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Pyankova AI, Fattakhov TA, Kozlov VA. The association between beverage-specific alcohol consumption and mortality among road users in Russia, 1965-2019. ACCIDENT; ANALYSIS AND PREVENTION 2022; 178:106859. [PMID: 36274542 DOI: 10.1016/j.aap.2022.106859] [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: 01/27/2021] [Revised: 09/22/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
A vast body of literature suggests a relationship between alcohol consumption and road traffic fatalities. Despite an impressive downward trend in road traffic fatalities in Russia, the death rate is still unacceptably high. Far fewer studies have differentiated the association by road users and types of alcoholic beverages. This population-based study aims to estimate the associations of total and beverage-specific alcohol per capita (15+) consumption (APC) based on official alcohol sales statistics and road traffic mortality using police data on the number of deaths by road users. The study covers the period 1965-2019. We employed a first-order difference linear regression model with robust and autocorrelation consistent standard errors, controlling for a level of motorisation. To examine the possible evolution of the phenomenon, we repeated models separately for three consecutive periods (1965-1984, 1985-2002, 2003-2019). The findings suggest that an annual 1-litre increase in APC (in litres of pure alcohol) associated with a corresponding increase in the death rates (per 100,000 inhabitants) of both unprotected road users and motor vehicle occupants by about 0.3 (p < 0.01) and 0.4 (p < 0.05), respectively. A beverage-specific analysis for 1965-2019 revealed a positive and significant association between mortality of pedestrians and cyclists and the consumption of strong alcoholic beverages (p < 0.05) as well as mortality of drivers and passengers and the consumption of weaker alcoholic beverages, primarily beer (p < 0.01). Various road safety strategies should be applied to prevent road traffic fatalities of road users.
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Affiliation(s)
- Anastasiya I Pyankova
- Institute of Demography, HSE University, 20 Myasnitskaya Ulitsa, Moscow 101000, Russia.
| | - Timur A Fattakhov
- Institute of Demography, HSE University, 20 Myasnitskaya Ulitsa, Moscow 101000, Russia.
| | - Vladimir A Kozlov
- Institute of Demography, HSE University, 20 Myasnitskaya Ulitsa, Moscow 101000, Russia.
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Dadgar I, Norström T. Is there a link between all-cause mortality and economic fluctuations? Scand J Public Health 2022; 50:6-15. [PMID: 34666579 PMCID: PMC8808227 DOI: 10.1177/14034948211049979] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 08/12/2021] [Accepted: 09/09/2021] [Indexed: 11/16/2022]
Abstract
Background: All-cause mortality is a global indicator of the overall health of the population, and its relation to the macro economy is thus of vital interest. The main aim was to estimate the short-term and the long-term impact of macroeconomic change on all-cause mortality. Variations in the unemployment rate were used as indicator of temporary fluctuations in the economy. Methods: We used time-series data for 21 OECD countries spanning the period 1960-2018. We used four outcomes: total mortality (0+), infant mortality (<1), mortality in the age-group 20-64, and old-age mortality (65+). Data on GDP/capita were obtained from the Maddison Project. Unemployment data (% unemployed in the work force) were sourced from Eurostat. We applied error correction modelling to estimate the short-term and the long-term impact of macroeconomic change on all-cause mortality. Results: We found that increases in unemployment were statistically significantly associated with decreases in all mortality outcomes except old-age mortality. Increases in GDP were associated with significant lowering long-term effects on mortality. Conclusions: Our findings, based on data from predominantly affluent countries, suggest that an increase in unemployment leads to a decrease in all-cause mortality. However, economic growth, as indicated by increased GDP, has a long-term protective health impact as indexed by lowered mortality.
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Affiliation(s)
- Iman Dadgar
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
| | - Thor Norström
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
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Stickley A, Baburin A, Jasilionis D, Krumins J, Martikainen P, Kondo N, Leinsalu M. Macroeconomic changes and educational inequalities in traffic fatalities in the Baltic countries and Finland in 2000-2015: a register-based study. Sci Rep 2021; 11:2397. [PMID: 33504848 PMCID: PMC7840907 DOI: 10.1038/s41598-021-81135-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 12/31/2020] [Indexed: 11/10/2022] Open
Abstract
This study examined trends and inequalities in road traffic accident (RTA) mortality in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in relation to large-scale macroeconomic changes in the 2000s. Educational inequalities in RTA mortality in 2000-2003, 2004-2007, 2008-2011 and 2012-2015 among 30-74 year olds were examined using census-linked longitudinal mortality data and by estimating the relative and slope index of inequality. Overall RTA mortality decreased substantially between 2000-2003 and 2012-2015. From 2004-2007 to 2008-2011, the RTA mortality decline accelerated but was larger in the Baltic countries. Among men the RTA mortality decline was mostly driven by a larger fall among the high and middle educated. Among women, the changes in RTA mortality by educational level had no clear pattern. From 2000-2003 to 2012-2015 relative educational inequalities in RTA mortality increased among men, although more in the Baltic countries. Among women the pattern was mixed across countries. Absolute inequalities fell in all countries among both sexes. Educational inequalities in male RTA mortality may be growing because of increasingly less access to safer cars and a more hazardous driving culture among the lower educated.
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Affiliation(s)
- Andrew Stickley
- Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, 141 89, Huddinge, Sweden. .,Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.
| | - Aleksei Baburin
- Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia
| | - Domantas Jasilionis
- Max Planck Institute for Demographic Research, Rostock, Germany.,Demographic Research Centre, Vytautas Magnus University, Kaunas, Lithuania
| | - Juris Krumins
- Demography Unit, Faculty of Business, Management and Economics, University of Latvia, Riga, Latvia
| | - Pekka Martikainen
- Max Planck Institute for Demographic Research, Rostock, Germany.,Population Research Unit, University of Helsinki, Helsinki, Finland.,Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, Stockholm, Sweden
| | - Naoki Kondo
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Kyoto, Japan.,Institute for Future Initiatives, The University of Tokyo, Tokyo, Japan
| | - Mall Leinsalu
- Stockholm Centre for Health and Social Change (SCOHOST), Södertörn University, 141 89, Huddinge, Sweden. .,Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.
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Norström T, Landberg J. The link between per capita alcohol consumption and alcohol-related harm in educational groups. Drug Alcohol Rev 2020; 39:656-663. [PMID: 32654401 DOI: 10.1111/dar.13114] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 04/20/2020] [Accepted: 05/03/2020] [Indexed: 01/07/2023]
Abstract
INTRODUCTION AND AIMS Research based on individual-level data suggests that the same amount of alcohol yields more harm in low-socioeconomic status (SES) groups than in high-SES groups. Little is known whether the effect of changes in population-level alcohol consumption on harm rates differs by SES-groups. The aim of this study was to elucidate this issue by estimating the association between per capita alcohol consumption and SES-specific rates of alcohol-related mortality. DESIGN AND METHODS Per capita alcohol consumption was proxied by Systembolaget's alcohol sales (litres 100% alcohol per capita 15+). Quarterly data on mortality and alcohol consumption spanned the period 1991Q1-2017Q4. We used two outcomes: (i) alcohol-specific mortality (deaths with an explicit alcohol diagnosis); and (ii) violent deaths. SES was measured by education. We used three educational groups: (i) low (<10 years); (ii): intermediate (10-12 years); and (iii) high (13+ years). We applied error correction modelling to estimate the association between alcohol and alcohol-specific mortality, and seasonal autoregressive integrated moving average-modelling to estimate the association between alcohol and violent deaths. RESULTS The estimated associations between per capita consumption and the two outcomes were positive and statistically significant in the two groups with low and intermediate education, but not in the high education group. There was a significant gradient in the level of association between alcohol consumption and alcohol-related harm by educational group; the association was stronger the lower the educational group. DISCUSSION AND CONCLUSIONS Our findings suggest that the association between per capita consumption and alcohol-related harm was stronger the lower the educational group.
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Affiliation(s)
- Thor Norström
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
| | - Jonas Landberg
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Wang X, Du J, Zhuang Z, Wang ZG, Jiang JX, Yang C. Incidence, casualties and risk characteristics of civilian explosion blast injury in China: 2000-2017 data from the state Administration of Work Safety. Mil Med Res 2020; 7:29. [PMID: 32522241 PMCID: PMC7288536 DOI: 10.1186/s40779-020-00257-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 05/18/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Civilian explosion blast injury is more frequent in developing countries, including China. However, the incidence, casualties, and characteristics of such incidents in China are unknown. METHODS This is a retrospective analysis of the State Administration of Work Safety database. Incidents during a period from January 1, 2000 to April 30, 2017 were included in the analysis. The explosions were classified based on the number of deaths into extraordinarily major, major, serious and ordinary type. Descriptive statistics was used to analyze the incidence and characteristics of the explosions. Correlation analysis was performed to examine the potential correlations among various variables. RESULTS Data base search identified a total of 2098 explosions from 2000 to 2017, with 29,579 casualties: 15,788 deaths (53.4%), 12,637 injured (42.7%) and 1154 missing (3.9%). Majority of the explosions were serious type (65.4%). The number of deaths (39.5%) was also highest with the serious type (P = 0.006). The highest incidence was observed in the fourth quarter of the year (October to December), and at 9:00-11:00 am and 4:00-6:00 pm of the day. The explosions were most frequent in coal-producing provinces (Guizhou and Shanxi Province). Coal mine gas explosions resulted majority of the deaths (9620, 60.9%). The number of explosion accidents closely correlated with economic output (regional economy and national GDP growth rate) (r = - 0.372, P = 0.040; r = 0.629, P = 0.028). CONCLUSIONS The incidence and civilian casualties due to explosions remain unacceptabe in developing China. Measures that mitigate the risk factors are of urgently required.
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Affiliation(s)
- Xu Wang
- State Key Laboratory of Trauma, Burn and Combined Injury, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China.,Department of Emergency, the Second Affiliated Hospital of Medical College in Zhejiang University, Hangzhou, 310009, China
| | - Juan Du
- State Key Laboratory of Trauma, Burn and Combined Injury, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Zhuo Zhuang
- Applied Mechanics Laboratory, School of Aerospace, Tsinghua University, Beijing, 100084, China
| | - Zheng-Guo Wang
- State Key Laboratory of Trauma, Burn and Combined Injury, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Jian-Xin Jiang
- State Key Laboratory of Trauma, Burn and Combined Injury, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China.
| | - Ce Yang
- State Key Laboratory of Trauma, Burn and Combined Injury, Research Institute of Surgery, Daping Hospital, Army Medical University, Chongqing, 400042, China.
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Yasin YJ, Grivna M, Abu-Zidan FM. Reduction of pedestrian death rates: a missed global target. World J Emerg Surg 2020; 15:35. [PMID: 32430037 PMCID: PMC7236348 DOI: 10.1186/s13017-020-00315-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 05/07/2020] [Indexed: 12/19/2022] Open
Abstract
Background The UN Decade of Action for Road Safety aimed to reduce road traffic deaths by half by year 2020. We aimed to study risk factors affecting global pedestrian death rates overtime, and whether the defined target of its reduction by WHO has been achieved. Methods The studied variables were retrieved from the WHO Global Status Reports on Road Safety published over 2010–2018. These covered years 2007–2016 and included the estimated road traffic death rates per 100,000 population, policies to promote walking and cycling, enforcement levels of national speed limits, the gross national income per capita and the vehicle/person ratio in each country. A mixed linear model was performed to define the factors affecting the change of pedestrian death rates overtime. Results Global pedestrian mortality decreased by 28% over 10 years. This was significant between years 2007 and 2010 (p = 0.034), between years 2013 and 2016 (p = 0.002) but not between 2010 and 2013 (p = 0.06). Factors that reduced pedestrian death rates included time (p < 0.0001), GNI (p < 0.0001), and vehicle/person ratio (p < 0.0001). There was a significant drop overtime in both the middle-income, and high-income countries (p < 0.0001, Friedman test), but not in the low-income countries (p = 0.35, Friedman test). Conclusions Global pedestrian mortality has dropped by 28% over a recent decade, which is less than the 50% targeted reduction. This was mainly driven by improved GNI and using more vehicles. The economical gap between poor and rich countries has a major impact on pedestrian death rates.
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Affiliation(s)
- Yasin J Yasin
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.,Department of Environmental Health and Behavioral Sciences, School of Public health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Michal Grivna
- Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Fikri M Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates.
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Dadgar I, Norström T. Is there a link between cardiovascular mortality and economic fluctuations? Scand J Public Health 2020; 48:770-780. [PMID: 31916500 DOI: 10.1177/1403494819890699] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Unemployment might affect several risk factors of cardiovascular disease (CVD), which is the leading cause of death globally. The characterisation of the relation between these two phenomena is thus of great significance from a public-health perspective. The main aim of this study was to estimate the association between the unemployment rate and mortality from CVD and from coronary heart disease (CHD). Additional aims were (a) to assess whether the associations are modified by the degree of unemployment protection; (b) to determine the impact of GDP on heart-disease mortality; and (c) to assess the impact of the Great Recession in this context. Methods: We used time-series data for 32 countries spanning the period 1960-2015. We applied two alternative modelling strategies: (a) error correction modelling, provided that the data were co-integrated; and (b) first-difference modelling in the absence of co-integration. Separate models were estimated for each of five welfare state regimes with different levels of unemployment protection. We also performed country-specific ARIMA-analyses. Results: Because the data did not prove to be co-integrated, we applied first-difference modelling. The estimated effect of unemployment and GDP on CVD as well as CHD was statistically insignificant across age and sex groups and across the various welfare state regimes. An interaction term capturing the possible excess effect of unemployment during the Great Recession was also statistically insignificant. Conclusions: Our findings, based on data from predominantly affluent countries, suggest that heart-disease mortality does not respond to economic fluctuations.
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Affiliation(s)
- Iman Dadgar
- Swedish Institute for Social Research, Stockholm University, Sweden
| | - Thor Norström
- Swedish Institute for Social Research, Stockholm University, Sweden
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The Vagus Nerve Can Predict and Possibly Modulate Non-Communicable Chronic Diseases: Introducing a Neuroimmunological Paradigm to Public Health. J Clin Med 2018; 7:jcm7100371. [PMID: 30347734 PMCID: PMC6210465 DOI: 10.3390/jcm7100371] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/10/2018] [Accepted: 10/15/2018] [Indexed: 12/16/2022] Open
Abstract
Global burden of diseases (GBD) includes non-communicable conditions such as cardiovascular diseases, cancer and chronic obstructive pulmonary disease. These share important behavioral risk factors (e.g., smoking, diet) and pathophysiological contributing factors (oxidative stress, inflammation and excessive sympathetic activity). This article wishes to introduce to medicine and public health a new paradigm to predict, understand, prevent and possibly treat such diseases based on the science of neuro-immunology and specifically by focusing on vagal neuro-modulation. Vagal nerve activity is related to frontal brain activity which regulates unhealthy lifestyle behaviors. Epidemiologically, high vagal activity, indexed by greater heart rate variability (HRV), independently predicts reduced risk of GBD and better prognosis in GBD. Biologically, the vagus nerve inhibits oxidative stress, inflammation and sympathetic activity (and associated hypoxia). Finally, current non-invasive methods exist to activate this nerve for neuro-modulation, and have promising clinical effects. Indeed, preliminary evidence exists for the beneficial effects of vagal nerve activation in diabetes, stroke, myocardial infarction and possibly cancer. Thus, we propose to routinely implement measurement of HRV to predict such GBD in populations, and to test in randomized controlled trials effects of non-invasive vagal nerve activation on prevention and treatment of GBD, reflecting possible neuro-modulation of health.
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