Multiple faces of the health transition

Objectives: to know the relationship between self-care time and life expectancy. Methods: to calculate self-care time and its proportion in life expectancy. Results: the proportions of Disability-Adjusted Life Expectancy and Dementia-Adjusted Life Expectancy in life expectancy show downward trend with age growth. The proportion of dementia declines fast by comparison. Conclusions: the calculation of Disability-Adjusted Life Expectancy and Dementia-Adjusted Life Expectancy both support morbidity expansion theory, in the background of life extension, we should pay more attention to quality of life among the elderly.

Studies on malaria related maternal mortality in Nigeria have focused largely on preventive behaviours and healthcare providers’ knowledge of treatment regimen. Negligible attention has been paid to the proximate determinants and patterns of treatment adopted by care seekers in relevant contexts. Employing both qualitative and quantitative data collection techniques, the study established that malaria treatment among pregnant women in the area was influenced by social, residential and demographic factors in both rural and urban areas of the state. Expectant mothers without formal education reported high adherence to medication (r=-631 p< .034) than those of higher educational status, indicating that the level of education does not necessarily influence adherence to medication. Mother in-laws contributed remarkably to household social and counseling support and were the major determinants of choice of treatment options. Informal care providers remained essential part of maternal healthcare delivery in the absence of a functional formal medical system.

Population decline is common for modern Russia because of bad health, fertility decline and rapid mortality increase, especially male of working age.
The aim of our study is a critical analysis of modern methods of calculation of economic damage and the development (modification) of the optimal methodologies to assess the extent of economic losses due to mortality in the Far East Federal District, taking into account the valuation of the average life. This study is based on the concept of human capital, which considers health as one of the most important conditions for social and economic development of any territory.
Overall the Far East the total damage from the mortality of all ages increased by 2.8 times in 2003-2010, amounting to 42.7 billion of rubles or 2.4% of GRP in 2010. In Russia the growth rate of this indicator amounted to 2.6 times (in 2010 - 798 billion rubles or 2.5% of GDP). These estimates show that the mortality rate in the Far East and Russia as a whole, is associated with very significant economic losses, which couldn’t be ignored in the current circumstances, considering the low level of health, high mortality in the working age and the reduction of population.

This paper investigates the relationship between positive attitude and the remaining time lived healthily and happily over individual’s life cycle for Brazil and Mexico. Building on principles derived from theories of reasoned action and subjective norms, coupled with the multidimensional concept of attitude from Cacioppo & Berntson (1994), we estimate an empirical measure of multidimensional attitude based on three levels of perception: the self, the relations to social networks, and the surrounding environment. Our empirical measure of multidimensional attitude (estimated by means of GoM models) is then used to evaluate differences in healthy (HLE) and happy life expectancy (GLE) over the individual’s life cycle (estimated by Sullivan Method) according to the degree of one’s attitude. At last, we apply demographic decomposition techniques to estimate to what extent morbidity compression is happening in each country and how sensitive this trend is to attitudinal levels. Using the World Values Survey (Brazil 1997, 2006; Mexico 1996, 2005), we find evidence of a positive association between positive attitude and HLE and GLE, although the association is not linear over individual’s life cycle for health. Brazilians experience higher proportion of time happy and in good health then Mexicans, regardless of attitudinal status.

We quantify the impact of adult deaths from AIDS, and from other causes on household economic wellbeing, using a large longitudinal dataset spanning more than a decade. Verbal autopsies allow us to distinguish AIDS mortality from that of other causes. We find that households in which members die of AIDS are systematically poorer than other households, measured using members’ educations, household assets, and self-assessed poverty. The timing of the lower SES observed for these households and their AIDS deaths suggests that the socioeconomic gradient in AIDS mortality is being driven primarily by poor households being at higher risk for AIDS, rather than AIDS impoverishing the households. Moreover, we find, using reports on asset holdings and households’ self-reports of poverty, that households that experience a death from any cause are systematically poorer following a death. Funeral expenses born by the deceased’s household can explain some of the impoverishing effects of death in the household. The scale-up of antiretroviral therapy (ART), late in our study period, has begun to change the age profile of mortality in the study area. However, to date, ART has not changed the socioeconomic status gradient observed in AIDS deaths.

In 2009, more than 37 thousand Brazilians died due to traffic accidents. Of these, 35% were between 15 and 29 years old and 81.5% were men. The number of people who lose their lives in traffic accidents is rising since the beginning of the 2000´s.
Meanwhile, the mortality by this cause is declining in developed countries. Until the end of 1980´s, the pattern of deaths by traffic accidents in Spain had similarities with the one observed for Brazil. In 1989, the country invested in traffic security and mortality fell from 18.8 to 6.65 deaths / 100.000 persons in 2009. In Brazil, this rate went from 22.22 in 1990 to 20.11 deaths / 100.000 persons in 2009 (rates standardized by the Spanish population in 1981).
The aim of this article is to analyze the characteristics and changes in the patterns of traffic mortality in both countries.

Infectious and parasitic diseases nowadays represent a very small share of the total mortality of developed countries which mortality profile is dominated by cancers and diseases of the circulatory system. It has been suggested that, due to old people’s frailty, population aging may result in a fresh upsurge in infectious diseases. Routine indicators of cause-specific mortality are likely to underestimate the role played by these diseases in mortality because 1) the chapter “certain infectious and parasitic diseases“ of the 10th ICD includes only part of these diseases 2) these indicators only account for the underlying cause of the death. In a previous study, we have shown that roughly 3 out of 4 mentions of an infectious/parasitic disease are not selected as the underlying cause. Multiple (both contributing and underlying) cause-of-death data have been used in order to re-evaluate mortality levels attributed to a given condition, as well as to examine what are the most frequent associations of causes involving this condition. We use this approach to analyse the mortality involving infectious/parasitic diseases of France and Italy. The analysis is performed on an extended list of the infectious and parasitic diseases.

In the present era, mental disability is a major public health problem in the society. Many of the mental disabilities are curable if detected early. Social and economic status of mentally disabled person may depend on age onset. The data for this study has been taken from the survey of disabled persons in India conducted by the NSSO, 2002. In this paper we try to establish the relationship between cause of mental disability and age on onset and socio-economic status of elder mentally disabled persons in India with respect to age on onset. This study gives a comprehensive explanation of the multivariate technique called correspondence analysis, applied in the context of age on onset of mentally disabled older persons. Analysis shows that the nature of general education, cause of mental disability, marital status, living arrangement, treatment taken and usual activity status varies significantly with respect to age on onset of the mentally disabled elder persons. This study will provide one of the primary steps towards proper public health planning for elder section of mentally disabled persons in India.

In a view of recent and future demographic changes, the provision of long-term care for the elderly becomes increasingly challenging. The development of the policies and programs attempting to offer the cost-effective care requires a sufficient amount of information not only on the macro but also on the individual level. Utilizing the German Micro Census data, the paper estimates the association between the individual’s socioeconomic status (by means of education) and the prevalence in public long-term care (PLTC) among people aged 65 years and above. These are the only data allowing studying this association. Particular attention is paid to the disparities between men and women and between the residents from East/West Germany. Being assigned to one of the three care levels (‘Pflegestufe’) is considered as a proxy for LTC utilization, the eligibility to which depends on the physical evaluation of the applicants. The logit regression model is applied to study the direction and the strength of the relationship. The preliminary results reveal the lower prevalence in care for people with higher education but they are found to be in need of more extensive care. The regression results show that education certainly matters for prevalence in LTC.

This research is exploring the situation of decreasing in infant mortality rate, mortality under five and child health and maternal mortality in Macedonia during last decades until nowadays. The paper then compare the general rates of mortality over the years and focus on socio-economic influence and the differences in mortality that may appear when comparing mortality trends in Macedonia. The research shows that the infant mortality rate was very high (over 100%o) in the 1960s.With the "rapid" decline in the next two decades, reaching the value of 31.6%o in 1990 Macedonia has experienced a sharp fall in infant mortality rates, from 22.7 per 1000 live births in 1995 to 11.9 per 1000 live births in 2001.Also the level of the maternal mortality ratio in Macedonia fell by 40% in the decade between 1993 and 2003.The analysis leads to a general conclusion that the existing economic and social conditions in the Republic of Macedonia significantly influences the demographic phenomena, such as mortality trends, deaths by age, life expectancy and the health of population.