel, die vorzeitige Mortalität um 34% innerhalb von 15 Jahren zu senken, kann nach dem gegenwärtigen Trend nur bis 13,5% für Männer und bis 5,2% für Frauen erreicht werden. Daraus werden Schlussfolgerungen abgeleitet, wie die vorzeitige Sterblichkeit stärker abgesenkt werden kann.

Objectives: The study aims to make use of individual data to estimate the impact on premature mortality due to both existing commuter bicycling and the potential impact due to increased physical activity through shifting transport mode from car commuting to bicycling. Methods: Using registry data on home and work addresses for the population of Stockholm County the shortest bicycling route on a network of bicycle paths and roads was retrieved. Travel survey data were used to establish current modes of commuting. The relation between duration of bicycling and distance bicycled within the general population in 2015 was established as a basis for identifying individuals that currently drive a car to work but were estimated to have the physical capacity to bicycle to work within 30 min. Within this mode-shift scenario from car-to-bike the duration of bicycling per week was estimated, both among current and potential bicycle commuters. The health impact assessment (HIA) on mortality due to bicycle commuting physical activity was estimated using the same relative risk as within the WHO Health Economic Assessment Tool. Results: The current number of bicycle commuters were 53 000, and the scenario estimated an additional 111 000. Their mean bicycle distances were 4.5 and 3.4 km, respectively. On average these respective amounts of physical activity reduced the yearly mortality by 16% and 12%, resulting in 11.3 and 16.2 fewer preterm deaths per year. Conclusion: The HIA of transferring commuting by car to bicycle estimated large health benefits due to increased physical activity., FAAP

Objectives: The study aims to make use of individual data to estimate the impact on premature mortality due to both existing commuter bicycling and the potential impact due to increased physical activity through shifting transport mode from car commuting to bicycling. Methods: Using registry data on home and work addresses for the population of Stockholm County the shortest bicycling route on a network of bicycle paths and roads was retrieved. Travel survey data were used to establish current modes of commuting. The relation between duration of bicycling and distance bicycled within the general population in 2015 was established as a basis for identifying individuals that currently drive a car to work but were estimated to have the physical capacity to bicycle to work within 30 min. Within this mode-shift scenario from car-to-bike the duration of bicycling per week was estimated, both among current and potential bicycle commuters. The health impact assessment (HIA) on mortality due to bicycle commuting physical activity was estimated using the same relative risk as within the WHO Health Economic Assessment Tool. Results: The current number of bicycle commuters were 53 000, and the scenario estimated an additional 111 000. Their mean bicycle distances were 4.5 and 3.4 km, respectively. On average these respective amounts of physical activity reduced the yearly mortality by 16% and 12%, resulting in 11.3 and 16.2 fewer preterm deaths per year. Conclusion: The HIA of transferring commuting by car to bicycle estimated large health benefits due to increased physical activity., FAAP

Introduction: Injuries due to external causes are one of the main worldwide public health problems. The standardized methodology to evaluate burden diseases through the disability-adjusted life years (DALYs) allows us to know the health condition in a population and prioritize actions. Objective: To determine the burden of disease in terms of disability and death as consequence of injuries due to external causes in Bucaramanga, 2017. Methodology:descriptive study was conducted. The DALYs produced by injuries due to external causes were estimated using information from the National Administrative Department of Statistics, the National Public Health Surveillance System and the Individual Registry of Service Provision of Health databases from 2017 for the city of Bucaramanga, Colombia. Results: The global burden of diseases due to external causes was estimated at 12.04 DALYs per 1000 inhabitants; 0.51 DALYs were attributed to disability and 11.53 DALYs to mortality. Assaults and road traffic accident injuries (RTAI) were the main external causes with higher DALYs. In the population between 5 and 59 years old, assaults and RTAI had the highest DALYs attributed to mortality. RTAI were the first external cause of DALYSs in the population between 60 and 79 years old, and the second cause in the population older than 80 years. Conclusion: Considering that RTAI was the external cause with the highest DALYs attributed to premature mortality, it is recommended to implement or intensify high-impact strategies to reduce RTAI., Introducción: las lesiones por causa externa son uno de los principales problemas de salud pública en el mundo, y la metodología estandarizada de carga de enfermedad a través de los años de vida saludable perdidos (AVISAS) permite conocer el estado de salud poblacional y priorizar acciones. Objetivo: determinar la carga de enfermedad en términos de discapacidad y muerte como consecuencia de lesiones por causas externas en Bucaramanga, 2017. Diseño metodológico: estudio descriptivo de carga de la enfermedad. Se estimó los AVISAS producidos por LCE utilizando las bases de datos del Departamento Administrativo Nacional de Estadísticas, Sistema de Nacional de Vigilancia en Salud Pública y Registro Individual de la Prestación de Servicios de Salud, del año 2017, de la ciudad de Bucaramanga. Resultados: se estimó una carga global de enfermedad por LCE de 12,04 AVISAS por cada 1000 personas; 0,51 AVISAS atribuibles a discapacidad y 11,53 AVISAS, a mortalidad. Las agresiones y accidentes de tránsito (AT) son las dos principales LCE con mayor número de AVISAS. En la población de 5-59 años las agresiones y AT presentan AVISAS por mortalidad de mayor peso; los AT son la principal causa externa en la población de 60 a 79 años y la segunda en mayores de 80 años. Conclusiones: considerando que los AT fueron la causa externa con las más altas AVISAS atribuidas a mortalidad prematura, se recomienda implementar o intensificar estrategias de alto impacto que contribuyan a disminuir los AT.

Recently, oil and natural gas (O&NG) production activities in the Denver-Julesburg Basin have expanded rapidly. Associated nonmethane hydrocarbon (NMHC) emissions contribute to photochemical formation of ground-level ozone and include benzene as well as other hazardous air pollutants. Using positive matrix factorization (PMF) and chemical mass balance (CMB) methods, we estimate how much O&NG activities and other sources contribute to morning NMHC mixing ratios measured from 2013 to mid-2016 at a site in Platteville, CO, in the Denver-Julesburg Basin, and at a contrasting site in downtown Denver. A novel adjoint sensitivity analysis method is then used to estimate corresponding contributions to ozone and ozone-linked mortality in the Denver region. Average 6-9 am NMHC mixing ratios in Platteville were seven times higher than those in Denver in 2013 but four times higher in 2016. CMB estimates that O&NG activities contributed to the Platteville (Denver) site an average of 96% (56%) of NMHC on a carbon basis while PMF indicated 92% (33%). Average vehicle-related contributions of NMHC are estimated as 41% by CMB and 53% by PMF in Denver. Estimates of the fractional contribution to potential ozone and ozone-linked mortality from O&NG activities are smaller while those from vehicles are larger than the NMHC contributions. CMB (PMF) indicate that greater than 78% (40%) of annual average benzene in Denver is attributable to vehicle emissions while greater than 75% (67%) of benzene in Platteville is attributable to O&NG activities.

Objectives: The study aims to make use of individual data to estimate the impact on premature mortality due to both existing commuter bicycling and the potential impact due to increased physical activity through shifting transport mode from car commuting to bicycling. Methods: Using registry data on home and work addresses for the population of Stockholm County the shortest bicycling route on a network of bicycle paths and roads was retrieved. Travel survey data were used to establish current modes of commuting. The relation between duration of bicycling and distance bicycled within the general population in 2015 was established as a basis for identifying individuals that currently drive a car to work but were estimated to have the physical capacity to bicycle to work within 30 min. Within this mode-shift scenario from car-to-bike the duration of bicycling per week was estimated, both among current and potential bicycle commuters. The health impact assessment (HIA) on mortality due to bicycle commuting physical activity was estimated using the same relative risk as within the WHO Health Economic Assessment Tool. Results: The current number of bicycle commuters were 53 000, and the scenario estimated an additional 111 000. Their mean bicycle distances were 4.5 and 3.4 km, respectively. On average these respective amounts of physical activity reduced the yearly mortality by 16% and 12%, resulting in 11.3 and 16.2 fewer preterm deaths per year. Conclusion: The HIA of transferring commuting by car to bicycle estimated large health benefits due to increased physical activity., FAAP

Recently, oil and natural gas (O&NG) production activities in the Denver-Julesburg Basin have expanded rapidly. Associated nonmethane hydrocarbon (NMHC) emissions contribute to photochemical formation of ground-level ozone and include benzene as well as other hazardous air pollutants. Using positive matrix factorization (PMF) and chemical mass balance (CMB) methods, we estimate how much O&NG activities and other sources contribute to morning NMHC mixing ratios measured from 2013 to mid-2016 at a site in Platteville, CO, in the Denver-Julesburg Basin, and at a contrasting site in downtown Denver. A novel adjoint sensitivity analysis method is then used to estimate corresponding contributions to ozone and ozone-linked mortality in the Denver region. Average 6-9 am NMHC mixing ratios in Platteville were seven times higher than those in Denver in 2013 but four times higher in 2016. CMB estimates that O&NG activities contributed to the Platteville (Denver) site an average of 96% (56%) of NMHC on a carbon basis while PMF indicated 92% (33%). Average vehicle-related contributions of NMHC are estimated as 41% by CMB and 53% by PMF in Denver. Estimates of the fractional contribution to potential ozone and ozone-linked mortality from O&NG activities are smaller while those from vehicles are larger than the NMHC contributions. CMB (PMF) indicate that greater than 78% (40%) of annual average benzene in Denver is attributable to vehicle emissions while greater than 75% (67%) of benzene in Platteville is attributable to O&NG activities.

[Resumen]: La contaminación del aire y en concreto la contaminación por material particulado (PM10 y PM2.5) constituye un riesgo emergente para la salud humana. En este trabajo se aproxima la relación entre los contaminantes PM10 y PM2.5 y las tasas de fallecidos y hospitalizados por ictus en España para el año 2018, así como la consecuente estimación del coste económico de hospitalizaciones y muertes prematuras. Usando datos a nivel provincial sobre el total de fallecimientos y hospitalizaciones por ictus, variables socioeconómicas como el PIB per cápita, la edad media de la población y el número de médicos como proxy del sistema sanitario, se ha construido un modelo de regresión para fundamentar la asociación entre variables. Para la estimación del coste económico se ha procedido con el método basado en el Valor de la Vida Estadística. Los resultados evidencian una relación directa entre el material particulado y el ictus, dejando un coste económico de más de 5 mil millones de euros, lo que supone el 0,55% del PIB de nuestro país. Como posible solución, entre las principales politicas públicas que se pueden articular, los gobiernos podrían apostar por la vía de los mercados de cupos de contaminantes o incluso optar por impuestos pigouvianos a través de políticas fiscales que penalicen las principales fuentes de emisión de PM10 y PM2.5., [Abstract]: Air pollution and in specific pollution by particulate matter (PM10 and PM2.5) constitutes an emerging risk for human health. This project aims to approximate the relationship between the pollutants PM10 and PM2.5 and the rates of deaths and hospitalizations due to stroke in Spain in 2018, as well as the consequent estimation of the economic cost of hospitalizations and premature deaths. Using data by provincial level of the total number of deaths and hospitalizations due to stroke, socioeconomic variables such as GDP per capita, the average age of the population and the number of physicians as a proxy of the health system, a regression model has been built to support the association between variables. To estimate the economic cost, we have proceeded with the method based on the Value of a Statistical Life. The results show a direct relationship between particulate matter and stroke, leaving an economic cost of more than 5 billion euros, which is 0,55% of our country’s GDP. As a possible solution to the problem, among the main public policies that can be articulated, governments could opt for pollutant quota markets or even opt for pigouvian taxes through fiscal policies that penalize the main sources of PM10 and PM2.5 emissions.

Objectives: The study aims to make use of individual data to estimate the impact on premature mortality due to both existing commuter bicycling and the potential impact due to increased physical activity through shifting transport mode from car commuting to bicycling. Methods: Using registry data on home and work addresses for the population of Stockholm County the shortest bicycling route on a network of bicycle paths and roads was retrieved. Travel survey data were used to establish current modes of commuting. The relation between duration of bicycling and distance bicycled within the general population in 2015 was established as a basis for identifying individuals that currently drive a car to work but were estimated to have the physical capacity to bicycle to work within 30 min. Within this mode-shift scenario from car-to-bike the duration of bicycling per week was estimated, both among current and potential bicycle commuters. The health impact assessment (HIA) on mortality due to bicycle commuting physical activity was estimated using the same relative risk as within the WHO Health Economic Assessment Tool. Results: The current number of bicycle commuters were 53 000, and the scenario estimated an additional 111 000. Their mean bicycle distances were 4.5 and 3.4 km, respectively. On average these respective amounts of physical activity reduced the yearly mortality by 16% and 12%, resulting in 11.3 and 16.2 fewer preterm deaths per year. Conclusion: The HIA of transferring commuting by car to bicycle estimated large health benefits due to increased physical activity., FAAP

Objectives: The study aims to make use of individual data to estimate the impact on premature mortality due to both existing commuter bicycling and the potential impact due to increased physical activity through shifting transport mode from car commuting to bicycling. Methods: Using registry data on home and work addresses for the population of Stockholm County the shortest bicycling route on a network of bicycle paths and roads was retrieved. Travel survey data were used to establish current modes of commuting. The relation between duration of bicycling and distance bicycled within the general population in 2015 was established as a basis for identifying individuals that currently drive a car to work but were estimated to have the physical capacity to bicycle to work within 30 min. Within this mode-shift scenario from car-to-bike the duration of bicycling per week was estimated, both among current and potential bicycle commuters. The health impact assessment (HIA) on mortality due to bicycle commuting physical activity was estimated using the same relative risk as within the WHO Health Economic Assessment Tool. Results: The current number of bicycle commuters were 53 000, and the scenario estimated an additional 111 000. Their mean bicycle distances were 4.5 and 3.4 km, respectively. On average these respective amounts of physical activity reduced the yearly mortality by 16% and 12%, resulting in 11.3 and 16.2 fewer preterm deaths per year. Conclusion: The HIA of transferring commuting by car to bicycle estimated large health benefits due to increased physical activity., FAAP

Since the demographic situation in the Russian Federation is characterised by high mortality of the economically active population, it is necessary to assess significant economic and social losses for the country and its regions. In this regard, the importance of the research lies in developing a methodology to assess economic losses from premature mortality of the population. We hypothesise that both the loss of production of goods and services and the volume of their consumption determine the value of economic losses from premature mortality, which can be differentiated by gender, age and causes of death of the population, depending on regional characteristics. As the main research methods, we applied statistical data analysis using the methodology of the System of National Accounts (SNA). Then, we proposed a methodological approach to a comprehensive assessment of economic losses from premature mortality of the population based on three differentiating features such as gender, age, and cause of death. Moreover, we structure economic losses, depending on the components of the gross regional product in the present and in the future. We have substantiated the feasibility of considering the consumption of goods and services by the unemployed population aged from 0 to 72 years in the structure of economic losses from premature mortality. We tested the methodology on the statistical database of Federal State Statistic Service (Rosstat) for the Perm region in the period 2009 — 2017. The methodological approach allowed us to comprehensively analyse the economic losses from premature mortality of the population in the region. In contrast to those strategies described in the academic literature, our methodology provides a more complete assessment of the magnitude of economic losses, allowing the selection of effective tools for regional health policy., Демографическая ситуация в Российской Федерации характеризуется высокой смертностью населения в экономически активных возрастах, формирующей значительные экономические и социальные потери страны и ее регионов, которые требуют адекватной оценки. В этой связи научная значимость представленных результатов исследования обусловлена необходимостью развития методического обеспечения оценки экономических потерь региона от преждевременной смертности населения. Гипотеза исследования: величина экономических потерь региона от преждевременной смертности определяется потерей объемов не только производства товаров и услуг, но и их потребления, и дифференцируется по полу, возрасту и классам причин смерти населения, имеющим региональные различия. В качестве основных методов исследования применен статистический анализ данных с использованием методологии системы национальных счетов (СНС). В статье предложен представляющий новизну результатов исследования методический подход к оценке потерь региона от преждевременной смертности населения с использованием трех дифференцирующих признаков: пол, возраст, класс причин смерти и структурирования потерь по составляющим валового регионального продукта настоящего и будущего периодов. Обоснована целесообразность учета в структуре экономических потерь сокращения объемов потребления товаров и услуг не занятым в экономике региона населением в возрастном диапазоне от 0 до 72 лет. Методический инструментарий апробирован на статистической базе данных Росстата по Пермскому краю за период 2009–2017 гг. Методический подход позволяет проводить комплексную оценку потерь экономики региона от преждевременной смертности населения и, в отличие от имеющихся в научной литературе, обеспечивает более полную оценку величины данных потерь, позволяя осуществлять выбор результативных инструментов региональной политики в сфере снижения преждевременной смертности.

Research shows consistently that social ties are important for longevity, and they may be particularly important during adolescence. An absence of social ties, or social isolation, during adolescence may adversely affect long-term health and wellbeing. While prior research has examined associations between isolation from friends and long-term health, and having no siblings and mortality, no study (of which we are aware) considers jointly both the role of having no friends and no siblings, nor more generally with whom adolescents spend time, and the risk of premature mortality. This paper extends the literature by drawing on data from the Stockholm Birth Cohort Study to examine the association between different types of social isolation during adolescence (i.e., an absence of friends, siblings, and time with other adolescents) and the risk of premature mortality by midlife. Results suggest that having no siblings, being unliked at school, and spending (mostly) no time with other adolescents, increases the risk of premature mortality. The association between being unliked and premature mortality was attenuated by demographic and adolescent characteristics. Consistent with our expectations, net of a robust set of covariates, adolescents who had no siblings and mostly spent no time with other adolescents (i.e., isolates) were the group most vulnerable to premature mortality by midlife. However, this was only true for females., Reproduction of inequality through linked lives (RELINK)