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Background: People experiencing psychosis are at greater risk of physical health conditions and premature mortality. It is likely that Indigenous Māori youth, who experience additional systemic inequities caused by settler-colonisation, face even greater physical health and mortality risks following a diagnosis of first-episode psychosis. Objective: Compare Māori and non-Māori for risk of hospitalisation and mortality for up to 15 years following first-episode psychosis diagnosis. Methods: A cohort (N = 14,122) of young people (16–24 years) with first-episode psychosis diagnosis between 2001 and 2019 were identified. Using crude Kaplan–Meier and adjusted Cox proportional hazards models, Māori (n = 5211) and non-Māori (n = 8911) were compared on hospitalisation and mortality outcomes for up to 15 years. Results: In the 15 years following first-episode psychosis diagnosis, Māori had higher adjusted risk of all-cause mortality (hazard ratio = 1.21, 95% confidence interval = [1.01, 1.45]), hospitalisation with diabetes (hazard ratio = 1.44, 95% confidence interval = [1.15, 1.79]), injury/poisoning (hazard ratio = 1.11, 95% confidence interval = [1.05, 1.16]), general physical health conditions (hazard ratio = 1.07, 95% confidence interval = [1.02, 1.13]) and also appeared to be at greater risk of cardiovascular hospitalisations (hazard ratio = 1.34, 95% confidence interval = [0.97, 1.86]). Kaplan–Meier plots show hospitalisation and mortality inequities emerging approximately 4–7 years following first-episode psychosis diagnosis. Conclusions: Māori are at greater risk for hospitalisation and premature mortality outcomes following first-episode psychosis. Early screening and intervention, facilitated by culturally safe health service delivery, is needed to target these inequities early. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease (CVD) is the leading cause of premature mortality worldwide. Despite existing research on CVD risk factors, the study of premature CVD mortality in Malaysia remains limited. This study employs survival analysis to model modifiable risk factors associated with premature CVD mortality among Malaysian adults. Method: We utilised data from Malaysia's National Health and Morbidity Survey (NHMS) conducted in 2006, 2011, and 2015, linked with mortality records. The cohort comprised individuals aged 18 to 70 during the NHMS interview. Follow-up extended to 2021, focusing on CVD-related premature mortality between ages 30 and 70. We employed six survival models: a semi-parametric Cox proportional hazard (PH) and five parametric survival models, which were Exponential, Weibull, Gompertz, log-normal and log-logistic distributions using R software. The age standardized incidence rate (ASIR) of premature CVD mortality was calculated per 1000 person-years. Results: Among 63,722 participants, 886 (1.4%) experienced premature CVD mortality, with an ASIR of 1.80 per 1000 person-years. The best-fit models (based on AIC value) were the stratified Cox model by age (semi-parametric) and the log-normal accelerated failure time (AFT) model (parametric). Males had higher risk (Hazard Ratio, HR = 2.68) and experienced 49% shorter survival time (Event Time Ratio, ETR = 0.51) compared to females. Compared to Chinese ethnicity, Indians, Malays, and other Bumiputera had higher HR and lower survival times. Rural residents and those with lower education also faced increased HRs and reduced survival times. Diabetes (diagnosed: HR = 3.26, ETR = 0.37; undiagnosed: HR = 1.63, ETR = 0.63), hypertension (diagnosed: HR = 1.84, ETR = 0.53; undiagnosed: HR = 1.46, ETR = 0.68), and undiagnosed hypercholesterolemia (HR = 1.31, ETR = 0.80) increased risk and decreased survival times. Additionally, current smoking and abdominal obesity elevated risk (HR = 1.38, 1.60) and shortened survival (ETR = 0.81, 0.71). Conclusion: The semi-parametric and parametric survival models both highlight the considerable impact of socioeconomic status and modifiable risk factors on premature CVD mortality, underscoring the imperative for targeted interventions to effectively mitigate these effects. [ABSTRACT FROM AUTHOR]

Background: While death in old age is inevitable, premature death at younger ages is within our control. Premature mortality (death < 70 years) is a crucial indicator of health status and access to healthcare, with variations observed across regions. In North Africa and the Middle East, ischemic heart disease (IHD), road injuries, stroke, and chronic kidney disease are projected to be the main causes of premature mortality. Unfortunately, few studies have been conducted on premature mortality worldwide. This study aimed to analyze the causes of premature death and associated risk factors within the Pars Cohort Study. Methods: The Pars Cohort Study is a prospective cohort study conducted in Fars Province, Iran, involving 9,264 individuals aged 40–75 years, 53.8% of whom were women. We assessed participants from baseline (2012–2014) to 2021. The data were gathered through interviews, biological samples, and physical examinations. The causes of premature mortality, hazard ratios (HRs), and population attributable fraction (PAF) with 95% confidence intervals (95% CIs) for the variables were calculated. Results: Out of 388 deaths, 54% were premature. The most common causes of premature death included IHD (40%), stroke (11%), road traffic injuries (6%), lower respiratory infections (5%), and COVID-19 (3%). The predictive factors [adjusted HRs (95% CIs)] associated with premature mortality included age [year, 1.07 (1.04, 1.10)], tobacco [1.43 (0.96, 2.11)], opium [2.12 (1.39, 3.24)], hypertension [1.52 (1.10, 2.12)], waist circumference [cm, 1.03 (1.00, 1.05)], female sex [0.30 (0.19, 0.47)], education [> 8 years vs. no formal schooling, 0.46 (0.24, 0.88)], being married [0.60 (0.37, 0.97)], physical activity [3rd vs. 1st tertile, 0.38 (0.26, 0.57)], hip circumference [cm, 0.96 (0.92, 0.99)], estimated GFR [mL/min/1.73 m², 0.99 (0.978, 0.999)], and wealth score [4th vs. 1st quartile, 0.54 (0.32, 0.90)]. The PAF (95% CI) for all modifiable predictors was 0.83 (0.62, 0.92). Conclusions: The predominant causes of premature mortality were IHD and stroke. To mitigate premature deaths, it is recommended to address both socioeconomic and behavioral factors simultaneously. [ABSTRACT FROM AUTHOR]

Objective: Bipolar Disorder (BD) is a severe mental illness associated with high rates of general medical comorbidity, reduced life expectancy, and premature mortality. Although BD has been associated with high medical hospitalization, the factors that contribute to this risk remain largely unexplored. We used baseline medical and psychiatric records to develop a supervised machine learning model to predict general medical admissions after discharge from psychiatric hospitalization. Methods: In this retrospective three-year cohort study of 71 patients diagnosed with BD (mean age=52.19 years, females=56.33%), lasso regression models combining medical and psychiatric records, as well as those using them separately, were fitted and their predictive power was estimated using a leaveone- out cross-validation procedure. Results: The proportion of medical admissions in patients with BD was higher compared with age- and sex-matched hospitalizations in the same region (25.4% vs. 8.48%). The lasso model fairly accurately predicted the outcome (area under the curve [AUC]=69.5%, 95%C.I.=55--84.1; sensitivity=61.1%, specificity=75.5%, balanced accuracy=68.3%). Notably, pre-existing cardiovascular, neurological, or osteomuscular diseases collectively accounted for more than 90% of the influence on the model. The accuracy of the model based on medical records was slightly inferior (AUC=68.7%, 95%C.I. = 54.6-82.9), while that of the model based on psychiatric records only was below chance (AUC=61.8%, 95% C.I.=46.2--77.4). Conclusion: Our findings support the need to monitor medical comorbidities during clinical decision-making to tailor and implement effective preventive measures in people with BD. Further research with larger sample sizes and prospective cohorts is warranted to replicate these findings and validate the predictive model. [ABSTRACT FROM AUTHOR]

Long-term exposure to PM2.5 pollution increases the risk of cardiovascular diseases, particularly ischemic heart disease (IHD). Current assessments of the health effects related to PM2.5 exposure are limited by sparse ground monitoring stations and applicable disease research cohorts, making accurate health effect evaluations challenging. Using satellite-observed aerosol optical depth (AOD) data and the XGBoost-PM25 model, we obtained 1 km scale PM2.5 exposure levels across China. We quantified the premature mortality caused by PM2.5-exposure-induced IHD using the Global Exposure Mortality Model (GEMM) and baseline mortality data. Furthermore, we employed the Gini coefficient, a measure from economics to quantify inequality, to evaluate the distribution differences in health impacts due to PM2.5 exposure under varying socioeconomic conditions. The results indicate that PM2.5 concentrations in China are higher in the central and eastern regions. From 2007 to 2022, the national overall level showed a decreasing trend, dropping from 47.41 μg/m3 to 25.16 μg/m3. The number of premature deaths attributable to PM2.5 exposure increased from 819 thousand in 2007 to 870 thousand in 2022, with fluctuations in certain regions. This increase is linked to population growth and aging because PM2.5 levels have decreased. The results also indicate disparities in premature mortality from IHD among different economic groups in China from 2007 to 2022, with middle-income groups having a higher cumulative proportion of IHD-related premature deaths compared with high- and low-income groups. Despite narrowing GDP gaps across regions from 2007 to 2022, IHD consistently "favored" the middle-income groups. The highest Gini coefficient was observed in the Northwest (0.035), and the lowest was in the South (0.019). Targeted policy interventions are essential to establish a more equitable atmospheric environment. [ABSTRACT FROM AUTHOR]

Abstract Background Cardiovascular disease (CVD) is the leading cause of premature mortality worldwide. Despite existing research on CVD risk factors, the study of premature CVD mortality in Malaysia remains limited. This study employs survival analysis to model modifiable risk factors associated with premature CVD mortality among Malaysian adults. Method We utilised data from Malaysia’s National Health and Morbidity Survey (NHMS) conducted in 2006, 2011, and 2015, linked with mortality records. The cohort comprised individuals aged 18 to 70 during the NHMS interview. Follow-up extended to 2021, focusing on CVD-related premature mortality between ages 30 and 70. We employed six survival models: a semi-parametric Cox proportional hazard (PH) and five parametric survival models, which were Exponential, Weibull, Gompertz, log-normal and log-logistic distributions using R software. The age standardized incidence rate (ASIR) of premature CVD mortality was calculated per 1000 person-years. Results Among 63,722 participants, 886 (1.4%) experienced premature CVD mortality, with an ASIR of 1.80 per 1000 person-years. The best-fit models (based on AIC value) were the stratified Cox model by age (semi-parametric) and the log-normal accelerated failure time (AFT) model (parametric). Males had higher risk (Hazard Ratio, HR = 2.68) and experienced 49% shorter survival time (Event Time Ratio, ETR = 0.51) compared to females. Compared to Chinese ethnicity, Indians, Malays, and other Bumiputera had higher HR and lower survival times. Rural residents and those with lower education also faced increased HRs and reduced survival times. Diabetes (diagnosed: HR = 3.26, ETR = 0.37; undiagnosed: HR = 1.63, ETR = 0.63), hypertension (diagnosed: HR = 1.84, ETR = 0.53; undiagnosed: HR = 1.46, ETR = 0.68), and undiagnosed hypercholesterolemia (HR = 1.31, ETR = 0.80) increased risk and decreased survival times. Additionally, current smoking and abdominal obesity elevated risk (HR = 1.38, 1.60) and shortened survival (ETR = 0.81, 0.71). Conclusion The semi-parametric and parametric survival models both highlight the considerable impact of socioeconomic status and modifiable risk factors on premature CVD mortality, underscoring the imperative for targeted interventions to effectively mitigate these effects.

Abstract Background While death in old age is inevitable, premature death at younger ages is within our control. Premature mortality (death 8 years vs. no formal schooling, 0.46 (0.24, 0.88)], being married [0.60 (0.37, 0.97)], physical activity [3rd vs. 1st tertile, 0.38 (0.26, 0.57)], hip circumference [cm, 0.96 (0.92, 0.99)], estimated GFR [mL/min/1.73 m², 0.99 (0.978, 0.999)], and wealth score [4th vs. 1st quartile, 0.54 (0.32, 0.90)]. The PAF (95% CI) for all modifiable predictors was 0.83 (0.62, 0.92). Conclusions The predominant causes of premature mortality were IHD and stroke. To mitigate premature deaths, it is recommended to address both socioeconomic and behavioral factors simultaneously.

Objectives The aim of this work is to initiate or revive a scientific discussion on the impact of professional life on the parameters of human lifespan. Material and Methods Presented analysis is based on 8578 Polish elite or well-known person who died in 2001–2021. Results The results of the conducted analysis indicate that in the case of men the highest values of the median age at death were characteristic of freelancers (median [Me] ± quartile deviation [QD] 85.5±8.5 years), followed by scientists and academic teachers of the biological and medical specialty (Me±QD 84.0±7.5 years) and officers of power structures (Me±QD 83.5±8.5 years). Subsequently, the highest value of the median age at death was recorded for social activists (Me±QD 83.0±9.5 years), clergy (Me±QD 82.0±7.5 years) and scientists and academic teachers of specialties other than biological and medical (Me±QD 82.0±8.0 years). Significantly, at the very end of this list are athletes (Me±QD 77.0±9.0 years). Nevertheless, the results of the analysis confirm that professional athletes are characterized by higher median age at death compared to the general population. Analysis made only within athletes group demonstrated that the parameters of lifespan of athletes of endurance disciplines (Me±QD 78.0±8.0 years) are the most favorable compared to athletes of other disciplines, in particular in compare to team sports athletes (Me±QD 75.0±10.0 years) or combat sports athletes (Me±QD 75.0±7.1 years). Conclusions What is new and innovative in this paper is comparing the lifespan characteristics of athletes in comparison to widely represented group of other professions with higher socio-economic status. Unexpectedly, the lifespan of athletes occurred to be lower than for fast all other analyzed occupational groups, except mainly of entertainment musicians. Finally, the results presented in this paper emphasize the need to analyze the lifespan characteristics of athletes in a broader scope than only in relation to the general population. Int J Occup Med Environ Health 2024;37(3):335–50

Services play a crucial role in responding to homelessness, facilitating stable housing, and improving health outcomes. Yet people in need do not always access services and little is known about such individuals and groups. Using mortality data from the New Mexico Office of the Medical Investigator (OMI) that was cross-referenced with services records from Homelessness Management Information Systems (HMIS), this study identified and compared people affected by homelessness (N = 1196) who died between 2014 and 2019 based on whether they had engaged with homelessness services (n = 841) or who were unhoused without a record services engagement (n = 355). Groups were compared by age, race, gender, region of the state, and leading causes of death. Approximately 30 percent of individuals found to be homeless were not engaged in homelessness services. There were statistically greater numbers of Native Americans among those who were unhoused without a record of homelessness services. There were also inequities across regions of the state. This supports the need for increased outreach in rural areas and removing barriers to service engagement. The leading causes of death were drug overdose, alcohol, and heart disease, thus reinforcing the need for harm reduction education and practices both within and outside of services. [ABSTRACT FROM AUTHOR]

Objective: This study analyzed the mortality trends from avoidable causes in Korea from 1997 to 2021, to estimate its contribution to the overall mortality in different subgroups, including. Gender, age, and cause of disease. Methods: The all-cause and avoidable mortality were presented as a time series plot and average annual percent change. Trend of avoidable mortality was also analyzed by subgroups, disease causes and the percentage attributed to each causes. Results: The decline in avoidable mortality accounted for 82.6% of all-cause mortality reduction. Preventable mortality showed a more pronounced decline than treatable mortality, explaining 72.3% of the avoidable mortality reduction. In 1997-2001, avoidable death occurred in 72.2% (537,024 cases) of all-cause deaths, which declined to 60.0% (342,979 cases) in 2017-2021. The contribution of avoidable mortality in the decline of all-cause morality was greater in males (83.6%) than in females (79.3%). Conclusion: The decline in avoidable mortality and its contribution to the all-cause mortality reduction implies general improvement of the population health in Korea. Nevertheless, the heterogenous trend within different subgroups warrants more equitable design and implementation of health services and policies. [ABSTRACT FROM AUTHOR]

Background: Sudden unexpected death in epilepsy (SUDEP) is in most cases probably due to a fatal complication of tonic-clonic seizures and plays a significant role in the premature mortality of individuals with epilepsy. The reported risks of SUDEP vary considerably depending on the study population, so that an up-dated systematic review of SUDEP incidence including most recent studies is required to improve the estimated SUDEP risk and the counseling of individuals with epilepsy. Objective: To provide an overview of the current research landscape concerning SUDEP incidence across different patient populations and discuss potential conclusions and existing limitations. Material and methods: A systematic literature review on SUDEP incidence was conducted in MEDLINE and EMBASE, supplemented by a manual search in June 2023. Out of a total of 3324 publications, 50 were reviewed for this study. Results: The analyzed studies showed significant heterogeneity concerning cohorts, study design and data sources. Studies conducted without specific criteria and relying on comprehensive registers indicated an incidence of 0.78–1.2 per 1000 patient-years. Research providing incidences across various age groups predominantly show an increase with age, peaking in middle age. Discussion: Due to varying methods of data collection and incidence calculation, comparing between studies is challenging. The association with age might be due to an underrepresentation of children, adolescents and patients over 60 years. Conclusion: Considering all age groups and types of epilepsy it is estimated that about 1 in 1000 individuals with epilepsy dies of SUDEP annually. With an assumed epilepsy prevalence of 0.6% in Germany, this could lead to more than one SUDEP case daily. Standardization of research methods is essential to gain more profound insights. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) adopted a global noncommunicable disease monitoring framework in 2013 with a target of a 25% reduction in premature mortality from four noncommunicable diseases (NCDs) such as cancer, diabetes, cardiovascular disease (CVD) and chronic respiratory disease (CRD) by 2025 compared to 2010. The Sustainable Development Goals (SDGs) target to reduce premature deaths from the four major NCDs by one‐third from 2015 to 2030. The objective of this study was to estimate the trend and reduction in premature mortality in India due to 4 major NCDs combined and separately between 2001 and 2030 and compare its progress toward the WHO and SDG target achievement. The publicly available data from the census for population and the Sample Registration System (SRS) for cause of death by 5‐year‐age groups were extracted. Age standardized premature mortality rates, unconditional probability of dying and annual percent change (APC) were computed. The premature mortality for four major NCDs decreased by −13.9% from 2010 to 2025 and by −15.6% from 2015 to 2030. The percentage changes in premature mortality from 2010 to 2025 were −33.9%, −17.4%, −9.3%, and 6.9% for CRD, cancer, CVD and diabetes respectively. For 2015–2030, these changes were −21.7%, −11.5%, −15.4%, and −15.1%. A significant reduction trend was observed for CRD with an average APC of −5.2%. The current reduction trend in premature mortality indicates that either the 25% reduction by 2025 or a one‐third reduction by 2030 will require intensive implementation of policies and program for NCD reduction. [ABSTRACT FROM AUTHOR]

Introduction: India contributes two‐thirds of the global mortality due to oral cancer and has a younger population at risk. The societal costs of this premature mortality are barely discussed. Methods: Using the human capital approach, we aimed to estimate the productivity lost due to premature mortality, valued using individual socioeconomic data, related to oral cancer in India. A bottom‐up approach was used to prospectively collect data of 100 consecutive patients with oral cancer treated between 2019 and 2020, with a follow‐up of 36 months. Results: The disease‐specific survival for early and advanced stage was 85% and 70%, with a median age of 47 years. With 671 years lost prematurely, the loss of productivity was $41 900/early and $96 044/advanced stage. Based on population level rates, the total cost of premature mortality was $5.6 billion, representing 0.18% of GDP. Conclusion: India needs to implement tailored strategies to reduce the economic burden from premature mortality. [ABSTRACT FROM AUTHOR]

ObjectiveBipolar Disorder (BD) is a severe mental illness associated with high rates of general medical comorbidity, reduced life expectancy, and premature mortality. Although BD has been associated with high medical hospitalization, the factors that contribute to this risk remain largely unexplored. We used baseline medical and psychiatric records to develop a supervised machine learning model to predict general medical admissions after discharge from psychiatric hospitalization.MethodsIn this retrospective three-year cohort study of 71 patients diagnosed with BD (mean age=52.19 years, females=56.33%), lasso regression models combining medical and psychiatric records, as well as those using them separately, were fitted and their predictive power was estimated using a leave-one-out cross-validation procedure.ResultsThe proportion of medical admissions in patients with BD was higher compared with age- and sex-matched hospitalizations in the same region (25.4% vs. 8.48%). The lasso model fairly accurately predicted the outcome (area under the curve [AUC]=69.5%, 95%C.I.=55–84.1; sensitivity=61.1%, specificity=75.5%, balanced accuracy=68.3%). Notably, pre-existing cardiovascular, neurological, or osteomuscular diseases collectively accounted for more than 90% of the influence on the model. The accuracy of the model based on medical records was slightly inferior (AUC=68.7%, 95%C.I. = 54.6-82.9), while that of the model based on psychiatric records only was below chance (AUC=61.8%, 95%C.I.=46.2–77.4).ConclusionOur findings support the need to monitor medical comorbidities during clinical decision-making to tailor and implement effective preventive measures in people with BD. Further research with larger sample sizes and prospective cohorts is warranted to replicate these findings and validate the predictive model.

Abstract Introduction Avoidable mortality is widely used by public health researchers to measure population health, and many related methodologies have been proposed for doing so. This scoping review presents a comprehensive view of global peer-reviewed and grey literature exploring the association between socioeconomic status (SES) and avoidable mortality. Methods We searched Ovid Medline, Scopus, and Web of Science to find articles that investigated SES inequalities in avoidable mortality. We limited our review to articles in English published between 2000 and 2020. For grey literature, we searched leading global and Canadian health information websites. We extracted data on different study characteristics, avoidable mortality definition, SES indicator, method of analysis of the association between avoidable mortality and SES, and main findings of the studies. Results We identified 34 articles to review, including 29 scientific papers and 5 grey literature documents. The findings of the selected articles consistently indicate a negative association between SES and avoidable mortality rates. Studies have not all used the same definitions of avoidable mortality or SES nor operationalized them in the same way. Conclusion Our review highlights the absence of a globally standard definition in avoidable mortality health equity research. Additional work to establish a standardized definition is crucial for supporting global comparability.

Objectives: The aim of this work is to initiate or revive a scientific discussion on the impact of professional life on the parameters of human lifespan. Material and Methods: Presented analysis is based on 8578 Polish elite or well-known person who died in 2001-2021. Results: The results of the conducted analysis indicate that in the case of men the highest values of the median age at death were characteristic of freelancers (median [Me] ± quartile deviation [QD] 85.5±8.5 years), followed by scientists and academic teachers of the biological and medical specialty (Me±QD 84.0±7.5 years) and officers of power structures (Me±QD 83.5±8.5 years). Subsequently, the highest value of the median age at death was recorded for social activists (Me±QD 83.0±9.5 years), clergy (Me±QD 82.0±7.5 years) and scientists and academic teachers of specialties other than biological and medical (Me±QD 82.0±8.0 years). Significantly, at the very end of this list are athletes (Me±QD 77.0±9.0 years). Nevertheless, the results of the analysis confirm that professional athletes are characterized by higher median age at death compared to the general population. Analysis made only within athletes group demonstrated that the parameters of lifespan of athletes of endurance disciplines (Me±QD 78.0±8.0 years) are the most favorable compared to athletes of other disciplines, in particular in compare to team sports athletes (Me±QD 75.0±10.0 years) or combat sports athletes (Me±QD 75.0±7.1 years). Conclusions: What is new and innovative in this paper is comparing the lifespan characteristics of athletes in comparison to widely represented group of other professions with higher socio-economic status. Unexpectedly, the lifespan of athletes occurred to be lower than for fast all other analyzed occupational groups, except mainly of entertainment musicians. Finally, the results presented in this paper emphasize the need to analyze the lifespan characteristics of athletes in a broader scope than only in relation to the general population. [ABSTRACT FROM AUTHOR]

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Coal-fired power plants (CFPPs) account for > 70% of electricity generation in India, but < 5% of facilities have installed technologies for sulfur dioxide (SO2) and nitrogen oxide (NOX) removal. Emissions of these pollutants lead to the formation of fine particulate matter (PM2.5) and an increased risk of premature mortality for exposed populations. Here, we use a nested version of the GEOS-Chem global chemical transport model (0.5° × 0.625° resolution) for India to estimate reductions in PM2.5 concentrations that could have been achieved by implementing existing emission control technologies like flue-gas desulfurization (FGD) and/or selective catalytic reduction (SCR). We quantify the associated burden of disease using the integrated exposure response (IER) and global exposure mortality model (GEMM) functions and compare the costs of premature mortality to those for FGD installation. Model simulations for 2010 suggest installation of FGD would have reduced mean annual PM2.5 concentrations across India by 8%, compared to 3% with SCR installation, and 11% with both FGD and SCR. A 7–28% reduction in PM2.5 was simulated for local communities closest to CFPPs (same model grid cell), leading to up to 17% reduction in annual premature mortality. Overall, more than 0.21–0.48 million premature deaths would have been avoided over a 10-year period if FGD had been implemented on all CFPPs, compared to 0.09–0.21 million with SCR and 0.22–0.72 million with both FGD and SCR. Benefits associated with such actions are approximately $18.1–$604 billion USD per year, which is equivalent to ~ 0.44 to 10% of India's GDP. These results suggest that monetary benefits from avoided premature mortality far outweigh the capital and operational costs of FGD and/or SCR installation of $19.5 billion and/or $32.8 billion per year, respectively. This information is essential because the high costs of installation and operation are often given as reasons for delaying installation and commissioning. We conclude that policy actions to control air pollution from CFPPs are economically justifiable. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Copyright of Adicciones is the property of Sociedad Cientifica Espanola de Estudios sobre el Alcohol and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Methodological approaches to assessing possible damage to public health from climate change and its impact, primarily that of temperature extremes, including heat waves, are contemplated. The limitations of these approaches and the algorithm for calculating economic damage from excess morbidity and premature mortality caused by the above mentioned climatic factors are substantiated. Improvements of the operational Methodological Recommendations of Rospotrebnadzor of 2011, including calculation methods are introduced. Examples of assessments of the damage to human health in terms of excess morbidity and premature mortality from heat waves are considered. [ABSTRACT FROM AUTHOR]

Introduction: Avoidable mortality is widely used by public health researchers to measure population health, and many related methodologies have been proposed for doing so. This scoping review presents a comprehensive view of global peer-reviewed and grey literature exploring the association between socioeconomic status (SES) and avoidable mortality. Methods: We searched Ovid Medline, Scopus, and Web of Science to find articles that investigated SES inequalities in avoidable mortality. We limited our review to articles in English published between 2000 and 2020. For grey literature, we searched leading global and Canadian health information websites. We extracted data on different study characteristics, avoidable mortality definition, SES indicator, method of analysis of the association between avoidable mortality and SES, and main findings of the studies. Results: We identified 34 articles to review, including 29 scientific papers and 5 grey literature documents. The findings of the selected articles consistently indicate a negative association between SES and avoidable mortality rates. Studies have not all used the same definitions of avoidable mortality or SES nor operationalized them in the same way. Conclusion: Our review highlights the absence of a globally standard definition in avoidable mortality health equity research. Additional work to establish a standardized definition is crucial for supporting global comparability. [ABSTRACT FROM AUTHOR]

Background: Multifetal gestation could be associated with higher long‐term maternal mortality because it increases the risk of pregnancy complications such as preeclampsia and preterm birth, which are in turn linked to postpartum cardiovascular risk. Objectives: We examined whether spontaneously conceived multifetal versus singleton gestation was associated with long‐term maternal mortality in a racially diverse U.S. cohort. Methods: We ascertained vital status as of 2016 via linkage to the National Death Index and Social Security Death Master File of 44,174 mothers from the Collaborative Perinatal Project (CPP; 1959–1966). Cox proportional hazards models with maternal age as the time scale assessed associations between history of spontaneous multifetal gestation (in the last CPP observed pregnancy or prior pregnancy) and all‐cause and cardiovascular mortality, adjusted for demographics, smoking status, and preexisting medical conditions. We calculated hazard ratios (HR) for all‐cause and cause‐specific mortality over the study period and until age 50, 60, and 70 years (premature mortality). Results: Of eligible participants, 1672 (3.8%) had a history of multifetal gestation. Participants with versus without a history of multifetal gestation were older, more likely to have a preexisting condition, and more likely to smoke. By 2016, 51% of participants with and 38% of participants without a history of multifetal gestation had died (unadjusted all‐cause HR 1.14, 95% confidence interval [CI] 1.07, 1.23). After adjustment for smoking and preexisting conditions, a history of multifetal gestation was not associated with all‐cause (adjusted HR 1.00, 95% CI 0.93, 1.08) or cardiovascular mortality (adjusted HR 0.99, 95% CI 0.87, 1.11) over the study period. However, history of multifetal gestation was associated with an 11% lower risk of premature all‐cause mortality (adjusted HR 0.89, 95% CI 0.82, 0.96). Conclusions: In a cohort with over 50 years of follow‐up, history of multifetal gestation was not associated with all‐cause mortality, but may be associated with a lower risk of premature mortality. [ABSTRACT FROM AUTHOR]

The correlation of daytime napping and nighttime sleep duration on mortality was inconsistent. We aimed to explore their separate links to all-cause/premature mortality, and evaluate their combined impact on all-cause mortality risk. All of 20617 (mean age: 56.90 ± 10.19, 52.18 % females) participants from China Health and Retirement Longitudinal Study were followed for a median of 7 years (interquartile range: 4–7) to detect death status. Baseline self-reported napping and sleep duration was categorized: napping as none, <60 min, 60–90 min, and ≥90 min, sleep as <6 h/night, 6–8 h/night, and ≥8 h/night. Death event was tracked, and premature death was defined using 2015 China's average life expectancy (73.64 years for men, and 79.43 years for women). Cox regression models analyzed the data. During follow-up, 1621 participants (7.86 %) died, including 985 (4.78 %) premature deaths. Compared to none nappers, napping ≥90 min associated with a higher risk of all-cause mortality (Hazard ratio, [HR] 1.23, 95 % confidence interval [CI] 1.06-1.42) and premature mortality (HR 1.23, 95 % CI 1.02-1.49), while napping <60 min correlated with a lower risk of premature mortality (HR 0.71, 95 % CI 0.54-0.95), after adjustment. Compared to sleep 6–8 h/night, nighttime sleep ≥8 h was associated with an increased risk of all-cause mortality (HR 1.20, 95 % CI 1.04-1.37) and premature mortality (HR 1.28, 95 % CI 1.08-1.52). Participants napping ≥90 min and sleeping ≥8 h had a multi-adjusted HR (95%CI) of 1.50 (95 % CI 1.17-1.92) for all-cause mortality, versus no napping and 6–8 h/night sleep. Prolonged napping and extended nighttime sleep linked to increased mortality risk, particularly in combination. Optimizing sleep patterns may have potential implication in mortality prevention. • Prolong daytime napping and nighttime sleep may increase the risk of all-cause mortality and premature mortality. • Short daytime napping may decrease the risk of premature mortality. • Focus on the joint effects of daytime napping and nighttime sleep, optimize sleep time to reduce the risk of death. [ABSTRACT FROM AUTHOR]

Abstract: This study aimed to analyze the trends and disparities in preventable or treatable mortality rates among different age groups, sexes, and states in Mexico from 2000 to 2019. Using national data from 2000 to 2019, we examined potentially avoidable premature mortality (PAPM) rates, disaggregated into preventable and treatable deaths. Trends over time were visualized using the average annual percent change (AAPC) derived from joinpoint analysis. Subnational analysis was conducted to identify state-specific trends for each sex and age group. The national PAPM rate decreased from 297 deaths per 100,000 in 2000 to 281 per 100,000 in 2019. Potentially preventable premature mortality (PPPM) rates were more pronounced than potentially treatable premature mortality (PTPM) rates, with 170 deaths per 100,000 and 111 per 100,000, respectively. Sex-based disparities were observed particularly in the working-age population. Our analysis at the state level revealed significant differences in trends, as certain regions experienced reductions while others rises. These disparities became more evident when examining the different aspects of PAPM, especially in terms of PTPM. Our study highlights the differences in PAPM rates across age groups, sexes, and states in Mexico. Despite a general downward trend, upward trends were observed in the male working-age group. There was also wide variation among states, highlighting the need to use PAPM in conjunction with other health metrics for a holistic health analysis.

South Africa remains an uncharted realm in terms of marine mobile emissions inventory and hence the impact of pollution from ships in coastal cities remains unknown. Such a void creates uncertainties about the extent of population exposure to pollution from ships, the health impact and economic value associated with the changes in policies for the port city of Durban.This study was aimed at estimating the health and economic impact of marine mobile emissions and the health and economic benefits associated with improvement in air quality within the port city of Durban, which is under eThekwini municipality. The population exposure to particulate matter of less than 2.5 and 10 μm (PM2.5 and PM10) and sulphur dioxide (SO2) from ships calling into Durban port were estimated using the AERMOD air dispersion model. The BenMAP modelling tool was then used to estimate the health impact and economic value of changes in emission of PM2.5, PM10 and SO2 from ships visiting Durban port. The reduction in emissions from ships was due to the reduction in the sulphur content of fuel from 3.5% to 0.5% that was implemented by the International Maritime Organisation (IMO) on the 01st of January 2020.The results showed that PM2.5 and PM10 emissions reduced by 63% in 2020 compared to 2018, whilst SO2 emissions reduced by 82% over the same period. The BenMAP results indicated that 49 premature mortalities were avoided in 2020 compared to 2018 since the IMO's forced reduction in sulphur content of fuel by 85% in 2020. These avoided cases on mortality were estimated a monetary value of R228 million using the World Bank’s 2016 estimates and R683 million using the USEPA Mean VSL estimate. Such monetary values were respectively equivalent to 0.05% and 0.2% of the eThekwini's GDP, which was estimated at R468 billion in 2016.

To confront the challenges posed by air pollution and climate change, China has undertaken significant initiatives to develop strategies that address both issues concurrently. However, the health benefits of these initiatives have not been clearly articulated. In this study, the dynamic changes in health impacts under air pollution and carbon reduction actions in China are evaluated by employing the latest concentration–response models and projected PM2.5 concentrations under future scenarios. From 2020 to 2060, the enforcement of clean air and climate mitigation policies is expected to increase the percentage of the population living with PM2.5 concentrations meeting the 10 μg/m3 standard by 79 %. Without the implementation of relevant mitigation measures, PM2.5-associated deaths are projected to double due to an aging population. In comparison to the 2060 reference scenario, the joint implementation of clean air and carbon neutrality measures is expected to reduce nationwide PM2.5-associated mortality by 62 %, equivalent to 2.15 (95 % CI: 1.80–2.48) million deaths. Stringent pollution controls are crucial for reducing PM2.5-associated deaths before 2030, after which carbon neutrality actions become increasingly significant from 2030 to 2060. The challenges of mitigating future PM2.5-associated deaths vary greatly across regions, showing a critical response to pollution control and carbon reduction. The research proves the effectiveness of China's future air pollution control and carbon reduction policies in mitigating PM2.5-associated deaths.

Summary: Background: Immigrants in high-income countries experienced inequities in COVID-19 severe outcomes. We examined hospitalization and death throughout the pandemic, and change during the vaccine era, in Ontario, Canada. Methods: We conducted a population-based study using linked immigration and health data, following two cohorts for 20 months from January 1, 2020 (pre-vaccine) and September 1, 2021 (vaccine era). We used multivariable Poisson generalized estimating equation regression to estimate adjusted rate ratios (aRR) with 95% confidence intervals (CI), accounting for age, sex and co-morbidities. We calculated age-standardized years of life lost (ASYRs) rates by immigrant category. Findings: Of 11,692,387 community-dwelling adults in the pre-vaccine era cohort and 11,878,304 community-dwelling adults in the vaccine era cohort, 21.6% and 21.4% of adults in each era respectively were immigrants. Females accounted for 57.9% and 57.8% of sponsored family, and 68.4% and 67.6% of economic caregivers, in each era respectively. Compared to other Ontarians in the pre-vaccine era cohort, hospitalization rates were highest for refugees (aRR [95% CI] 3.41 [3.39–3.44]) and caregivers (3.13 [3.07–3.18]), followed by sponsored family and other economic immigrants. Compared to other Ontarians, aRRs were highest for immigrants from Central America (5.00 [4.92–5.09]), parts of South Asia (3.95 [3.89–4.01]) and Jamaica (3.56 [3.51–3.61]) with East Asians having lower aRRs. Mortality aRRs were similar to hospitalization aRRs. In the vaccine era, all aRRs were attenuated and most were similar to or lower than other Ontarians, with refugees and a few regions maintaining higher rates. In the pre-vaccine era ASYRs were higher for all immigrant groups. ASYRs dropped in the vaccine era with only refugees continuing to have higher rates. Interpretation: Immigrants, particularly refugees, experienced greater premature mortality. aRRs for most immigrant groups dropped substantially after high vaccine coverage was achieved. Vaccine outreach and improvements in the social determinants of health are needed. Funding: Canadian Institutes of Health Research, Canada Research Chairs Program.

Abstract 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.

Objectives The coronavirus disease 2019 (COVID-19) pandemic has had a severe impact on global health. Apart from the disease itself, the strict restrictions and lockdowns enforced to minimize its spread have also substantially disrupted personal and public health. Methods An analysis of forensic autopsy investigations was conducted between 2019 and 2022 on a selected urban population in Colombo, Sri Lanka, assessing the effects of the COVID-19 pandemic on mortality within these communities. Results During the COVID-19 restrictions, there was a 2.5-fold increase in the total number of deaths, with a significantly higher percentage of female deaths than before. The majority of these deaths were due to cardiovascular causes, while COVID-19-related deaths ranked third overall. The highest proportion of COVID-19 deaths occurred among unvaccinated females. The monthly frequency of deaths from traffic accidents, poisoning, and asphyxiation decreased, while deaths from blunt trauma, sharp trauma, burns, and immersion increased. There was also a rise in blunt homicides and a greater number of femicides during the COVID-19 restrictions than in the pre-pandemic period. A significantly higher percentage of males who received the COVID-19 vaccine died from cardiovascular causes compared to those in the unvaccinated group. Conclusion The significant changes in mortality demographics and causes of death within this community during the COVID-19 restrictions underscore the disruption in healthcare, health-seeking behavior, and social interactions during this period. The vulnerability of individuals residing in highly urbanized areas with lower socioeconomic status, particularly women, is brought into sharp focus.

Background Socio-economic status (SES) disparities in coronavirus disease 2019 (COVID-19) mortality have been reported but complete information and time trends are scarce. In this study, we analysed the years of life lost (YLL) due to COVID-19 premature mortality during the pandemic in Chile and its evolution according to SES and sex compared with a counterfactual scenario [cerebrovascular accidents (stroke)]. Method We used Chile's national mortality databases from 2020 to 2022. YLL and age-standardized YLL and mortality rates by sex and by epidemic waves were determined. The 346 communes were stratified into SES groups according to their poverty index quintile. Negative binomial regression models were used to test trends. Results In >2 years of the pandemic, the COVID-19 YLL was 975 937, corresponding to 61 174 deaths. The YLL rate per 100 000 inhabitants was 1027 for males and 594 for females. There was a heterogeneous distribution of YLL rates and the regional level. Communes in the most advantaged SES quintile (Q5) had the highest YLL during the first wave compared with those in the lowest SES quintile (Q1) (P  <   0.001) but the opposite was true during the second wave. COVID-19 YLL trends declined and differences between Q1 and Q2 vs Q5 converged from the second to the fourth waves (0.33 and 0.15, Ptrend  < 0.001 and Ptrend  = 0.024). YLL declined but differences persisted in stroke (–0.002, Ptrend  = 0.979). Conclusions COVID-19 deaths resulted in a higher impact on premature death in Chile, especially in men, with a heterogeneous geographic distribution along the territory. SES and sex disparities in COVID-19 premature mortality had narrowed by the end of the pandemic. [ABSTRACT FROM AUTHOR]

Despite mortality improvements across Europe, premature mortality notably persists in Central and East European countries. This study is aimed to assess premature mortality variations across Central and East European countries from 1970 to 2019, employing both classical premature mortality indicators and the more nuanced lifespan disparity indicators. Specifically, the analysis utilised the proportion of deaths up to the age of 65, lifespan disparity, and an age threshold derived from lifespan disparity to explore mortality trends. The findings reveal a stable reduction in premature mortality within Central European and Baltic countries, contrasting with the pronounced fluctuations experienced by East European countries. Remarkably, Czechia, Slovakia, and Estonia demonstrating the most significant progress in mitigating premature deaths. The trajectory of premature mortality in Central and Eastern European nations underscores the influence of socioeconomic crises and distinct alcohol consumption patterns on mortality trends. The study highlights the limitations of employing a static age threshold of 65 years in analysis of premature mortality, which fails to capture the full scope of premature mortality realities, particularly among females. However, the traditional metric of deaths before age 65 provides a broadly understandable measure, the nuanced insights offered by lifespan disparity and its derived age threshold enhance our understanding of premature mortality dynamics. Recognising the strengths and limitations of each indicator is essential for advancing our grasp of premature mortality and for refining the development and execution of targeted public health interventions throughout Europe. [ABSTRACT FROM AUTHOR]

In the United States (U.S.), premature mortality in adulthood from suicide, alcohol-related disease, and substance overdoses has increased steadily over the past two decades. To better understand these trends, it is necessary to first examine the harmful behaviors that often precede these preventable deaths (i.e., suicidal ideation and attempts, and harmful alcohol and substance use). Representing critical developmental periods in which psychopathology is most likely to emerge, childhood and adolescence provide an informative lens through which to investigate susceptibility to harmful behaviors. This article synthesizes current evidence describing these rising U.S. mortality rates and the prevalence rates of harmful behaviors linked to these types of mortality. A brief selective review of longitudinal research on harmful behaviors in relation to the most relevant categories of child and adolescent psychopathology is then provided. Finally, recommendations for future research and implications for prevention are discussed. [ABSTRACT FROM AUTHOR]

Over the past several years, Shenzhen's air quality has significantly improved despite increased ground-level ozone (O3) and the challenges in reducing fine particulate matter (PM2.5). We investigated concentration trends, concurrent pollution features, and long-term exposure health risks to enhance our understanding of the characteristics of O3 and PM2.5 pollution. From 2016 to 2022, there was a decrease in PM2.5 levels, but an increase in O3. Additionally, the premature mortality attributed to long-term air pollution exposure decreased by 20.1%. High-O3-and-PM2.5 days were defined as those when the MDA8 O3 ≥ 160 μg m–3 and PM2.5 ≥ 35 μg m–3. Significantly higher levels of O3, PM2.5, nitrogen dioxide (NO2), OX (OX = O3 + NO2), and sulfur dioxide (SO2) were observed on high-O3-and-PM2.5 days. Vehicle emissions were identified as the primary anthropogenic sources of volatile organic compounds (VOCs), contributing the most to VOCs (58.4 ± 1.3%), O3 formation (45.3 ± 0.6%), and PM2.5 formation (46.6 ± 0.4%). Cities in Guangdong Province around Shenzhen were identified as major potential source regions of O3 and PM2.5 during high-O3-and-PM2.5 days. These findings will be valuable in developing simultaneous pollution control strategies for PM2.5 and O3 in Shenzhen. [ABSTRACT FROM AUTHOR]

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has had a severe impact on global health. Apart from the disease itself, the strict restrictions and lockdowns enforced to minimize its spread have also substantially disrupted personal and public health. Methods: An analysis of forensic autopsy investigations was conducted between 2019 and 2022 on a selected urban population in Colombo, Sri Lanka, assessing the effects of the COVID-19 pandemic on mortality within these communities. Results: During the COVID-19 restrictions, there was a 2.5-fold increase in the total number of deaths, with a significantly higher percentage of female deaths than before. The majority of these deaths were due to cardiovascular causes, while COVID-19-related deaths ranked third overall. The highest proportion of COVID-19 deaths occurred among unvaccinated females. The monthly frequency of deaths from traffic accidents, poisoning, and asphyxiation decreased, while deaths from blunt trauma, sharp trauma, burns, and immersion increased. There was also a rise in blunt homicides and a greater number of femicides during the COVID-19 restrictions than in the pre-pandemic period. A significantly higher percentage of males who received the COVID-19 vaccine died from cardiovascular causes compared to those in the unvaccinated group. Conclusion: The significant changes in mortality demographics and causes of death within this community during the COVID-19 restrictions underscore the disruption in healthcare, healthseeking behavior, and social interactions during this period. The vulnerability of individuals residing in highly urbanized areas with lower socioeconomic status, particularly women, is brought into sharp focus. [ABSTRACT FROM AUTHOR]

Background Research from various countries has shown increases in alcohol- and drug-related deaths and suicide, known as 'deaths of despair' over recent decades, particularly among low-educated middle-aged individuals. However, little is known about trends in death-of-despair causes in Spain. Therefore, we aim to descriptively examine this among 25–64-year-olds from 1980 to 2019 and by educational attainment for the years 2017–19. Methods We obtained mortality and population data from the National Institute of Statistics to estimate age-standardized mortality rates and assess educational inequalities using the relative index of inequality (RII). Results Deaths of despair as a share of total mortality slightly increased from 2000 onwards, particularly among 25–64-year-old men (from 9 to 10%). Only alcohol-related mortality declined relatively more since 1980 compared with all-cause mortality. Regarding educational differences, low-educated men presented higher mortality rates in all death-of-despair causes (alcohol-related: RII 3.54 (95% CI: 2.21–5.66); drug-related: RII 3.49 (95% CI: 1.80–6.77); suicide: RII 1.97 (95% CI: 1.49–2.61)). Women noteworthy differences were only observed for alcohol-related (RII 3.50 (95% CI: 2.13–5.75)). Conclusions Findings suggest an increasing proportion of deaths of despair among 25–64-year-olds since 2000, particularly among men. Public health policies are needed to reduce and prevent these premature and preventable causes of mortality. [ABSTRACT FROM AUTHOR]

India implemented a range of multifarious strategies to address the issue of substandard air quality. One such flagship scheme of government of India is National Clean Air Programme (NCAP), which recommends sector specific reduction in emissions and increase in forest cover etc. To reduce particulate matter concentrations by 40% in 2026 compared to 2019. The present study aims to gauge the impact of Land Use Land Cover (LULC) changes alone on success of NCAP, using weather research forecasting model with chemistry (WRF-Chem) and integrated geographical information system and remote sensing software Terrset. The findings elucidate that, by the year 2026, the Ventilation Coefficient (VC) in India's eastern, central, northern, and north-eastern regions is anticipated to register a decline ranging from 18% to 50% compared to the baseline year of 2019. Conversely, an increase of 17% is expected in the southern region. The alterations in Fallow Land, Barren and sparsely vegetated land, Urban and Built-up Land, and Tundra, contribute to these shifts, displaying varying percentage changes across distinct zones. Simulations indicate that these LULC changes are impeding the planned reduction in PM2.5 levels. Projections suggest an increase in PM2.5 levels as high as 13% in the eastern, central, northern, and north-eastern regions, accompanied by a decrease of 33% in the Southern zone of the country. Significantly, non-attainment cities in Himachal Pradesh and Maharashtra are expected to witness a substantial rise in PM2.5-induced premature mortality, with Pune city projected to experience over 24,525 additional premature deaths by 2026. A comparable examination conducted for the year 2022, utilizing actual LULC data, suggests that if the NCAP fails to effectively implement LULC changes, it may reduce this anticipated trade-off. Addressing this concern, the study employed WRF-Chem to simulate 60 combinations, proposing LULC enhancements conducive to improving VC. The results underscore the critical importance of preserving at least 36% of the LULC category of mixed forest land, encompassing plantations, orchards, and areas under shifting agriculture. Additionally, a reduction in barren land and fallow land emerges as pivotal for enhancing the ventilation coefficient. The study accentuates the necessity of refraining from further expansion in densely populated areas to counter these anticipated VC trends. This study provides valuable insights, highlighting the need to prioritize LULC management to effectively combat the alarming air pollution.

Background One-third to half of people with intellectual disabilities suffer from chronic constipation (defined as two or fewer bowel movements weekly or taking regular laxatives three or more times weekly), a cause of significant morbidity and premature mortality. Research on risk factors associated with constipation is limited. Aims To enumerate risk factors associated with constipation in this population. Method A questionnaire was developed on possible risk factors for constipation. The questionnaire was sent to carers of people with intellectual disabilities on the case-loads of four specialist intellectual disability services in England. Data analysis focused on descriptively summarising responses and comparing those reported with and without constipation. Results Of the 181 people with intellectual disabilities whose carers returned the questionnaire, 42% reported chronic constipation. Constipation was significantly associated with more severe intellectual disability, dysphagia, cerebral palsy, poor mobility, polypharmacy including antipsychotics and antiseizure medication, and the need for greater toileting support. There were no associations with age or gender. Conclusions People with intellectual disabilities may be more vulnerable to chronic constipation if they are more severely intellectually disabled. The associations of constipation with dysphagia, cerebral palsy, poor mobility and the need for greater toileting support suggests people with intellectual disabilities with significant physical disabilities are more at risk. People with the above disabilities need closer monitoring of their bowel health. Reducing medication to the minimum necessary may reduce the risk of constipation and is a modifiable risk factor that it is important to monitor. By screening patients using the constipation questionnaire, individualised bowel care plans could be implemented.

Abstract Background The association of childhood adversities with mortality has rarely been explored, and even less studied is the question of whether any excess mortality may be potentially preventable. This study examined the association between specific childhood adversities and premature and potentially avoidable mortality (PPAM) in adulthood in a representative sample of the general population. Also, we examined whether the associations were potentially mediated by various adult socioeconomic, psychosocial, and behavioral factors. Methods The study used data from the National Population Health Survey (NPHS-1994) linked to the Canadian Vital Statistics Database (CVSD 1994–2014) available from Statistics Canada. The NPHS interview retrospectively assessed childhood exposure to prolonged hospitalization, parental divorce, prolonged parental unemployment, prolonged trauma, parental problematic substance use, physical abuse, and being sent away from home for doing something wrong. An existing definition of PPAM, consisting of causes of death considered preventable or treatable before age 75, was used. Competing cause survival models were used to examine the associations of specific childhood adversities with PPAM in adulthood among respondents aged 18 to 74 years (rounded n = 11,035). Results During the 20-year follow-up, 5.4% of the sample died prematurely of a cause that was considered potentially avoidable. Childhood adversities had a differential effect on mortality. Physical abuse (age-adjusted sub-hazard ratio; SHR 1.44; 95% CI 1.03, 2.00) and being sent away from home (age-adjusted SHR 2.26; 95% CI 1.43,3.57) were significantly associated with PPAM. The associations were attenuated when adjusted for adulthood factors, namely smoking, poor perceived health, depression, low perceived social support, and low income, consistent with possible mediating effects. Other adversities under study were not associated with PPAM. Conclusion The findings imply that the psychological sequelae of childhood physical abuse and being sent away from home and subsequent uptake of adverse health behavior may lead to increased risk of potentially avoidable mortality. The potential mediators identified offer directions for future research to perform causal mediation analyses with suitable data and identify interventions aimed at preventing premature mortality due to potentially avoidable causes. Other forms of adversities, mostly related to household dysfunction, may not be determinants of the distal health outcome of mortality.

Abstract Background Cancer control initiatives are informed by quantifying the capacity to reduce cancer burden through effective interventions. Burden measures using health administrative data are a sustainable way to support monitoring and evaluating of outcomes among patients and populations. The Fraction of Life Years Lost After Diagnosis (FLYLAD) is one such burden measure. We use data on Aboriginal and non-Aboriginal South Australians from 1990 to 2010 to show how FLYLAD quantifies disparities in cancer burden: between populations; between sub-population cohorts where stage at diagnosis is available; and when follow-up is constrained to 24-months after diagnosis. Method FLYLADcancer is the fraction of years of life expectancy lost due to cancer (YLLcancer) to life expectancy years at risk at time of cancer diagnosis (LYAR) for each person. The Global Burden of Disease standard life table provides referent life expectancies. FLYLADcancer was estimated for the population of cancer cases diagnosed in South Australia from 1990 to 2010. Cancer stage at diagnosis was also available for cancers diagnosed in Aboriginal people and a cohort of non-Aboriginal people matched by sex, year of birth, primary cancer site and year of diagnosis. Results Cancers diagnoses (N = 144,891) included 777 among Aboriginal people. Cancer burden described by FLYLADcancer was higher among Aboriginal than non-Aboriginal (0.55, 95% CIs 0.52–0.59 versus 0.39, 95% CIs 0.39–0.40). Diagnoses at younger ages among Aboriginal people, 7 year higher LYAR (31.0, 95% CIs 30.0–32.0 versus 24.1, 95% CIs 24.1–24.2) and higher premature cancer mortality (YLLcancer = 16.3, 95% CIs 15.1–17.5 versus YLLcancer = 8.2, 95% CIs 8.2–8.3) influenced this. Disparities in cancer burden between the matched Aboriginal and non-Aboriginal cohorts manifested 24-months after diagnosis with FLYLADcancer 0.44, 95% CIs 0.40–0.47 and 0.28, 95% CIs 0.25–0.31 respectively. Conclusion FLYLAD described disproportionately higher cancer burden among Aboriginal people in comparisons involving: all people diagnosed with cancer; the matched cohorts; and, within groups diagnosed with same staged disease. The extent of disparities were evident 24-months after diagnosis. This is evidence of Aboriginal peoples’ substantial capacity to benefit from cancer control initiatives, particularly those leading to earlier detection and treatment of cancers. FLYLAD’s use of readily available, person-level administrative records can help evaluate health care initiatives addressing this need.

Long-term exposure to PM2.5 pollution increases the risk of cardiovascular diseases, particularly ischemic heart disease (IHD). Current assessments of the health effects related to PM2.5 exposure are limited by sparse ground monitoring stations and applicable disease research cohorts, making accurate health effect evaluations challenging. Using satellite-observed aerosol optical depth (AOD) data and the XGBoost-PM25 model, we obtained 1 km scale PM2.5 exposure levels across China. We quantified the premature mortality caused by PM2.5-exposure-induced IHD using the Global Exposure Mortality Model (GEMM) and baseline mortality data. Furthermore, we employed the Gini coefficient, a measure from economics to quantify inequality, to evaluate the distribution differences in health impacts due to PM2.5 exposure under varying socioeconomic conditions. The results indicate that PM2.5 concentrations in China are higher in the central and eastern regions. From 2007 to 2022, the national overall level showed a decreasing trend, dropping from 47.41 μg/m3 to 25.16 μg/m3. The number of premature deaths attributable to PM2.5 exposure increased from 819 thousand in 2007 to 870 thousand in 2022, with fluctuations in certain regions. This increase is linked to population growth and aging because PM2.5 levels have decreased. The results also indicate disparities in premature mortality from IHD among different economic groups in China from 2007 to 2022, with middle-income groups having a higher cumulative proportion of IHD-related premature deaths compared with high- and low-income groups. Despite narrowing GDP gaps across regions from 2007 to 2022, IHD consistently “favored” the middle-income groups. The highest Gini coefficient was observed in the Northwest (0.035), and the lowest was in the South (0.019). Targeted policy interventions are essential to establish a more equitable atmospheric environment.

Abstract Background Cardiovascular disease (CVD) is a significant cause of premature mortality worldwide, with a growing burden in recent years. Despite this, there is a lack of comprehensive meta-analyses that quantify the extent of premature CVD mortality. Study addressed this gap by estimating the pooled age-standardized mortality rate (ASMR) of premature CVD mortality. Methods We conducted a systematic review of published CVD mortality studies that reported ASMR as an indicator for premature mortality measurement. All English articles published as of October 2022 were searched in four electronic databases: PubMed, Scopus, Web of Science (WoS), and the Cochrane Central Register of Controlled Trials (CENTRAL). We computed pooled estimates of ASMR using random-effects meta-analysis. We assessed heterogeneity from the selected studies using the I2 statistic. Subgroup analyses and meta regression analysis was performed based on sex, main CVD types, income country level, study time and age group. The analysis was performed using R software with the “meta” and “metafor” packages. Results A total of 15 studies met the inclusion criteria. The estimated global ASMR for premature mortality from total CVD was 96.04 per 100,000 people (95% CI: 67.18, 137.31). Subgroup analysis by specific CVD types revealed a higher ASMR for ischemic heart disease (ASMR = 15.57, 95% CI: 11.27, 21.5) compared to stroke (ASMR = 12.36, 95% CI: 8.09, 18.91). Sex-specific differences were also observed, with higher ASMRs for males (37.50, 95% CI: 23.69, 59.37) than females (15.75, 95% CI: 9.61, 25.81). Middle-income countries had a significantly higher ASMR (90.58, 95% CI: 56.40, 145.48) compared to high-income countries (21.42, 95% CI: 15.63, 29.37). Stratifying by age group indicated that the age groups of 20–64 years and 30–74 years had a higher ASMR than the age group of 0–74 years. Our multivariable meta-regression model suggested significant differences in the adjusted ASMR estimates for all covariates except study time. Conclusions This meta-analysis synthesized a comprehensive estimate of the worldwide burden of premature CVD mortality. Our findings underscore the continued burden of premature CVD mortality, particularly in middle-income countries. Addressing this issue requires targeted interventions to mitigate the high risk of premature CVD mortality in these vulnerable populations.

BackgroundFrequent air pollution events in Northwest China pose a serious threat to human health. However, there is a lack of specific differences assessment in PM2.5-related disease burden. Therefore, we aimed to estimate the PM2.5-related premature deaths and health economic losses in this typical northwest region, taking into account disease-specific, age-specific, and region-specific factors.MethodsWe utilized the WRF-Chem model to simulate and analyze the characteristics and exposure levels of PM2.5 pollution in Gansu Province, a typical region of Northwest China. Subsequently, we estimated the premature mortality and health economic losses associated with PM2.5 by combining the Global Exposure Mortality Model (GEMM) and the Value of a Statistical Life (VSL).ResultsThe results suggested that the PM2.5 concentrations in Gansu Province in 2019 varied spatially, with a decrease from north to south. The number of non-accidental deaths attributable to PM2.5 pollution was estimated to be 14,224 (95% CI: 11,716–16,689), accounting for 8.6% of the total number of deaths. The PM2.5-related health economic loss amounted to 28.66 (95% CI: 23.61–33.63) billion yuan, equivalent to 3.3% of the regional gross domestic product (GDP) in 2019. Ischemic heart disease (IHD) and stroke were the leading causes of PM2.5-attributed deaths, contributing to 50.6% of the total. Older adult individuals aged 60 and above accounted for over 80% of all age-related disease deaths. Lanzhou had a higher number of attributable deaths and health economic losses compared to other regions. Although the number of PM2.5-attributed deaths was lower in the Hexi Corridor region, the per capita health economic loss was higher.ConclusionGansu Province exhibits distinct regional characteristics in terms of PM2.5 pollution as well as disease- and age-specific health burdens. This highlights the significance of implementing tailored measures that are specific to local conditions to mitigate the health risks and economic ramifications associated with PM2.5 pollution.

While air quality in China has improved significantly in recent years, the population is becoming increasingly vulnerable to air pollution due to the aging population. In this study, we assessed premature deaths attributable to long- and short-term exposures to PM2.5 and O3, as well as their driving forces in Shandong from 2014 to 2060 based on county-level near-real-time air pollutant concentration datasets and projected concentrations of PM2.5 and O3. We found that the concentrations of PM2.5 and O3 in most districts and counties from Shandong are still higher than the corresponding concentration limit of Grade II. Premature mortality caused by long- and short-term exposures to PM2.5 decreased by 13,045 and 8092 in 2020 compared with those in 2014, respectively. Furthermore, premature mortality attributable to short-term exposure to O3 was 36.08% higher than that due to short-term exposure to PM2.5 in 2020. The results of the driving force analysis indicate that the health benefits brought about by the improvement in air quality have been offset by the changes in population age structure. In the future, the increase in O3 concentration and population aging are the top two driving forces having adverse effects on the health burden. This study provides support for controlling the health risks of PM2.5 and O3 pollution, especially for the development of dual-pollutant concentration targets and synergistic control strategies. [ABSTRACT FROM AUTHOR]

Background: The association of childhood adversities with mortality has rarely been explored, and even less studied is the question of whether any excess mortality may be potentially preventable. This study examined the association between specific childhood adversities and premature and potentially avoidable mortality (PPAM) in adulthood in a representative sample of the general population. Also, we examined whether the associations were potentially mediated by various adult socioeconomic, psychosocial, and behavioral factors. Methods: The study used data from the National Population Health Survey (NPHS-1994) linked to the Canadian Vital Statistics Database (CVSD 1994–2014) available from Statistics Canada. The NPHS interview retrospectively assessed childhood exposure to prolonged hospitalization, parental divorce, prolonged parental unemployment, prolonged trauma, parental problematic substance use, physical abuse, and being sent away from home for doing something wrong. An existing definition of PPAM, consisting of causes of death considered preventable or treatable before age 75, was used. Competing cause survival models were used to examine the associations of specific childhood adversities with PPAM in adulthood among respondents aged 18 to 74 years (rounded n = 11,035). Results: During the 20-year follow-up, 5.4% of the sample died prematurely of a cause that was considered potentially avoidable. Childhood adversities had a differential effect on mortality. Physical abuse (age-adjusted sub-hazard ratio; SHR 1.44; 95% CI 1.03, 2.00) and being sent away from home (age-adjusted SHR 2.26; 95% CI 1.43,3.57) were significantly associated with PPAM. The associations were attenuated when adjusted for adulthood factors, namely smoking, poor perceived health, depression, low perceived social support, and low income, consistent with possible mediating effects. Other adversities under study were not associated with PPAM. Conclusion: The findings imply that the psychological sequelae of childhood physical abuse and being sent away from home and subsequent uptake of adverse health behavior may lead to increased risk of potentially avoidable mortality. The potential mediators identified offer directions for future research to perform causal mediation analyses with suitable data and identify interventions aimed at preventing premature mortality due to potentially avoidable causes. Other forms of adversities, mostly related to household dysfunction, may not be determinants of the distal health outcome of mortality. [ABSTRACT FROM AUTHOR]

Particulate matter with a diameter of less than 2.5 microns (PM2.5) has been identified as a global health concern in recent decades. Indeed, PM2.5 exposure causes detrimental health problems in the general population. Estimating the short- and long-term health impacts of PM2.5 exposure should help to shape public health policy concerning air pollution. Hence, this study sought to estimate the rate of premature death attributable to PM2.5 exposure among the Thai population if the PM2.5 concentration met the applied counterfactual factor. The PM2.5 concentration, population numbers, and numbers of health incidences were collected from secondary data sources in 2019. A health impact analysis was performed using AirQ+ software to estimate the incidences of premature deaths attributable to PM2.5 exposure. More specifically, the analysis provided the estimated proportion of attributable cases and the rate of premature death per 100,000 population aged ≥ 30 years. The annual average PM2.5 concentration in Thailand was found to be 24.15 µg per cubic meter (μg/m3) in 2019, while the natural mortality rate was around 1,107 per 100,000 population nationwide. With regard to short-term PM2.5 exposure, it was determined that 8 premature deaths per 100,000 population could be prevented if the PM2.5 concentration met the World Health Organization (WHO) short-term gold standard of 15 μg/m3. Moreover, 159 premature deaths per 100,000 population could be avoided if the PM2.5 concentration met the WHO's long-term gold standard of 5 μg/m3. This estimation of premature deaths due to the short- and long-term impacts of PM2.5 exposure can support policymakers and stakeholders in creating a roadmap to combating the adverse impacts of PM2.5 exposure and protect the health of the Thai population. [ABSTRACT FROM AUTHOR]