We only die once... but from how many causes?

Analysing causes of death provides a betterunderstanding of long-term mortality trends. InFrance, the death certificates completed by physiciansgenerally mention several causes of death (2.4 onaverage in 2011). As a general rule, just one of them,the so-called underlying cause, is taken into account.As a result, the contribution of certain diseases-endocrine diseases for example-to mortality isseverely underestimated. In a context of rising lifeexpectancy where people increasingly die not from asingle cause of death but from several, it is importantto also take these contributing causes into account

Detecting spatio-temporal mortality clusters of European countries by sex and ag

[EN] Background: Mortality decreased in European Union (EU) countries during the last century. Despite these similar trends, there are still considerable differences in the levels of mortality between Eastern and Western European countries. Sub-group analysis of mortality in Europe for different age and sex groups is common, however to our knowledge a spatio-temporal methodology as in this study has not been applied to detect significant spatial dependence and interaction with time. Thus, the objective of this paper is to quantify the dynamics of mortality in Europe and detect significant clusters of mortality between European countries, applying spatio-temporal methodology. In addition, the joint evolution between the mortality of European countries and their neighbours over time was studied. Methods: The spatio-temporal methodology used in this study takes into account two factors: time and the geographical location of countries and, consequently, the neighbourhood relationships between them. This methodology was applied to 26 European countries for the period 1990-2012. Results: Principally, for people older than 64 years two significant clusters were obtained: one of high mortality formed by Eastern European countries and the other of low mortality composed of Western countries. In contrast, for ages below or equal to 64 years only the significant cluster of high mortality formed by Eastern European countries was observed. In addition, the joint evolution between the 26 European countries and their neighbours during the period 1990-2012 was confirmed. For this reason, it can be said that mortality in EU not only depends on differences in the health systems, which are a subject to national discretion, but also on supra-national developments. Conclusions: This paper proposes statistical tools which provide a clear framework for the successful implementation of development public policies to help the UE meet the challenge of rethinking its social model (Social Security and health care) and make it sustainable in the medium term.The authors are grateful for the financial support provided by the Ministry of Economy and Competitiveness, project MTM2013-45381-P. Adina Iftimi gratefully acknowledges financial support from the MECyD (Ministerio de Educacion, Cultura y Deporte, Spain) Grant FPU12/04531. Francisco Montes is grateful for the financial support provided by the Spanish Ministry of Economy and Competitiveness, project MTM2016-78917-R. The research by Patricia Carracedo and Ana Debon has been supported by a grant from the Mapfre Foundation.Carracedo-Garnateo, P.; Debón Aucejo, AM.; Iftimi, A.; Montes-Suay, F. (2018). Detecting spatio-temporal mortality clusters of European countries by sex and ag. 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Beliefs and traditions related to a child´s first year of life : a study of the Northwest of Portugal

In this paper we propose an approach to investigate, in the North-west of Portugal, the parents’ behaviour at birth and during the first year of life of their children. We compare the heritage, specifically the beliefs and traditions, with the changes that resulted from the recent and deep cultural transformations that have taken place in Portugal in the last few decades. In parallel, we tried to determine if the parents’ behaviours, based on beliefs and traditions, can affect the children’s health. We based our investigation on standardized interviews with 76 mothers of one-year-old children (born between January and December 2001) who lived in two parishes of Vizela city. This is a territory where a more traditional way of life prevails than in other territories of the centre and south of the country, where there is a strong attachment for religious and social values and where the influence of the ancestral traditions is still alive. The paper concludes that cultural heritage can have important impact on individual health. Health professionals, who work in primary care and in hospitals, must be aware of the responsibility they have to change this scenario.(undefined

Sharp upturn of life expectancy in the Netherlands: effect of more health care for the elderly?

During the 1980s and 1990s life expectancy at birth has risen only slowly in the Netherlands. In 2002, however, the rise in life expectancy suddenly accelerated. We studied the possible causes of this remarkable development. Mortality data by age, gender and cause of death were analyzed using life table methods and age-period-cohort modeling. Trends in determinants of mortality (including health care delivery) were compared with trends in mortality. Two-thirds of the increase in life expectancy at birth since 2002 were due to declines in mortality among those aged 65 and over. Declines in mortality reflected a period rather than a cohort effect, and were seen for a wide range of causes of death. Favorable changes in mortality determinants coinciding with the acceleration of mortality decline were mainly seen within the health care system. Health care expenditure rose rapidly after 2001, and was accompanied by a sharp rise of specialist visits, drug prescriptions, hospital admissions and surgical procedures among the elderly. A decline of deaths following non-treatment decisions suggests a change towards more active treatment of elderly patients. Our findings are consistent with the idea that the sharp upturn of life expectancy in the Netherlands was at least partly due to a sharp increase in health care for the elderly, and has been facilitated by a relaxation of budgetary constraints in the health care system

The State Socialist Mortality Syndrome

Death rates for working-age men in European state socialist countries deviated from general improvements in survival observed in the rest of Europe during the 20th century. The magnitude of structural labor force changes across countries correlates with lagged increases in death rates for men in the working ages. This pattern is consistent with a hypothesis that hyper-development of heavy industry and stagnation (even contraction) of the service sector created anomic conditions leading to unhealthy lifestyles and self-destructive behavior among men moving from primary-sector to secondary-sector occupations. Occupational contrasts within countries similarly show concentration of rising male death rates among blue collar workers. Collapse of state socialist systems produced rapid corrections in labor force structure after 1990, again correlated with a fading of the state socialist mortality syndrome in following decades

Convergence or Divergence? Life Expectancy Patterns in Post-communist Countries, 1959–2010

In the 1960s and 1970s, the countries of Central and Eastern Europe and the Soviet Union experienced an unanticipated stagnation in the process of mortality reduction that was accelerating in the west. This was followed by even starker fluctuations and overall declines in life expectancy during the 1980s and 1990s. We identify statistically the extent to which, since the 1990s, the countries of the post-communist region have converged as a group towards other regional or cross-regional geopolitical blocks, or whether there are now multiple steady emerging among these countries. We apply a complex convergence club methodology, including a recursive analysis, to data on 30 OECD countries (including 11 post-communist countries) drawn from the Human Mortality Database and spanning the period 1959-2010. We find that, rather than converging uniformly on western life expectancy levels, the post-communist countries have diverged into multiple clubs, with the lowest seemingly stuck in low-level equilibria, while the best performers (e.g. Czech Republic) show signs of catching-up with the leading OECD countries. As the post-communist period has progressed, the group of transition countries themselves has become more heterogeneous and it is noticeable that distinctive gender and age patterns have emerged. We are the first to employ an empirical convergence club methodology to help understand the complex long-run patterns of life expectancy within the post-communist region, one of very few papers to situate such an analysis in the context of the OECD countries, and one of relatively few to interpret the dynamics over the long-term

Cause-of-Death Contributions to Educational Inequalities in Mortality in Austria between 1981/1982 and 1991/1992: Les contributions des causes de décès aux inégalités de mortalité par niveau d’éducation en Autriche entre 1981/1982 et 1991/1992

This article uses census records and deaths records to analyze trends in educational inequalities in mortality for Austrian women and men aged 35–64 years between 1981/1982 and 1991/1992. We find an increasing gradient in mortality by education for circulatory diseases and especially ischaemic heart disease. Respiratory diseases and, in addition for women, cancers showed the opposite trend. Using decomposition analysis, we give evidence that in many cases changes in the age-structure within the 10-year interval had a bigger effect than direct improvements in mortality on the analyzed subpopulations