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Wang S, Yin X, Jiang T, Xu J, Wang D. Impact of Cardiovascular and Cerebrovascular Diseases Mortality on Life Expectancy in Tianjin, 2004 and 2020. Asia Pac J Public Health 2024:10105395241251531. [PMID: 38736321 DOI: 10.1177/10105395241251531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
This study aims to analyze the impact of cardiovascular and cerebrovascular diseases (CCVDs) mortality on Tianjin's life expectancy (LE) in 2004 compared with 2020 using Arriaga's decomposition method. The LE increment for Tianjin residents due to the decrease in CCVDs mortality was 1.54 years (38.7%). Males, females, urban residents, and rural residents contributed 1.29 years (36.83%), 1.76 years (40.25%), 2.11 years (44.41%), and 0.71 years (25.06%), respectively. A total of 38.2% of the LE increment was attributed to deaths from CCVDs in people aged ≥65 years. Cerebral infarction, intracerebral hemorrhage, acute myocardial infarction, and other heart diseases contributed positively to the increase in LE (24.8%, 22.68%, 16.66%, and 11.3%). Sequelae of cerebrovascular disease and other coronary heart diseases contributed negatively to the increase in LE (-25.2% and -17.92%). Therefore, we need to control the risk factors of the elderly, males, rural residents, sequelae of cerebrovascular disease, and other coronary heart diseases.
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Affiliation(s)
- Shiyu Wang
- School of Public Health, Tianjin Medical University, Tianjin, China
- NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Xiaolin Yin
- School of Public Health, Tianjin Medical University, Tianjin, China
- NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Tingting Jiang
- School of Public Health, Tianjin Medical University, Tianjin, China
- NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Jiahui Xu
- School of Public Health, Tianjin Medical University, Tianjin, China
- NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, Tianjin, China
| | - Dezheng Wang
- School of Public Health, Tianjin Medical University, Tianjin, China
- NCDs Preventive Department, Tianjin Centers for Disease Control and Prevention, Tianjin, China
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Liu C, He L, Shan X, Zhang L, Ge E, Zhang K, Luo B. The Burden of Occupational Noise-Induced Hearing Loss From 1990 to 2019: An Analysis of Global Burden of Disease Data. Ear Hear 2024:00003446-990000000-00271. [PMID: 38616317 DOI: 10.1097/aud.0000000000001505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
OBJECTIVES The relationship between long-term exposure to occupational noise and hearing loss has been extensively documented. We aimed to assess spatial and temporal changes in the burden of occupational noise-induced hearing loss (ONIHL) in 204 countries and territories with varying socio-demographic indexes (SDI) from 1990 to 2019. DESIGN Temporal and spatial trends in age-standardized disability-adjusted life year rates (ASDR) for ONIHL were estimated by sex, age, SDI level, country, and geographic region from 1990 to 2019. We used the Joinpoint model to calculate annual average percentage changes to assess such trends and projected trends in ASDR for ONIHL globally and across different income regions from 2020 to 2044 using an age-period-cohort model. We fitted the relationship between ASDR and SDI, ASDR and healthcare access and quality index, respectively. RESULTS Overall, the global burden of ONIHL has decreased since 1990, especially in middle and lower SDI regions. In 2019, the global ASDR for ONIHL was 84.23 (95% confidence interval: 57.46 to 120.52) per 100,000 population. From 1990 to 2019, the global ASDR for ONIHL decreased by 1.72% (annual average percentage change = -0.05, 95% confidence interval: -0.07 to -0.03). Our projections showed a decreasing trend in the global ONIHL burden until 2044. ASDR and SDI (R = -0.8, p < 0.05), ASDR and healthcare access and quality index (R = -0.75, p < 0.05) showed significant negative correlations. CONCLUSIONS The global ONIHL burden has decreased over the past three decades, especially in regions with middle and lower SDI levels. However, the global ONIHL burden still remained severe in 2019, notably among males, the middle-aged and elderly, and regions with lower SDI levels.
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Affiliation(s)
- Ce Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Li He
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Xiaobing Shan
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Ling Zhang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Erjia Ge
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, New York, USA
- These authors contributed equally to this work
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
- These authors contributed equally to this work
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Sauerberg M, Klüsener S, Mühlichen M, Grigoriev P. Sex differences in cause-specific mortality: regional trends in seven European countries, 1996-2019. Eur J Public Health 2023; 33:1052-1059. [PMID: 37507140 PMCID: PMC10710349 DOI: 10.1093/eurpub/ckad111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Male excess mortality is mostly related to non-biological factors, and is thus of high social- and health-policy concern. Previous research has mainly focused on national patterns, while subnational disparities have been less in the focus. This study takes a spatial perspective on subnational patterns, covering seven European countries at the crossroad between Eastern and Western Europe. METHODS We analyze a newly gathered spatially detailed data resource comprising 228 regions with well-established demographic methods to assess the contribution of specific causes of death to the evolution of sex mortality differentials (SMDs) since the mid-1990s. RESULTS Our results show that declines in SMDs were mostly driven by a reduction of male excess mortality from cardiovascular diseases and neoplasms (about 50-60% and 20-30%, respectively). In Western Europe, trends in deaths from neoplasms contributed more to the reduction of SMDs, while among regions located in Eastern-Central Europe narrowing SMDs were mostly driven by changes in cardiovascular disease-related deaths. Moreover, men show up to three times higher mortality levels from external causes as compared to women in several analyzed regions. But in absolute terms, external deaths play only a minor role in explaining SMDs due to their small contribution to overall mortality. CONCLUSIONS We conclude that examining the regional development of SMDs is useful for introducing targeted social and health policies in order to reduce and prevent mortality inequalities between women and men.
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Affiliation(s)
- Markus Sauerberg
- Federal Institute for Population Research (BiB), Wiesbaden, Germany
| | - Sebastian Klüsener
- Federal Institute for Population Research (BiB), Wiesbaden, Germany
- Vytautas Magnus University, Kaunas, Lithuania
- University of Cologne, Cologne, Germany
| | | | - Pavel Grigoriev
- Federal Institute for Population Research (BiB), Wiesbaden, Germany
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Zazueta-Borboa JD, Aburto JM, Permanyer I, Zarulli V, Janssen F. Contributions of age groups and causes of death to the sex gap in lifespan variation in Europe. POPULATION STUDIES 2023; 77:475-496. [PMID: 37366162 DOI: 10.1080/00324728.2023.2222723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/17/2023] [Indexed: 06/28/2023]
Abstract
Much less is known about the sex gap in lifespan variation, which reflects inequalities in the length of life, than about the sex gap in life expectancy (average length of life). We examined the contributions of age groups and causes of death to the sex gap in lifespan variation for 28 European countries, grouped into five European regions. In 2010-15, males in Europe displayed a 6.8-year-lower life expectancy and a 2.3-year-higher standard deviation in lifespan than females, with clear regional differences. Sex differences in lifespan variation are attributable largely to higher external mortality among males aged 30-39, whereas sex differences in life expectancy are due predominantly to higher smoking-related and cardiovascular disease mortality among males aged 60-69. The distinct findings for the sex gap in lifespan variation and the sex gap in life expectancy provide additional insights into the survival differences between the sexes.
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Affiliation(s)
| | - José Manuel Aburto
- London School of Hygiene and Tropical Medicine
- University of Oxford
- University of Southern Denmark
| | - Iñaki Permanyer
- ICREA
- Centre for Demographic Studies (CED-CERCA), Autonomous University of Barcelona
| | | | - Fanny Janssen
- Netherlands Interdisciplinary Demographic Institute-KNAW
- University of Groningen
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Fan J. The burden of ischemic heart disease attributable to ambient and household particulate matter pollution, 1990-2019: a global analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:114514-114524. [PMID: 37861827 DOI: 10.1007/s11356-023-30336-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023]
Abstract
Elevated risk of ischemic heart disease (IHD) is associated with exposure to fine particulate matter. However, there is limited data on trends and comparisons in the global burden of IHD due to household air pollution from solid fuels (HAP) and ambient particulate matter pollution (APMP), particularly in regions of varying socio-economic levels. Based on the Global Burden of Disease Study 2019 (GBD 2019), we obtained age-standardized mortality rates (ASMR) and age-standardized disability-adjusted life years (ASDR) of IHD due to APMP and HAP from 1990 to 2019. Trends in the burden of IHD attributable to APMP and HAP during the period 1990 to 2019 were calculated by Joinpoint models. We estimated the relationship between ASMR with the socio-demographic indexes (SDI) and the health care accessibility and quality (HAQ) index by the Loess regression model. In 2019, the global burden of IHD ASMR attributed to APMP stabilized, but the most significant increases were observed in low-middle SDI regions. The global IHD ASMR attributed to APMP was 16.60 [95% Uncertainty Interval (UI), 13.61 to 19.44] per 100,000 population, with the highest APMP burden in middle SDI regions. From 1990 to 2019, the global ASMR for HAP-attributable IHD declined. The global ASMR of IHD attributable to HAP in 2019 was 6.30 (95% UI, 4.28 to 8.80) per 100,000 population, with the highest burden observed in the low SDI regions. From 1990 to 2019, the global burden of ASMR and ASDR of IHD attributable to APMP showed stabilization, whereas the HAP burden exhibited a decrease. There are a large burden of APMP particularly in middle SDI countries and a higher burden of HAP in low SDI countries. The burden of IHD due to APMP and HAP in men, the elderly, and populations in low, medium, and low SDI regions should be noticed.
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Affiliation(s)
- Jinsong Fan
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China.
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Feraldi A, Zarulli V. Patterns in age and cause of death contribution to the sex gap in life expectancy: a comparison among ten countries. GENUS 2022. [DOI: 10.1186/s41118-022-00171-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
AbstractWomen live longer than men and the absolute difference between male and female mortality risk reaches its maximum at old ages. We decomposed the sex gap in life expectancy and investigated the changes over time of the profile of the age–cause specific contributions with indicators of location, magnitude and dispersion in ten countries. Data were retrieved from the Human Cause-of-Death Database. The decomposition analyses revealed that neoplasm, heart diseases and external causes were the main drivers of the gender gap. We also find two main patterns in the development of age-specific contributions. With mortality delay, regarding neoplasm-related mortality and heart disease-related mortality, the shift (i.e., movement of the modal age at contribution towards older ages) and compression (i.e., dispersion concentrated on a shorter age interval) of the survival advantage of women over a narrower age range reveal that men are gradually improving their survival. This might be linked to improvements in survival, diagnosis and access to treatment, at least to those ages no longer affected by the most significant differences.
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Zirra A, Rao SC, Bestwick J, Rajalingam R, Marras C, Blauwendraat C, Mata IF, Noyce AJ. Gender Differences in the Prevalence of Parkinson's Disease. Mov Disord Clin Pract 2022; 10:86-93. [PMID: 36699001 PMCID: PMC9847309 DOI: 10.1002/mdc3.13584] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 09/03/2022] [Indexed: 01/28/2023] Open
Abstract
Background Parkinson's disease (PD) affects males more than females. The reasons for the gender differences in PD prevalence remain unclear. Objective The objective of this systematic review and meta-analysis was to update the overall male/female prevalence ratios (OPR). Methods We updated previous work by searching MEDLINE, SCOPUS, and OVID for articles reporting PD prevalence for both genders between 2011 and 2021. We calculated OPRs and investigated heterogeneity in effect estimates. Results We included 19 new articles and 13 articles from a previously published meta-analysis. The OPR was 1.18, 95% CI, [1.03, 1.36]. The OPR was lowest in Asia and appeared to be decreasing over time. Study design, national wealth, and participant age did not explain OPR heterogeneity. Conclusion Gender differences in PD prevalence may not be as stark as previously thought. Studies are needed to understand the role of other determinants of gender differences in PD prevalence.
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Affiliation(s)
- Alexandra Zirra
- Preventive Neurology UnitWolfson Institute of Population Health, Queen Mary University of LondonLondonUnited Kingdom
| | - Shilpa C. Rao
- Genomic Medicine InstituteLerner Research Institute, Cleveland Clinic FoundationClevelandOhioUSA,Department of Molecular MedicineCase Western Reserve UniversityClevelandOhioUSA
| | - Jonathan Bestwick
- Preventive Neurology UnitWolfson Institute of Population Health, Queen Mary University of LondonLondonUnited Kingdom
| | | | - Connie Marras
- University Health NetworkUniversity of TorontoTorontoOntarioCanada
| | - Cornelis Blauwendraat
- Laboratory of Neurogenetics, National Institute of AgingNational Institutes of HealthBethesdaMarylandUSA
| | - Ignacio F. Mata
- Genomic Medicine InstituteLerner Research Institute, Cleveland Clinic FoundationClevelandOhioUSA,Department of Molecular MedicineCase Western Reserve UniversityClevelandOhioUSA
| | - Alastair J. Noyce
- Preventive Neurology UnitWolfson Institute of Population Health, Queen Mary University of LondonLondonUnited Kingdom,Department of Clinical and Movement NeurosciencesUCL Institute of NeurologyLondonUnited Kingdom
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Shulgin S, Zinkina Y, Korotayev A. The impact of values of men and women on their life expectancy. POPULATION 2022. [DOI: 10.19181/population.2022.25.1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The female advantage in life expectancy (LE) is found throughout the world, despite differences in living conditions. However, this advantage has diminished in recent years in countries with low mortality rates. In Russia, according to data for 2020, the difference in life expectancy at birth between women and men is 10 years (according to Rosstat) and is one of the highest in the world. The aim of our study is to find out what contribution to the gender gap in life expectancy can be made by the difference between men and women in terms of the value of health and the practice of self-caring behavior. To do this, we used data from the Sample Survey of Behavioral Factors Affecting the Health of the Population conducted by Rosstat in 2013, namely, the respondents' answers to a number of questions related to self-caring and health-preserving behavior. Using these questions, the level of the gap in the value of their own health and health-preserving behavior between Russian men and women is quantified according to the microdata of the survey using OLS regression and ordinal logit regression, where the respondent's answer to the question is used as a dependent variable, and the main independent variable is the gender of the respondent. The results showed that value attitudes to healthy lifestyle significantly affect health-preserving behavior. Correlations between the value of health and various aspects of health-preserving behavior turned out to be in the predicted direction. At the same time, at the level of the subjects of the Russian Federation, the analysis showed a high statistical significance of the following predictors of the gender gap in life expectancy: high levels of consumption of strong alcoholic beverages and tobacco smoking. The increase in the value of health among Russian men is here only of very limited importance for reducing the gender gap in life expectancy.
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Affiliation(s)
- Sergey Shulgin
- Russian Presidential Academy of National Economy and Public Administration, Moscow, Russia
| | - Yulia Zinkina
- Russian Presidential Academy of National Economy and Public Administration, Moscow, Russia
| | - Andrey Korotayev
- Russian Presidential Academy of National Economy and Public Administration, Moscow, Russia; Higher School of Economics, Moscow, Russia
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Kankaanpää A, Tolvanen A, Saikkonen P, Heikkinen A, Laakkonen EK, Kaprio J, Ollikainen M, Sillanpää E. Do epigenetic clocks provide explanations for sex differences in lifespan? A cross-sectional twin study. J Gerontol A Biol Sci Med Sci 2021; 77:1898-1906. [PMID: 34752604 PMCID: PMC9434475 DOI: 10.1093/gerona/glab337] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Indexed: 11/22/2022] Open
Abstract
Background The sex gap in life expectancy has been narrowing in Finland over the past 4–5 decades; however, on average, women still live longer than men. Epigenetic clocks are markers for biological aging which predict life span. In this study, we examined the mediating role of lifestyle factors on the association between sex and biological aging in younger and older adults. Methods Our sample consists of younger and older twins (21‒42 years, n = 1 477; 50‒76 years, n = 763) including 151 complete younger opposite-sex twin pairs (21‒30 years). Blood-based DNA methylation was used to compute epigenetic age acceleration by 4 epigenetic clocks as a measure of biological aging. Path modeling was used to study whether the association between sex and biological aging is mediated through lifestyle-related factors, that is, education, body mass index, smoking, alcohol use, and physical activity. Results In comparison to women, men were biologically older and, in general, they had unhealthier life habits. The effect of sex on biological aging was partly mediated by body mass index and, in older twins, by smoking. Sex was directly associated with biological aging and the association was stronger in older twins. Conclusions Previously reported sex differences in life span are also evident in biological aging. Declining smoking prevalence among men is a plausible explanation for the narrowing of the difference in life expectancy between the sexes. Data generated by the epigenetic clocks may help in estimating the effects of lifestyle and environmental factors on aging and in predicting aging in future generations.
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Affiliation(s)
- Anna Kankaanpää
- Gerontology Research Center (GEREC), Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Asko Tolvanen
- Methodology Center for Human Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pirkko Saikkonen
- Gerontology Research Center (GEREC), Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Aino Heikkinen
- Institute for Molecular Medicine Finland (FIMM), HiLife, University of Helsinki, Helsinki, Finland
| | - Eija K Laakkonen
- Gerontology Research Center (GEREC), Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), HiLife, University of Helsinki, Helsinki, Finland
| | - Miina Ollikainen
- Institute for Molecular Medicine Finland (FIMM), HiLife, University of Helsinki, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Elina Sillanpää
- Gerontology Research Center (GEREC), Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Institute for Molecular Medicine Finland (FIMM), HiLife, University of Helsinki, Helsinki, Finland
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Liu C, Wang B, Liu S, Li S, Zhang K, Luo B, Yang A. Type 2 diabetes attributable to PM 2.5: A global burden study from 1990 to 2019. ENVIRONMENT INTERNATIONAL 2021; 156:106725. [PMID: 34171589 DOI: 10.1016/j.envint.2021.106725] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/03/2021] [Accepted: 06/15/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Long-term exposure to fine particulate matter (PM2.5) is associated with an increased risk of type 2 diabetes (T2D). However, limited data on trends in the global burden of T2D attributed to PM2.5, particularly in different regions by social-economic levels. We evaluated the spatio-temporal changes in the disease burden of T2D attributed to PM2.5 from 1990 to 2019 in 204 countries and regions with different socio-demographic indexes (SDI). METHODS This is a retrospective analysis with data from the Global Burden of Disease Study 2019 (GBD2019) database. The burden of T2D attributed to PM2.5, age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life year rate (ASDR) were estimated according to sex, age, nationality and SDI. The annual percentage change (APCs) and the average annual percentage change (AAPCs) were calculated by using the Joinpoint model to evaluate the changing trend of ASMR and ASDR attributed to PM2.5 from 1990 to 2019. The Gaussian process regression model was used to estimate the relationship of SDI with ASMR and ASDR. RESULTS Overall, the global burden of T2D attributable to PM2.5 increased significantly since 1990, particularly in the elderly, men, Africa, Asia and low-middle SDI regions. The ASMR and ASDR of T2D attributable to PM2.5 in 2019 were 2.47 (95% CI: 1.71, 3.24) per 100,000 population and 108.98 (95% CI: 74.06, 147.23) per 100,000 population, respectively. From 1990 to 2019, the global ASMR and ASDR of T2D attributed to T2D increased by 57.32% and 86.75%, respectively. The global AAPCs of ASMR and ASDR were 1.57 (95% CI: 1.46, 1.68) and 2.17 (95% CI: 2.02, 2.32), respectively. Declining trends were observed in North America, South America, Europe, Australia, and other regions with high SDI. CONCLUSIONS Over this 30-years study, the global T2D burden attributable to PM2.5 has increased particularly in regions with low-middle SDI. PM2.5 remains a great concern on the global burden of diabetes.
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Affiliation(s)
- Ce Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Bo Wang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Shang Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China
| | - Sheng Li
- The First People's Hospital of Lanzhou, Lanzhou, Gansu 730050, People's Republic of China
| | - Kai Zhang
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, One University Place, Rensselaer, NY 12144, USA
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu 730000, People's Republic of China; Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Bureau, Shanghai 200030, People's Republic of China; Shanghai Typhoon Institute, China Meteorological Administration, Shanghai 200030, People's Republic of China.
| | - Aimin Yang
- Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
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Janssen F. The Role of Smoking in Country Differences in Life Expectancy Across Europe, 1985-2014. Nicotine Tob Res 2021; 23:152-160. [PMID: 31943074 PMCID: PMC7789949 DOI: 10.1093/ntr/ntaa011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 01/13/2020] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Smoking contributes substantially to mortality levels and trends. Its role in country differences in mortality has, however, hardly been quantified. The current study formally assesses the-so far unknown-changing contribution of smoking to country differences in life expectancy at birth (e0) across Europe. METHODS Using all-cause mortality data and indirectly estimated smoking-attributable mortality rates by age and sex for 30 European countries from 1985 to 2014, the differences in e0 between each individual European country and the weighted average were decomposed into a smoking- and a nonsmoking-related part. RESULTS In 2014, e0 ranged from 70.8 years in Russia to 83.1 years in Switzerland. Men exhibited larger country differences than women (variance of 21.9 and 7.0 years, respectively). Country differences in e0 increased up to 2005 and declined thereafter. Among men, the average contribution of smoking to the country differences in e0 was highest around 1990 (47%) and declined to 35% in 2014. Among women, the average relative contribution of smoking declined from 1991 to 2011, and smoking resulted in smaller differences with the average e0 level in the majority of European countries. For both sexes combined, the contribution of smoking to country differences in e0 was higher than 20% throughout the period. CONCLUSIONS Smoking contributed substantially to the country differences in e0 in Europe, their increases up to 1991, and their decreases since 2005, especially among men. Policies that discourage smoking can help to reduce inequalities in mortality levels across Europe in the long run. IMPLICATIONS Smoking contributes substantially to country differences in life expectancy at birth (e0) in Europe, particularly among men, for whom the contribution was highest around 1990 (47%) and declined to 35% in 2014. In line with the anticipated progression of the smoking epidemic, the differences between European countries in e0 due to smoking are expected to further decline among men, but to increase among women. The role of smoking in mortality convergence since 2005 illustrates that smoking policies can help to reduce inequalities in life expectancy levels across Europe, particularly when they target smoking in countries with low e0.
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Affiliation(s)
- Fanny Janssen
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
- Netherlands Interdisciplinary Demographic Institute/KNAW, University of Groningen, The Hague, The Netherlands
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