Gender differences in premature mortality for cardiovascular disease in India, 2017-18.

BACKGROUND: The present study tries to provide a comprehensive estimate of gender differences in the years of life lost due to CVD across the major states of India during 2017-18. METHODS: The information on the CVD related data were collected from medical certification of causes of death (MCCD reports, 2018). Apart from this, information from census of India (2001, 2011), SRS (2018) were also used to estimate YLL. To understand the variation in YLL due to CVD at the state level, nine sets of covariates were chosen: share of elderly population, percentage of urban population, literacy rate, health expenditure, social sector expenditure, labour force participation, HDI Score and co-existence of other NCDs such as diabetes, & obesity. The absolute number of YLL and YLL rates were calculated. Further, Pearson's correlation had been calculated and to understand the effect of explanatory variables on YLL due to CVD, multiple linear regression analysis had been applied. RESULTS: Men have a higher burden of premature mortality in terms of Years of life lost (YLL) due to CVD than women in India, with pronounced differences at adult ages of 50-54 years and over. The age pattern of YLL rate suggests that the age group 85 + makes the highest contribution to the overall YLL rate due to CVD. YLL rate showed a J-shaped relationship with age, starting high at ages below 1 years, dropping to their lowest among children aged 1-4 years, and rising again to highest levels at 85 + years among both men and women. In all the states except Bihar men had higher estimated YLL due to CVD for all ages than women. Among men the YLL due to CVD was higher in Tamil Nadu followed by Madhya Pradesh and Chhattisgarh. On the other hand, the YLL due to CVD among men was lowest in Jharkhand followed by Assam. Similarly, among women the YLL due to CVD was highest in Tamil Nadu followed by Madhya Pradesh and Chhattisgarh. While, the YLL due to CVD among women was lowest in Jharkhand. Irrespective of gender, all factors except state health expenditure were positively linked with YLL due to CVD, i.e., as state health expenditure increases, the years of life lost (YLL) due to CVDs falls. Among all the covariates, the proportion of a state's elderly population emerges as the most significant predictor variable for YLL for CVDs (r = 0.42 for men and r = 0.50 for women). CONCLUSION: YLL due to cardiovascular disease varies among men and women across the states of India. The state-specific findings of gender differences in years of life lost due to CVD may be used to improve policies and programmes in India.

Disease burden of benign prostatic hyperplasia in China, Japan and South Korea from 1990 to 2019: a comparative study / 现代泌尿外科杂志

【Objective】 To analyze the disease burden of benign prostatic hyperplasia (BPH) in China, Japan and South Korea from 1990 to 2019, so as to provide scientific basis for rational allocation of health resources. 【Methods】 Data were obtained from the Global Burden of Disease Study 2019. The incidence, prevalence and years lived with disability(YLD)were used to analyze the burden, and the average annual percent change and annual percent change were calculated. 【Results】 The incidence, prevalence and YLD rate in China were much higher than those in Japan and South Korea. The crude incidence in China, Japan and South Korea increased by 2.56%, 1.49% and 3.59% per year from 1990 to 2019, the crude prevalence rate increased by 2.70%, 2.34% and 4.03%, and the crude YLD rate increased by 2.68%, 2.33% and 4.04%. After age standardization, the disease burden in China decreased with time, but the trend was not significant, and the standardized rate in Japan and Korea increased significantly with time. The disease burden of BPH increased with age, and those aged 60 to 84 years had the highest burden. In addition, the disease burden increased with the increase of socio-demographic index (SDI) in all three countries. 【Conclusion】 The disease burden of BPH was very heavy in China, Japan and South Korea, especially in China. Males aged 60 to 84 years were the high-risk group. Targeted intervention should be adopted for these population.

Influenza-attributable years of life lost in older adults in a subtropical city in China, 2012-2017: A modeling study based on a competing risks approach.

OBJECTIVE: The aim of this study was to estimate influenza-attributable years of life lost (YLL) in older adults in subtropical Hefei, China during the years 2012-2017, based on a competing risks approach. METHODS: The quasi-Poisson model was fitted to weekly numbers of all-cause deaths by 5-year age groups for older adults ≥60 years of age. The product of the weekly influenza-like illness consultation rate and the proportion of specimens that tested positive for influenza was taken as the measurement of influenza activity, which was incorporated into the model as an exploratory variable. Excess deaths associated with influenza were calculated by subtracting baseline deaths (setting influenza activity to zero) from fitted deaths. Influenza-attributable YLL accounting for competing risks was estimated using restricted mean lifetime survival analysis. RESULTS: The annual influenza-attributable YLL was highest in the 75-79 years age group (565 per 100,000 persons, 95% confidence interval 550-580), followed by the 80-84, 70-74, 85-89, 65-69, and 60-64 years age groups. Influenza A(H3N2) virus was associated with higher YLL than A(H1N1) and B viruses. Influenza-attributable YLL accounted for 1.03-1.53% of total YLL, and the proportion would be overestimated to 2.91-7.34% if the traditional Kaplan-Meier method ignoring competing risks was used. CONCLUSIONS: Although influenza-associated mortality increased with age, influenza-attributable YLL was found to be highest in the 75-79 years age group.

The impact of aerosol direct radiative effects on PM2.5-related health risk in Northern Hemisphere during 2013-2017.

This study estimates the health risk due to PM2.5 and ADE primarily in 4 regions across Northern Hemisphere during 2013-2017. Mortality in China due to PM2.5 dipped from 1.15 million (95%CI (Confidence Interval) 0.64-1.6 million) to 1.02 million (95%CI 0.59-1.49 million) during 2013-2017 as a result of reduction in PM2.5 population weighted concentration (PWC) from 29.26 µg/m3 to 22.05 µg/m3 while India overtook China in terms of death due to PM2.5 which increased to 1.16 million (95%CI 0.72-1.67 million) from 1.07 million (95%CI 0.62-1.53 million) as a result of increase in PWC from 38.18 to 44.47 µg/m3. The years of life lost per person (YLL/person) due to PM2.5 was still observed to be high in China with 5.58 YLL/person followed by India (4.13), Europe (2.19) and US (0.46) in 2017. Aerosols such as PM2.5 have the capability to scatter or absorb solar radiation resulting in perturbation of ground meteorology which further affects dispersion of pollutants and it's resultant health impacts. ADE resulted in 7.27% of total or 77,866 deaths in India during 2013 which increased to 8.05% or 93,575 deaths in 2017 which was highest among all regions while in China ADE deaths reduced from 59,529 (5.15% of total) to 40,470 (3.94% of total) deaths during the same period, other regions too reported reduction in ADE deaths with US reporting 906 (-1.27%) lower deaths while Europe also reported 785 (-0.46%) lower deaths in 2017 as compared to 2013. ADE resulted in increased YLL/person in India from 0.29 to 0.33 during 2013-2017 while it was observed to reduce in all other regions, in China it reduced from 0.37 to 0.22 likewise YLL/person also reduced in US from 0.04 to 0.01 and in Europe from 0.01 to 0.002.

[ICD coding of causes of death: challenges for calculating the burden of disease in Germany]. / ICD-Codierung von Todesursachen: Herausforderungen bei der Berechnung der Krankheitslast in Deutschland.

In the project BURDEN 2020 - "The burden of disease in Germany and its regions" - the years of life lost (YLL) due to premature mortality are calculated on the basis of official cause-of-death statistics. This requires the identification and redistribution of the so-called ill-defined ICD codes. "Ill-defined" means that an ICD code does not sufficiently reflect the cause of death, such that it is not informative for the calculation of the burden of disease.The first steps on the way to calculating cause-specific YLL are presented. Different frameworks of ill-defined codes are compared. The number of deaths with ill-defined codes that can be found in the German cause-of-death statistics in absolute and relative terms are analyzed, including how they are distributed by age, sex, and region.According to the WHO framework, 15.6% of the 925,200 deaths in Germany in 2015 can be identified as ill-defined. According to the framework of the Institute for Health Metrics and Evaluation (IHME) in the Global Burden of Disease Study (GBD), the proportion of ill-defined codes is 26.6%. The ICD-related distribution patterns hardly differ between WHO and IHME classifications. Considerable differences exist between the federal states, with shares of ill-defined codes between 16 and 35% (IHME framework).The cause-of-death statistics in Germany contain a considerable proportion of ill-defined codes. The differences between the federal states can only partially be explained by different electronic data processing. Due to further dissemination and improvement of electronic data collection, higher quality of cause-of-death statistics can be expected in the future.

A Quantification of the Net Consumer Surplus from Gambling Participation.

Gambling exposes people to risk for harm, but also has recreational benefits. The present study aimed to measure gambling harm and gambling benefits on similar scales using two novel methods adapted from the Burden of Disease approach (McCormack et al. in Psychol Med 18(4):1007-1019, 1988; Torrance et al. in Health Serv Res 7(2):118-133, 1972) to find whether gambling either adds or subtracts from quality of life. A Tasmanian population-representative survey of 5000 adults (2534 female) from random digit dialling (RDD) of landline telephones in Tasmania (50%), as well as pre-screened Tasmanian RDD mobiles (17%) and listed mobile numbers (33%), measured gambling benefits and harms amongst gamblers (59.2%) and a non-exclusive set of people who were "affected" by someone else's gambling (4.5%). The majority of gamblers indicated no change to their quality of life from gambling (82.5% or 72.6% based on direct elicitation or time trade off methods, respectively). Nevertheless, a weighted average of all the positive and negative influences on quality of life, inclusive of gamblers and affected others, revealed that the quality of life change from gambling is either a very modest + 0.05% or a more concerning - 1.9% per capita. Gambling generates only small or negative net consumer surpluses for Tasmanians.

Evaluating the impact of criminalizing drunk driving on years of life lost due to road traffic deaths in one megacity, China.

Objective: Road safety is an important public health issue worldwide. However, few studies have analyzed the association between criminalizing drunk driving and years of life lost (YLL) due to road traffic deaths (RTDs). Our study can provide useful information about this policy. Methods: We used interrupted time-series analysis to find the changes in monthly YLL and RTD before and after law enforcement began using RTD data from 2008 to 2014 in Tianjin. Results: After adjustment for seasonality, months, holidays, and the number of people in each district, criminalizing drunk driving was followed by a 11.1% (95% confidence interval [CI], 1.1-21.1%) reduction in risk of RTDs and a corresponding 778.1-year (95% CI, 200-1,355.1) reduction in monthly YLL. The reduction in YLL was especially significant among males, those aged 16-64 years old, and suburban residents. Conclusions: This study highlights that the law can lead to a reduction in YLL due to RTDs in Tianjin, China. Large immediate public health benefits resulted from the new road traffic law in China. YLL provides a complementary measure for examining the effect of criminalization on drunk driving RTDs.

The burden of cardio-cerebrovascular disease and lung cancer attributable to PM2.5 for 2009, Guangzhou: a retrospective population-based study.

Particulate matter pollution has become a widely-concerned issue in public health and led to a substantial loss of health. The study reports relationship between particulate matter with aerodynamic diameter <2.5 µm (PM2.5) and years of life lost (YLL) in Guangzhou. A retrospective burden analysis on annual mean PM2.5 data was conducted. Data on annual mortality were collected for 2009, from the Health Department of Guangzhou. Data on particulate matter were collected for period 2006-2009. Comparative risk assessment and exposure-response function were used to estimate attributable YLL. The exposure to PM2.5 was associated with a total of 454.6 YLLs (95% uncertainty interval 449.0-460.1) per 100,000 people in 2009. This study has confirmed the substantial adverse health effects of PM2.5 exposure in population with cardio-cerebrovascular disease and lung cancer. This study highlights the need to reduce ambient particulate pollution for better environmental health and lower burden of disease.

Premature Mortality among Elderly in Malaysia, 2014

@#Introduction Substantial advances on the life expectancy have been achieved in Malaysia over the past few decades. It is essential that elderly lead a healthier old age which leans towards successful aging. Thus, this study describes the major causes of premature mortality among the elderly population in Malaysia, 2014. Methods The calculation of premature mortality in terms of Years of Life Lost (YLL) was based on the method used in the Global Burden of Disease (GBD) study. YLL is the mortality component determined by the age-sex specific number of deaths and life expectancy at the age of death. Mortality data was obtained from the Department of Statistics Malaysia. Elderly aged 60 years and above were included in this study. Results The major causes of premature mortality among elderly in Malaysia were Cardiovascular and Circulatory Diseases (39.0%); followed by Malignant Neoplasms (16.6%), Respiratory Diseases (9.8%), Respiratory Infections (9.2%) and Diabetes Mellitus (6.8%). Conclusions Awareness programme, early screening and help seeking among elderly should be a priority in planning health services to reduce the burden of Noncommunicable diseases (NCD) among elderly.

Future temperature-related years of life lost projections for cardiovascular disease in Tianjin, China.

It is widely accepted that temperatures is associated with cardiovascular mortality, however, few studies have explored the effects of temperature on years of life lost (YLL) from cardiovascular mortality in China under future global warming scenarios. Therefore, there is an urgent need to obtain projections of YLL from cardiovascular diseases. Here we applied nineteen global-scale climate models (GCMs) and three Representative Concentration Pathway emission scenarios (RCPs) in the 2050s and 2070s for temperature-related YLL projection in Tianjin, China. We found the relationships between daily maximum temperatures with YLL from cardiovascular mortality were basically U-shaped. We observed increasing net annual YLL across a range of multiple models under different climate scenarios, suggesting that increasing heat-related YLL from cardiovascular mortality could offset decreasing cold-related YLL from cardiovascular mortality. The largest temperature-related YLL from cardiovascular mortality were observed under the RCP8.5 scenario and increased more rapidly in the 2070s versus the 2050s. Monthly analyses of percent changes in YLL from cardiovascular mortality showed that the largest percent increases occurred from May to September. If warm adaptation occurs, only the adverse effects under RCP2.6 could be fully offset in both 2050 and 2070. Our exploration provided further evidence for the potential health impacts of global warming and highlighted that government should develop environmental policies for future health risks.

Projecting temperature-related years of life lost under different climate change scenarios in one temperate megacity, China.

Temperature has been associated with population health, but few studies have projected the future temperature-related years of life lost attributable to climate change. To project future temperature-related disease burden in Tianjin, we selected years of life lost (YLL) as the dependent variable to explore YLL attributable to climate change. A generalized linear model (GLM) and distributed lag non-linear model were combined to assess the non-linear and delayed effects of temperature on the YLL of non-accidental mortality. Then, we calculated the YLL changes attributable to future climate scenarios in 2055 and 2090. The relationships of daily mean temperature with the YLL of non-accident mortality were basically U-shaped. Both the daily mean temperature increase on high-temperature days and its drop on low-temperature days caused an increase of YLL and non-accidental deaths. The temperature-related YLL will worsen if future climate change exceeds 2 °C. In addition, the adverse effects of extreme temperature on YLL occurred more quickly than that of the overall temperature. The impact of low temperature was greater than that of high temperature. Men were vulnerable to high temperature compared with women. This analysis highlights that the government should formulate environmental policies to reach the Paris Agreement goal.

Estimating the social and economic burden of road traffic injuries in the Philippines

@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> Road traffic injuries (RTI) are a leading cause of morbidity and mortality globally. Despite underreporting, the scarce Philippine data suggest that RTI pose a significant health problem in the country. It is imperative, therefore, to accurately quantify the burden of RTI in the Philippines.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study aimed to provide the first comprehensive baseline estimation of the socioeconomic burden of RTI in the Philippines for year 2014.</p><p style="text-align: justify;"><strong>METHODS:</strong> The study was a mixed method study design that utilized both primary and secondary data. These data were used to construct parameters needed for the modeling estimates. Measure of socioeconomic burden estimated were (1) economic costs, (2) disability-adjusted life years (DALYs), and (3) healthy life years (HeaLY).</p><p style="text-align: justify;"><strong>RESULT:</strong> Estimated deaths due to RTI in 2014 were 12,336 translating to 454,650 years life lost due to premature death. Injury episodes from RTI were estimated to be 2,798,088 in 2014 with 186,174 leading to admissions, translating to 56,224 years life lost to disability. The total DALY loss due to RTI in 2014 was estimated at 510, 874, while healthy life years lost were estimated to be 76,215,477.4. The estimated deaths and injuries for that year equaled to direct medical cost of PhP 1.213 B, productivity loss due to premature death of PhP 24.620 B, and productivity loss due to illness of PhP 685 M resulting to a total economic cost of PhP 26.519 B to the society.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> The findings indicate that RTI is an important public health concern in the Philippines with substantial economic and health burden. Investing in preventive measures will likely yield significant economic and health gains for the Philippines.</p>

Burden of Outdoor Air Pollution in Kerala, India­A First Health Risk Assessment at State Level.

Ambient air pollution causes a considerable disease burden, particularly in South Asia. The objective of the study is to test the feasibility of applying the environmental burden of disease method at state level in India and to quantify a first set of disease burden estimates due to ambient air pollution in Kerala. Particulate Matter (PM) was used as an indicator for ambient air pollution. The disease burden was quantified in Years of Life Lost (YLL) for the population (30 + years) living in urban areas of Kerala. Scenario analyses were performed to account for uncertainties in the input parameters. 6108 (confidence interval (95% CI): 4150-7791) of 81,636 total natural deaths can be attributed to PM, resulting in 96,359 (95% CI: 65,479-122,917) YLLs due to premature mortality (base case scenario, average for 2008-2011). Depending on the underlying assumptions the results vary between 69,582 and 377,195 YLLs. Around half of the total burden is related to cardiovascular deaths. Scenario analyses show that a decrease of 10% in PM concentrations would save 15,904 (95% CI: 11,090-19,806) life years. The results can be used to raise awareness about air quality standards at a local level and to support decision-making processes aiming at cleaner and healthier environments.