Human development reportedly includes critical and sensitive periods during which environmental stressors can affect traits that persist throughout life. Controversy remains over which of these periods provides an opportunity for such stressors to affect health and longevity. The elaboration of reproductive biology and its behavioral sequelae during adolescence suggests such a sensitive period, particularly among males. We test the hypothesis that life expectancy at age 20 among males exposed to life-threatening stressors during early adolescence will fall below that among other males. We apply time-series methods to cohort mortality data in France between 1816 and 1919, England and Wales between 1841 and 1919, and Sweden between 1861 and 1919. Our results indicate an inverse association between cohort death rates at ages 10-14 and cohort life expectancy at age 20. Our findings imply that better-informed and more strategic management of the stressors encountered by early adolescents may improve population health.
In this paper we discuss the Russian adult health crisis and its implications. Although some hope that economic growth will trigger improvements in health, we argue that a scenario is more likely in which the unfavorable health status would become a barrier to economic growth. We also show that ill health is negatively affecting the economic well-being of individuals and households. We provide suggestions on interventions to improve health conditions in the Russian Federation, and we show that if health improvements are achieved, this will result in substantial economic gains in the future.
The paper aims at comparative analysis of future trends of population ageing in Russia and Ukraine. The UN Population Prospects (The 2004 Revision) and probabilistic projections for Russia and Ukraine up to the year 2050 are analyzed. A number of ageing characteristics (proportions of the population aged 65+ and 80+, old age dependency ratio, median age) are considered.
Russia remains in the grip of a mortality crisis in which alcohol plays a central role. In 2007, male life expectancy at birth was 61 years, while for females it was 74 years. Alcohol is implicated particularly in deaths among working-age men.
To review the current state of knowledge about the contribution of alcohol to the continuing very high mortality seen among Russian adults
Conservative estimates attribute 31-43% of deaths among working-age men to alcohol. This latter estimate would imply a minimum of 170 000 excess deaths due to hazardous alcohol consumption in Russia per year. Men drink appreciably more than women in Russia. Hazardous drinking is most prevalent among people with low levels of education and those who are economically disadvantaged, partly because some of the available sources of ethanol are very cheap and easy to obtain. The best estimates available suggest that per capita consumption among adults is 15-18 litres of pure ethanol per year. However, reliable estimation of the total volume of alcohol consumed per capita in Russia is very difficult because of the diversity of sources of ethanol that are available, for many of which data do not exist. These include both illegal spirits, as well as legal non-beverage alcohols (such as medicinal tinctures). In 2006 regulations were introduced aimed at reducing the production and sale of non-beverage alcohols that are commonly drunk. These appear to have been only partially successful.
There is convincing evidence that alcohol plays an important role in explaining high mortality in Russia, in particular among working age men. However, there remain important uncertainties about the precise scale of the problem and about the health effects of the distinctive pattern of alcohol consumption that is prevalent in Russia today. While there is a need for further research, enough is known to justify the development of a comprehensive inter-sectoral alcohol control strategy. The recent fall in life expectancy in Russia should give a renewed urgency to attempts to move the policy agenda forward.
We examined mortality among working-age Russian men whose identity could not be determined, focusing on where and how they died.
Employing micro-data from deaths that occurred in Izhevsk (Ural region) between June 2004 and September 2005, we analysed the characteristics of decedent men aged 25-54 (n = 2158). Differences between completely identified (n = 1699) and unidentified deaths (n = 282) were compared via logistic regression. Data on all deaths in Russia in 2002 were used for supplemental comparisons.
We found that relative to identified men, unidentified men were at a higher risk of death from exposure to natural cold, violence, alcoholic cardiomyopathy, acute respiratory infections and poisonings. Our results also revealed that alcohol played an important role in the mortality of unidentified men. The places and causes of death among these unidentified men provide substantial evidence of their homelessness and social isolation.
The increase in deaths among unidentified men of working-age indicates the emergence of a health threat associated with homelessness and social marginalization. This vulnerable group is exposed to different levels and causes of mortality compared with the larger population and represent a new challenge that requires serious and immediate scholarly attention and policy responses.
Examining causes of death and making comparisons across countries may increase understanding of the income-related differences in life expectancy.
To describe income-related differences in life expectancy and causes of death in Norway and to compare those differences with US estimates.
A registry-based study including all Norwegian residents aged at least 40 years from 2005 to 2015.
Household income adjusted for household size.
Life expectancy at 40 years of age and cause-specific mortality.
In total, 3 041 828 persons contributed 25 805 277 person-years and 441?768 deaths during the study period (mean [SD] age, 59.3 years [13.6]; mean [SD] number of household members per person, 2.5 [1.3]). Life expectancy was highest for women with income in the top 1% (86.4 years [95% CI, 85.7-87.1]) which was 8.4 years (95% CI, 7.2-9.6) longer than women with income in the lowest 1%. Men with the lowest 1% income had the lowest life expectancy (70.6 years [95% CI, 69.6-71.6]), which was 13.8 years (95% CI, 12.3-15.2) less than men with the top 1% income. From 2005 to 2015, the differences in life expectancy by income increased, largely attributable to deaths from cardiovascular disease, cancers, chronic obstructive pulmonary disease, and dementia in older age groups and substance use deaths and suicides in younger age groups. Over the same period, life expectancy for women in the highest income quartile increased 3.2 years (95% CI, 2.7-3.7), while life expectancy for women in the lowest income quartile decreased 0.4 years (95% CI, -1.0 to 0.2). For men, life expectancy increased 3.1 years (95% CI, 2.5-3.7) in the highest income quartile and 0.9 years (95% CI, 0.2-1.6) in the lowest income quartile. Differences in life expectancy by income levels in Norway were similar to differences observed in the United States, except that life expectancy was higher in Norway in the lower to middle part of the income distribution in both men and women.
In Norway, there were substantial and increasing gaps in life expectancy by income level from 2005 to 2015. The largest differences in life expectancy between Norway and United States were for individuals in the lower to middle part of the income distribution.
Notes
CommentIn: JAMA. 2019 May 21;321(19):1877-1879 PMID 31083727
In the late seventies the World Health Organization developed a strategy of Health for all towards year 2000, to which Norwegian health authorities have consented. This article presents and discusses the sub-goals for expectation of life and mortality, and analyzes the possibilities of reaching them. The desired reduction of at least 25% in accident mortality rates and cardiovascular mortality rates in relation to the reference period 1976-80 will probably be reached. In addition, the desired 15% reduction in cancer mortality is likely to be reached for persons under 40 years of age. Infant mortality does not appear to be declining, cancer mortality for people over 40 years of age is increasing, and the suicidal and homicidal rates are increasing faster than any other cause of death. The possibilities of reversing this development require a structured plan and comprehensive changes in the way society is organized, with more emphasis on care, social network planning and reduction of the multicausal risk load that modern life implies. Some of the sub-goals are not sufficiently founded on accessible information, and should be revised.
