Global, regional, and national age-sex-specific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

© 2018 The Author(s). Background: Assessments of age-specifc mortality and life expectancy have been done by the UN Population Division, Department of Economics and Social Afairs (UNPOP), the United States Census Bureau, WHO, and as part of previous iterations of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD). Previous iterations of the GBD used population estimates from UNPOP, which were not derived in a way that was internally consistent with the estimates of the numbers of deaths in the GBD. The present iteration of the GBD, GBD 2017, improves on previous assessments and provides timely estimates of the mortality experience of populations globally. Methods: The GBD uses all available data to produce estimates of mortality rates between 1950 and 2017 for 23 age groups, both sexes, and 918 locations, including 195 countries and territories and subnational locations for 16 countries. Data used include vital registration systems, sample registration systems, household surveys (complete birth histories, summary birth histories, sibling histories), censuses (summary birth histories, household deaths), and Demographic Surveillance Sites. In total, this analysis used 8259 data sources. Estimates of the probability of death between birth and the age of 5 years and between ages 15 and 60 years are generated and then input into a model life table system to produce complete life tables for all locations and years. Fatal discontinuities and mortality due to HIV/AIDS are analysed separately and then incorporated into the estimation. We analyse the relationship between age-specifc mortality and development status using the Socio-demographic Index, a composite measure based on fertility under the age of 25 years, education, and income. There are four main methodological improvements in GBD 2017 compared with GBD 2016: 622 additional data sources have been incorporated; new estimates of population, generated by the GBD study, are used; statistical methods used in diferent components of the analysis have been further standardised and improved; and the analysis has been extended backwards in time by two decades to start in 1950. Findings: Globally, 18·7% (95% uncertainty interval 18·4-19·0) of deaths were registered in 1950 and that proportion has been steadily increasing since, with 58·8% (58·2-59·3) of all deaths being registered in 2015. At the global level, between 1950 and 2017, life expectancy increased from 48·1 years (46·5-49·6) to 70·5 years (70·1-70·8) for men and from 52·9 years (51·7-54·0) to 75·6 years (75·3-75·9) for women. Despite this overall progress, there remains substantial variation in life expectancy at birth in 2017, which ranges from 49·1 years (46·5-51·7) for men in the Central African Republic to 87·6 years (86·9-88·1) among women in Singapore. The greatest progress across age groups was for children younger than 5 years; under-5 mortality dropped from 216·0 deaths (196·3-238·1) per 1000 livebirths in 1950 to 38·9 deaths (35·6-42·83) per 1000 livebirths in 2017, with huge reductions across countries. Nevertheless, there were still 5·4 million (5·2-5·6) deaths among children younger than 5 years in the world in 2017. Progress has been less pronounced and more variable for adults, especially for adult males, who had stagnant or increasing mortality rates in several countries. The gap between male and female life expectancy between 1950 and 2017, while relatively stable at the global level, shows distinctive patterns across super-regions and has consistently been the largest in central Europe, eastern Europe, and central Asia, and smallest in south Asia. Performance was also variable across countries and time in observed mortality rates compared with those expected on the basis of development. Interpretation: This analysis of age-sex-specifc mortality shows that there are remarkably complex patterns in population mortality across countries. The fndings of this study highlight global successes, such as the large decline in under-5 mortality, which refects signifcant local, national, and global commitment and investment over several decades. However, they also bring attention to mortality patterns that are a cause for concern, particularly among adult men and, to a lesser extent, women, whose mortality rates have stagnated in many countries over the time period of this study, and in some cases are increasing

Social protection and the citizen rights in Latin America: a narrative revision

Social protection includes all the economic, political and social variables that guarantee protection amidst the adversity that can damage the rights to health, employment, well-being, and quality of life. Objective: to unveil the link between the systems of social protection in Latin America and the fulfillment of social rights. Method: from the start point of documentary revision, a comparison among the different models of social protection applied in Latin America and the diverse types of citizen rights in the last decades is carried out. Several approaches of social protection are considered: social attendance, social security and social insurance; and additionally, the Minimum Networks of Social Protection (m n s p) of the 80’s, and the recent social protection as social risk management of the World Bank. The classification of the human rights are again took up: civil, political and social rights.Discussion: difficulties in Latin America that condition the model of social protection according to differences among social levels, the fragmentation of the social policy and the prevailing conditions of inequity that deny the possibilities of citizen rights to be effective are pointed out. In conclusion, the total fulfillment of social rights is feasible through the development of models of social protection capable of covering all the population and all the implied risks, not only in the work by itself but in the integral human development

Generalización e inferencia: un acercamiento a su compresión desde tres enfoques / Generalization and inference: an understanding based on three approaches

Se trata de una reflexión que busca poner en discusión los diferentes significados que pueden adquirir los conceptos de generalización e inferencia, de acuerdo con el enfoque o perspectiva desde el cual se pretendan utilizar. Para este propósito, en primer lugar, se pone en consideración la importancia y el uso que se ha dado a estos conceptos en el campo de la epidemiología clásica-moderna, especialmente para definir asuntos de validez interna y externa y para la formulación de hipótesis. Seguidamente, se presentan las principales argumentaciones que al respecto defiende Clifford Geertz desde su perspectiva epistemológica de la etnografía interpretativista y de acuerdo con su concepción teórica de la cultura. Posteriormente, se presentan las ideas que sustenta Juan Samaja desde su enfoque epistemológico y metodológico para la investigación en salud, abogando principalmente por el razonamiento abductivo, y no sólo el inductivo y el deductivo que han sido privilegiados en los estudios lógicos. Por último se presenta una discusión y unas conclusiones destacando que en estas tres perspectivas la salud pública tiene una oportunidad para enriquecer sus procesos de generación de nuevo conocimiento y para comprender de mejor manera las condiciones de salud y de bienestar colectivo This paper is a reflection which seeks to stimulate discussion and debate concerning the different meanings that the concepts of generalization and inference can take on, based on the approach or perspective that is being employed. For this purpose the importance and usage which has been accorded to these concepts within the field of classic-modern epidemiology is taken into consideration, especially in order to define internal and external validity issues and to formulate hypotheses. Next the main arguments are presented and are defended by Clifford Geertz from his epistemological perspective of interpretive ethnography and based on his theoretical conception of culture. Subsequently the ideas maintained by Juan Samaja are presented from his epistemological and methodological approach for research into health, advocating primarily for abductive reasoning, and not simply inductive and deductive, which have until now been privileged in logic studies. Finally a discussion and conclusions are presented, highlighting that from these three perspectives public health has the opportunity to expand its new knowledge generation processes and to better understand the conditions for good collective health and wellbein

Toward a Cenozoic history of atmospheric CO₂

The geological record encodes the relationship between climate and atmospheric carbon dioxide (CO2) over long and short timescales, as well as potential drivers of evolutionary transitions. However, reconstructing CO2 beyond direct measurements requires the use of paleoproxies and herein lies the challenge, as proxies differ in their assumptions, degree of understanding, and even reconstructed values. In this study, we critically evaluated, categorized, and integrated available proxies to create a high-fidelity and transparently constructed atmospheric CO2 record spanning the past 66 million years. This newly constructed record provides clearer evidence for higher Earth system sensitivity in the past and for the role of CO2 thresholds in biological and cryosphere evolution.</p

Toward a Cenozoic history of atmospheric CO₂

INTRODUCTIONAnthropogenic carbon dioxide (CO2) emissions have driven an increase in the global atmospheric CO2 concentration from 280 parts per million (ppm) before industrialization to an annual average of 419 ppm in 2022, corresponding to an increase in global mean surface temperature (GMST) of 1.1°C over the same period. If global CO2 emissions continue to rise, atmospheric CO2 could exceed 800 ppm by the year 2100. This begs the question of where our climate is headed. The geologic record is replete with both brief and extended intervals of CO2 concentration higher than today and thus provides opportunities to project the response of the future climate system to increasing CO2. For example, it has been estimated that global surface temperature 50 million years ago (Ma) was ~12°C higher than today, in tandem with atmospheric CO2 concentrations some 500 ppm higher (i.e., more than doubled) than present-day values. Consistent with these estimates, Antarctica and Greenland were free of ice at that time. However, reconstructing these values prior to direct instrumental measurements requires the use of paleoproxies—measurable properties of geological archives that are closely, but only indirectly, related to the parameter in question (e.g., temperature, CO2). To date, at least eight different proxies from both terrestrial and marine archives have been developed and applied to reconstruct paleo-CO2, but their underlying assumptions have been revised over time, and published reconstructions are not always consistent. This uncertainty complicates quantification of the climate responses to the ongoing rise of atmospheric CO2 concentrations.RATIONALEAlthough earlier studies have compiled published paleo-CO2 estimates, those studies typically applied only limited proxy vetting, included estimates that were made before the proxies were sufficiently validated, and/or focused on only a subset of available proxy data. The international consortium of the Cenozoic CO2 Proxy Integration Project (CenCO2PIP) has undertaken a 7-year effort to document, evaluate, and synthesize published paleo-CO2 records from all available archives, spanning the past 66 million years. The most reliable CO2 estimates were identified, some records were recalculated to conform with the latest proxy understanding, age models were updated where necessary and possible, and data were categorized according to the community’s level of confidence in each estimate. The highest-rated data were eventually combined into a reconstruction of the Cenozoic history of atmospheric CO2.RESULTSThe resulting reconstruction illustrates a more quantitatively robust relationship between CO2 and global surface temperature, yielding greater clarity and confidence than previous syntheses. The new record suggests that early Cenozoic “hothouse” CO2 concentrations peaked around 1600 ppm at ~51 Ma. Near 33.9 Ma, the onset of continent-wide Antarctic glaciation coincided with an atmospheric CO2 concentration of 720 ppm. By ~32 Ma, atmospheric CO2 had dropped to 550 ppm, and this value coincided with the onset of radiation in plants with carbon-concentrating mechanisms that populate grasslands and deserts today. CO2 remained below this threshold for the remainder of the Cenozoic and continued its long-term decrease toward the present. Along this trajectory, the middle Miocene (~16 Ma) marks the last time that CO2 concentrations were consistently higher than at present; Greenland was not yet glaciated at that time, and independent estimates suggest that sea level was some 50 m higher than today. Values eventually dropped below 270 ppm at the Plio-Pleistocene boundary (2.6 Ma), when Earth approached our current “icehouse” state of bipolar glaciation. This and other climatic implications of the revised CO2 curve, including the evolution of the cryosphere, flora, and fauna, along with the cross-disciplinary data assessment process, are detailed in the full online article.CONCLUSIONThis community-vetted CO2 synthesis represents the most reliable data available to date and a means to improve our understanding of past changes in global climate and carbon cycling as well as organismal evolution. However, this effort is still incomplete. Data remain sparse during the earlier part of the record and in some instances are dominated by estimates from a single proxy system. Generating a paleo-CO2 record with even greater confidence will require further research using multiple proxies to fill in data gaps and increase overall data resolution, resolve discrepancies between estimates from contemporaneous proxy analyses, reduce uncertainty of established methods, and develop new proxies.</div

Toward a Cenozoic history of atmospheric CO2

The geological record encodes the relationship between climate and atmospheric carbon dioxide (CO2) over long and short timescales, as well as potential drivers of evolutionary transitions. However, reconstructing CO2 beyond direct measurements requires the use of paleoproxies and herein lies the challenge, as proxies differ in their assumptions, degree of understanding, and even reconstructed values. In this study, we critically evaluated, categorized, and integrated available proxies to create a high-fidelity and transparently constructed atmospheric CO2 record spanning the past 66 million years. This newly constructed record provides clearer evidence for higher Earth system sensitivity in the past and for the role of CO2 thresholds in biological and cryosphere evolution

Memorias IX Congreso Geológico Venezolano (1)

Memorias del IX Congreso Geol&oacute;gico Venezolan