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Comparing the impacts of COVID-19 across EU member states
Published in Linda Hantrais, Marie-Thérèse Letablier, Comparing and Contrasting the Impact of the COVID-19 Pandemic in the European Union, 2020
Linda Hantrais, Marie-Thérèse Letablier
Excess mortality for a given period is calculated from the number of people who died during the period compared to the number who would have been expected to die from all causes based on the same period in previous years (Ritchie et al., 2020). Excess mortality data include ‘collateral damage’ from other health conditions if the health system is overwhelmed by COVID-19 cases. Scientists have suggested that additional deaths could be related to people being deterred from seeking treatment for medical emergencies such as strokes or heart attacks, and from delaying routine operations and cancer screening. Conditions such as mental health problems and suicides linked to self-isolation, heart problems from lack of activity, the impact on health from increased unemployment and reduced living standards are likely to contribute to excess mortality in the aftermath of the pandemic.
Management of Acute Malnutrition in Infants under 6 Months of Age
Published in Crystal D. Karakochuk, Kyly C. Whitfield, Tim J. Green, Klaus Kraemer, The Biology of the First 1,000 Days, 2017
In the short term, mortality is the most serious risk faced by acutely malnourished infants <6 months. Acute malnutrition has a widely recognized, well-described high case fatality rate [15–17], but infants are at particular risk. Reasons include physiological and immunological immaturity, which make them more vulnerable in the first place and more likely to suffer severe adverse consequences. In one recent meta-analysis that compared infants <6 months with children 6–60 months in the same treatment programs, the infants’ risk of death was significantly greater (risk ratio 1.30, 95% CI: 1.09, 1.56; P< 0.01) [18]. Although biologically not unexpected, a key question is how much of this excess mortality can be avoided with improved or alternative treatment.
Health in later life
Published in Liam J. Donaldson, Paul D. Rutter, Donaldsons' Essential Public Health, 2017
Liam J. Donaldson, Paul D. Rutter
Measuring mortality in the winter months (usually December to March) as a proportion of mortality at other times of the year yields a measure called excess winter deaths. The excess winter mortality index is calculated as the number of excess winter deaths divided by the average nonwinter deaths, and is expressed as a percentage. The excess mortality is due to circulatory illness (ischaemic heart disease and stroke), respiratory disease (particularly influenza), accidents and violence (including hypothermia) and a range of other causes. The excess winter mortality rate rises sharply with age in the older age groups and is worse in years with influenza epidemics. The number of excess winter deaths in Britain has fluctuated year to year but generally has decreased over the decades (Figure 11.7).
Malignancy rates of salivary gland tumors in Greenlandic Inuit comparable to non-endemic populations; epidemiological mapping of salivary gland tumors 1990–2019
Published in Acta Oncologica, 2023
Carl Frederik Haugaard, Simon Andreasen, Patrick R. G. Eriksen, Caroline Olsen, Katalin Kiss, Kristine Bjørndal, Marie Westergaard-Nielsen, Preben Homøe
All statistical analyses were performed using R (version 4.0.5, R core team, Vienna Austria). We used the following packages: ‘Survival’ (Kaplan–Meier estimates), ‘timereg’(relative survival statistics). The mortality rate by age, calendar year, and sex for the Greenlandic Inuit population residing in Greenland was found in StatBank Greenland and used as a comparator for relative survival estimates [13]. Age-adjusted incidence was calculated using the WHO World Standard Population 2000–2025. The overall population used for incidence calculations included both individuals born in Greenland with residence in Greenland or Denmark. Estimates of overall survival were calculated using the Kaplan-Meier method; significance was assessed using the log-rank test. Excess mortality was calculated using the nonparametric additive excess hazards model [14]. Incidence rates were based on the period from 2009 to 2019. Overall survival (OS) was defined at the time from diagnosis until death of any cause.
Health Disparities, Systemic Racism, and Failures of Cultural Competence
Published in The American Journal of Bioethics, 2021
Jeffrey T. Berger, Dana Ribeiro Miller
The inequities that produce health disparities are an enduring moral deficit in the United States. Concerns of culture are largely beside the point. The ongoing public health crisis of health disparities, including the epidemic of excess mortality in racial and ethnic groups, remains relegated to a deprioritized position in medical education and in health and social policy. This crisis demands of medical educators an educational framework that centers on clearly articulated and incorporated principles of social justice. This framework should be over-arching across the curriculum and not particularized to courses in ethics, social medicine, or health system sciences. Social justice as it relates to health pertains to equity in both medical care and in societal structures that have bearing on health. Leaders in academic medicine must exhort social and political leaders to advance a more justly structured society as an essential condition for moral progress in health care and in health education. An educational framework that is directed toward reducing these disparities requires broad and coordinated efforts at four levels: health and social policy (macro), institutional-system activity (mezzo), the clinical encounter (micro), and the epistemic.
Gender differences in association of prescription opioid use and mortality: A propensity-matched analysis from the REasons for Geographic And Racial Differences in Stroke (REGARDS) prospective cohort
Published in Substance Abuse, 2021
Yulia Khodneva, Joshua Richman, Stefan Kertesz, Monika M. Safford
In the Veterans Aging Cohort Study, persons with PO were at 25% increased risk of death,49 which was greater than our finding of mortality risk for baseline POU in the REGARDS study. It is noteworthy that even after propensity score matching in the study conducted by Weisberg et al., veterans treated with PO significantly differed from non-users in the rates of smoking and comorbid conditions.49 This suggests that Weisberg’s study may not have achieved balance between POU and non-users on baseline characteristics, and raises the possibility of suboptimal minimization of confounding by indication. Excess mortality among persons with PO in some previous epidemiological studies may be related to the burden of worse socio-economic factors and/or comorbidity that could not be accounted for in those analyses.50