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The long-term trends in maternal and child health (MCH) in China and the national-level factors that may be associated with these changes have been poorly explored. This study aimed to assess trends in MCH indicators nationally and separately in urban and rural areas and the impact of public policies over a 30‒year period. An ecological study was conducted using data on neonatal mortality rate (NMR), infant mortality rate (IMR), under-five mortality rate (U5MR), and maternal mortality ratio (MMR) nationally and separately in urban and rural areas in China from 1991 to 2020. Joinpoint regression models were used to estimate the annual percentage changes (APC), average annual percentage changes (AAPC) with 95% confidence intervals (CIs), and mortality differences between urban and rural areas. From 1991 to 2020, maternal and child mortalities in China gradually declined (national AAPC [95% CI]: NMRs − 7.7% [− 8.6%, − 6.8%], IMRs − 7.5% [− 8.4%, − 6.6%], U5MRs − 7.5% [− 8.5%, − 6.5%], MMRs − 5.0% [− 5.7%, − 4.4%]). However, the rate of decline nationally in child mortality slowed after 2005, and in maternal mortality after 2013. For all indicators, the decline in mortality was greater in rural areas than in urban areas. The AAPCs in rate differences between rural and urban areas were − 8.5% for NMRs, − 8.6% for IMRs, − 7.7% for U5MRs, and − 9.6% for MMRs. The AAPCs in rate ratios (rural vs. urban) were − 1.2 for NMRs, − 2.1 for IMRs, − 1.7 for U5MRs, and − 1.9 for MMRs. After 2010, urban‒rural disparity in MMR did not diminish and in NMR, IMR, and U5MR, it gradually narrowed but persisted. MCH indicators have declined at the national level as well as separately in urban and rural areas but may have reached a plateau. Urban‒rural disparities in MCH indicators have narrowed but still exist. Regular analyses of temporal trends in MCH are necessary to assess the effectiveness of measures for timely adjustments.

Although the current COVID-19 crisis is felt globally, at the local level, COVID-19 has disproportionately affected poor, highly segregated African American communities in Chicago. To understand the emerging pattern of racial inequality in the effects of COVID-19, we examined the relative burden of social vulnerability and health risk factors. We found significant spatial clusters of social vulnerability and risk factors, both of which are significantly associated with the increased COVID-19-related death rate. We also found that a higher percentage of African Americans was associated with increased levels of social vulnerability and risk factors. In addition, the proportion of African American residents has an independent effect on the COVID-19 death rate. We argue that existing inequity is often highlighted in emergency conditions. The disproportionate effects of COVID-19 in African American communities are a reflection of racial inequality and social exclusion that existed before the COVID-19 crisis.

Background The long‐term trend in cancer death in a rapidly developing country provides information for cancer prophylaxis. Here, we aimed to identify the trends in cancer mortality in China during the 2004‐2018 period. Methods Using raw data from the national mortality surveillance system of China, we assessed the mortalities of all cancer and site‐specific cancers during the 2004‐2018 period. The participants were divided into three age groups: ≥65 years, 40‐64 years, and ≤39 years. Changing trends in cancer death by gender, residency, and tumor location were estimated using fitting joinpoint models to log‐transformed crude mortality rates (CMRs) and age‐standardized mortality rates (ASMRs). Results Cancer death accounted for 24% of all‐cause of death in China during 2014‐2018. The CMR of all cancer was 150.0 per 100,000 persons. Cancer was the leading cause of death in the population <65 years. The six major cancer types (lung/bronchus cancer, liver cancer, stomach cancer, esophagus cancer, colorectal cancer, and pancreas cancer) accounted for 75.85% of all cancer deaths. The CMR of all cancer increased while the ASMR decreased during 2014‐2018 (P < 0.001). Lung/bronchus cancer and liver cancer were the leading causes of cancer death in the population <65 years, accounting for 45.31% (CMR) and 44.35% (ASMR) of all cancer death, respectively. The ASMR of liver cancer was higher in the 40‐64 years population than in the ≥65 years population, in contrast to the other five major cancers. The ASMRs of liver cancer, stomach cancer, and esophagus cancer decreased although they were higher in rural residents than in urban residents; the ASMRs of lung/bronchus cancer, colorectal cancer, and pancreas cancer increased in rural residents although they were higher in urban residents than in rural residents during 2014‐2018. Conclusion Although the ASMR of all cancer decreased in China during 2004‐2018, lung/bronchus cancer and liver cancer remained the leading causes of cancer‐related premature death. Lung/bronchus cancer, colorectal cancer, and pancreas cancer increased in rural residents. This 15‐year longitudinal study described cancer burden of a rapid changing country with significant regional and urban‐rural disparities, which is important in evaluating the effect of population ageing, risk factor exposure, and public health efforts on cancer mortality. Lung and liver cancers were the 1st leading cause of immature death in women and men, respectively. Lung, colorectal, and pancreatic cancers kept increasing in rural areas. These findings are references for policy making to control cancer.

Objectives The main aim of this study was to find the prevalence of mortality among hospitalized COVID-19 infected patients and associated risk factors for death. Methods Three electronic databases including PubMed, Science Direct and Google Scholar were searched to identify relevant cohort studies of COVID-19 disease from January 1, 2020, to August 11, 2020. A random-effects model was used to calculate pooled prevalence rate (PR), risk ratio (RR) and 95% confidence interval (CI) for both effect measures. Cochrane chi-square test statistic Q, I 2 , and τ 2 tests were used to measure the presence of heterogeneity. Publication bias and sensitivity of the included studies were also tested. Results In this meta-analysis, a total of 58 studies with 122,191 patients were analyzed. The pooled prevalence rate of mortality among the hospitalized COVID-19 patients was 18.88%, 95% CI (16.46–21.30), p < 0.001. Highest mortality was found in Europe [PR 26.85%, 95% CI (19.41–34.29), p < 0.001] followed by North America [PR 21.47%, 95% CI (16.27–26.68), p < 0.001] and Asia [PR 14.83%, 95% CI (12.46- 17.21), p < 0.001]. An significant association were found between mortality among COVID-19 infected patients and older age (> 65 years vs. < 65 years) [RR 3.59, 95% CI (1.87–6.90), p < 0.001], gender (male vs. female) [RR 1.63, 95% CI (1.43–1.87), p < 0.001], ICU admitted patients [RR 3.72, 95% CI (2.70–5.13), p < 0.001], obesity [RR 2.18, 95% CI (1.10–4.34), p < 0.05], hypertension [RR 2.08,95% CI (1.79–2.43) p < 0.001], diabetes [RR 1.87, 95% CI (1.23–2.84), p < 0.001], cardiovascular disease [RR 2.51, 95% CI (1.20–5.26), p < 0.05], and cancer [RR 2.31, 95% CI (1.80–2.97), p < 0.001]. In addition, significant association for high risk of mortality were also found for cerebrovascular disease, COPD, coronary heart disease, chronic renal disease, chronic liver disease, chronic lung disease and chronic kidney disease. Conclusion This meta-analysis revealed that the mortality rate among COVID-19 patients was highest in the European region and older age, gender, ICU patients, patients with comorbidity had a high risk for case fatality. Those findings would help the health care providers to reduce the mortality rate and combat this pandemic to save lives using limited resources.

It is widely discussed that GDP growth has a vague impact on environmental pollution due to carbon dioxide emissions from fossil fuels consumed in production, transportation, and power generation. The main purpose of this study is to investigate the relationships between economic growth, fossil fuel consumption, mortality (from cardiovascular disease (CVD), diabetes mellitus (DM), cancer, and chronic respiratory disease (CRD), and environmental pollution since environmental pollution can be a reason for societal mortality rate increases. This study uses the generalized method of moments (GMM) estimation technique for the Commonwealth of Independent States (CIS) members for the period from 1993–2018. The major results revealed that the highest variability of mortality could be explained by CO2 variability. Regarding fossil fuel consumption, the estimation proved that this variable positively affects mortality from CVD, DM, cancer, and CRD. Additionally, any improvements in the human development index (HDI) have a negative effect on mortality increases from CVD, DM, cancer, and CRD in the CIS region. It is recommended that the CIS members implement different policies to improve energy transitions, indicating movement from fossil fuel energy sources to renewable sources. Moreover, we recommend the CIS members enhance various policies for easy access to electricity from green sources and increase the renewable supply through improved technologies, sustainable economic growth, and increase the use of green sources in daily social life.

Building on our earlier research (Case and Deaton 2015), we find that mortality and morbidity among white non-Hispanic Americans in midlife since the turn of the century continued to climb through 2015. Additional increases in drug overdoses, suicides, and alcohol-related liver mortality—particularly among those with a high school degree or less—are responsible for an overall increase in all-cause mortality among whites. We find marked differences in mortality by race and education, with mortality among white non-Hispanics (males and females)risingfor those without a college degree, andfallingfor those with a college degree. In contrast, mortality rates among blacks and Hispanics have continued to fall, irrespective of educational attainment. Mortality rates in comparably rich countries have continued their premillennial fall at the rates that used to characterize the United States. Contemporaneous levels of resources—particularly slowly growing, stagnant, and even declining incomes—cannot provide a comprehensive explanation for poor mortality outcomes. We propose a preliminary but plausible story in whichcumulative disadvantagefrom one birth cohort to the next—in the labor market, in marriage and child outcomes, and in health—is triggered by progressively worsening labor market opportunities at the time of entry for whites with low levels of education. This account, which fits much of the data, has the profoundly negative implication that policies—even ones that successfully improve earnings and jobs, or redistribute income—will take many years to reverse the increase in mortality and morbidity, and that those in midlife now are likely to do worse in old age than the current elderly. This is in contrast to accounts in which resources affect health contemporaneously, so that those in midlife now can expect to do better in old age as they receive Social Security and Medicare. None of this, however, implies that there are no policy levers to be pulled. For instance, reducing the overprescription of opioids should be an obvious target for policymakers.

Background Despite the declining trends worldwide, infant and child mortality rates are still high in many African countries. These high rates are problematic; therefore, this study attempts to explore the contributing factors that cause high infant and child mortality rates in 14 African countries using panel data for the period of 2000–2018. In particular, the role globalisation is explored. Methods The panel corrected standard error (PCSE), the Feasible generalized least square (FGLS) models, and the pair-wise Granger causality test have been applied as methodological approaches. Results The public health expenditure, numbers of physicians, globalization, economic development, education, good governance, and HIV prevalence rate have been revealed as the determinants of infant and child mortality in these countries. All these variables except the HIV prevalence rate negatively affect the infant and child mortality rates, while the HIV prevalence rate is found to be positive. Bidirectional and unidirectional causal relationships between the variables are also attained. Conclusions Effective socio-economic policy priority with due consideration of globalization should be emphasized to reduce infant and child mortality rates in these countries.

Coffee consumption has been associated with several benefits toward human health. However, its association with mortality risk has yielded contrasting results, including a non-linear relation to all-cause and cardiovascular disease (CVD) mortality and no association with cancer mortality. As smoking habits may affect the association between coffee and health outcomes, the aim of the present study was to update the latest dose-response meta-analysis of prospective cohort studies on the association between coffee consumption and mortality risk and conduct stratified analyses by smoking status and other potential confounders. A systematic search was conducted in electronic databases to identify relevant studies, risk estimates were retrieved from the studies, and dose-response analysis was modeled by using restricted cubic splines. A total of 31 studies comprising 1610,543 individuals and 183,991 cases of all-cause, 34,574 of CVD, and 40,991 of cancer deaths were selected. Analysis showed decreased all-cause [relative risk (RR) = 0.86, 95 % confidence interval (CI) = 0.82, 0.89)] and CVD mortality risk (RR = 0.85, 95 % CI = 0.77, 0.93) for consumption of up to 4 cups/day of coffee, while higher intakes were associated with no further lower risk. When analyses were restricted only to non-smokers, a linear decreased risk of all-cause (RR = 0.94, 95 % CI = 0.93, 0.96), CVD (RR = 0.94, 95 % CI = 0.91, 0.97), and cancer mortality (RR = 0.98, 95 % CI = 0.96, 1.00) for 1 cup/day increase was found. The search for other potential confounders, including dose-response analyses in subgroups by gender, geographical area, year of publication, and type of coffee, showed no relevant differences between strata. In conclusion, coffee consumption is associated with decreased risk of mortality from all-cause, CVD, and cancer; however, smoking modifies the observed risk when studying the role of coffee on human health.

We evaluated the incidence, outcomes, and causative agents of bloodstream infections (BSI) in Finland during 2004–2018 by using data from the national registries. We identified a total of 173,715 BSIs; annual incidence increased from 150 to 309 cases/100,000 population. BSI incidence rose most sharply among persons >80 years of age. The 1-month case-fatality rate decreased from 13.0% to 12.6%, but the 1-month all-cause mortality rate rose from 20 to 39 deaths/100,000 population. BSIs caused by Escherichia coli increased from 26% to 30% of all BSIs. BSIs caused by multidrug-resistant microbes rose from 0.4% to 2.8%, mostly caused by extended-spectrum β-lactamase-producing E. coli. We observed an increase in community-acquired BSIs, from 67% to 78%. The proportion of patients with severe underlying conditions rose from 14% to 23%. Additional public health and healthcare prevention efforts are needed to curb the increasing trend in community-acquired BSIs and antimicrobial drug–resistant E. coli.

Although the association between depression and excess mortality has been well established, it is not clear whether this is greater in major depression than in subthreshold depression. To compare excess mortality in major depression with that in subthreshold depression. We searched bibliographic databases and included prospective studies in which both major and subthreshold depression were examined at baseline and mortality was measured at follow-up. A total of 22 studies were included. People with major depression had a somewhat increased chance of dying earlier than people with subthreshold depression but this difference was not significant, although there was a trend (relative risk 1.13, 95% CI 0.98-1.30, P = 0.1). The population attributable fraction was 7% for major depression and an additional 7% for subthreshold depression. Although excess mortality may be somewhat higher in major than in subthreshold depression, the difference is small and the overall impact on excess mortality is comparable.