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"HEALTH AND MORTALITY"
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Obesity and Impaired Metabolic Health Increase Risk of COVID-19-Related Mortality in Young and Middle-Aged Adults to the Level Observed in Older People: The LEOSS Registry
Advanced age, followed by male sex, by far poses the greatest risk for severe COVID-19. An unresolved question is the extent to which modifiable comorbidities increase the risk of COVID-19-related mortality among younger patients, in whom COVID-19-related hospitalization strongly increased in 2021. A total of 3,163 patients with SARS-COV-2 diagnosis in the Lean European Open Survey on SARS-CoV-2-Infected Patients (LEOSS) cohort were studied. LEOSS is a European non-interventional multi-center cohort study established in March 2020 to investigate the epidemiology and clinical course of SARS-CoV-2 infection. Data from hospitalized patients and those who received ambulatory care, with a positive SARS-CoV-2 test, were included in the study. An additive effect of obesity, diabetes and hypertension on the risk of mortality was observed, which was particularly strong in young and middle-aged patients. Compared to young and middle-aged (18–55 years) patients without obesity, diabetes and hypertension (non-obese and metabolically healthy; n = 593), young and middle-aged adult patients with all three risk parameters (obese and metabolically unhealthy; n = 31) had a similar adjusted increased risk of mortality [OR 7.42 (95% CI 1.55–27.3)] as older (56–75 years) non-obese and metabolically healthy patients [ n = 339; OR 8.21 (95% CI 4.10–18.3)]. Furthermore, increased CRP levels explained part of the elevated risk of COVID-19-related mortality with age, specifically in the absence of obesity and impaired metabolic health. In conclusion, the modifiable risk factors obesity, diabetes and hypertension increase the risk of COVID-19-related mortality in young and middle-aged patients to the level of risk observed in advanced age.
Journal Article
Global, regional, and national burden of suicide mortality 1990 to 2016: systematic analysis for the Global Burden of Disease Study 2016
AbstractObjectivesTo use the estimates from the Global Burden of Disease Study 2016 to describe patterns of suicide mortality globally, regionally, and for 195 countries and territories by age, sex, and Socio-demographic index, and to describe temporal trends between 1990 and 2016.DesignSystematic analysis.Main outcome measuresCrude and age standardised rates from suicide mortality and years of life lost were compared across regions and countries, and by age, sex, and Socio-demographic index (a composite measure of fertility, income, and education).ResultsThe total number of deaths from suicide increased by 6.7% (95% uncertainty interval 0.4% to 15.6%) globally over the 27 year study period to 817 000 (762 000 to 884 000) deaths in 2016. However, the age standardised mortality rate for suicide decreased by 32.7% (27.2% to 36.6%) worldwide between 1990 and 2016, similar to the decline in the global age standardised mortality rate of 30.6%. Suicide was the leading cause of age standardised years of life lost in the Global Burden of Disease region of high income Asia Pacific and was among the top 10 leading causes in eastern Europe, central Europe, western Europe, central Asia, Australasia, southern Latin America, and high income North America. Rates for men were higher than for women across regions, countries, and age groups, except for the 15 to 19 age group. There was variation in the female to male ratio, with higher ratios at lower levels of Socio-demographic index. Women experienced greater decreases in mortality rates (49.0%, 95% uncertainty interval 42.6% to 54.6%) than men (23.8%, 15.6% to 32.7%).ConclusionsAge standardised mortality rates for suicide have greatly reduced since 1990, but suicide remains an important contributor to mortality worldwide. Suicide mortality was variable across locations, between sexes, and between age groups. Suicide prevention strategies can be targeted towards vulnerable populations if they are informed by variations in mortality rates.
Journal Article
Short-term PM2.5 air pollution and “deaths of despair” in Michigan, 2006-2016: a case-crossover study
Introduction
Particulate matter is a known risk factor for cardiovascular and respiratory illness. Ecological analyses have indicated associations for mental health outcomes, but there has been only limited work on the impacts of individual exposure to air pollutants and mental health-related mortality. This research uses a novel case-crossover design to assess associations between short-term lag exposure to particulate matter 2.5 (PM
2.5
) and mortality from suicide, alcohol-related liver failure and opioid drug overdose.
Methods
Records for all deaths from suicide, alcohol-related liver failure, and overdose were obtained from the Michigan Department of Health and Human Services (MDHHS) for the years 2006 to 2020. Residential addresses were geocoded, and latitude/longitude locations were added to the database. Gridded raster data of daily PM
concentrations at 1km resolution were obtained from the CAFE Climate and Health Research Coordinating Center Collection. PM
exposure for all 14 days preceding the recorded date of death was extracted for all decedents at each point. A case-crossover design was used, where everyone served as their own control, staggering exposure days on the same weekday in the same month of the date of death. Lag associations of PM
and mortality were then tested using regression models stratified by race and sex within a distributed lag non-linear modelling framework, including the cross-basis for PM
exposure.
Results
There were 30,930 mental health-related deaths included in the dataset between 2006-2016. Among these, there were 13,336 suicides, 6,875 deaths from alcohol-related liver failure and 10,719 deaths from overdose. The mean PM
2.5
exposure was 9.65 micrograms per cubic meter. Patterns of association between time and exposure to PM
differed between the types of mortality. While no association was statistically significant, exposure to extremely high levels of PM
had a positive association with mortality from all three types of mortality at and around lag day 7, but not after. Seasonal analyses indicated that increasing exposure to high levels of PM
was significantly associated with suicide in the Fall and Winter months. In the Summer, exposure to any amount of PM
over the WHO recommended safe level up to two weeks was associated with increased risk for suicide mortality. Tests for effect modification by Black/white and binary sex groups did not indicate significant differences in mortality risk given exposure.
Conclusions
While we did not find overall statistically significant associations of PM
exposure with mental health-related mortality, our results suggest that there might be possible associations of cumulative extreme levels of PM
exposure over one week. As suicide, alcohol-related mortality and overdose are the end of a long cascade of events and factors, future work might test lag associations with non-fatal mental health-related episodes or assess individuals’ exposure directly.
Journal Article
Mortality
\"Courageous, insightful and candid thoughts on malady and mortality from one of our most celebrated writers\"--Provided by the publisher.
BOOK
Estimating life expectancy adjusted by self-rated health status in the United States: national health interview survey linked to the mortality
Background
Life expectancy is increasingly incorporated in evidence-based screening and treatment guidelines to facilitate patient-centered clinical decision-making. However, life expectancy estimates from standard life tables do not account for health status, an important prognostic factor for premature death. This study aims to address this research gap and develop life tables incorporating the health status of adults in the United States.
Methods
Data from the National Health Interview Survey (1986–2004) linked to mortality follow-up through to 2006 (age ≥ 40,
n
= 729,531) were used to develop life tables. The impact of self-rated health (excellent, very good, good, fair, poor) on survival was quantified in 5-year age groups, incorporating complex survey design and weights. Life expectancies were estimated by extrapolating the modeled survival probabilities.
Results
Life expectancies incorporating health status differed substantially from standard US life tables and by health status. Poor self-rated health more significantly affected the survival of younger compared to older individuals, resulting in substantial decreases in life expectancy. At age 40 years, hazards of dying for white men who reported poor vs. excellent health was 8.5 (95% CI: 7.0,10.3) times greater, resulting in a 23-year difference in life expectancy (poor vs. excellent: 22 vs. 45), while at age 80 years, the hazards ratio was 2.4 (95% CI: 2.1, 2.8) and life expectancy difference was 5 years (5 vs. 10). Relative to the US general population, life expectancies of adults (age < 65) with poor health were approximately 5–15 years shorter.
Conclusions
Considerable shortage in life expectancy due to poor self-rated health existed. The life table developed can be helpful by including a patient perspective on their health and be used in conjunction with other predictive models in clinical decision making, particularly for younger adults in poor health, for whom life tables including comorbid conditions are limited.
Journal Article
The undying : pain, vulnerability, mortality, medicine, art, time, dreams, data, exhaustion, cancer, and care
\"A ... meditation on data, pain, time, and the limited capacity of literature to comprehend life and death in a sensate and vulnerable body\"-- Provided by publisher.
Book
Partial Contribution of Socioeconomic Factors to the Mortality Rate of the Working-Age Population in Russia
This study’s relevance lies in the need to assess the role of socioeconomic, medical, and demographic factors on working-age population mortality in Russia. The purpose of this study is to substantiate the methodological tools for the assessment of the partial contribution of the most important factors that determine the dynamics of the mortality of the working-age population. Our hypothesis is that the factors determining the socioeconomic situation in the country affect the level and dynamics of mortality of the working-age population, but to a different extent in each separate period. To analyse the impact of the factors, we used official Rosstat data for the period from 2005 to 2021. We used the data that reflect the dynamics of socioeconomic and demographic indicators, including the dynamics of mortality of the working-age population in Russia as a whole and in its 85 regions. First, we selected 52 indicators of socioeconomic development and then grouped them into four factor blocks (working conditions, health care, life security, living standards). To reduce the level of statistical noise, we carried out a correlation analysis, which allowed us to narrow down the list to 15 key indicators with the strongest association with the mortality rate of the working-age population. The total period of 2005–2021 was divided into five segments of 3–4 years each, characterising the picture of the socioeconomic state of the country during the period under consideration. The socioeconomic approach used in the study made it possible to assess the extent to which the mortality rate was influenced by the indicators adopted for analysis. The results of this study show that over the whole period, life security (48%) and working conditions (29%) contributed most to the level and dynamics of mortality in the working-age population, while factors determining living standards and the state of the healthcare system accounted for much smaller shares (14% and 9%, respectively). The methodological apparatus of this study is based on the application of methods of machine learning and intelligent data analysis, which allowed us to identify the main factors and their share in the total influence on the mortality rate of the working-age population. The results of this study show the need to monitor the impact of socioeconomic factors on the dynamics and mortality rate of the working-age population in order to improve the effectiveness of social programme. When developing and adjusting government programmes to reduce mortality in the working-age population, the degree of influence of these factors should be taken into account.
Journal Article