Age patterns of adult mortality in relation to causes of death and increasing longevity

Mortality Information System (MIS) with responsibility for compiling cause of death data in Brazil was created by Ministry of Heath in 1975. Despite MIS continuous improvements, Brazil was categorized in 2000 as producing medium-quality death registration data. The aim of this proposal is to evaluate the evolution of quality of causes of death data, to describe the profile of deceased with ill-defined or unspecified cause of death and to evaluate the impact of the improvement of quality of data on mortality levels from some specific causes of death among adults and elders (15-59 and 60+) in Brazil from 1980 to 2010. For evaluating cause of death data quality we considered the criteria of completeness and validity. To analyze the profile of deceased with ill-defined cause of death, socio-demographic characteristics and variables on circumstances of death and its certification are considered. Although the important improvement in levels of completeness and validity of causes of death data in Brazil, especially after 2005, differences in quality of data among regions, age and other characteristics persist. With population rapidly aging, to assess quality of data on adult and elderly mortality in order to better evaluate health policy for these age groups is extremely important.

This paper, using data from 2004 to 2009 Iran Civil registration Organization. Both descriptive and inferential statistics were employed in this paper. First, to assess time trends in mortality over time, the proportional mortality ratio (PMR) was calculated for each year and also for five-year intervals. Second, Cox proportional hazard models were fitted for deaths of all ages. The model specification accounts for residence, sex and cause of death. Measure of association among characteristic were expressed using hazard ratios (HR) with %95 confidence intervals (CI). Results indicate that risk of death were significant for residence, sex and cause of death. Results indicate that with controlling all factors, risk of death among women were 0.17 lower than men. In the other words, women live longer but, with entering cause of death to the previous model, risk of women death increase 0.3 than the men. With controlling all factors risk of rural were 0.6 lower than urban, it means that rural live longer. But, with entering cause of death to this model the rural directions of risk change. Because of longer life of urban we can conclude that increase in risk rate was due to differences in cause of death.
Key words: mortality, Tehran, hazard ratios

In the world, death by road traffic accident (RTA), self-inflicted injuries and interpersonal violence are among the first four leading causes of death. Most cross national research has relied upon data from countries with complete vital registration systems. Consequently, little is known about the age and sex patterns of violence related mortality in developing countries, including India. The paper intends to highlight patterns of violence related adult mortality in India for different age-group and sex. The data related to total violent deaths considering homicides, suicides and (RTA) are taken from the National Crime Records Bureau, Ministry of Home Affairs, Government of India. The Census data (2001) has been taken as the base year, and has been projected for each consecutive year from 2002 to 2011 using SPECTRUM software package. There is continuous increase in the total homicides, suicides and RTA deaths till 2011, except in the year 2009. There are sex differentials in the adult mortality in homicide, suicide and RTA deaths, that is, these death rates are more for males than females in all age groups. Unlike the homicide and suicide cases, the RTA cases are increasing in all age groups irrespective of sexes.

We examine the effect of health reform in 1995 in Taiwan on health transition among the elderly Taiwanese, including functioning, disability and death by employing a nationally representative longitudinal survey, the “Survey of Health and Living Status of the Middle Aged and Elderly in Taiwan” for analyses. This study ran hazard models over 3 to 4 years to analyze changes from no physical function problem to having difficulty in physical functioning, no ADL/IADL problem to disability, and alive to dead. We found the higher-education benefited from national health insurance (NHI) more than the lower-education to get better mortality outcome. Because the higher-education were more likely to know when the new technology/medicine were available and covered by NHI. As for disability and physical functioning, our study showed that NHI helped to eliminate the income gap by allowing the lower income groups to have better access to health care after health reform.

Life expectancy at birth has been widely used as indicator of overall health of population. It is the only single indicator which captures the effects of multi-dimensional development in socio-economic and health aspects of a country in a real sense. Globally, life expectancy has increased commendably over the last few decades. India too has reserved pace with the other countries in health status performance. Decline in mortality in India from 1970-75 to 2001-06 resulted in gains in expectation of life for both males and females though the improvement in the male life expectancy was slightly higher. Over the last four decades, life expectancy in India has increased from 50 to 63 years. This paper examines: i) the levels and trends in life expectancy at birth in India and its major states during 1970-2006; ii) the effects of improvement in age-specific mortality rates on the gains in life expectancy at birth by sex and residence from 1970-75 to 2001-06 & iii) a panel regression analysis to assess the transition in life expectancy at birth and its determinants.

The concern for a further global rise of asbestos-related diseases is growing. A recent WHO study on global mesothelioma deaths reported between 1994 and 2008, shows an increase in mortality worldwide (Delgermaa, Takahashi et al. 2011). Because Belgian data have not been reported as a consequence of the regionalization process, Belgium was not included in this study.
With companies as Eternit, Belgium has been a top producer and a top consumer of asbestos worldwide. Nonetheless, asbestos-related mortality remained largely unexplored for Belgium.
Our aim is to improve the understanding of the impact of asbestos in an international perspective by providing a descriptive analysis of mesothelioma mortality in Belgium (1969-2008).
Compared to the results of the WHO study, Belgium ranks fourth in the world in age adjusted mortality rates, just behind the UK, Australia and Italy. The high male/female ratio points to occupational related hazards, a fact confirmed by our geographical analysis. Mesothelioma mortality is higher in areas with a history of industrial asbestos use. Finally, our results also suggest a further increase in asbestos-related mortality in Belgium.

Like other developing countries, India is undergoing rapid epidemiological transition as a result of its demographic, economic and social changes. India is moving from second to third stage of epidemiological transition. However, India is facing both double burdens of diseases that burden of communicable and non-communicable. Lack of accurate data on cause of deaths is a major hindrance to comprehensive assessment of epidemiological transition. The urban Maharashtra known to be the only state where the vital events registration is above 90%. The results are evident that Maharashtra is at third stage of epidemiological transition. Among all causes of death “Diseases of the Circulatory System” is ranked first from 1990 to 2006. For youth, the leading cause of death is “Injury and poisoning” for both males and females. In the adult groups, leading cause of death is” Infectious and parasitic disease”. Among adult males the leading cause of death is” Infectious and parasitic disease” and among adult female it is “disease of circulatory system”. For the old age group, “Disease of circulatory system is the leading cause of death in Urban Maharashtra for both males and females. This indicates that state is non-communicable diseases but the state is facing double burden of diseases.

Recent evidences suggest increase in adult mortality due to increase in non-communicable diseases, change in life style and age-structural transition. Though adult mortality and hospitalization in India are showing increasing trend over years, little is known about its magnitude, differentials and the risk factors and deaths by cause. This paper aims to estimate the magnitude of adult deaths by age group, sex and cause of death in India. The data for this study has been taken from multiple sources; Sample Registration System (SRS), Census of India and Special Survey on Cause of Deaths (Million Death Study). Results indicate monotonic increase in adult and old age mortality over time and shift in concentration of deaths from early ages to adult ages. Similar pattern appear for the three selected states Uttar Pradesh, Maharashtra and Kerala which are in different phases of demographic transition, though the level is different. Result shows a shift in cause of death from communicable to non-communicable diseases which is consistent with the epidemiological transition occurred in India and need urgent policy attention.

Road Traffic Accidents (RTA) is increasingly being recognized as a growing public health problem in the world. Nevertheless, little attention has been paid by the social scientists, including demographers, and policy makers to mitigate the problem. Therefore, there is an urgent need to explore the issue in detail to have a comprehensive understanding. The paper aims to assess various dimensions and magnitudes of RTA in India. At the same time, the study also explores the trends and patterns of RTA in India. The study uses data from the National Crime Record Bureau; Ministry of Home Affairs; and the Department of Road Transport and Highways, Govt. of India. The analysis shows that there is a persistent increase in the number of motor vehicle crashes, injuries and fatalities. RTA by the two wheelers is disproportionaly high and so are the fatalities. One of the most dangerous aspects of RTA is that it has been affecting the most productive young working population. Heavy vehicles accounts for about 35% of total deaths in India. Furthermore, with the growing rate of urbanization in India, and its expected increase in the decades to come, there is steep increase in RTA in the last two decades.

Though the cardiovascular diseases are the leading cause of deaths in India, there are limited studies that provide estimates on burden of cardiovascular diseases. The aim of this paper is to project the age and sex pattern of deaths and hospitalisation due to cardiovascular diseases in India and its major regions. The data have been drawn from multiple sources; Special Survey on Cause of Death, 2001-03, Sample Registration System 2004-2010, Expert Committee Projection on Population 2001 and Census of India 2011. The projections are carried out, for 2004-21, under baseline, optimistic and pessimistic scenario. A sensitivity analysis has been carried out on the estimates of cardiovascular deaths. Under the baseline scenario the number of deaths due to cardiovascular diseases was estimated at 1.4 million in 2004, 1.6 million in 2010, 1.8 million in 2016 and 2.1 million in 2021. The total hospitalisation was estimated as 6.7 million in 2004, 7.7 million in 2010, 9.5 million in 2016 and 10.9 million by 2021. While, deaths were relatively higher among older adults, hospitalisation was concentrated among prime working age group. The regional estimates suggest that the majority of the deaths and hospitalisation were in the southern and eastern region of India.