Age-Specific Death Rates with Tobacco Smoking and Occupational Activity: Sensitivity to Sample Length, Functional Form, and Unobserved Frailty

Abstract Background Tobacco smoking is a major leading preventable cause of mortality. The Peto-Lopez method and its variants are commonly used for estimating smoking-attributable mortality in population in high-income countries. The method assumes the average cumulative exposure of tobacco smoking in the population can be approximated using lung cancer death rates. However, providing estimates at an infra-national level is often much more challenging because the observed number of deaths for lung cancer are generally too low to use directly the method. The aim of this study was to estimate the number of deaths attributable to smoking at the regional level in France in 2015. Methods Population attributable fractions were computed using the Peto-Lopez method modified by Parkin which combines mortality statistics, lung cancer death rates and adjusted relative risks of deaths associated with smoking. To estimate the proxy for smoking prevalence in regional level by sex and age group, we pooled lung cancer mortality on several years according to the size of the regional populations and we smoothed the non-linear relationship of age with the estimates of the proxy. The attributable fractions were estimated for the 13 metropolitan regions and 4 French overseas regions. Results In whole France, we estimated that 19% of deaths among men and 7% among women were attributable to smoking in 2015. Deaths attributable to smoking ranged across metropolitan regions from 17% to 23% among men and from 5.5% to 8.7% among women. In overseas territories, estimates presented much more variability with a range from 6% to 18% for men and from 1.2% to 4.3% for women. Conclusions We highlighted disparities in regional mortality attributable to smoking. Producing estimates of the burden of smoking at an infra-national level is a tool offering many perspectives for better analyzing territorial inequalities and ultimately to further guide more effective localized interventions to reduce tobacco consumptions. Key messages We provide a straightforward solution to estimate the infra-national burden attributable to tobacco from a usual method. Our results highlight the disparities in mortality attributable to smoking across regions in France in 2015.

Download Full-text

The Complexity of Health Disparities: More Than Just Black–White Differences

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-20-00199 ◽

2021 ◽

pp. 1-10

Author(s):

Charles Ellis ◽

Molly Jacobs

Keyword(s):

Health Disparities ◽

Clinical Outcomes ◽

The United States ◽

Careful Examination ◽

White Americans ◽

Speech Language Pathology ◽

Death Rates ◽

The Social ◽

Health Related ◽

Language Pathology

Health disparities have once again moved to the forefront of America's consciousness with the recent significant observation of dramatically higher death rates among African Americans with COVID-19 when compared to White Americans. Health disparities have a long history in the United States, yet little consideration has been given to their impact on the clinical outcomes in the rehabilitative health professions such as speech-language pathology/audiology (SLP/A). Consequently, it is unclear how the absence of a careful examination of health disparities in fields like SLP/A impacts the clinical outcomes desired or achieved. The purpose of this tutorial is to examine the issue of health disparities in relationship to SLP/A. This tutorial includes operational definitions related to health disparities and a review of the social determinants of health that are the underlying cause of such disparities. The tutorial concludes with a discussion of potential directions for the study of health disparities in SLP/A to identify strategies to close the disparity gap in health-related outcomes that currently exists.

Download Full-text

Diabetic Ketoacidosis Death Rates Decline Overall

Internal Medicine News ◽

10.1016/s1097-8690(05)71936-3 ◽

2005 ◽

Vol 38 (18) ◽

pp. 40

Author(s):

Miriam E. Tucker

Keyword(s):

Diabetic Ketoacidosis ◽

Death Rates

Download Full-text

Assessing the Impact of Suicide Exclusion Periods on Life Insurance

Crisis ◽

10.1027/0027-5910/a000023 ◽

2010 ◽

Vol 31 (4) ◽

pp. 217-223 ◽

Cited By ~ 1

Author(s):

Paul Yip ◽

David Pitt ◽

Yan Wang ◽

Xueyuan Wu ◽

Ray Watson ◽

...

Keyword(s):

Life Insurance ◽

Accidental Death ◽

Insurance Policy ◽

Death Rates ◽

Insurance Policies ◽

Suicidal Death ◽

Insured Individual ◽

The Impact ◽

Insurance Data ◽

The Relationship

Background: We study the impact of suicide-exclusion periods, common in life insurance policies in Australia, on suicide and accidental death rates for life-insured individuals. If a life-insured individual dies by suicide during the period of suicide exclusion, commonly 13 months, the sum insured is not paid. Aims: We examine whether a suicide-exclusion period affects the timing of suicides. We also analyze whether accidental deaths are more prevalent during the suicide-exclusion period as life-insured individuals disguise their death by suicide. We assess the relationship between the insured sum and suicidal death rates. Methods: Crude and age-standardized rates of suicide, accidental death, and overall death, split by duration since the insured first bought their insurance policy, were computed. Results: There were significantly fewer suicides and no significant spike in the number of accidental deaths in the exclusion period for Australian life insurance data. More suicides, however, were detected for the first 2 years after the exclusion period. Higher insured sums are associated with higher rates of suicide. Conclusions: Adverse selection in Australian life insurance is exacerbated by including a suicide-exclusion period. Extension of the suicide-exclusion period to 3 years may prevent some “insurance-induced” suicides – a rationale for this conclusion is given.

Download Full-text