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Background: Homicide is killing of human being by another human being, which is one of the oldest crimes in human civilization. It started from the murder of Abel by the hands of Cane. Violence is a significant public health problem and homicide is severest form of violence, depriving a human being of his fundamental right to live. Homicide is prevalent widely almost all over the world. Nowadays, the increasing incidence of homicide is worldwide and it is manner of great concern. Methods: This study was conducted at Dept. Of Forensic Medicine and Toxicology, Smt. N. H. L. Municipal Medical College, Ellisbridge, Ahmedabad. The present study was conducted over period of July 2009 to November 2011. Out of which 50 were considered as homicidal death after going through inquest papers and indoor case papers. Results: Homicidal deaths constituted of 50/2639 (1.86%) all autopsies. Ratio of male to female victim was 1.94:1. Near half of victims were of age 21-40 years (48%). Head injury constituted the most common cause of death (34%) and near half of homicides (46%) caused by sharp and pointed weapons. The head, neck and face sustained the highest numbers of injuries 28 (56%) followed by thorax 12 (24%) and abdomen 10 (20%). Majority of cases were occurred during summer season (40%) very closely followed by winter (30%) and monsoon (30%). More than half (58%) of the cases occurred during night hours 15 (30%) and evening hours 14 (28%). 31 (62%) cases were with known motives among which personal dispute plays a major role. Conclusion: In this study, young age victims constituted the dominant group. Sharp weapons were commonly employed in this region for homicide. Proper counselling for developing positive attitude and controlling the aggression in youth have to be promoted at large by the government. [ABSTRACT FROM AUTHOR]

This paper concerns the difficulty of taking long-term effects on health into account in an economic valuation. Indeed, public decision makers should incorporate the cessation lag between implementation of an abatement policy and achievement of all of the expected mortality-related benefits for any projects involving health impacts. This paper shows how this time lag problem can be handled by proposing two approaches—either in terms of deaths avoided or of life years saved—within a dynamic perspective. The main findings are that long-term health benefits calculated by standard methods and widely applied to adverse health effects should be corrected downwards when incorporated into an economic analysis. The magnitude of correction depends on the discount rate, on technical choices dealing with epidemiology and on the method chosen to assess mortality benefits. [ABSTRACT FROM AUTHOR]

Over the past two decades methamphetamine-related harms have increased in Australia. Previous analysis of methamphetamine-related deaths has covered limited timeframes, and largely focused on drug-toxicity deaths. This paper examines long-term trends in methamphetamine-related deaths over 20 years, including deaths due to a range of specific causes. Descriptive analyses were conducted on Australian methamphetamine-related deaths (2001–2023) by cause, extracted from the National Coronial Information System, an online database containing deaths reported to coroners in Australia and New Zealand. Joinpoint trend analyses were used to assess changes over time between 2001 and 2020 (with data from 2021 to 2023 likely incomplete and thus excluded). Unintentional drug toxicity was the cause of 49.8 % of methamphetamine-related deaths, intentional self-harm (including toxicity) 23.3 %, unintentional injury 15.1 %, natural causes 9.6 %, and assaults 2.3 %. Between 2001 and 2020, joinpoint analysis showed three trend change points among all-cause methamphetamine-related mortality rates, resulting in four distinct periods: two periods where they increased (2001–2006 – annual percentage change (APC) = 15.4 %; 2009–2016 – APC 25.5 %), and two where they decreased (2006–2009 – APC = –11.8 %; 2017–2020 – APC = –2.9 %). Similar patterns were evident among rates of intentional self-harm and unintentional injury. Deaths caused by unintentional drug toxicity saw two trend change points (2011, 2016), and rates increased across all three periods. Natural cause deaths had three trend change points (2007, 2010, 2015), and rates continued to rise after 2015, largely driven by increases in circulatory diseases. Cause-specific models highlighted diverse trends. Recent trends show unintentional drug toxicity deaths have slightly increased, intentional self-harm stabilised, and unintentional injury and assault deaths have declined. Deaths from natural causes involving methamphetamine continued to increase, highlighting a public health concern and a potential need for early circulatory disease screening among people who use methamphetamine. [ABSTRACT FROM AUTHOR]

Introduction: Several regions in Canada have recently experienced sharp increases in opioid overdoses and related hospitalizations and deaths. This paper describes opioidrelated mortality and disability from opioid use disorder in Canada from 1990 to 2014 using data from the Global Burden of Disease (GBD) study. Methods: We used data from the GBD study to describe temporal trends (1990-2014) in opioid-related mortality and disability from opioid use disorder using common metrics: disability-adjusted life years (DALY), deaths, years of life lost (YLL) and years lived with disability (YLD). We also compared age-standardized YLL and DALY rates per 100 000 population between Canada, the USA and other regions. Results: The age-standardized opioid-related DALY rate in Canada was 355.5 per 100 000 population in 2014, which was higher than the global rate of 193.2, but lower than the rate of 767.9 in the United States. Between 1990 and 2014, the age-standardized opioid-related YLL rate in Canada increased by 142.2%, while globally this rate decreased by 10.1%. In comparison with YLL, YLD accounted for a larger proportion of the overall opioid-related burden across all age groups. Health loss was greater for males than females, and highest among those aged 25 to 29 years. Conclusion: The health burden associated with opioid-related mortality and disability from opioid use disorder in Canada is significant and has increased dramatically from 1990 to 2014. These data point to a need for public health action including enhanced monitoring of a range of opioid-related harms. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper highlights and expands on the extensive work concerning extreme heat events, and the environmental and societal factors that affect human health. Selections of this work were presented originally in a Union of Concerned Scientists public report (' Heat in the Heartland'). As humans respond concomitantly to a suite of meteorological variables, we accordingly aim to examine summertime frequencies and characteristics of select synoptic weather types in the Midwestern United States, particularly those associated with elevated health impacts risk. We analyse five major urban centres, paired with five nearby smaller cities, to investigate the potential relative differences due to urban form and size. In virtually all of these locales, the frequency of health-debilitating hot weather types has increased in the six most recent decades, with many of these also demonstrating statistically significant upward trends in air and dew point temperatures. This is most prevalent for overnight temperatures, where the hottest weather types display increasing overnight temperatures in both large and small cities, thus causing the diurnal temperature ranges to decrease. Furthermore, the prevalence of three or more consecutive runs of these days is on the rise, with all five large cities experiencing a higher number of heat waves today than in the late 1940s. We emphasize the importance of city-level efforts to assist in minimizing future climate-related health risks. Finally, we demonstrate the increasing human mortality response in one select city (Detroit, MI), which is estimated without the presence of city-level efforts, targeted interventions, adaptation strategies, or physiological acclimatization. This highlights the importance of providing accurate heat-health warnings to the public, and provides essential understanding of the Midwest US region's summertime climate trends. [ABSTRACT FROM AUTHOR]

This paper reviews the literature on the effects of post-disaster relocation on physical and mental heath, and develops a conceptual framework to guide future research. Forty articles were selected for full-text review and incorporation into the conceptual framework. Twenty-four articles were reviewed for results and methodology. These overwhelmingly tracked mental health outcomes. Only four (16 per cent) focused on physical health. Eight of ten showed an association between relocation and psychological morbidity. Certain outcomes (such as mortality, injury and cardiovascular disease risk factors) revealed inconsistent results, but these were rarely studied. Despite the frequency of post-disaster relocation and evidence of its effect on psychological morbidity, there is a relative paucity of studies; the few examples in the literature reveal weak study designs, inconsistent results, and inattention to physical health impacts and the challenges facing vulnerable populations. Further research guided by theory is needed to inform emergency preparedness and recovery policy. [ABSTRACT FROM AUTHOR]

Abstract: There is renewed interest in understanding how fluctuations in mortality and in health are related to fluctuations in economic conditions. The traditional perspective that economic recessions lower health and raise mortality has been challenged by recent findings that reveal mortality is actually procyclical. The epidemiology of the phenomenon – traffic accidents, cardiovascular disease, and smoking and drinking – suggests that socioeconomically vulnerable populations might be disproportionately at risk of “working themselves to death” during periods of heightened economic activity. In this paper, I examine mortality by individual characteristic during the 1980s and 1990s using the U.S. National Longitudinal Mortality Study. I find scant evidence that disadvantaged groups are significantly more exposed to procyclical mortality. Rather, working-age men with more education appear to bear a heavier burden, while those with little education experience countercyclical mortality. [Copyright &y& Elsevier]

This paper aims to measure whether there are country variations in the efficiency of the physician workforce in reducing various measures of mortality across 21 OECD countries over 3 decades. It utilises a multilevel modelling approach both to measure country variations in physician efficiency and to explore the determinants of these variations. The results suggested that physician numbers are an important determinant of mortality across OECD countries, and cross-country heterogeneity in the effect of physician availability on health is significant. We also found that availability of advanced medical technology is an important factor intervening in this relationship. [ABSTRACT FROM AUTHOR]

Background and aims: Alcohol use has been identified as a major risk factor for burden of mortality and disease, particularly for countries in eastern Europe. During the past two decades, several countries in this region have implemented effective alcohol policy measures to combat this burden. The aim of the current study was to measure the association between Lithuania's alcohol control policies and adult all‐cause mortality. Design Interrupted time–series methodology by means of general additive models. Setting: Lithuania. Participants: Adult population of Lithuania, aged 20 years and older. Measurements Alcohol control policies were ascertained via a document review of relevant legislation materials. Policy effects were evaluated as follows: (1) slope changes in periods of legislative (non‐)activity with regard to alcohol control policy (analysis 1); (2) level changes of three interventions following recommendations of the World Health Organization (analysis 2); and (3) level changes of seven interventions judged a priori by an international panel of experts (analysis 3). Mortality was measured by sex‐stratified and total monthly age‐standardized rates of all‐cause mortality for the adult population. Findings During the period 2001–18, effective alcohol control policy measures were implemented on several occasions, and in those years the all‐cause mortality rate declined by approximately 3.2% more than in years without such policies. In particular, the implementation of increased taxation in 2017 was associated with reduced mortality over and above the general trend for men and in total for all analyses, which amounted to 1452 deaths avoided (95% confidence interval = −166 to –2739) in the year following the implementation of the policy. Conclusions: Alcohol control policies in Lithuania appear to have reduced the overall adult all‐cause mortality over and above secular trends. [ABSTRACT FROM AUTHOR]

Data are available to study the variation in mortality in this country occurring month by month for fully six decades. Death rates by month have been computed and published for the expanding death-registration area of the United States of 1900-1932 and for the complete nation (48 States and ultimately 50 States) from 1933 to the present. Even a cursory glance at the available data leads to the obvious conclusion that a definite pattern of seasonal variation of deaths exists. This seasonal swing is characterized by a high death rate in the early part of the year dropping to a trough in the summer months, and rising again during the latter part of the year. The general pattern is well recognized, as are similar seasonal curves for various causes of death. Despite the apparent wealth of statistical material at hand relatively little analytical matter has been produced in this country measuring seasonality of mortality as compared with the wide range of data compiled for statistical series portraying the nation's economic operations. Yet seasonal variation is receiving increasing attention in the evaluation of statistics of vital events. The very factors which make seasonal indices so valuable to economists and analysts also have proved to be of service to demographers and public health researchers. Seasonal adjustments provide refined information about current trends; they separate the seasonal components of statistical data from cyclical and irregular fluctuations; they provide indices with which to measure the significance of month to month change. Seasonal variation in the crude birth rate has been analyzed for the period 1933-40 using the link relative method [1]. Seasonal indices for 1948-54 were prepared with the aid of Univac, the high-speed electronic computer of the United States Bureau of the Census, using an adaptation of the standard ratio to moving average method [2]. The indices prepared by the Bureau of the Census became the basis for the regular computation of seasonally adjusted figures of births by the National Vital Statistics Division, U. S. Public Health Service 131. Similarly, marriage data published by the National Vital Statistics Division have been "deseasonalized" with the aid of methods developed by the Bureau of the Census [4]. This paper presents the results of an effort made with the assistance of Univac to eliminate seasonal variation from mortality data. Some of the particular problems encountered in adjusting mortality data, and the attempts to surmount these are described. [ABSTRACT FROM AUTHOR]

In a major recent review of the causes of death in the U.S., researchers found, unsurprisingly, that smoking remains the leading cause of mortality. The researchers also concluded, notably, that poor diet and physical inactivity may soon overtake tobacco as the leading cause of death. The reaction to this news was swift, broad, curious, and instructive. Researchers ultimately state that their findings argue persuasively that the need to establish a more preventive orientation in the U.S. health care and public health systems has become more urgent. Not smoking prevention or obesity prevention, but simply an overall more preventive orientation.

Despite a marked improvement in 10-year survival for systemic lupus erythematosus (SLE) patients over the past five decades, mortality rates from SLE remain high compared to those in the general population. SLE was also among the leading causes of death in young women in the United States during 2000-2015. However, it is encouraging that SLE mortality rates and the ratios of SLE mortality rates to non-SLE mortality rates have decreased every year since the late 1990s. Despite this improvement, disparities in SLE mortality persist according to sex, race, age, and place of residence. Furthermore, demographic and geographic variables seem to modify the effect of each other in influencing SLE mortality, leading to interactions between sex/race/ethnicity-associated factors and geographic differences. In other words, individuals of the same sex/race/ethnicity had differences in SLE mortality depending on where they lived. These observations highlight SLE as an important public health issue. The recognition of SLE as a leading cause of death in the general population might spur targeted public health programs and research funding to address the high lupus mortality. [ABSTRACT FROM AUTHOR]

Background: Cause-specific mortality trends are routinely reported for Scotland. However, ill-defined deaths are not routinely redistributed to more precise and internationally comparable categories nor is the mortality reported in terms of years of life lost to facilitate the calculation of the burden of disease. This study describes trends in Years of Life Lost (YLL) for specific causes of death in Scotland from 2000 to 2015. Methods: We obtained records of all deaths in Scotland by age, sex, area and underlying cause of death between 2000 and 2015. We redistributed Ill-Defined Deaths (IDDs) to more exact and meaningful causes using internationally accepted methods. Years of Life Lost (YLL) using remaining life expectancy by sex and single year of age from the 2013 Scottish life table were calculated for each death. These data were then used to calculate the crude and age-standardised trends in YLL by age, sex, cause, health board area, and area deprivation decile. Results: Between 2000 and 2015, the annual percentage of deaths that were ill-defined varied between 10% and 12%. The proportion of deaths that were IDDs increased over time and were more common: in women; amongst those aged 1–4 years, 25–34 years and >80 years; in more deprived areas; and in the island health boards. The total YLL fell from around 17,800 years per 100,000 population in 2000 to around 13,500 years by 2015. The largest individual contributors to YLL were Ischaemic Heart Disease (IHD), respiratory cancers, Chronic Obstructive Pulmonary Disease (COPD), cerebrovascular disease and Alzheimer’s/dementia. The proportion of total YLL due to IHD and stroke declined over time, but increased for Alzheimer’s/dementia and drug use disorders. There were marked absolute inequalities in YLL by area deprivation, with a mean Slope Index of Inequality (SII) for all causes of 15,344 YLL between 2001 and 2015, with IHD and COPD the greatest contributors. The Relative Index of Inequality (RII) for YLL was highest for self-harm and lower respiratory infections. Conclusion: The total YLL per 100,000 population in Scotland has declined over time. The YLL in Scotland is predominantly due to a wide range of chronic diseases, substance misuse, self-harm and increasingly Alzheimer’s disease and dementia. Inequalities in YLL, in both relative and absolute terms, are stark. [ABSTRACT FROM AUTHOR]

Preparedness for bioterrorist attacks and early recognition of specific agents are essential for public health. Emergency departments may play an important role in this field. The large spectrum of bioterrorism involves not only disastrous terrorism with mass casualties, but also microevents using low technology but producing civil unrest, disruption, disease, disabilities, and death. It aims not only to cause mortality and morbidity, but also to lead to social and political disruption. Preparedness appears to be the most potent defense against possible bioterrorist events. In this article, we aim to create awareness against biological agents and underline the importance of emergency departments in this public health problem. [ABSTRACT FROM AUTHOR]

Background: The criteria for defining severe malaria have evolved over the last 20 years. We aimed to assess the strength of association of death with features currently characterizing severe malaria through a systematic review and meta-analysis.Method: Electronic databases (Medline, Embase, Cochrane Database of Systematic Reviews, Thomson Reuters Web of Knowledge) were searched to identify publications including African children with severe malaria. PRISMA guidelines were followed. Selection was based on design (epidemiological, clinical and treatment studies), setting (Africa), participants (children < 15 years old with severe malaria), outcome (survival/death rate), and prognostic indicators (clinical and laboratory features). Quality assessment was performed following the criteria of the 2011 Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Odds ratios (ORs) were calculated for each study and prognostic indicator, and, when a test was assessed in at least two studies, pooled estimates of ORs were computed using fixed- or random-effects meta-analysis.Results: A total of 601 articles were identified and screened and 30 publications were retained. Features with the highest pooled ORs were renal failure (5.96, 95% CI 2.93-12.11), coma score (4.83, 95% CI 3.11-7.5), hypoglycemia (4.59, 95% CI 2.68-7.89), shock (4.31, 95% CI 2.15-8.64), and deep breathing (3.8, 95% CI 3.29-4.39). Only half of the criteria had an OR > 2. Features with the lowest pooled ORs were impaired consciousness (0.58, 95% CI 0.25-1.37), severe anemia (0.76, 95% CI 0.5- 1.13), and prostration (1.12, 95% CI 0.45-2.82).Conclusion: The findings of this meta-analysis show that the strength of association between the criteria defining severe malaria and death is quite variable for each clinical and/or laboratory feature (OR ranging from 0.58 to 5.96). This ranking allowed the identification of features weakly associated with death, such as impaired consciousness and prostration, which could assist to improve case definition, and thus optimize antimalarial treatment. [ABSTRACT FROM AUTHOR]

Premature death is the ultimate failure in public health. Failure to complete substance user treatment increases the likelihood of death. Using the five-year follow-up (1990/91-1995/96) of a representative sample of 3,047 clients discharged from drug user treatment, this article documents that deaths after treatment were 4.7 times higher for substance user treatment clients than for the U.S. population matched by age, sex, and race; death rates ranged from 3.5 times as likely for Black males to nine times as likely for White females. Logistic regression models show that completion of treatment is associated with a three-fifths decreased likelihood of death. [ABSTRACT FROM AUTHOR]

No abstract available Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

To describe three aspects of the epidemiology of alcohol-attributable deaths in Europe, dose, demography and place, and to illustrate how such knowledge can better be used to inform alcohol policy formulation and implementation. epidemiological and population health modeling. Europe. Based on country-specific aggregate statistics. Exposure: country-specific adult per capita consumption triangulated with survey data; outcomes: mortality statistics. The absolute risk of dying from an alcohol-attributable disease and injury (accounting for a protective effect for ischaemic diseases) increases with increasing daily alcohol consumption beyond 10g alcohol per day, the first data point. Over 2/3 of all alcohol-attributable deaths occurring amongst the 20-64 year old population of the European Union (minus Cyprus and Malta) occur in the 45-64 year olds. About 25% of the difference in life expectancy between western and eastern Europe for men aged 20-64 years in 2002 can be attributed to alcohol, largely, but not exclusively, as a result of differences in heavy episodic drinking patterns. Any reduction in the dose of alcohol consumed, at least down to 10g/day, will reduce the annual and lifetime risk of an alcohol-related death. There is a need for alcohol policy to focus on measures in reducing alcohol consumption, throughout middle age, with immediacy of impact. Policy should strive to reduce alcohol-related health inequalities, with the specific recommendations for policy depending on the cost-effectiveness of interventions related to the epidemiological profile of the country or region under consideration. Fortunately, there are evidence-based policy options that reduce the amount of alcohol consumed and many alcohol-related harms with immediate effect, that reduce the risk of an alcohol-related death in middle age, and that would help to close the health gap between eastern and western Europe. [ABSTRACT FROM AUTHOR]

The aim of this study is to describe the characteristics of fatal drowning in Guangdong Province during the period 2004-2005. Twelve areas were randomly chosen by stratified cluster sampling, and a retrospective cross-sectional survey was conducted in 2006 to collect death cases during the 2004-2005 period. Causes of death relating to drowning were coded according to International Classification of Diseases, the tenth version. During 2004-2005, 849 unintentional drowning deaths occurred, representing a drowning rate of 5.6/100,000 per year. The rate was higher in rural areas (6.4/100,000) than in city (3.7/100,000), and the rate ratio of male to female was 1.5. The elderly aged 80 years and over and children aged 5-9 years had higher mortalities among all age groups, representing rates of 28.8 and 11.0 per 100,000 person years. For children aged 5-9 years, deaths from drowning accounted for the highest proportion (62.5%) of all injury deaths. The most common site of drowning was natural bodies of water (60.8%), and summer was the highest risk season for drowning. The results suggest drowning is an important public health problem, and it primarily threatens children in Guangdong province. Drowning intervention programs should be a health priority in Guangdong province. [ABSTRACT FROM AUTHOR]

Quantification of the impact of exposure to modifiable risk factors on a particular outcome at the population level is a fundamental public health issue. In cohort studies, the population attributable fraction (PAF) is used to assess the proportion of the outcome that is attributable to exposure to certain risk factors in a given population during a certain time interval. This is done by combining information about the prevalence of the risk factor in the population with estimates of the strength of the association between the risk factor and the outcome. In case of mortality, the PAF demonstrates what proportion of mortality can be delayed during the given follow-up time. However, literature on carrying out model-based estimation of PAF and its variance in cohort studies while properly taking follow-up time into account is still scarce. In this article, the authors present formulas for estimation of PAF, its variance, and its confidence interval using the piecewise constant hazards model and apply a SAS macro created for the estimation of PAF (SAS Institute Inc., Cary, North Carolina) to estimate the mortality attributable to some common risk factors. [ABSTRACT FROM PUBLISHER]

Background: Dermatomyositis (DM) and polymyositis (PM) are rare systemic autoimmune rheumatic diseases with high fatality rates. There have been few population-based mortality studies of dermatomyositis and polymyositis in the world, and none have been conducted in Brazil. The objective of the present study was to employ multiple-cause- of-death methodology in the analysis of trends in mortality related to dermatomyositis and polymyositis in the state of São Paulo, Brazil, between 1985 and 2007. Methods: We analyzed mortality data from the São Paulo State Data Analysis System, selecting all death certificates on which DM or PM was listed as a cause of death. The variables sex, age and underlying, associated or total mentions of causes of death were studied using mortality rates, proportions and historical trends. Statistical analysis were performed by chi-square and H Kruskal-Wallis tests, variance analysis and linear regression. A p value less than 0.05 was regarded as significant. Results: Over a 23-year period, there were 318 DM-related deaths and 316 PM-related deaths. Overall, DM/PM was designated as an underlying cause in 55.2% and as an associated cause in 44.8%; among 634 total deaths females accounted for 71.5%. During the study period, age- and gender-adjusted DM mortality rates did not change significantly, although PM as an underlying cause and total mentions of PM trended lower (p < 0.05). The mean ages at death were 47.76 ± 20.81 years for DM and 54.24 ± 17.94 years for PM (p = 0.0003). For DM/PM, respectively, as underlying causes, the principal associated causes of death were as follows: pneumonia (in 43.8%/ 33.5%); respiratory failure (in 34.4%/32.3%); interstitial pulmonary diseases and other pulmonary conditions (in 28.9%/17.6%); and septicemia (in 22.8%/15.9%). For DM/PM, respectively, as associated causes, the following were the principal underlying causes of death: respiratory disorders (in 28.3%/26.0%); circulatory disorders (in 17.4%/ 20.5%); neoplasms (in 16.7%/13.7%); infectious and parasitic diseases (in 11.6%/9.6%); and gastrointestinal disorders (in 8.0%/4.8%). Of the 318 DM-related deaths, 36 involved neoplasms, compared with 20 of the 316 PM-related deaths (p = 0.03). Conclusions: Our study using multiple cause of deaths found that DM/PM were identified as the underlying cause of death in only 55.2% of the deaths, indicating that both diseases were underestimated in the primary mortality statistics. We observed a predominance of deaths in women and in older individuals, as well as a trend toward stability in the mortality rates. We have confirmed that the risk of death is greater when either disease is accompanied by neoplasm, albeit to lesser degree in individuals with PM. The investigation of the underlying and associated causes of death related to DM/PM broaden the knowledge of the natural history of both diseases and could help integrate mortality data for use in the evaluation of control measures for DM/PM. [ABSTRACT FROM AUTHOR]

Life course epidemiology concentrates on the contribution that social or physical exposures have across the life course on adult health. It is known that the area of residence can affect health, but little is known about the effect of the area of residence across the life course. We examine the contribution that area of residence in 1960, 1970, 1980 and 1990 made on subsequent mortality for 49736 male inhabitants of Oslo in 1990. We compare the performance of multiple-membership and cross-classified multilevel models on these data with a correlated cross-classified model that was developed for this. [ABSTRACT FROM AUTHOR]

Francesco Checchi and Les Roberts discuss how mortality among crisis-affected populations is currently documented, barriers to better documentation, and how these barriers might be overcome. [ABSTRACT FROM AUTHOR]

Background: We examined mortality among working-age Russian men whose identity could not be determined, focusing on where and how they died. Methods: Employing micro-data from deaths that occurred in lzhevsk (Ural region) between June 2004 and September 2005, we analysed the characteristics of decedent men aged 25-54 (n = 2158). Differences between completely identified (n=1699) and unidentified deaths (n=282) were compared via logistic regression. Data on all deaths in Russia in 2002 were used for supplemental comparisons. Results: We found that relative to identified men, unidentified men were at a higher risk of death from exposure to natural cold, violence, alcoholic cardiomyopathy, acute respiratory infections and poisonings. Our results also revealed that alcohol played an important role in the mortality of unidentified men. The places and causes of death among these unidentified men provide substantial evidence of their homelessness and social isolation. Conclusion: The increase in deaths among unidentified men of working-age indicates the emergence of a health threat associated with homelessness and social marginalization. This vulnerable group is exposed to different levels and causes of mortality compared with the larger population and represent a new challenge that requires serious and immediate scholarly attention and policy responses. [ABSTRACT FROM AUTHOR]

This article examines the discursive transformation of death from a destined fate into a manageable and calculable risk in statistical writings dating back to the mid 17th century. It analyses early works in 'political arithmetic' and vital statistics in an effort to illuminate how death was reconceived as a more or less predictable occurrence that is governed, in the aggregate, by social, economic and political, as well as environmental factors. The construction of death as a risk played a significant role in making death amenable to political management (as in public health projects) and even economic profit-making (as in life insurance calculations). Yet, it also created an attitude of intolerance toward death and toward those segments of the population that are deemed to be at risk or high risk. [ABSTRACT FROM AUTHOR]

Aims: To examine how a rural community profoundly affected by escalating rates of largely AIDS-related deaths of young and middle-aged people makes sense of this phenomenon and its impact on their everyday lives. Methods: Data were collected in Agincourt subdistrict, Limpopo Province. Twelve focus groups were constituted according to age and gender and met three times (a total of 36 focus-group discussions [FGDs]). The FGDs explored sequentially people's expectations of their lives in the "new" South Africa, their interpretations of the acceleration of death amongst the young and middle-aged, and their understandings of HIV/AIDS. Discussions were recorded, fully transcribed, and thematically analysed. Results: Respondents acknowledged escalating death rates in their community, yet few referred directly to HIV/AIDS as the cause. Rather, respondents focused on the social and cultural causes of death, including the erosion of cultural norms and traditions such as cultural taboos on sex. There are many competing versions of what HIV/AIDS is, what causes it and how it is spread, ranging from scientific explanations to conspiracy theories. Findings highlight the relationship between AIDS and other traditional diseases with some respondents suggesting that AIDS is a new form of other longstanding illnesses. Conclusions: This study points to the centrality of cultural explanations in understanding "bad death" (AIDS death) in the Agincourt area. Physical illness is understood to be a symptom of "cultural damage". Implications of this for public health practice and research are outlined. [ABSTRACT FROM AUTHOR]

Abstract Objectives : The present study is designed to estimate the health impact of alcohol consumption in terms of the number of deaths and person-years of life lost (PYLL) in Switzerland. To that end, three hypothetical situations have been compared to the current situation used as a reference. The underlying question was: how many deaths and person-years of life lost would be avoided if all individuals were: (1) non-drinkers, (2) low drinkers only or (3) both (either abstainers or low level drinkers)? Methods: Etiological fractions of alcohol-related health consequences by age and gender were applied to the officially reported numbers of deaths to estimate the total number of deaths and PYLL. Results : Depending upon the hypothetical situation, the estimated number of alcohol-related deaths varied between an overall net protective and an overall net causal effect: in situation (1), there would occur 730 additional deaths in reference to the current situation (+1.2% of the total alcohol-related mortality in Switzerland), whereas in situation (2) there would be 3460 deaths less (-5.5%). Thus, the current situation in Switzerland would be preferable compared to a society, in which no one drinks alcohol. A society, however, in which every individual drinks at low levels, would be preferable to the current situation. The corresponding figures for PYLL are 23,596 vs. 29,229 (6.4% vs. 7.9% of total PYLL). Conclusions : The hypothetical situation decisively impacts on the number of deaths attributable to alcohol. In contrast, it has much less influence on the number of alcohol-related PYLL. Thus, mortality is at least a questionable indicator of alcohol-related health outcomes. The study also indicated that more lives and PYLL were saved in the low-risk situation than in the abstinence situation. Public health policies should not concentrate on the promotion of abstinence. [ABSTRACT FROM AUTHOR]

Objective: To assess the interobserver variability of the measurement of the MPM II system.Design: Random sample of an inception cohort.Setting: Fifteen adult medical and surgical intensive care units (ICUs) in Spain.Patients: A 5% random sample (n = 119) of 2332 patients consecutively admitted in the ICU, aged 18 years or older.Interventions: Prospective data collection during the stay of the patient in the ICU. Repeated data collection, after the patient's hospital discharge.Measurements and Main Results: Demographic information, length-of-stay and vital status at both ICU and hospital discharge, as well as all variables necessary for computing the MPM II system were measured. Interobserver variability for categorical variables was measured computing the kappa index. For interval variables the interobserver variability was assessed by the intraclass correlation coefficient, the paired t-test, and linear regression. In the MPM II0 index, the variables coma, heart rate, systolic blood pressure, chronic renal insufficiency, metastatic neoplasm, acute renal failure, cardiac dysrhythmia and cardiopulmonary resuscitation, showed moderate or low levels of agreement. In the MPM II24 index, the variables coma or deep stupor, PaO2 and prothrombin time showed low or moderate interobserver agreement. Agreement for the MPM II probability of death was high, although the external observer obtained a lower estimation than the hospital observer.Conclusions: The MPM II severity system showed a high level of stability when used in groups of patients. Nevertheless, the observed variability in some variables means that it should be used with caution for individual patients. [ABSTRACT FROM AUTHOR]

This article examines the decline in mortality which occurred in Philadelphia in the late nineteenth and early twentieth centuries. Age- and cause-specific mortality rates accounting for the decline are isolated and the relative importance of several variables in explaining the reduction of overall mortality levels is assessed. By using small areas within the city we are able to establish the impact of particular innovations on specific causes fo death. [ABSTRACT FROM AUTHOR]

The antismoking campaign has encouraged millions of people to quit smoking cigarettes and millions of others not to initiate the habit. Because quitting smoking, or deciding not to start, reduces one's mortality risks relative to the continuing smoker, we estimate that these consumption impacts resulted in the avoidance of more than 200,000 premature smoking-related deaths during 1964-1978. On average, each of these premature deaths averted translates into 23 additional years of life. Furthermore, campaign-related smoking cessation and non-initiation during the 1964-1978 period will result in the avoidance of many more premature deaths in the coming decades. Although these figures suggest that the antismoking campaign has been successful, tens of millions of Americans continue to smoke and the premature deaths avoided constitute only a small fraction of the 4 million deaths attributable to smoking that occurred during the same years. [ABSTRACT FROM AUTHOR]

Abstract: A non-concurrent prospective study in Washington County. Maryland identified 4,032 11,204 male, 2,828 female) White persons aged 18 and over who were enumerated in a 1963 non-official census and who became widowed between 1963 and 1974 and an equal number of married person, each matched to a widowed as to race, sex, year of birth and geography of residence. All were followed to 1975, the date of a second census. Mortality rates based on person-years at risk were about the same for widowed as for married females, but significantly higher for make widowed than male married, even after adjustment for a number of demographic, socioeconomic, and behavioral variables. Mortality rates among widowed males who remarried were very much lower than among those who did not remarry, but no significant difference was observable among widowed females who did or did not remarry. Multiple regression analysis also showed that, for both sexes and independently of other factors, moving into a nursing home or other chronic care facility was associated with higher mortality than any other residential change or no change, and living alone was associated with higher mortality than living with someone else in the household. (Am J Public Health 1981; 71:802-809.) INSET: Used Oil--The Hidden Asset. [ABSTRACT FROM AUTHOR]

This article presents a study to increase the understanding of the evolution of adult mortality in Italy. The second objective is to investigate the relationship between early and adult mortality, on the hypothesis that the life experiences which influence the former during the youngest years also affect the latter later in life. Previous analyses of Italian mortality over the last century have suggested interesting links between period and cohort mortality,' in particular the delayed effects of certain dramatic events, such as the two world wars. It has been suggested that the persistent higher mortality of the cohorts involved in the First World War was the result of a genera! weakening due to exposure to high health risks and to particularly unfavorable living conditions during the war. Similarly, the events of the first years of life-which are known to have a major influence on the subsequent health and development of an individual-may be important factors in determining the level of cohort mortality. It is possible for example, that unfavorable conditions during infancy and childhood are a handicap for future survival. An alternative hypothesis would be that a cohort which has lost its weakest members early in their lives has been preselected and is in a better position later.

In the Health and Retirement Study respondents were asked about the chances they would live to 75 or to 85. We analyze these responses to determine if they behave like probabilities of survival, if their averages are close to average probabilities in the population, and if they have correlations with other variables that are similar to correlations with actual mortality outcomes. We find that generally they do behave tike probabilities and that they do aggregate to population probabilities. Most remarkable, however, is that they covary with other variables in the same way actual outcomes vary with the variables. For example, respondents with higher socioeconomic status give higher probabilities of survival, whereas respondents who smoke give lower probabilities. We conclude that these measures of subjective probabilities have great potential use in models of intertemporal decision-making under uncertainty. [ABSTRACT FROM AUTHOR]

In this article an attempt is made to assess the major health problems of the second half of the twentieth century in developed countries, the methods appropriate to these problems, and the pattern of medical services necessary to deal with them. From an examination of mortality and morbidity trends it is suggested that the most important problems are likely to be the mortality, malformation and disability established before birth, mental illness, and the disease and disability associated with aging. Reasons are given for doubting whether control of breeding, the method that has contributed greatly to the improvement of plants and other animals, can be expected to be effective in the case of man and hence reliance must continue to be placed on modifications of the environment to which achievement hitherto has been entirely due. Profound changes will be needed in the pattern of services through which medical knowledge is applied, the most important being unification of the major classes of hospitals, acute, mental and chronic; association of the preventive personal health services with curative services; and the strengthening of domiciliary medical care, particularly through a new and more intimate relationship between general practitioner and hospital services.