Measuring the burden of premature death due to smoking in Korea from 1990 to 1999

This study estimated the burden of premature death due to smoking in Korea between 1990 and 1999 using the years of life lost (YLL) due to premature death method. To implement this study, age-group-specific YLL due to premature death were calculated by employing the standard expected years of life lost method. YLL due to smoking were calculated based on assumptions and methods developed by the Global Burden of Disease Study Group. The burden of premature death due to smoking was estimated by multiplying the population attributable risk by the YLL of smoking-related diseases. In 1999, the burden of premature death due to smoking was 57.7% in males and 11.4% in females in Korea. The burden of premature death due to smoking increased from 1643 person years per 100,000 in 1990 to 1888 person years in 1999 for males, and increased from 151 person years in 1990 to 225 person years in 1999 for females in Korea. Our results suggest that the method employed in this study, generated in quantified terms, enabled the burden of premature death due to smoking to be obtained comparably with methods used by other international studies in this field, and thus can provide a rational basis for national health policy planning regarding premature death from smoking and the related risk factors in Korea.     

Influenza-related hospitalisation and death in Australians aged 50 years and older

Estimating the true burden of influenza is problematic because relatively few hospitalisations or deaths are specifically coded as influenza related. Statistical regression techniques using influenza and respiratory syncytial virus surveillance data were used to estimate the number of excess hospitalisations and deaths attributable to influenza. Several International Classification of Diseases 10th Revision (ICD-10) groupings were used for both hospitalisation and mortality estimates, including influenza and pneumonia, other respiratory disorders, and circulatory disorders. For Australians aged 50-64 years, the annual excess hospitalisations attributable to influenza were 33.3 (95%CI: 23.2-43.4) per 100,000 for influenza and pneumonia and 57.6 (95%CI: 32.5-82.8) per 100,000 for other respiratory disorders. For Australians aged > or =65 years, the annual excess hospitalisations attributable to influenza were 157.4 (95%CI: 108.4-206.5) per 100,000 for influenza and pneumonia and 282.0 (95%CI: 183.7-380.3) per 100,000 for other respiratory disorders. The annual excess all-cause mortality attributable to influenza was 6.4 (95%CI: 2.6-10.2) per 100,000 and 116.4 (95%CI: 71.3-161.5) per 100,000, for Australians aged 50-64 years and those aged > or =65 years, respectively. In the age-group > or =65 years, a significant association was found between influenza activity and circulatory mortality. We conclude that influenza is responsible for a substantial amount of mortality and morbidity, over and above that which is directly diagnosed as influenza in Australians aged > or =50 years.     

2015—2019年焦作市解放区主要慢性病死亡及早死趋势分析

目的 了解焦作市解放区主要慢性病死亡及早死概率等相关指标及其变化趋势。 方法 收集2015—2019年焦作市解放区居民死因资料,采用有关疾病和健康问题的国际统计分类第10版(ICD-10)分类方法进行死因分类,分别计算粗死亡率、标化死亡率、平均减寿年数(average years of life lost,AYLL)、早死概率等指标并分析焦作市解放区居民死亡资料。 结果 2015—2019年焦作市解放区65岁及以上人口占总人口比例由8.52%上升至10.82%,年度变化百分比(annual percent change,APC)为5.39%,呈上升趋势(t=5.579,P=0.011);恶性肿瘤、糖尿病、心脑血管疾病、慢性呼吸系统疾病4种主要慢性病死亡占总死亡人口数的比例由84.76%上升至88.20%,标化死亡率由 543.46/10万下降至459.64/10万;男性死亡率均高于女性(P<0.05);心脑血管疾病为首位死亡原因,年平均粗死亡率为315.78/10万,AYLL为11.77～12.97年,粗死亡率及AYLL的APC分别为0.67%和-1.42%,未见明显变化趋势(P>0.05)。 结论 老年人口占比呈上升趋势,心脑血管疾病为重点干预病种,男性为重点干预人群,应针对不同慢性病危险因素采取综合防控措施降低慢性病早死概率。     

Socio-demographic variations in smoking status among Australians aged ≥18: multivariate results from the 1995 National Health Survey

OBJECTIVE: To determine the association between socio-demographic variables and smoking status in a national sample of Australians aged > or = 18. METHOD: The data came from the 1995 National Health Survey (NHS), which was conducted by the Australian Bureau of Statistics (ABS). Information was collected from 20,165 females and 18,948 males using face-to-face interviews. The dependent variable was smoking status distinguishing regular smokers from occasional, ex-smokers and never-smokers. Multiple logistic regression was used to examine the association of smoking status with gender, age, marital status, region of residence, country of birth and three socio-economic measures. RESULTS: Analyses showed that gender, age, marital status, country of birth and socio-economic position were significantly related to smoking status. The odds of being a smoker were largest for respondents who were 20-34 years old, were not married, had a low socio-economic standing, and were born in the Middle East, southern and western Europe for men, and the United Kingdom/Ireland and western Europe for women. The results also revealed that the geographic measure of socio-economic status had a stronger association with smoking likelihood than the individual level indicators (education and income), suggesting the importance of the social environment. CONCLUSION: There is substantial socio-demographic variability in smoking status. IMPLICATION: Of groups identified as having higher smoking rates, the socio-economically disadvantaged groups have the highest priority for targeted campaigns.     

Influence of gender and socio-economic status on dietary patterns and nutrient intakes in 18-year-old Australians

This study used two-day diet records to examine dietary behaviours in 504 Australian 18 year-olds in relation to gender, socio-economic status (SES) and national dietary guidelines. Fat intake exceeded 30% of energy in about 80% of subjects and was greater than 40% in about one-quarter. Saturated fat provided more than 10% of dietary energy in more than 90% of participants; less than 1% achieved a polyunsaturated to saturated fat ratio of at least one. The major food groups contributing to fat intake were convenience foods (32% in men, 28% in women) and meat (27% in men, 25% in women). Fibre intake was less than 30 g/day in 93% of women and 77% of men. Intakes of calcium, magnesium, potassium, and vitamins C and A, as a ratio of energy consumption, were greater in women than men, while sodium intake was significantly higher in men. Convenience foods were the greatest contributors to sodium intake (27% in men, 22% in women) followed by meat, bread, and soups and sauces. Greater consumption of cereals, fruit, vegetables and low-fat foods in young women of higher SES was reflected in their nutrient profile with higher intake of fibre and vitamin C and lower intake of fat. Men ate more cereals, meat and sugary foods and less fruit, vegetables and low-fat foods. Only 2.5% of men and 4.1% of women conformed with the health promotion message, widely publicised locally, to eat two fruits and five vegetables daily. Not eating breakfast was associated with lower calcium intake in men and women, and lower iron and fibre intake in women. Achieving behavioural changes in young adults must take into account differences in dietary behaviour related to gender and SES.     

The hazards of death by smoking in middle-aged women

Recent studies have found that the risk of death continues to increase among female smokers, as compared with women who have never smoked. We wanted to examine the effect of smoking on all-cause and cause-specific mortality and calculate the corresponding population attributable fraction (PAF) of mortality in the Norwegian women and cancer study; a nationally representative prospective cohort study. We followed 85,320 women, aged 31–70 years, who completed a questionnaire in 1991–1997, through linkages to national registries through December 2008. Questionnaire data included information on lifestyle factors, including lifetime history of smoking. Poisson regression models were fitted to estimate relative risks (RRs) with 95 % confidence intervals (CIs) adjusting for age, birth cohort, education, postmenopausal status, alcohol consumption and body mass index, all at enrollment. During a mean follow-up time of 14 years 2,842 deaths occurred. Compared with that of never smokers, current smokers had a mortality rate that was double (RR = 2.34; 95 % CI 2.13–2.62) from deaths overall, triple (RR = 3.30; 95 % CI 2.21–4.82) from cerebrovascular disease and myocardial infarction (RR = 3.65; 95 % CI 2.18–6.15), 12 times (RR = 12.16; 95 % CI 7.80–19.00) from lung cancer and seventeen times (RR = 17.00; 95 % CI 5.90–48.78) from chronic obstructive pulmonary diseases. The PAF of mortality due to smoking was 34 % (CI 30–39). In summary, one in three deaths among middle aged women in Norway could have been prevented if the women did not smoke. More middle-aged women, than ever before, are dying prematurely due to smoking in Norway.     

Childhood infectious disease and premature death from cancer: a prospective cohort study

Studies of the association between early life infections and cancer have produced inconsistent findings, possibly due to limited adjustment for confounding and retrospective designs. This study utilised data from the Newcastle Thousand Families Study, a prospective cohort of 1,142 individuals born in Newcastle-upon-Tyne in 1947, to assess the impact of various childhood infectious diseases on cancer mortality during ages 15–60 years. Detailed information was collected prospectively on a number of early life factors. Deaths from cancer during ages 15–60 years were analysed in relation to childhood infections, adjusting for potential early-life confounders, using Cox proportional-hazards regression. In a subsample who returned questionnaires at aged 49–51 years, additional adjustment was made for adult factors to predict death from cancer during ages 50–60 years. Childhood history of measles and influenza, were both independently associated with lower cancer mortality during ages 15–60 years (adjusted hazard ratios = 0.39, 95 % CI 0.17–0.88 and 0.49, 95 % CI 0.24–0.98 respectively). In contrast, childhood pertussis was associated with higher cancer mortality during ages 15–60 years (adjusted hazard ratio = 4.88, 95 % CI 2.29–10.38). In the subsample with additional adjustment for adult variables, measles and pertussis remained significantly associated with cancer mortality during ages 50–60 years. In this pre-vaccination cohort, childhood infection with measles and influenza were associated with a reduced risk of death from cancer in adulthood, while pertussis was associated with an increased risk. While these results suggest some disease-specific associations between early-life infections and cancer, further studies are required to confirm the specific associations identified.     

Change in children''s smoking from age 9 to age 15 years: The Dunedin study

Studies have shown that the rate at which children take up smoking is still very high, particularly for female adolescents. While some progress has been made in determining the factors related to the initiation of smoking, an issue that still requires investigation is the relationship between early smoking patterns and later smoking behaviour. This paper reports the results of a longitudinal study which examined the continuity between smoking at an early age and later smoking behaviour. The smoking behaviour of a cohort of New Zealand children was followed from age 9 to age 15 years. Results showed that children's smoking pattern at age 9 years was not highly related to their smoking behaviour at age 15. The children most likely to become daily smokers by age 15 were those who had smoked within the last year at ages 11 and 13. It was concluded that the formative period for children's daily smoking at age 15 was from 10 to 13 years of age.     

Risks of smoking and hypertension in an Australian community: a cohort study

A prevalence study of smoking behaviour and blood pressure was carried out in Queenscliff, Victoria, in 1975. At the end of 1981, of the 1124 subjects who attended the survey and were aged 40 years or more, all but 12 could be positively identified as being alive or dead. In the case of the latter, the date of death was ascertained. Using a proportional hazards analysis, the relative risks were calculated for hypertension and for smoking; these were similar to those reported from the bench-mark studies carried out over 20 years ago. The risks appear to be additive, with no evidence of interaction.     

Job stress and other working conditions: Relationships with smoking behaviors in a representative sample of working Australians

OBJECTIVES: To assess the relationships between current smoking status and psychosocial working conditions. METHODS: A cross-sectional population-based telephone survey was conducted (66% response rate, N = 1,101). Job stress was measured using the demand/control, effort/reward imbalance (ERI), and job pressure models. Multiple regression modelling was conducted for smoking status (current versus non-smokers, and a more restricted analysis of current versus former-smokers) and daily smoking intensity outcomes in relation to job stress measures, working hours, shift work, and other independent variables. RESULTS: After adjustment for age, education, martial status, and hostility, high job strain was positively associated with current smoking in men only. Employment in active jobs was associated with decreased odds of smoking among women only. High strain jobs were associated with decreased odds of current smoking compared to former smoking in women. In men, extreme and moderate job pressure were related to current smoking compared to current non-smoking, and moderate job pressure was associated with current smoking compared with former smokers. Other working conditions associated with smoking were excessive working hours in men and physical demand in women. Daily smoking intensity in current smokers was associated with high psychological demand and with ERI in women. CONCLUSIONS: These results suggest that job stress is related to smoking status at the population level, with different patterns in men and women.     

The management of diabetes in indigenous Australians from primary care

Background  

Indigenous Australians have high rates of diabetes and its complications. This study examines ethnic differences in the management of patients with type 2 diabetes in Australian primary care.     

合肥市12岁和15岁少儿牙周病抽样调查分析

目的:了解合肥市区12岁和15岁少儿的牙周健康状况.方法:采用分层、不等比、多阶段、整群抽样法,随机对部分中小学12岁和15岁学生进行牙周健康状况调查.结果:两个年龄组的牙龈出血检出率、牙石检出率以及牙石平均区段数,15岁年龄组明显高于12岁年龄组.结论:虽然两个年龄组牙石平均区段数与WHO评价指标相比,已处于很低等级水平,但随着年龄的增长,牙周病患病上升趋势仍在继续.应充分重视儿童口腔保健工作,注意培养儿童良好的口腔卫生习惯.     

高死亡率地区早产儿死亡的路径分析

目的了解高死亡率地区早产儿死亡的死亡路径及就医情况。方法采用典型抽样的方法在新生儿高死亡率地区的4个县开展调查,对死亡早产儿的看护人进行一对一的问卷调查。结果266例新生儿死亡中有110例（41．4％）为早产儿,这些早产儿平均死亡年龄为2．5天。89．1％的早产儿出生在医疗机构,但是大部分死于家中（45．4％）,其次是县级医疗机构（27．3％）。结论加强孕期保健工作,预防早产发生,提高县级医疗机构对早产儿的护理和抢救水平是降低早产儿死亡率的主要措施。     

Years of potential life lost: Evaluating premature cancer death in men

Cancer is one of the most serious health concerns facing the nation. Health care policy makers who determine cancer research and treatment priorities must analyze death rates as an indicator of public health priorities. Two additional indexes that account for premature death include years of potential life lost (YPLL) and potential years of life lost per death (YPLL/D). Data for ten leading causes of cancer death in men from 1974-1983 were analyzed and the YPLL and YPLL/D corresponding to these cancers was calculated. Each cancer was then ranked from most to least significant according to each index. The analyses show that using YPLL and YPLL/D to evaluate cancer death in men results in rankings that differ from those obtained when using death rates alone. The premature death indexes, when used in combination with traditional mortality indexes, would enhance the data base used by funding agencies who select and evaluate cancer treatment and prevention programs.