RESUMO
Background: Socioeconomic disparities in life expectancy are well-documented in various contexts, including Chile. However, there is a lack of research examining trends in life expectancy inequalities and lifespan variation over time. Addressing these gaps can provide crucial insights into the dynamics of health inequalities. Methods: This study utilizes data from census records, population surveys, and death certificates to compare the life expectancy and the lifespan variation at age 26 of individuals according to their rank in the distribution of years of education within their own birth cohort. The analysis spans three periods (1991, 2002, and 2017) and focuses on two educational groups: individuals in the first (lowest) quintile and tenth (highest) decile of educational attainment. Changes in life expectancy are disaggregated by major causes of death to elucidate their contributions to overall trends. Results: Consistent with existing literature, our findings confirm that individuals with lower education levels experience lower life expectancy and higher lifespan variation compared to their more educated counterparts. Notably, by 2017, life expectancy for individuals in the lowest quintile of education has caught up with that of the top decile in 1991, albeit with contrasting trends between genders. Among women, the gap has reduced, while it has increased for males. Moreover, lifespan variation decreased (increased) over time for individuals in the tenth decile (first quintile). The leading causes of death that explain the increase in life expectancy in women and men in the tenth decile as well as women in the first quintile are cardiovascular, cancer, respiratory and digestive diseases. In the case of males in the first quintile, few gains have been made in life expectancy resulting from cancer and a negative contribution is associated with digestive conditions. Conclusions: This study underscores persistent socioeconomic disparities in life expectancy in Chile, emphasizing the importance of ongoing monitoring of health inequalities across different demographic segments. The gender-specific and educational gradient trends highlight areas for targeted interventions aimed at reducing health disparities and improving overall population health outcomes. Further research is warranted to delve into specific causes of death driving life expectancy differentials and to inform evidence-based policy interventions.
Assuntos
Causas de Morte , Disparidades nos Níveis de Saúde , Expectativa de Vida , Fatores Socioeconômicos , Humanos , Expectativa de Vida/tendências , Chile/epidemiologia , Masculino , Feminino , Adulto , Causas de Morte/tendências , Pessoa de Meia-Idade , Escolaridade , Longevidade , IdosoRESUMO
Fundamento: el envejecimiento es un hecho que afecta a toda la población mundial, y de manera considerable, a los países más desarrollados, en los que la esperanza de vida ha ido aumentando tal y como se refleja en el informe de Naciones Unidas. Objetivo: describir el contexto social y capacidad funcional en gerontos del consultorio # 8 del Área de Salud I del municipio Cienfuegos durante el año 2022. Método: se realizó un estudio descriptivo de corte transversal. Se seleccionó aleatoriamente una muestra del 30 % para un total de 131 ancianos. Se realizó una entrevista estructurada, que recogió las variables generales: edad, sexo, nivel de escolaridad, ocupación, antecedentes patológicos personales, la colaboración de apoyo y para completar la valoración social se aplicó el Cuestionario de Funcionamiento Familiar. Resultados: el grupo de edad de 60 a 65 años tuvo más prevalencia, el 45,5 % estudió hasta la primaria terminada, seguidos de los de secundaria terminada con el 29,0 %. Los jubilados estuvieron representados en un 38,9 %, las principales enfermedades no transmisibles que prevalecieron fueron: la hipertensión arterial, la cardiopatía isquémica y la diabetes mellitus tipo 2, el 40,4 % vivía solo, el 19,8 % tenía cuidador, el 14,5 % no recibían apoyo y el 9,9 % de los ancianos que se encontraban en probable estado de necesidad social. Conclusiones: un adulto mayor bien nutrido, querido, apoyado, con todas las necesidades básicas satisfechas, así como todas las enfermedades asociadas propias de esta etapa de la vida compensadas, tendrá en cualquier sociedad una mejor calidad de vida.
Foundation: aging is a fact that affects the entire world population, and considerably, the most developed countries, in which life expectancy has been increasing as reflected in the United Nations report. Objective: to describe the social context and functional capacity in gerontos of clinic # 8 of Health Area I of the Cienfuegos municipality during the year 2022. Method: a descriptive cross-sectional study was carried out. A 30 % sample was randomly selected for a total of 131 elderly people. A structured interview was carried out, which included the general variables: age, sex, level of education, occupation, personal pathological history, support collaboration and to complete the social assessment, the Family Functioning Questionnaire was applied. Results: the age group of 60 to 65 years had the most prevalence, 45.5 % studied until they completed primary school, followed by those who completed secondary school with 29.0 %. Retirees were represented at 38.9 %, the main non-communicable diseases that prevailed were: high blood pressure, ischemic heart disease and type 2 diabetes mellitus, 40.4 % lived alone, 19.8 % had a caregiver, 14.5 % did not receive support and 9.9 % of the elderly who were in a probable state of social need. Conclusions: a well-nourished, loved, supported older adult, with all basic needs satisfied, as well as all associated diseases typical of this stage of life compensated, will have a better quality of life in any society.
RESUMO
BACKGROUND: Mortality rate estimation in small areas can be difficult due the low number of events/exposure (i.e. stochastic error). If the death records are not completed, it adds a systematic uncertainty on the mortality estimates. Previous studies in Brazil have combined demographic and statistical methods to partially overcome these issues. We estimated age- and sex-specific mortality rates for all 5,565 Brazilian municipalities in 2010 and forecasted probabilistic mortality rates and life expectancy between 2010 and 2030. METHODS: We used a combination of the Tool for Projecting Age-Specific Rates Using Linear Splines (TOPALS), Bayesian Model, Spatial Smoothing Model and an ad-hoc procedure to estimate age- and sex-specific mortality rates for all Brazilian municipalities for 2010. Then we adapted the Lee-Carter model to forecast mortality rates by age and sex in all municipalities between 2010 and 2030. RESULTS: The adjusted sex- and age-specific mortality rates for all Brazilian municipalities in 2010 reveal a distinct regional pattern, showcasing a decrease in life expectancy in less socioeconomically developed municipalities when compared to estimates without adjustments. The forecasted mortality rates indicate varying regional improvements, leading to a convergence in life expectancy at birth among small areas in Brazil. Consequently, a reduction in the variability of age at death across Brazil's municipalities was observed, with a persistent sex differential. CONCLUSION: Mortality rates at a small-area level were successfully estimated and forecasted, with associated uncertainty estimates also generated for future life tables. Our approach could be applied across countries with data quality issues to improve public policy planning.
Assuntos
Teorema de Bayes , Cidades , Expectativa de Vida , Mortalidade , Humanos , Brasil/epidemiologia , Masculino , Feminino , Mortalidade/tendências , Lactente , Pré-Escolar , Idoso , Pessoa de Meia-Idade , Adolescente , Adulto , Criança , Adulto Jovem , Recém-Nascido , Idoso de 80 Anos ou mais , Fatores Sexuais , Distribuição por Idade , Fatores Etários , Distribuição por Sexo , PrevisõesRESUMO
The aim of the present study was to develop the first life tables for the dog population of the Autonomous City of Buenos Aires by constructing life expectancy tables. Data on canines received for final disposal at the Luis Pasteur Zoonosis Institute of the Autonomous City of Buenos Aires from January 2018 to December 2021 were used to prepare the life tables. Of the 11,429 dogs that died in that period, the overall life expectancy at birth was 11.88 years (95% CI = 11.37-12.39). There was no difference in life expectancy at birth by sex or by pure versus cross breeds. According to neuter status, life expectancy at birth in neutered (13.98 years) was significantly higher than in entire (11.46 years) (p-value = 0.00001). Life tables varied according to the breed studied, with the Pekingese having the highest life expectancy at birth 16.42 years (95% CI: 15.87-16.98), and the Pit bull having the lowest life expectancy at birth 10.13 years (95% CI: 9.58-10.68). The current study provides useful information for veterinary professionals and pet owners and is a valuable tool for planning and developing effective health policies.
Assuntos
Expectativa de Vida , Animais , Cães , Argentina/epidemiologia , Masculino , Feminino , Tábuas de VidaRESUMO
The aim of the study was to analyze gender differences in life expectancy free of depressive symptoms among the adult population in Chile between 2003 and 2016. The Sullivan method was used to estimate the total and marginal life expectancy, based on prevalence data from the National Health Survey (2003, 2010 and 2016), and abridged life tables for the Chilean population. There was a compression of morbidity among middle-aged men during the first period and among younger and older women during the last one. Men at all ages could expect to live a higher proportion of their lives without depressive symptoms during the whole period. The gender gap in the proportion of life expectancy free of depressive symptoms reached 10 percent points or more, considering almost all ages and periods. Unemployment and lower education increased the probability of depressive symptoms, and these effects were more marked among women. Public policies should have a gender-sensitive approach to address the gap in depression and the disadvantage experienced by women in life expectancy free of depressive symptoms, considering those dimensions that intersect with gender, such as access to education, employment or income.
RESUMO
INTRODUCTION: In Brazil, though Antiretroviral Therapy (ART) is available to all, the benefits may not be experienced uniformly. We projected Life Expectancy (LE) for People Living with HIV (PLHIV) in care as currently observed and estimated the impact of guideline-concordant care. METHODS: Using a microsimulation model, we projected LE for a cohort of PLHIV and for four population groups: cisgender Men who have Sex with Men (MSM), cisgender Men who have Sex with Women (MSW), Cisgender Women (CGW), and Transgender Women (TGW). Cohort data from Evandro Chagas National Institute of Infectious Diseases/Oswaldo Cruz Foundation (INI/Fiocruz) informed model parameters. We modeled five scenarios: 1) Current care: ART initiation, adherence, and retention in care as currently observed, 2) Guideline-concordant care: immediate ART initiation, full adherence to treatment, and consistent retention in care, 3) Immediate ART initiation with observed adherence to treatment and retention in care, 4) Full adherence to treatment with observed timing of ART initiation and retention in care, and 5) Consistent retention in care with observed timing of ART initiation and adherence. RESULTS: With current care, LE from age 15 would be 45.9, 44.4, 54.2, and 42.3 years, for MSM, MSW, CGW, and TGW. With guideline-concordant care, LE would be 54.2, 54.4, 63.1, and 53.2 years, for MSM, MSW, CGW and TGW, with TGW experiencing the greatest potential increase in LE (10.9 years). When investigating the components of care separately, MSW and CGW would gain most LE with immediate ART initiation, whereas for MSM and TGW consistent retention in care would be most impactful. CONCLUSIONS: In settings like INI/Fiocruz, MSW and CGW would benefit most from interventions focused on earlier diagnosis and linkage to care, whereas TGW and MSM would benefit from interventions to sustain engagement in care. Assessment of the HIV care continuum for specific populations should inform care priorities.
Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Pessoas Transgênero , Humanos , Masculino , Feminino , Adolescente , Homossexualidade Masculina , Brasil/epidemiologia , Comportamento Sexual , Infecções por HIV/epidemiologiaRESUMO
The consequences of mass radiological events, particularly those involving the activation of a radiological dispersion device (RDD), have been extensively studied by scientific groups. However, the critical initial period of such an event, usually spanning the first 100 h, can be characterized by a scarcity of information, potentially leading to delays in mitigating strategies. In response, a research group utilized computer simulations to generate solid, conservative analytical details that can aid decision-making and guide the prioritization of initial care based on variables such as age, sex, location, and local atmospheric stability conditions. The study estimates the Lost Life Expectancy (LLE) and provides relevant information to increase support for decision-making and allow evaluation of data closer to the lay public. The research team behind the study has been granted funding by the Brazilian National Council for Scientific and Technological Development (CNPq), and further simulations will be conducted utilizing codes that implement numerical models, specifically in atmospheric data forecasting. The methodology used to evaluate the LLE can be applied to any location, provided that the relevant variables are updated accordingly. Overall, this study offers critical insights into the impact of mass radiological events and enhances simulations' predictive capacity and precision.
Assuntos
Monitoramento de Radiação , Expectativa de Vida , Simulação por Computador , BrasilRESUMO
Bulimulus bonariensis is considered a species of relevance to agribusiness, having been declared a pest with indirect damage because of its negative effects on several crops such as soybeans, chickpeas, and corn in central and northern Argentina. The objective of this work was to analyze the growth pattern of a population born under laboratory conditions, to explore population aspects such as survival and mortality, to estimate the age and size at gonadal maturity and first reproduction, and to contribute to the knowledge of the reproductive biology of this gastropod. From the clutches obtained, the basic biologic parameters were calculated and the individuals hatched under laboratory conditions counted and measured every two weeks. The clutches contained an average of 44 eggs, which took about 13.7 days to hatch at a birth rate of 41.82%. The growth pattern in the five clutches was analyzed individually, and the logistic model used was the one with the highest degree of fit to that observed growth pattern, followed by the Gompertz model, and finally the von Bertalanffy model. In addition, the models were applied to the 102 specimens analyzed together as a cohort, where the best fitting model was also proved to be the logistic growth model. A concave type III survival curve was obtained from the horizontal life table. The cohort was reduced by 48% during the first 50 days after birth. Beyond one month of hatching, life expectancy gradually increased and remained high between 65-302 days of life. After day 330, life expectancy decreased and only 13.72% exceeded one year of birth, with an average length of 16.68 mm. The last specimen died after 23 months at a total length of 20.24 mm, and the life expectancy was estimated at almost three years. In addition, it was inferred that gonadal maturity, when these gastropods reach 12 mm of total shell length, is reached after 200 days of life. Therefore, the individuals that are born are able to reproduce for the first time a year after birth, when they have the approximate size of 16.68 mm.
Assuntos
Gastrópodes , Humanos , Animais , Feminino , Biomassa , Coeficiente de Natalidade , Modelos Logísticos , Ciclo CelularRESUMO
BACKGROUND: Although about 10% of the Latin American population is indigenous, ethnic differences in disability-free life expectancy (DFLE) and life expectancy with disability (DLE) are unknown. OBJECTIVE: To estimate disability-free life expectancy and disabled life expectancy among Mapuche (the largest indigenous group) and non-indigenous older adults aged 60 years or more in Chile. METHOD: Disability was measured following a methodology that combines limitations of daily living, cognitive impairment and dependence previously validated in Chile. Finally, the DFLE was estimated using Sullivan's method combining life tables by ethnicity and disability proportions from the EDES survey designed for the study of ethnic differentials in health and longevity in Chile. RESULTS: Non-Indigenous people have a higher total and Disability-free life expectancy compared to Mapuche people at all ages. While at age 60 a Mapuche expects to live 18.9 years, of which 9.4 are disability-free, a non-Indigenous expects to live 26.4 years, of which 14 are disability-free. In addition, although the length of life with disability increases with age for both populations, Mapuche who survive to age 80 or 90 expect to live 84% and 91% of their remaining life with disability, higher proportions compared to non-indigenous people (62.9% and 75%, respectively). CONCLUSIONS: This is the first study addressing inequities in DFLE between the Mapuche and non-Indigenous population, reflected in lower total life expectancy, lower DFLE and higher DLE in Mapuche compared to the non-Indigenous population. Our results underscore the need for increased capacity to monitor mortality risks among older people, considering ethnic differences.
Assuntos
Pessoas com Deficiência , Expectativa de Vida Saudável , Indígenas Sul-Americanos , Idoso , Humanos , Chile/epidemiologia , Expectativa de Vida , Pessoa de Meia-Idade , Idoso de 80 Anos ou maisRESUMO
Abstract Introduction In Brazil, though Antiretroviral Therapy (ART) is available to all, the benefits may not be experienced uniformly. We projected Life Expectancy (LE) for People Living with HIV (PLHIV) in care as currently observed and estimated the impact of guideline-concordant care. Methods Using a microsimulation model, we projected LE for a cohort of PLHIV and for four population groups: cisgender Men who have Sex with Men (MSM), cisgender Men who have Sex with Women (MSW), Cisgender Women (CGW), and Transgender Women (TGW). Cohort data from Evandro Chagas National Institute of Infectious Diseases/Oswaldo Cruz Foundation (INI/Fiocruz) informed model parameters. We modeled five scenarios: 1) Current care: ART initiation, adherence, and retention in care as currently observed, 2) Guideline-concordant care: immediate ART initiation, full adherence to treatment, and consistent retention in care, 3) Immediate ART initiation with observed adherence to treatment and retention in care, 4) Full adherence to treatment with observed timing of ART initiation and retention in care, and 5) Consistent retention in care with observed timing of ART initiation and adherence. Results With current care, LE from age 15 would be 45.9, 44.4, 54.2, and 42.3 years, for MSM, MSW, CGW, and TGW. With guideline-concordant care, LE would be 54.2, 54.4, 63.1, and 53.2 years, for MSM, MSW, CGW and TGW, with TGW experiencing the greatest potential increase in LE (10.9 years). When investigating the components of care separately, MSW and CGW would gain most LE with immediate ART initiation, whereas for MSM and TGW consistent retention in care would be most impactful. Conclusions In settings like INI/Fiocruz, MSW and CGW would benefit most from interventions focused on earlier diagnosis and linkage to care, whereas TGW and MSM would benefit from interventions to sustain engagement in care. Assessment of the HIV care continuum for specific populations should inform care priorities.
RESUMO
BACKGROUND: Life expectancy (LE) is an indicator related to medical, demographic, social and geographic conditions. OBJECTIVES: To analyze the effect of the COVID-19 pandemic on LE and of its distribution according to sociodemographic variables in municipalities of Mexico. METHODS: Information on mortality was collected from data published by the Ministry of Health, and demographic information, from the 2020 Population and Housing Census. LE was calculated according to the standard actuarial method. A risk analysis was carried out between expected years of life lost and the size of the economically active population, years of education and indigenous-speaking population. RESULTS: In 2020, there was a nation-wide average drop of 4.7 years in LE, but its distribution was heterogeneous at the municipal level, with extreme values of -2.8 years and 12.6 years. The risk analysis showed an inverse relationship between sociodemographic variables and expected years of life lost, except for the indigenous-speaking population. CONCLUSIONS: The impact of the COVID-19 pandemic on LE in Mexico was significant and was influenced by the analyzed sociodemographic variables, particularly by the municipalities' population size.
ANTECEDENTES: La esperanza de vida es un indicador relacionado con condiciones médicas, demográficas, sociales y geográficas. OBJETIVOS: Analizar el efecto de la pandemia de COVID-19 en la esperanza de vida y de su distribución según variables sociodemográficas en municipios de México. MATERIAL Y MÉTODOS: Se recabó información sobre mortalidad de la Secretaría de Salud, así como información demográfica del Censo de Población y Vivienda de 2020. La esperanza de vida se calculó conforme el método actuarial estándar. Se realizó análisis de riesgo entre la pérdida de la esperanza de vida en años y el tamaño de la población, población económicamente activa, años de escolaridad y población de habla indígena. RESULTADOS: En 2020 se registró una caída promedio de 4.7 años en la esperanza de vida a nivel nacional, pero su distribución fue heterogénea en los municipios, con valores extremos de −2.8 años y 12.6 años. El análisis de riesgo mostró una relación inversa entre las variables sociodemográficas y la pérdida de años de esperanza de vida, con excepción de la población de habla indígena. CONCLUSIONES: El impacto de la pandemia de COVID-19 en la esperanza de vida en México fue significativo, matizado por las variables sociodemográficas analizadas, particularmente por el tamaño de la población de los municipios.
Assuntos
COVID-19 , Pandemias , Humanos , México/epidemiologia , Cidades , COVID-19/epidemiologia , Expectativa de VidaRESUMO
El envejecimiento poblacional constituye uno de los logros y uno de los retos más importantes del desarrollo de las sociedades. La principal causa del envejecimiento es el descenso de la fecundidad de las mujeres, y en menor proporción la emigración externa, sobre todo de jóvenes. En Cuba, ya mueren más que los que nacen, debido fundamentalmente a los bajos niveles de reemplazo en la fecundidad, situación agravada en los años de la pandemia de COVID-19. Entre las consecuencias negativas del envejecimiento poblacional, se identifican cuatro principales: sanitarias, económicas, socioculturales y legales; entre las positivas, hay algunos reportes de cohortes de personas que llegan a edades avanzadas en mejor estado físico y mental. Los cambios ocurridos en la institución familiar en muchas sociedades y la discriminación por edad de los mayores, tienen consecuencias graves para la salud, el bienestar y los derechos humanos de los ancianos. Se considera que existe mucha información sobre el "diagnóstico" y el "pronóstico" del envejecimiento poblacional, pero hay menos acerca de acciones eficaces para su "tratamiento", aspecto complejo y difícil de enfrentar. Se exponen algunas propuestas de mitigación de estos inevitables cambios demográficos. El propósito de esta comunicación es comentar determinados aspectos del envejecimiento de la población cubana.
Population aging constitutes one of the achievements and one of the most important challenges in the development of societies. The main cause of aging is the decrease in the fertility of women and to a lesser extent external emigration, especially of young people. In Cuba, more people die than are born, mainly due to low replacement levels in fertility, a situation aggravated in the years of the COVID-19 pandemic. Among the negative consequences of population aging, four main ones are identified: health, economic, sociocultural and legal; among the positive ones, there are some reports of cohorts of people who reach advanced ages in better physical and mental condition. The changes that have occurred in the family institution in many societies and the age discrimination of the elderly have serious consequences for the health, well-being and human rights of the elderly. It is considered that there is a lot of information about the "diagnosis" and "prognosis" of population aging, but there is less about effective actions for its "treatment", a complex and difficult aspect to face. Some proposals are presented to mitigate these inevitable demographic changes. The purpose of this communication is to comment on certain aspects of the aging of the Cuban population.
RESUMO
Resumen Antecedentes: Entre 2020 y 2021, México experimentó 2.21 millones de defunciones, de las cuales 25.3 % estuvo relacionado con infección por SARS-COV-2. Objetivos: Evaluar la mortalidad por COVID-19 en 2020-2021, determinar su influencia en la esperanza de vida al nacer a nivel nacional, estatal y en países seleccionados de la región, así como analizarla en función del perfil sociodemográfico. Material y métodos: Se utilizaron datos del Global Burden of Disease 2021 para reportar la mortalidad, el impacto en la esperanza de vida y las causas subyacentes entre 2019 y 2021. Se usó una regresión cuadrática para evaluar la mortalidad en exceso como indicador de la respuesta de los estados a la pandemia, considerando su estructura sociodemográfica. Resultados: Entre 2020 y 2021, se registraron 708 971 muertes en exceso, que disminuyeron la esperanza de vida al nacer en 4.6 años; 76 % de esta reducción se atribuyó a COVID-19. La tasa de mortalidad por COVID-19 fue superior a la esperada conforme a las condiciones sociodemográficas de las entidades. Conclusiones: En México y los países de la región, la pandemia fue devastadora y generó regresiones en la esperanza de vida al nacer, que variaron de dos a nueve años. Se requiere más investigación para entender las variaciones en sus efectos.
Abstract Background: Between 2020 and 2021, Mexico documented 2.21 million fatalities, out of which 25.3% were attributable to SARS-COV-2 infection. Objectives: To evaluate COVID-19 mortality during 2020-2021, determine its impact on national- and state-level life expectancy at birth, and in a group of selected countries of the region, as well as to analyze it according to sociodemographic profiles. Material and methods: Data from the Global Burden of Disease 2021 study were used to report mortality, the impact on life expectancy and underlying causes between 2019 and 2021. A quadratic regression model was used to evaluate excess mortality as an indicator of the response of the states to the pandemic, considering their sociodemographic structure. Results: Between 2020 and 2021, 708,971 excess deaths were recorded, which decreased life expectancy at birth by 4.6 years; 76% of this reduction was attributed to COVID-19. The COVID-19 mortality rate was higher than expected according to the sociodemographic conditions of the states. Conclusions: In Mexico and the countries of the region, the pandemic was devastating and generated regressions in life expectancy at birth, which varied from two to nine years. Further investigation is required for understanding the variations on its effects.
RESUMO
Abstract Objective: The objective of this paper is assessed the nexus among health status, economic growth, and the Gini index in North America and its countries using a panel model. Materials and Method: The materials consist of annual data regarding life expectancy, government health expenditure as percentage of the gross domestic product, Gini index, and gross domestic product at constant 2015 US$ for the period 2000-2019. The method applies a panel model for North America and its three countries: Canada, Mexico and The United States. North America diversity treatment among countries is dealt with fixed and random effects. Results: North America inhabitants health status are negatively influenced by an increasing income inequality, and a reduction on economic growth. The country that expends more in health care is The United States, follow by Canada and Mexico. The biggest reduction on life expectancy from an increase in income inequality is in The United States, followed by Canada and Mexico. Life expectancy increases when Canada and The United States experience economic growth. The countries with inarticulate health policy responses to an increase in income inequality are first Mexico followed by The United States. Conclusions: In North America and its countries an increasing income inequality reduces life expectancy, and government health expenditure. Economic growth benefits life expectancy and government health expenditure. Health status seems to improve with a reduction in income inequality and a greater public health expenditure. Therefore, policies that increases income inequality and reduces public health expenditure seems to be advocates of a reduction: in health status, population welfare and economic growth.
Resumen: Objetivo: Un análisis cuantitativo de las relaciones entre salud, crecimiento económico e índice de Gini en América del Norte y sus países se realiza mediante un modelo de panel. El estado de salud está representado por la esperanza de vida y los sistemas de salud pública por el gasto público en salud. El crecimiento económico es el cambio porcentual del producto interno bruto. La desigualdad de ingresos se representa con el índice de Gini. Materiales y método: Los materiales consisten en datos anuales de esperanza de vida, gasto público en salud como porcentaje del producto interno bruto, índice de Gini y producto interno bruto en dólares estadounidenses constantes de 2015 para el período 2000-2019. El método consiste en aplicar un modelo de panel para América del Norte y sus tres países: Canadá, México y Estados Unidos. El tratamiento de la diversidad entre los países de América del Norte es abordada con efectos fijos y aleatorios. Resultados: El estado de salud de los habitantes de América del Norte se ve influenciado negativamente por la creciente desigualdad de ingresos y la reducción del crecimiento económico. El país que más gasta en salud es los Estados Unidos, seguido de Canadá y México. La mayor reducción en la esperanza de vida debido a un aumento en la desigualdad de ingresos se encuentra en los Estados Unidos, seguido de Canadá y México. La esperanza de vida aumenta cuando Canadá y Estados Unidos experimentan crecimiento económico. Los países con respuestas de política de salud desarticuladas ante un aumento en la desigualdad de ingresos son primero México seguido de Estados Unidos. Conclusiones: Las políticas que aumentan la desigualdad de ingresos y reducen el gasto público en salud parecen ser promotoras de una reducción: en el estado de salud, el bienestar de la población, y el crecimiento económico.
RESUMO
RESUMEN La mortalidad causada por COVID-19 en México se ha situado entre las más altas del mundo, por lo que es de interés epidemiológico estudiar su impacto respecto a la esperanza de vida (EV). El objetivo del presente trabajo fue analizar el impacto de la pandemia por COVID-19 en la esperanza de vida, comparando datos de 2019 y 2020, y evaluando su efecto por densidad poblacional de los municipios de los estados del noreste de México. La información sobre mortalidad para 2019 y 2020 se obtuvo de la Secretaría de Salud, y la demográfica del Consejo Nacional de Población. Se construyeron tablas de vida mediante el método actuarial estándar; se calcularon percentiles ≤ 25 y ≥ 75 de la diferencia en la EV; se evaluó la relación entre el tamaño de la población de los municipios y la magnitud de la diferencia en la pérdida de años en la EV. La pandemia por COVID-19 impactó en la EV en los estados del noreste de México, con gran heterogeneidad al interior en cada uno de ellos. La pérdida en años en promedio fue, para Coahuila de 5.4, Nuevo León 4.1 y Tamaulipas 4.9. Los municipios del percentil ≥ 75 mostraron una pérdida promedio de 9.2 años y los del percentil ≤ 25 de -0.35 años. La diferencia en la pérdida en años de EV, entre 2019 y 2020, se vio influenciada por el tamaño de la población, tendiendo a ser mayor en aquellos con mayor densidad demográfica, sin ser el único factor determinante.
ABSTRACT COVID-19 mortality in Mexico is among the highest in the world. Therefore, it is of epidemiologic interest to study its impact on life expectancy. The aim of the present paper was to analyze the impact of the COVID-19 pandemic on life expectancy through a comparison of data from 2019 and 2020. Specifically, the effect of population density in municipalities of Northeastern Mexican states. Information regarding 2019 and 2020 mortality rates for was obtained from the Ministry of Health, and demographics from the National Population Council. Life tables were constructed using the standard actuarial method. Percentiles ≤ 25 and ≥ 75 of the difference in life expectancy in the period were calculated. The relationship between the size of the population of the municipalities and the magnitude of the difference in life expectancy loss of years was evaluated. COVID-19 pandemic impacted on life expectancy with great heterogeneity in each of the northeastern states of Mexico. The loss in years in average life expectancy was 5.4 for Coahuila, 4.1 for Nuevo Leon and 4.9 for Tamaulipas. Municipalities above the ≥ 75th percentile showed an average loss of 9.2 years. Those in the lower than ≤ 25th percentile showed a decrease, of -0.35 years. The difference in the loss of life expectancy during 2019 and 2020 was influenced by population size, tending to be greater in those municipalities with higher population density, but was not the only determining factor.
RESUMO
Resumen Antecedentes: La esperanza de vida es un indicador relacionado con condiciones médicas, demográficas, sociales y geográficas. Objetivos: Analizar el efecto de la pandemia de COVID-19 en la esperanza de vida y de su distribución según variables sociodemográficas en municipios de México. Material y métodos: Se recabó información sobre mortalidad de la Secretaría de Salud, así como información demográfica del Censo de Población y Vivienda de 2020. La esperanza de vida se calculó conforme el método actuarial estándar. Se realizó análisis de riesgo entre la pérdida de la esperanza de vida en años y el tamaño de la población, población económicamente activa, años de escolaridad y población de habla indígena. Resultados: En 2020 se registró una caída promedio de 4.7 años en la esperanza de vida a nivel nacional, pero su distribución fue heterogénea en los municipios, con valores extremos de −2.8 años y 12.6 años. El análisis de riesgo mostró una relación inversa entre las variables sociodemográficas y la pérdida de años de esperanza de vida, con excepción de la población de habla indígena. Conclusiones: El impacto de la pandemia de COVID-19 en la esperanza de vida en México fue significativo, matizado por las variables sociodemográficas analizadas, particularmente por el tamaño de la población de los municipios.
Abstract Background: Life expectancy (LE) is an indicator related to medical, demographic, social and geographic conditions. Objectives: To analyze the effect of the COVID-19 pandemic on LE and of its distribution according to sociodemographic variables in municipalities of Mexico. Methods: Information on mortality was collected from data published by the Ministry of Health, and demographic information from the 2020 Population and Housing Census. LE was calculated according to the standard actuarial method. A risk analysis was carried out between expected years of life lost and the size of the population, economically active population, years of education and indigenous-speaking population. Results: In 2020, there was a nation-wide average drop of 4.7 years in LE, but its distribution was heterogeneous at the municipal level, with extreme values of -2.8 years and 12.6 years. The risk analysis showed an inverse relationship between sociodemographic variables and expected years of life lost, except for the indigenous-speaking population. Conclusions: The impact of the COVID-19 pandemic on LE in Mexico was significant, and was influenced by the analyzed sociodemographic variables, particularly by the municipalities' population size.
RESUMO
BACKGROUND: Life expectancy (LE) has usually been used as a metric to monitor population health. In the last few years, metrics such as Quality-Adjusted-Life-Expectancy (QALE) and Health-Adjusted-Life- Expectancy (HALE) have gained popularity in health research, given their capacity to capture health related quality of life, providing a more comprehensive approach to the health concept. We aimed to estimate the distribution of the LE, QALEs and HALEs across Socioeconomic Status in the Chilean population. METHODS: Based on life tables constructed using Chiang II´s method, we estimated the LE of the population in Chile by age strata. Probabilities of dying were estimated from mortality data obtained from national registries. Then, life tables were stratified into five socioeconomic quintiles, based on age-adjusted years of education (pre-school, early years to year 1, primary level, secondary level, technical or university). Quality weights (utilities) were estimated for age strata and SES, using the National Health Survey (ENS 2017). Utilities were calculated using the EQ-5D data of the ENS 2017 and the validated value set for Chile. We applied Sullivan´s method to adjust years lived and convert them into QALEs and HALEs. RESULTS: LE at birth for Chile was estimated in 80.4 years, which is consistent with demographic national data. QALE and HALE at birth were 69.8 and 62.4 respectively. Men are expected to live 6.1% less than women. However, this trend is reversed when looking at QALEs and HALEs, indicating the concentration of higher morbidity in women compared to men. The distribution of all these metrics across SES showed a clear gradient in favour of a better-off population-based on education quintiles. The absolute and relative gaps between the lowest and highest quintile were 15.24 years and 1.21 for LE; 18.57 HALYs and 1.38 for HALEs; and 21.92 QALYs and 1.41 for QALEs. More pronounced gradients and higher gaps were observed at younger age intervals. CONCLUSION: The distribution of LE, QALE and HALEs in Chile shows a clear gradient favouring better-off populations that decreases over people´s lives. Differences in LE favouring women contrast with differences in HALEs and QALEs which favour men, suggesting the need of implementing gender-focused policies to address the case-mix complexity. The magnitude of inequalities is greater than in other high-income countries and can be explained by structural social inequalities and inequalities in access to healthcare.
Assuntos
Expectativa de Vida Saudável , Qualidade de Vida , Recém-Nascido , Masculino , Feminino , Humanos , Pré-Escolar , Chile , Expectativa de Vida , Anos de Vida Ajustados por Qualidade de VidaRESUMO
Objetivo: Estimar los años potenciales de vida perdidos y la distribución espacial de la mortalidad por incidente vial según modo de transporte en Medellín 2010-2020, como línea base para la implementación de la estrategia Visión Cero, de la Organización Mundial de la Salud, en la movilidad de la ciudad. Metodología: Estudio retrospectivo y descriptivo de corte transversal, con fuente secundaria. El cálculo de los años potenciales de vida perdidos se hizo tomando como edad límite la esperanza de vida al nacer de Colombia, según año y género. El análisis espacial se realizó a partir de la dirección del incidente; la representación de la densidad de Kernel fue por el método de clasificación estándar-cuantil, y las zonas de influencia se crearon por el método búfer de anillos múltiples, con distancias de 500 y 1000 metros. Resultados: Medellín, entre 2010 y 2020, registró 2988 muertes por incidente vial. Quienes más murieron fueron los peatones, con 1423 (47,6 %) muertes, seguidos por los motociclistas, con 1295 (43,3 %). Los años potenciales de vida perdidos fueron 98 787. Las comunas de mayor concentración en muerte de peatones fueron: Candelaria, Buenos Aires y Manrique; en motociclistas, la mayor concentración se evidenció en el sistema vial del río. Por zonas de influencia, los peatones fallecidos en un radio de 1000 metros del sistema vial del río fueron 688 (49,8 %), y los motociclistas, 636 (52,2 %). Conclusión: Los motociclistas fueron quienes murieron más jóvenes y más años dejaron de vivir. Politraumatismos son diagnósticos constantes de muerte, pero lesiones en cabeza, cráneo y tórax son más letales en peatones y motociclistas.
Objective: To estimate the potential years of life lost and the spatial distribution of mortality from road incidents by mode of transport in Medellín 2010-2020, as a baseline for the implementation of the Vision Zero strategy of the World Health Organization in the city's mobility. Methodology: This is a retrospective and descriptive cross-sectional study, with a secondary source. The calculation of the potential years of life lost was made using the life expectancy at birth in Colombia as the age limit, according to year and gender. The spatial analysis was carried out from the direction of the incident; Kernel density was represented by the standard-quantile classification method, and the zones of influence were created by the multiple ring buffer method, with distances of 500 and 1000 meters. Results: Between 2010 and 2020, Medellín registered 2,988 deaths due to road incidents. Those who died the most were pedestrians, with 1,423 (47.6%) deaths, followed by motorcyclists, with 1,295 (43.3%). Potential years of life lost were 98,787. The zones (comunas) with the highest concentration of pedestrian deaths were: Candelaria, Buenos Aires and Manrique; in motorcyclists, the highest concentration was evidenced in the river road system. By areas of influence, pedestrians killed within a radius of 1,000 meters from the river road system were 688 (49.8%), and motorcyclists, 636 (52.2%). Conclusion: Motorcyclists were the ones who died the youngest and the most years they stopped living. Polytrauma is a constant diagnosis of death, but injuries to the head, skull and thorax are more lethal in pedestrians and motorcyclists.
Objetivo: Estimar os anos potenciais de vida perdidos e a distribuição espacial da mortalidade por incidente de trânsito segundo o modo de transporte em Medellín 2010-2020, como linha base para a implementação da estratégia Visão Zero, da Organização Mundial da Saúde, na mobilidade da cidade. Metodologia: Estudo retrospectivo e descritivo de corte transversal, com fonte secundária. O cálculo dos anos potenciais de vida perdidos foi feito considerando como idade limite a esperança de vida ao nascer da Colômbia, segundo ano e gênero. A análise espacial realizou-se a partir do local do incidente; a representação da densidade de Kernel foi pelo método de classificação padrão-quantil, e as zonas de influência criaram-se pelo método buffer de anéis múltiplos, com distâncias de 500 e 1000 metros. Resultados: Medellín, entre 2010 e 2020, registrou 2988 mortes por incidente de trânsito. O maior número de mortes foi de pedestres, sendo 1423 (47,6%), seguido pelo de motoqueiros, sendo 1295 (43,3%). Os anos potenciais de vida perdidos foram 98.787. As localidades com maior concentração de mortes de pedestres foram: Candelaria, Buenos Aires e Manrique; no caso dos motoqueiros, a maior concentração evidenciou-se no sistema viário do rio. Por zonas de influência, os pedestres falecidos em um raio de 1000 metros do sistema viário do rio foram 688 (49,8%), e os motoqueiros 636 (52,2%). Conclusão: Os motoqueiros foram quem morreram mais novos e mais anos deixaram de viver. Politraumatismos são diagnósticos constantes de morte, mas lesões na cabeça, no crâneo e no tórax são mais letais em pedestres e motoqueiros.
RESUMO
In the complex context of French Guiana, different vulnerabilities and different risk factors between genders may lead to complex differences in health outcomes, mortality, and life expectancy. Our aim was, thus, to compare male and female mortality and life expectancy, to compare it between French Guiana and mainland France, and to look at temporal trends and the main specific causes of death in order to identify actionable singularities. National databases were used to obtain life expectancy at birth, at 20, 40, and 60 years, and mortality statistics. Standardized death rates and causes of death for French Guiana and mainland France were obtained through the CEPIDC, which analyzes information from death certificates. When comparing with mainland France, life expectancy at birth was significantly shorter both in males and females (mean = -2.9 years); life expectancy at 20 years, which allows to remove the effect of the greater child mortality in French Guiana, was also shorter in French Guiana for males (mean = -1.8 years) and females (mean = -2 years). The differences between mainland France and French Guiana regarding life expectancy at 40 and 60 years (mean = -1.5 and -1.3 years) was mainly found among females, males in French Guiana life expectancy at 40 and 60 years was closer to that in mainland France (mean = -0.8 and -0.6 years). Although they have a greater life expectancy at birth than men, women in French Guiana are substantially more affected by overweight/obesity and type 2 diabetes. The observed patterns of life expectancy at different ages presumably reflect the burden of external causes and AIDS in males and perhaps metabolic diseases in women.
Assuntos
Diabetes Mellitus Tipo 2 , Recém-Nascido , Criança , Humanos , Masculino , Feminino , Guiana Francesa/epidemiologia , Caracteres Sexuais , Expectativa de Vida , FrançaRESUMO
Background: Ethnic and racial differences in life expectancy have been well established in different societies. However, even though an important part of the population of Latin America is Indigenous, there is little knowledge about them. Objective: Determine if there are ethnic differences in life expectancy at birth and at 60 years in Chile, and if the Mapuche (largest Indigenous ethnic group) have similar life expectancy to other Indigenous peoples. Method: Life tables for the Mapuche and other Indigenous groups and non-Indigenous people were built using the 2017 census. Specifically, we used the questions of the number of live children born and the number of surviving children. With this information, using the indirect method of own children we determined infantile mortality. Then, using the relational logit model and the model life table (west), we estimated the survival function for all ages. Results: Indigenous Chileans have seven years lower life expectancy at birth than the non-Indigenous population (76.2 vs. 83.2 years). The differential at age 60 is 6 years (20.3 vs. 26.4 years). We also found that Mapuche have an even greater disadvantage in survival than other ethnic groups. This is reflected in 2 years less life expectancy, both at birth and at 60 years. Discussion: Our results ratify the existence of marked ethnic-racial inequality in the extension of life in Chile and demonstrate a greater disadvantage in terms of survival of the Mapuche compared to other Indigenous and non-Indigenous groups. It is thus of great relevance to design policies that would decrease the existing inequalities in lifespan.