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At least 19 recordsLinked to original sources

PubMed1996

Mortality decline in the twentieth century and supply of kin over the life course.

Declining mortality over the Twentieth Century has altered the supply of older relatives in the kin networks of persons at all stages of life. Mortality decline has also changed the supply of kin for older persons. Using period life tables for selected years between 1900 and 2000, I calculate the proportion of persons who, at various stages of the life course, would have grandparents, parents, spouses, siblings and children still living. The results draw attention to the unprecedented potential for kinship ties involving older persons afforded by contemporary high survival rates.

Adult↗

PubMed2006

Declining mortality in patients with acute renal failure, 1988 to 2002.

Despite improvements in intensive care and dialysis, some experts have concluded that outcomes associated with acute renal failure (ARF) have not improved significantly over time. ARF was studied in hospitalized patients between 1988 and 2002 using the Nationwide Inpatient Sample, a nationally representative sample of discharges from acute-care, nonfederal hospitals. During a 15-yr period, 5,563,381 discharges with ARF and 598,768 with ARF that required dialysis (ARF-D) were identified. Between 1988 and 2002, the incidence of ARF rose from 61 to 288 per 100,000 population; the incidence of ARF-D increased from 4 to 27 per 100,000 population. Between 1988 and 2002, in-hospital mortality declined steadily in patients with ARF (40.4 to 20.3%; P < 0.001) and in those with ARF-D (41.3 to 28.1%; P < 0.001). Compared with 1988 to 1992, the multivariable-adjusted odds ratio (OR) of death was lower in 1993 to 1997 (ARF: OR 0.62, 95% confidence interval [CI] 0.61 to 0.64; ARF-D: OR 0.63, 95% CI 0.59 to 0.66) and 1998 to 2002 (ARF: OR 0.40, 95% CI 0.39 to 0.41; ARF-D: OR 0.47, 95% CI 0.45 to 0.50). The percentage of patients who had ARF with a Deyo-Charlson comorbidity index of 3 or more increased from 16.4% in 1988 to 26.6% in 2002 (P < 0.001). This study provides evidence from an administrative database that the incidence of ARF and ARF-D is rising. Despite an increase in the degree of comorbidity, in-hospital mortality has declined.

Acute Kidney Injury↗

PubMed1998

The Australian mortality decline: cause-specific mortality 1907-1990.

This review describes the changes in composition of mortality by major attributed cause during the Australian mortality decline this century. The principal categories employed were: infectious diseases, nonrheumatic cardiovascular disease, external causes, cancer, 'other' causes and ill-defined conditions. The data were age-adjusted. Besides registration problems (which also affect all-cause mortality) artefacts due to changes in diagnostic designation and coding are evident. The most obvious trends over the period are the decline in infectious disease mortality (half the decline 1907-1990 occurs before 1949), and the epidemic of circulatory disease mortality which appears to commence around 1930, peaks during the 1950s and 1960s, and declines from 1970 to 1990 (to a rate half that at the peak). Mortality for cancer remains static for females after 1907, but increases steadily for males, reaching a plateau in the mid-1980s (owing to trends in lung cancer); trends in cancers of individual sites are diverse. External cause mortality declines after 1970. The decline in total mortality to 1930 is associated with decline in infection and 'other' causes. Stagnation of mortality decline in 1930-1940 and 1946-1970 for males is a consequence of contemporaneous movements in opposite directions of infection mortality (decrease) and circulatory disease and cancer mortality (increase). In females, declines in infections and 'other' causes of death exceed the increase in circulatory disease mortality until 1960, then stability in all major causes of death to 1970. The overall mortality decline since 1970 is a consequence of a reduction in circulatory disease, 'other' cause, external cause and infection mortality, despite the increase in cancer mortality (for males).

Adolescent↗

PubMed1978

An evaluation of Brass mortality estimates under conditions of declining mortality.

An evaluation of the Brass childhood mortality estimates under conditions of declining mortality shows them to overestimate current mortality. Error increases as the rate of mortality decline increases, as the childhood age up to which cumulative mortality is being estimated increases, and as age at onset of childbearing decreases. We use the results to develop a method for correcting the Brass estimates for the effects of quasistability. The method requires an estimate of the rate of mortality decline within the population in addition to information on the pattern of childbearing in the population.

Birth Rate↗

PubMed2005

The role of morbidity in the mortality decline of the nineteenth century: evidence from the military population at Gibraltar 1818-1899.

The causes of the nineteenth-century decline of mortality, characterized by lower mortality rates and increased longevity, have been the subject of debate among researchers for the past half-century. Because of a paucity of reliable data, little is understood about the role of morbidity, or illness episodes, in the mortality decline. This article introduces the results of a study that looks at the relationship of morbidity in the mortality decline during this portion of the epidemiological transition. The data are comprised of hospital admissions and deaths collected by the British army on the soldiers of the Gibraltar garrison from 1819 to 1899. Morbidity dropped during this period, but at a slower rate than mortality, and all categories of disease did not fall in concert; in some categories, morbidity rose as mortality dropped. Statistical modeling is used to analyze the categories of diseases that were most influential in the decline of mortality in this group. This research shows that there are discernible relationships between morbidity and mortality and that the two parameters are responding to different driving forces. Because changes within the military medical system may have had an effect on the relationship of the morbidity and mortality rates of the soldiers, surviving medical reports are used to reconstruct the medical care of the troops during the study period.

Adult↗

PubMed1998

The Australian mortality decline: all-cause mortality 1788-1990.

This review describes the Australian decline in all-cause mortality, 1788-1990, and compares this with declines in Europe and North America. The period until the 1870s shows characteristic 'crisis mortality', attributable to epidemics of infectious disease. A decline in overall mortality is evident from 1880. A precipitous fall occurs in infant mortality from 1900, similar to that in European countries. Infant mortality continues downward during this century (except during the 1930s), with periods of accelerated decline during the 1940s (antibiotics) and early 1970s. Maternal mortality remains high until a precipitous fall in 1937 coinciding with the arrival of sulphonamide. Excess mortality due to the 1919 influenza epidemic is evident. Artefactual falls in mortality occur in 1930, and for men during the war of 1939-1945. Stagnation in overall mortality decline during the 1930s and 1945-1970 is evident for adult males, and during 1960-1970 for adult females. A decline in mortality is registered in both sexes from 1970, particularly in middle and older age groups, with narrowing of the sex differential. The mortality decline in Australia is broadly similar to those of the United Kingdom and several European countries, although an Australian advantage during last century and the first part of this century may have been due to less industrialisation, lower population density and better nutrition. Australia shows no war-related interruptions in the mortality decline. Australian mortality patterns from 1970 are also similar to those observed in North America and European countries (including the United Kingdom, but excluding Eastern Europe.

Adolescent↗

PubMed2003

Analysis of mortality decline along with age and latent congenital defects.

Mortality from congenital anomalies is inversely proportional to age after the age of 1 year. The theory of congenital individual risk explains this mortality decline. The overall aim of this study is to test whether the theory describes mortality decline for all diseases within the first year of life and after the age of 1. Mortality decline along with age was analyzed in five countries and for all causes of death. The theory of congenital individual risk describes well the real mortality decline for all diseases except malignant neoplasms after the birth. Decline of mortality is due to the dying out of the more impaired individuals. Mortality decline with the first power of age results from the selection before the birth. It is dominant and the frequency of defects decreases proportionally to the value of individual risk of death. In the case of identically probable defects, the selection does not occur and mortality declines with the square of age. Congenital defects were also identified as a cause of death in the case of infectious diseases occurring before the age of 10. Mortality from malignant neoplasms is age-independent within the age period 1-20 years and, contrary to all other diseases, no small subpopulation with a significant individual risk was identified.

Aging↗

PubMed2001

The role of cultural and economic determinants in mortality decline in the Netherlands, 1875/1879-1920/1924: a regional analysis.

The objective of this study was to determine the relative importance of cultural and economic factors in mortality decline in the Netherlands in the periods 1875/1879-1895/1899 and 1895/1899-1920/1924. Mortality data by region, age, sex and cause of death as well as population data were derived from Statistics Netherlands for the years 1875/1879, 1885/1889, 1895/1899, 1910/1914, 1920/1924. Regional mortality declines were estimated on the basis of Poisson regression models. In a multivariate analysis the estimated declines were associated with economic (wealth tax) and cultural variables (% Roman Catholics and secularisation) corrected for confounders (soiltype, urbanisation). In the period from 1875/1879-1895/1899, %Roman Catholics was significantly associated with all-cause mortality decline and with mortality decline from diseases other than infectious diseases. Mortality declined less rapidly in areas with a high percentage of Roman Catholics. Secularisation was significantly associated with infectious-disease mortality decline. In areas with a high percentage population without a religious affiliation, mortality declined more rapidly. In the period from 1895/1899 to 1920/1924, wealth tax was significantly associated with all-cause and infectious-disease mortality decline. Mortality declined more rapidly in wealthy areas. Intermediary factors in the relationship between cultural factors and mortality decline were fertility decline, but more importantly, the number of medical doctors per 100,000 inhabitants. No intermediary factors were found for the association between the economic variable and mortality decline. Cultural and economic factors both played an important role in mortality decline in The Netherlands, albeit in different periods of time. The analysis of intermediary factors suggests that the acceptance of new ideas on hygiene and disease processes was an important factor in the association between culture and mortality decline in the late 19th century.

Confounding Factors, Epidemiologic↗

PubMed1992

Declining mortality in international sterilization services.

Between 1973 and 1988, AVSC supported 1,516,478 female sterilizations and 401,856 vasectomies in 50 countries. Overall, 73 deaths were attributable to voluntary sterilization procedures (yielding mortality rates of 4.7 deaths per 100,000 female sterilizations and 0.5 per 100,000 vasectomies). Causes of death, in order of frequency, were anesthesia (22), intestinal injury (20), infection (19), intra-abdominal hemorrhage (6) and other (6). The female sterilization mortality rate declined from 7.1 per 100,000 procedures in 1973-1981 to 3.7 per 100,000 in 1982-1988. Safer anesthesia practices and improved infection control contributed most to this decline. The mortality rate related to surgical errors declined proportionately less than the rates related to anesthesia and infection. Contraceptive sterilization has become a very safe procedure in these 50 countries, where anesthesia (local and general), surgical technique (minilaparotomy and laparoscopy) and timing of the procedure (interval and postpartum) vary substantially. Future deaths will probably be rare. However, expert surgeons should review each case because identifying the most likely cause of death is always complex and these analyses help shape surgical contraception practices.

Cause of Death↗

PubMed2004

Breast cancer mortality patterns and time trends in 10 new EU member states: mortality declining in young women, but still increasing in the elderly.

Breast cancer is the cancer diagnosed most frequently in women worldwide. In Europe it is the most common cancer in the female population, with approximately 350,000 new cases diagnosed each year including 130,000 deaths. Incidence rates are increasing in the majority of European countries, whereas a decline in mortality rates has been observed in many West European countries since the late 1980s and early 1990s. Our study examines breast cancer mortality patterns and time trends in the new European Union (EU) member states and compares them with the situation in current EU member states. A Joinpoint regression analysis was used to assess temporal changes in mortality rates and the trends examined in the light of known risk factors, screening programs and advances in treatment. In the majority of the countries analyzed, a deceleration in the increase of mortality rates appeared, followed by a decrease of mortality in many of them in the second half of the 1990s. The declining tendency was visible primarily in young women, and to a lesser extent in middle-aged women, whereas in elderly women a continuing increase of mortality was observed. Analysis of mortality data, information from previous publications, as well as analysis of known factors influencing breast cancer risk suggest that changes observed are due mainly to recent advances in treatment rather than changes in lifestyle risk factors or the result of screening programs. Early detection and a shift toward more favorable stage distribution could have played the leading role for mortality decline in younger patients.

Adolescent↗

PubMed1986

Infant mortality decline in Malaysia, 1946-1975: the roles of changes in variables and changes in the structure of relationships.

This analysis has identified several factors contributing to the dramatic decline in infant mortality since World War II in Malaysia, as well as one factor that prevented the infant mortality rate from declining even more rapidly. Our main findings are the following: On average, mothers' education more than doubled over the study period, contributing to the decline in their infants' mortality. In addition, the beneficial effect of mothers' education on infant survival appears to have become stronger over the study period. Hence, further advances in education should lead to further improvements in infants' survival prospects. Another analysis of these data (Peterson et al. 1985) found that education is somewhat more influential in affecting child mortality in low-mortality, high-income areas than in the opposite type of areas. Therefore, socioeconomic development may have complemented, instead of substituted for, the the beneficial effect of mothers' education in promoting infant and child survival in Malaysia. Improvements in water and sanitation also contributed to the infant mortality decline, especially for babies who did not breastfeed. However, unlike education, these influences have become less important over time, especially for babies who are not breastfed. Hence, further improvements in water and sanitation, a goal of Malaysia's Rural Environmental Sanitation Programme, may have smaller relative effects on infant mortality than did previous improvements. Targeting such improvements on areas where women breastfeed little or not at all, however, will increase their effectiveness in promoting infant survival. The substantial reductions in breastfeeding that have taken place since World War II have kept the infant mortality rate in Malaysia from declining as rapidly as it would have otherwise. We estimate that, in our sample, the detrimental effects on infant survival of the decline in breastfeeding have more than offset the beneficial effects of improvements in water and sanitation. Unlike some other researchers (e.g., Palloni 1981), we find that changes in fertility levels and in the timing and spacing of births have had negligible effect in explaining the decline in infant mortality within the samples we have considered. We have excluded births to older women from our analysis, however; this exclusion may have led to an understatement of the influence of changes in the age pattern of childbearing.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗

PubMed1987

Declining mortality from ischemic heart disease and changes in coronary risk factors in Japan, 1956-1980.

Mortality from ischemic heart disease has declined in Japan since 1970. This paper addresses the declining mortality from ischemic heart disease and the possible contributing factors for 1956-1980. Mortality figures were obtained from Vital Statistics reports by the Ministry of Health and Welfare in Japan. National trends in blood pressure levels, prevalence of hypertension, Keys' lipid factor phi instead of the serum cholesterol level, and body mass index were obtained from the National Nutrition Survey which is carried out annually from random samples in Japan. The smoking rate which was obtained from other national surveys was also reviewed for this purpose. The age-adjusted (30-69 years) mortality from ischemic heart disease declined by 24% and 37% for men and women, respectively, between 1968 and 1978. It seemed that the decline in blood pressure levels and in the prevalence of hypertension and the increasing treatment rate for cardiovascular disease might contribute to the declining mortality from ischemic heart disease. The decline in cigarette smoking may, in part, also play a role. On the other hand, the increase in intake of lipids which resulted in Keys' lipid factor phi was compatible with the increase in mortality from ischemic heart disease during 1956-1970. The experience in Japan shows that the treatment of hypertension or the lowering of blood pressure and the recommendation to stop smoking help to prevent ischemic heart disease.

Adult↗

PubMed1985

Socioeconomic and health effects on mortality declines in developing countries.

It has been argued that mortality declines in developing countries have not been associated with social and economic factors because of the diffusion from the developed countries to the developing countries of health and medical techniques. This paper examines the relationship between socioeconomic development and health and mortality declines in developing countries which are in two different stages of the demographic transition. A path model linking socioeconomic and health variables and mortality is developed and tested for early and late transition nations. The empirical findings indicated that the network of socioeconomic variables and their effects on mortality were much more significant in late transition countries than in early transition countries. While the impact of health services on crude death rates is large in the early transition nations, its impact declines considerably as countries reach a more transitionally 'mature' stage.

Cross-Cultural Comparison↗

PubMed2005

Lifesaving explains mortality decline with time.

Mortality rates of human populations in developed countries are declining with time. We show that this effect can be explained via a 'lifesaving' methodology. Our approach is based on considering a non-homogeneous Poisson process of potentially harmful events. Each of these events can be 'cured' with a given probability or can result in a termination of the Poisson process (death) with a complementary probability. A lifesaving ratio, defining the corresponding relative increase in life expectancy for homogeneous and heterogeneous populations is analyzed. Some generalizations are discussed. Several simple examples are considered.

Humans↗

PubMed2003

Stagnation in mortality decline among elders in the Netherlands.

PURPOSE: This study assesses whether the stagnation of old-age (80+) mortality decline observed in The Netherlands in the 1980s continued in the 1990s and determines which factors contributed to this stagnation. Emphasis is on the role of smoking. DESIGN AND METHODS: Poisson regression analysis with linear splines was applied to total and cause-specific mortality data by age, year of death (1950-1999), and sex. An age-period-cohort analysis was carried out to determine whether the trends followed period or cohort patterns. ICD revisions were bridged by use of a concordance table. RESULTS: A sudden reversal in old-age mortality decline occurred around 1980, leading to a stagnation of the decline and even increases in mortality thereafter. Smoking-related cancers, chronic obstructive pulmonary disease, and diseases specifically related to old age contributed to this stagnation. Trends in smoking-related cancers and chronic obstructive pulmonary disease showed a cohort pattern--especially for men. When these smoking-related diseases were excluded, the trends in old-age mortality in The Netherlands showed an increasing stagnation for both sexes. IMPLICATIONS: Smoking behavior can only partly explain the stagnation of mortality. Other factors such as increased frailty and changes in medical and social services for elderly people probably played a more decisive role in the recent stagnation.

Age Distribution↗

PubMed1986

Mortality decline and widening social inequalities.

Mortality from coronary heart disease (CHD) is higher in manual than in non-manual occupational classes and is higher in Scotland, Wales, and the North of England than in the South. Trends in these inequalities were examined in the light of the decline in CHD mortality in Great Britain. With the use of 1979/83 death rates as standard, mortality ratios (SMRs) for all causes, lung cancer, CHD, and cerebrovascular disease in 1979/83 were compared with SMRs in 1970-72. Despite the general fall in mortality the relative disadvantage of manual compared with non-manual classes has increased for each of these 4 cause groups. The regional differences in CHD mortality persist. Among men, in every region of Great Britain, CHD mortality has declined in non-manual classes. Only in Wales has there been an appreciable decline in CHD mortality in manual classes. Among women, lung cancer and CHD mortality have fallen in non-manual classes but have increased in manual classes. Differences in smoking between social classes are likely to be important. Other differences in behaviour may be important, but the effect of unemployment and increased income differentials should also be explored.

Adult↗

PubMed2000

A universal pattern of mortality decline in the G7 countries.

Human lifespan has increased enormously this century. But we remain uncertain about the forces that reduce mortality, and about the cost implications of ageing populations and their associated social burden. The poor understanding of the factors driving mortality decline, and the difficulty of forecasting mortality are due in part to the pronounced irregularity of annual to decadal mortality change. Here we examine mortality over five decades in the G7 countries (Canada, France, Germany, Italy, Japan, UK, US). In every country over this period, mortality at each age has declined exponentially at a roughly constant rate. This trend places a constraint on any theory of society-driven mortality decline, and provides a basis for stochastic mortality forecasting. We find that median forecasts of life expectancy are substantially larger than in existing official forecasts. In terms of the costs of ageing, we forecast values of the dependency ratio (that is, the ratio of people over 65 to working people) in 2050 that are between 6% (UK) and 40% (Japan) higher than official forecasts.

Aging↗

PubMedDate not supplied

Infant mortality decline in Germany, 1871-1925: the roles of changes in variables and changes in the structure of relations.

"This paper applies regression decomposition procedures to the infant mortality decline in Germany 1871-1925.... Data concern 59 administrative areas at seven times. In contrast to contemporary less developed countries, little of this historical infant mortality decline is explained either by changes in the relationships between infant mortality and the variables considered here or by exogenous factors. Rather, trends in variable values account for most of the decline. Smaller family size and more hygienic child care improved living conditions for infants, thereby increasing their survivorship." (SUMMARY IN FRE AND ITA)

Behavior↗