Impact of the COVID-19 pandemic on life expectancy in Madrid (Spain)

The coronavirus disease (COVID-19) pandemic is causing substantial increases in mortality across populations worldwide. According to the World Health Organization, by 22 May 2020, >325 000 confirmed COVID-19 deaths have occurred worldwide.1 The pandemic has overwhelmed health systems in many countries, potentially leading to increases in morbidity and mortality beyond the direct impact of COVID-19 infection. These increases in mortality, both direct and indirect, have the potential to cause stagnations or declines in life expectancy

COVID-19 in the United States: Social Inequality as Cause and Consequence

The COVID-19 pandemic is one of the most severe health crises of the last century. In this manuscript, we summarize the epidemiologic situation of the United States of America (US), with a mixture of personal observations and epidemiological data. We highlight the importance of considering the pre-pandemic health and political situation, where the US showed a worse health status as compared to other Western economies, with an unequal and fragmented health system. We follow with a description of the evolution of the pandemic in the US, starting in New York and other large East Coast cities, followed by a second wave in the South. Last, we highlight two challenges during the pandemic: the worsening of existing health disparities and the political situation of the country, that has polarized epidemic control measures.La pandemia de COVID-19 es una de las crisis sanitarias globales mas importantes del último siglo. En este articulo resumimos la situación en los Estados Unidos de América (EEUU) con respecto a la pandemia, con una mezcla de observaciones personales y datos epidemiológicos. Reseñamos la importancia de considerar la situación sanitaria y política previa a la pandemia, desde donde EEUU parte como un país con una esperanza de vida más baja que otros países occidentales, con un sistema sanitario fragmentado y muy desigual. Seguidamente describimos como ha evolucionado la pandemia en el país, con un inicio en Nueva York y otras ciudades de la costa este, seguida de una segunda ola en el sur del país. Por último, destacamos dos retos fundamentales durante la pandemia: el agravamiento de las desigualdades en salud, y la situación política del país, que ha partidizado las medidas de control epidemiológico

Neighborhood Social and Economic Change, Food Environment Change and Diabetes Incidence in Madrid (Spain)

Background The dynamic nature of residential environments is an understudied macro-social determinant of health. Objectives The aims of this dissertation were to measure neighborhood social and economic change, and to evaluate its association with changes in the retail food environment and diabetes incidence. Methods We collected area-level data from multiple administrative sources in the city of Madrid (Spain) from 2005 to 2016. For Aim 1, we computed measures of change in indicators related to residential mobility, socioeconomic and sociodemographic characteristics, and housing construction and renovations. We used a finite mixture model to measure types of areas according to how they change, revealing four types of neighborhood social and economic change. For Aim 2, we geocoded and categorized retail food stores into 4 categories: a) any food store, b) supermarkets, c) small specialized stores and d) fruit and vegetable stores. We used a multinomial logistic regression model to evaluate the association between neighborhood change type and food environment change. For Aim 3, we used data from the HeartHealthyHoods Retrospective Study that included electronic health records on every individual registered in a health center of four districts of Madrid. We used a Cox proportional hazards model to estimate the association between neighborhood change type and diabetes incidence. Results Our discrete measurement model identified four types of neighborhoods (census sections) according to their change: (Type 1) areas with an increasing proportion of foreign-born migrants and a relative worsening in SES markers; (Type 2) areas with high residential mobility and housing constructions, relative reduction in average age and increase in total population; (Type 3) areas with a relative improvement in SES markers and increases in housing renovations; and (Type 4) areas with low residential mobility, and a relative increase in average age, reduction in foreign-born migrants and total population. Type 3 areas were associated with an increase in the number of small specialized stores, a decrease in the number of supermarkets and an increased incidence of diabetes. Type 1 and 4 areas were associated with an increase in the number of supermarkets and decrease in the incidence of diabetes. Conclusions Measuring a complex exposure such as neighborhood social and economic change is a challenging endeavor. Further study of this association with food environment changes should include consideration of opening hours. If the finding of an association between neighborhood type and diabetes incidence can be replicated, policy-based diabetes prevention programs may be developed and tested

Monitoring life expectancy levels during the COVID-19 pandemic : example of the unequal impact of the first wave on Spanish regions

Background: To provide an interpretable summary of the impact on mortality of the COVID-19 pandemic we estimate weekly and annual life expectancies at birth in Spain and its regions. Methods: We used daily death count data from the Spanish Daily Mortality Monitoring System (MoMo), and death counts from 2018, and population on July 1st, 2019 by region (CCAA), age groups, and sex from the Spanish National Statistics Institute. We estimated weekly and annual (2019 and 2020*, the shifted annual calendar period up to 5 july 2020) life expectancies at birth as well as their differences with respect to 2019. Results: Weekly life expectancies at birth in Spain were lower in weeks 11-20, 2020 compared to the same weeks in 2019. This drop in weekly life expectancy was especially strong in weeks 13 and 14 (March 23rd to April 5th), with national declines ranging between 6.1 and 7.6 years and maximum regional weekly declines of up to 15 years in Madrid. Annual life expectancy differences between 2019 and 2020 also reflected an overall drop in annual life expectancy of 0.9 years for both men and women. These drops ranged between 0 years in several regions (e.g. Canary and Balearic Islands) to 2.8 years among men in Madrid. Conclusions: Life expectancy is an easy to interpret measure for understanding the heterogeneity of mortality patterns across Spanish regions. Weekly and annual life expectancy are sensitive useful indicators for understanding disparities and communicating the gravity of the situation because differences are expressed in intuitive year units

Preventing noncommunicable diseases through structural changes in urban environments

The primary determinants of disease are mainly economic and social, and therefore its remedies must also be economic and social. Medicine and politics cannot and should not be kept apart. Rose1 To achieve [a reduction in overweight and obesity] is perhaps the major public health and societal challenge of the century. Potential strategies include [….] redesign of built environments to promote physical activity, changes in food systems, restrictions on aggressive promotion of unhealthy drinks and foods to children and economic strategies such as taxation. Willet

A CROSS-SECTIONAL STUDY TO ASSESS THE PERVASIVENESS OF IRRESISTIBLE MALADIES IN THE FLOOD AFFECTED AREAS

Background: Natural disasters are calamitous occasions with air, geologic, and hydrologic birthplaces. Calamities incorporate quakes, volcanic emissions, avalanches, waves, floods and dry season. Pakistan confronted floods in 2010 that started following substantial rainstorm rains in the Khyber Pakhtunkhwa, Sindh, Punjab and Baluchistan areas of Pakistan. Objectives: To assess the pervasiveness of irresistible maladies in the flood influenced people. Patients and Methods: This cross-sectional investigation was led at Services Hospital, Lahore from October 2017 to May 2018. The information with respect to age, sex, training, occupation, land beginning and nature of illness were gotten from the patients going to flood alleviation therapeutic camp for human services and were broke down on SPSS. Results: Amid the investigation time frame, 8074 patients were inspected. Patients all things considered and both genders were incorporated. Male to female proportion was 1 to 1.01. The patients run from neonates to over 70 years old. The kids younger than ten years were 40.99%. Among the flood affected, the most well-known sicknesses in diminishing request of recurrence were looseness of the bowels, RTI, skin contamination, eye disease, ear disease and bone injury. Conclusion: Health education, clean water and environmental hygiene with proper and timely medical cover can reduce mortality and grimness. Keywords: Flood, Flood Affected, Disease Epidemic

Educational inequalities, urbanicity and levels of non-communicable diseases risk factors: evaluating trends in Argentina (2005–2013)

Background: We investigated a) whether urbanicity is associated with individual-level non-communicable diseases (NCD) risk factors and whether urbanicity modifies trends over time in risk factors; and (b) whether educational inequalities in NCD risk factors change over time or are modified by province urbanicity. Methods: We used data from three large national surveys on NCD risk factors (Encuesta Nacional de Factores de Riesgo; ENFR2005–2009-2013) conducted in urban areas of Argentina (n = 108,489). We used gender-stratified logistic random-intercept models (individuals nested within provinces) to determine adjusted associations of self-reported individual NCD risk factors (hypertension, diabetes, obesity, and current smoking) with education and urbanicity. Results: In both men and women, the prevalence of obesity and diabetes increased over time but smoking decreased. Hypertension prevalence increased over time in men. Higher urbanicity was associated with higher odds of smoking and lower odds of hypertension in women but was not associated with NCD risk factors in men. Obesity increased more over time in more compared to less urbanized provinces (in men) while smoking decreased more over time in less urbanized provinces. All risk factors had a higher prevalence in persons with lower education (stronger in women than in men), except for diabetes in men and smoking in women. Educational inequalities in obesity (in men) and hypertension (in men and women) became stronger over time, while an initial inverse social gradient in smoking for women reverted and became similar to other risk factors over time. In general, the inverse associations of education with the risk factors became stronger with increasing levels of province urbanicity. Conclusion: Increasing prevalence of diabetes and obesity over time and growing inequities by education highlight the need for policies aimed at reducing NCD risk factors among lower socioeconomic populations in urban environments in Argentina.Fil: Rodríguez López, Santiago. Drexel University; Estados Unidos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad. Universidad Nacional de Córdoba. Centro de Investigaciones y Estudios sobre Cultura y Sociedad; Argentina. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales; ArgentinaFil: Bilal, Usama. Drexel University; Estados UnidosFil: Ortigoza, Ana F.. Drexel University; Estados UnidosFil: Diez Roux, Ana Victoria. Drexel University; Estados Unido