Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Premature Mortality”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed2003

Geographic disparity in premature mortality in Ontario, 1992-1996.

BACKGROUND: Standardized mortality ratios are used to identify geographic areas with higher or lower mortality than expected. This article examines geographic disparity in premature mortality in Ontario, Canada, at three geographic levels of population and considers factors that may underlie variations in premature mortality across geographic areas. All-cause, sex and disease chapter specific premature mortality were analyzed at the regional, district and public health unit level to determine the extent of geographic variation. Standardized mortality ratios for persons aged 0-74 years were calculated to identify geographic areas with significantly higher or lower premature mortality than expected, using Ontario death rates as the basis for the calculation of expected deaths in the local population. Data are also presented from the household component of the 1996/97 National Population Health Survey and from the 1996 Statistics Canada Census. RESULTS: Results showed approximately 20% higher than expected all-cause premature mortality for males and females in the North region. However, disparity in all-cause premature mortality in Ontario was most pronounced at the public health unit level, ranging from 20% lower than expected to 30% higher than expected. Premature mortality disparities were largely influenced by neoplasms, circulatory diseases, injuries and poisoning, respiratory diseases and digestive diseases, which accounted for more than 80% of all premature deaths. Premature mortality disparities were also more pronounced for disease chapter specific mortality. CONCLUSION: Geographic disparities in premature mortality are clearly greater at the small area level. Geographic disparities in premature mortality undoubtedly reflect the underlying distribution of population health determinants such as health related behaviours, social, economic and environmental influences.

Journal Article↗
PubMed2006

Trends in premature mortality in England and Wales, 1950-2004.

Premature mortality is a major public health concern but there has been little consensus among researchers on how it should be defined and reported. In this article four means of measuring early deaths are considered using four different age thresholds to define prematurity. Using these four indicators, trends in premature mortality are reported for England and Wales from 1950 to 2004. All measures show that, however 'premature' is defined, levels of premature mortality have decreased markedly over time. This article discusses which mortality indicator and age threshold would be most appropriate for a measure of premature mortality for use in national mortality statistics for England and Wales.

Adolescent↗
PubMedDate not supplied

Widening regional inequality in premature mortality rates in Manitoba.

OBJECTIVE: To describe regional trends in premature mortality in Manitoba. DESIGN: Comparison of all-cause and cause-specific mortality of persons less than age 75 in 11 Regional Health Authority populations over two time periods: 1985-89 and 1990-94. RESULTS: The provincial premature mortality rate declined over the two time periods (4.00/1,000 to 3.72/1,000). Declines were also observed in 9 of 11 regional populations. Premature mortality increased, however, in the 2 regional populations with the highest mortality rates in the first observation period. CONCLUSION: Declining premature mortality in low mortality populations and rising premature mortality in high mortality populations has resulted in a widening of regional mortality rates in Manitoba. Recent policy initiatives in many provinces, including the devolution of authority for the management and delivery of health services and the implementation of population need-based funding formulas to share health care resources among regional health authorities, if implemented, have the potential to partially mitigate the processes producing these widening regional health inequalities.

Adolescent↗
PubMedDate not supplied

Methodological alternatives for measuring premature mortality.

Although crude and age-adjusted mortality statistics are frequently used to quantify public health problems, they are heavily influenced by the underlying disease processes of the elderly. Alternative measures have been developed to reflect the mortality experience of younger age groups (i.e., premature mortality). We evaluated four different methods for tabulating premature mortality, one method weighted by the remaining life expectancy at death and three methods with constant end points using age spans from birth to 65 years, birth to 75 years, and 1 to 65 years. These alternatives provide dramatically different descriptions of premature mortality in the United States in 1984. In general, the constant end-point methods emphasize the different pattern of mortality among younger persons, while premature mortality computed by the remaining life expectancy method more closely resembles the pattern of crude mortality. Although no single method is preferable for all purposes, the constant end-point method best differentiates the leading causes of premature death.

Adolescent↗
PubMed1997

Premature mortality in Italy during the first decade of the AIDS epidemic: 1984-1993.

BACKGROUND: AIDS has become a leading cause of premature mortality in many countries, owing to the decline in other major causes of premature death and the increase in AIDS itself. This study was carried out to determine the trends in premature mortality due to selected causes in Italy. METHODS: Data from the Italian Mortality Data Base, for the ten years from 1984 to 1993 (the first decade of the AIDS epidemic) were analysed. Premature mortality was measured in terms of years of potential life lost before the age of 70 years (YPLL), excluding infant mortality. Trends in premature mortality due to AIDS were compared with those of the principal causes of premature death: lung cancer, colon-rectum cancer, stomach cancer, leukaemia, female breast cancer, uterine cancer, myocardial infarction, stroke, liver diseases, suicide, road accidents and overdose. RESULTS: In this period there has been a marked increase in premature mortality from AIDS both among males aged 1-69 years (from a rate of YPLL of 0.01 per 1000 in 1984 to 3.71 in 1993) and females of the same age group (from 0 deaths in 1984 to a rate of YPLL of 1.02). Throughout the same period all the other causes of premature death have been declining, with the exception of suicide and overdose among males, and overdose and lung cancer among females. For people aged 25-44 years, AIDS has become the greatest cause of premature death. The increasing trend in premature mortality due to AIDS is most pronounced in the northern and central areas of Italy. CONCLUSIONS: AIDS is the leading cause of death among males aged 25-44 years in Italy and is having an important impact on premature mortality among females in the same age group.

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Dynamics and spatial differentiation of premature mortality in the productive age group of the population--premise for in depth studies of causes and conditions of this phenomenon].

The increased mortality in Poland compared to that observed just after the war was mainly caused by the elevated frequency of premature deaths (under 65 years of age). The aim of the work was to assess: the premature mortality in the population of the productive age in Poland in comparison with other countries of Central and Eastern Europe, Scandinavian and Western European countries as well as with other developed countries in the world; the dynamics of premature mortality; the spatial differentiation of premature mortality in our country. Two age phases: I = 20 - 44 years, and II = 45 - 64 years were identified in premature mortality. A considerable increase in male premature mortality in phase II of the productive age which began in the second half of the sixties and had continued until 1991 doubled the mortality ratio in Poland when compared with the average ratio observed in all Scandinavian and Western European countries. The analysis of spatial differentiation of premature mortality indicates clearly the relationship between mortality and environmental conditions: the highest ratios are noted in highly urbanized and industrialized voivodships (provinces). It accounts for possible reasons of shortened by 7-8 years period of men's life in Poland as compared to Western countries or even by 10 year in comparison with Japan, for example. The situation among women is more favorable. These alarming data on premature mortality, especially among men in phase II of the productive age emphasize the urgent need for in-depth studies of causes, circumstances and factors contributing to deaths at the most active productive age.

Adult↗
PubMed2004

Beer consumption and premature mortality in Louisiana: an ecologic analysis.

OBJECTIVE: This study was conducted to determine whether beer consumption is associated with premature mortality across municipalities in Louisiana. METHOD: We conducted a cross-sectional ecologic study using tax data on the sales of beer and mortality data from Louisiana. We aggregated deaths that occurred before the age of 65 to the level of the municipality and calculated age-adjusted rates of both overall premature mortality and specific causes of premature mortality that may be related to alcohol. After controlling for potential confounders including population distributions for race, income, employment and education, we examined whether beer sales were independently associated with premature mortality rates due to homicides, unintentional injuries, other acute alcohol-related causes, liver diseases, cardiovascular disease and other chronic alcohol-related causes. RESULTS: After controlling for race and socioeconomic status, municipalities with greater beer consumption had higher premature mortality, with the model explaining up to 24% of all premature deaths. Beer consumption was also independently associated with homicide, liver diseases and cardiovascular disease. Neither unintentional injuries nor other chronic alcohol-related causes of mortality were significantly associated with beer consumption. CONCLUSIONS: The population-level association between beer consumption and mortality may reflect population-level determinants of beer consumption as well as indirect health effects of alcohol consumption on persons who are not heavy drinkers.

Adolescent↗
PubMedDate not supplied

Premature mortality in Australia 1983-1992, the first decade of the AIDS epidemic.

OBJECTIVE: To determine the trends in premature mortality due to selected causes in Australia and in selected States for the whole population and for adults aged 25 to 44 years. DESIGN: Analysis of data from the Australian Bureau of Statistics and the National AIDS Registry for the 10 years from 1983 to 1992. Premature mortality was measured in terms of years of potential life lost before the age of 75 years (YPLL-75). Trends in premature mortality due to AIDS were compared with those for lung cancer, melanoma of the skin, breast cancer, diabetes mellitus, acute myocardial infarction, cerebrovascular disease, traffic accidents and suicide. RESULTS: There have been marked increases in premature mortality due to AIDS and suicide in young men and an increase in deaths due to breast cancer in young women over the past decade. The overall number of potential years of life lost has remained constant, partially because these increases have been counterbalanced by declines in deaths from traffic accidents, acute myocardial infarction and cerebrovascular disease. The increasing trend in premature mortality due to AIDS is strongest in New South Wales, followed by Victoria and Queensland, with smaller increases in the other States and Territories. CONCLUSIONS: Apparent advances in medical care have reduced premature deaths from acute myocardial infarction and stroke and public health measures are likely to have reduced traffic accident deaths; but at the same time there have been serious increases in HIV, suicide and breast cancer among young adults.

Acquired Immunodeficiency Syndrome↗
PubMed1999

Premature mortality in the United States: the roles of geographic area, socioeconomic status, household type, and availability of medical care.

OBJECTIVES: This study examined premature mortality by county in the United States and assessed its association with metro/urban/rural geographic location, socioeconomic status, household type, and availability of medical care. METHODS: Age-adjusted years of potential life lost before 75 years of age were calculated and mapped by county. Predictors of premature mortality were determined by multiple regression analysis. RESULTS: Premature mortality was greatest in rural counties in the Southeast and Southwest. In a model predicting 55% of variation across counties, community structure factors explained more than availability of medical care. The proportions of female-headed households and Black populations were the strongest predictors, followed by variables measuring low education, American Indian population, and chronic unemployment. Greater availability of generalist physicians predicted fewer years of life lost in metropolitan counties but more in rural counties. CONCLUSIONS: Community structure factors statistically explain much of the variation in premature mortality. The degree to which premature mortality is predicted by percentage of female-headed households is important for policy-making and delivery of medical care. The relationships described argue strongly for broadening the biomedical model.

Aged↗
PubMed2002

Years of potential life lost and valued years of potential life lost in assessing premature mortality in Slovenia.

AIM: To determine the leading causes of death that contribute most to premature mortality in Slovenia; to classify premature mortality according to the cause of death, age, and sex; and to determine the age point before which premature mortality becomes a potential loss to the society. METHOD: Potential economic losses to society were estimated by use of years of potential life lost (YPLL), with a cut-off point at 65 years, and valued years of potential life lost (VYPLL) methods. We calculated the sex-, age-, and underlying causes of death-specific YPLL and VYPLL for residents of Slovenia who died at age younger than 65 years, using Slovene sex-specific life expectancy for 1998/1999 and age-specific weights of investment-producer-consumer model. RESULTS: In 1998, 4,558 YPLL per 100,000 population were lost to Slovenia. We found bimodal age distribution of YPLL, with the first peak in the 20-24 year age group and the second in the 45-49 year age group. Men to women rate ratio was 2.5. The leading causes of YPLL were external causes of death, followed by malignant neoplasms, and cardiovascular diseases. External causes, including suicides and traffic accidents, were the leading causes of death in men, whereas malignant neoplasms, including breast cancer and digestive cancer, were top-ranking causes in women. Among those, only external causes of death produced positive VYPLL, indicating a net loss to the society. CONCLUSION: In Slovenia, YPLL peaked in the 20-24 and 45-49 year age groups. Only external causes of death, most of which were preventable, accounted for the net economic loss to Slovenian society. We believe that YPLL and VYPLL, as specific mortality measures, can be reliably used in the evaluation of leading causes of death before age 65 and potential economic loss to the society caused by those deaths, and that they should be taken into account when setting public health priorities.

Adolescent↗
PubMedDate not supplied

Relationship between premature mortality and socioeconomic factors in black and white populations of US metropolitan areas.

OBJECTIVE: examined the association of mortality with selected socioeconomic indicators of inequality and segregation among blacks and whites younger than age 65 in 267 US metropolitan areas. The primary aim of the analysis was to operationalize the concept of institutional racism in public health. METHODS: Socioeconomic indicators were drawn from Census and vital statistics data for 1989-1991 and included median household income; two measures of income inequality; percentage of the population that was black; and a measure of residential segregation. RESULTS: Age-adjusted premature mortality was 81% higher in blacks than in whites, and median household income was 40% lower. Income inequality, as measured by the Gini coefficient, was greater within the black population (0.45) than within the white population (0.40; p < 0.001). To confirm that the proxy socioeconomic variables were relevant markers of population health status, regression analysis was performed initially on data for the total population. These variables were all independently and significantly related to premature mortality (p < or = 0.01; R(2) = 0.74). Income inequality for the total population was significantly correlated with premature mortality (r = 0.33). Black (r = 0.26) and white (r = 0.20) population-specific correlations between income inequality and premature mortality, while still significant, were smaller. Residential segregation was significantly related to premature mortality and income inequality for blacks (r = 0.38 for both); among whites, however, segregation was modestly correlated with premature mortality (r = 0.19) and uncorrelated with income inequality. Regional analyses demonstrated that the association of segregation with premature mortality was much more pronounced in the South and in areas with larger black populations. CONCLUSION: Social factors such as income inequality and segregation strongly influence premature mortality in the US. Ecologic studies of the relationships among social factors and population health can measure attributes of the social context that may be relevant for population health, providing the basis for imputing macro-level relationships.

Adolescent↗
PubMed2004

Increasing inequalities in premature mortality in Great Britain.

STUDY OBJECTIVE: To describe inequalities in all cause premature mortality between and within regions of Great Britain and how these inequalities have changed between 1979 and 1998. DESIGN: Retrospective study using routine population and death data aggregated into five year age and sex groups for each of 20 years. SETTING: All 459 local authority districts (England and Wales) and local government districts (Scotland). PARTICIPANTS: Estimated population and registered deaths aged 0-64. MAIN OUTCOME MEASURES: Indirectly standardised mortality ratios for all cause mortality; percentages of deaths that would be avoided if there were no inequalities between and within regions. RESULTS: The decrease in premature mortality of 36% seen in Great Britain ranged from 42% in Wales to 33% in Scotland and 31% in London. Differences between regions led to excess mortality of about 25% in Scotland, the North East, and the North West. In London excess mortality increased from 14% to 19%. Inequalities within regions increased in most parts of Great Britain, the exceptions being Wales, London, and the South West. The largest increase was seen in Scotland where the percentage of excess deaths increased from 23% to 33%. CONCLUSIONS: A decrease in premature mortality in Great Britain was seen in all regions, although less pronounced in London, but the gap between regions remained. Inequalities between districts within regions vary from one region to another and have increased in nearly every part of Great Britain.

Adolescent↗
PubMed2006

Mapping and measuring social disparities in premature mortality: the impact of census tract poverty within and across Boston neighborhoods, 1999-2001.

The identification and documentation of health disparities are important functions of public health surveillance. These disparities, typically falling along lines defined by gender, race/ethnicity, and social class, are often made visible in urban settings as geographic disparities in health between neighborhoods. Recognizing that premature mortality is a powerful indicator of disparities in both health status and access to health care that can readily be monitored using routinely available public health surveillance data, we undertook a systematic analysis of spatial variation in premature mortality in Boston (1999-2001) across neighborhoods and sub-neighborhoods in relation to census tract (CT) poverty. Using a multilevel model based framework, we estimated that the incidence of premature mortality was 1.39 times higher (95% credible interval 1.09-1.78) among persons living in the most economically deprived CTs (>/=20% below poverty) compared to those in the least impoverished tracts (<5% below poverty). We present maps of model-based standardized mortality ratios that show substantial within-neighborhood variation in premature mortality and a sizeable decrease in spatial variation after adjustment for CT poverty. Additionally, we present maps of model-based direct standardized rates that can more readily be compared to externally published rates and targets, as well as maps of the population attributable fraction that show that in some of Boston's poorest neighborhoods, the proportion of excess deaths associated with CT poverty reaches 25-30%. We recommend that these methods be incorporated into routine analyses of public health surveillance data to highlight continuing social disparities in premature mortality.

Adolescent↗
PubMed2003

Power relations and premature mortality in Spain's autonomous communities.

This trends ecological study analyzes, across 17 autonomous communities of Spain from 1989 to 1998, the relationship between mortality (total and by main causes of death) and power relations (type of government: social democratic (SDP), conservative (CDP), and others), labor market variables, welfare state variables, income inequality, absolute income, poverty, and number of civil associations. The authors conducted a descriptive analysis; a bivariate analysis (Pearson correlation coefficients) between mortality and each of the independent variables; and a multivariate analysis, adjusting multilevel linear regression models. All dimensions of the conceptual power relations model were related to premature mortality in the direction hypothesized. The cross-pooled multilevel regression models show that total premature mortality in males, male and female cerebrovascular mortality, male and female cirrhosis mortality, and male lung cancer mortality decreased somewhat more in communities where primary health care reform was implemented more quickly. Premature mortality decreased somewhat more in SDP than in CDP communities for male and female total premature mortality, cerebrovascular mortality, and cirrhosis mortality, and male lung cancer mortality. These results are in accord with earlier studies that found a relationship among health indicators and variables related to labor market, welfare state, income inequalities, civil associations, and power relations.

Adolescent↗
PubMed2004

[Gender differences in premature mortality and avoidable deaths].

OBJECTIVE: This paper aims to describe and to analyse disparities between men and women for "premature" mortality rates (deaths before 65 year-old). The study is particularly focused on "avoidable" causes of death. These types of deaths are greatly related to risk behaviours such as alcohol abuse, tobacco abuse or dangerous driving. Taking account of these indicators ("premature" and "avoidable" mortality) enables to study health status discrepancies by gender and to characterize specific public health issues in France including high rates of "premature" mortality and risk behaviours. METHODS: The analysis is based on exhaustive mortality data from 1980 to 1999 supplied by the Centre for epidemiology of medical causes of death (CepiDc-INSERM). Specific causes of death closely related to risk behaviours are classified as "avoidable": lung and upper airways cancers, cirrhosis, alcoholic psychosis, traffic accidents, aids and suicide. The contribution of these categories in the global male overmortality was assessed according to different demographic and geographic characteristics. RESULTS: Within "premature" mortality, males experience greater burden of "avoidable" mortality (sex-ratio: 4 versus 2). The gender differences are mainly due to injuries and suicides in the younger age groups and to tobacco and alcohol-related cancers (lung and upper airways) in the 45-64 years age group. The recent decline in "premature" mortality sex-ratio is explained by an increase of these two cancers for females. Among european countries, the French male overmortality is especially marked and mainly attributable to "avoidable" causes of death. CONCLUSION: "Avoidable" and "premature" mortality provide useful tools for the follow-up of health status in France particularly because of high risk behaviours and prevention inadequacy. Reducing gender discrepancies will depend mainly on public health policies in terms of primary prevention.

Adolescent↗
PubMed2007

Factors associated with premature mortality among young injection drug users in Vancouver.

BACKGROUND: Young injection drug users (IDUs) may be at increased risk of premature mortality due to the health risks associated with injection drug use including overdoses and infections. However, there has been little research conducted on mortality causes, rates and associations among this population. We undertook this study to investigate patterns of premature mortality, prior to age 30 years, among young IDUs. METHODS: Since 1996, 572 young (< or = 29 years) IDUs have been enrolled in the Vancouver Injection Drug Users Study (VIDUS). Semi-annually, participants have completed an interviewer-administered questionnaire and have undergone serologic testing for HIV and hepatitis C (HCV). Mortality data have been continually updated through linkages with the Provincial Coroner's Office. Crude and age-specific mortality rates, standardized mortality ratios, and life expectancy measures were calculated using person-time methods. Predictors of mortality were identified using Cox regression analyses. FINDINGS: Twenty-two participants died prior to age 30 years during the follow-up period for an overall crude mortality rate of 1,368 per 100,000 person-years. Overall, young IDUs were 16.4 times (95% confidence interval [CI]; 9.1-27.1) more likely to die; young women IDUs were 54.1 times (95%CI; 29.6-90.8) and young men IDUs were 12.9 times (95%CI; 5.5, 25.3) more likely to die when compared to the Canadian non-IDU population of the same age. The leading observed cause of death among females was: homicide (N = 9); and among males: suicide (N = 3) and overdose (N = 3). In Cox regression analyses, factors associated with mortality were, HIV infection (Hazard Ratio [HR]: 4.55; CI: 1.92-10.80) and sex work (HR: 2.76; CI: 1.16-6.56). INTERPRETATION: Premature mortality was 13 and 54 times higher among young men and women who use injection drugs in Vancouver than among the general population in Canada. The majority of deaths among the women were attributable to homicide, suggesting that interventions should occur not only through harm reduction services but also through structural interventions at the legal and policy level.

Journal Article↗
PubMed1979

Premature mortality attributable to smoking and hazardous drinking in Canada.

All causes of death related to the two risk factors, smoking and hazardous drinking, have been reviewed followed by a selection of those causes of death for which the causal role of the risk factor appears to be quasi-certain. For each cause, existing epidemiologic data were reviewed and used to determine the fraction of premature mortality which could be attributed to each factor (called the attributable fraction). This fraction was then multiplied by the corresponding Canadian premature mortality measured in terms of deaths between ages one and 70 and potential years of life lost (PYLL) between ages one and 70, which gives a higher weight to younger deaths. Of the 73,440 deaths between ages one and 70 in Canada in 1974, 12% (or 8718 deaths) were found to be attributable to current smoking and 6% (4716) to hazardous drinking. In terms of PYLL between ages one and 70, hazardous drinking ranks ahead of current smoking with 10% (or 132,044 PYLL) of the total PYLL, whereas current smoking represents 8% (105,085 PYLL) of the total . Regardless of whether premature mortality is expressed in terms of deaths or PYLL, about 18% of Canadian premature mortality is attributable to current smoking and/or drinking (with the range of possible values being 14-22%).

Accidents↗