Suicide mortality among the elderly Finnish population 1960–1979

Suicide mortality trends among the Finnish elderly population in 1960–1979 were examined on the basis of official statistics. As a cause of death, suicide was more common in the elderly than in the population aged 15–64 years. Suicide mortality remained unchanged among the elderly population between 1960 and 1979. Peaks were not found to coincide with economic recessions. On the other hand, suicide mortality among the population aged 15–64 years increased. The authors propose that international comparisons be undertaken.     

Changes in mortality among the elderly Finnish population 1951-1979

Morbidity and mortality cannot be explained by biological factors alone; socio-economic factors, environment, life-style and health care delivery system also affect mortality rates. Many changes have taken place in socio-economic factors and environment among the elderly, and the health care system has expanded over the last few decades in Finland. However, the social changes have not only been for the better; and the changes in different causes of death among the elderly may have been different. Overall mortality among elderly Finnish males and females decreased in the 1950s, but increased at the beginning of the 1960s. From the later half of the 1960s overall mortality decreased. The decrease in female death rates began earlier and was more rapid than among males. Over one-half of the decrease from 1960-1969 to 1970-1979 among elderly males was due to the decrease in cardiovascular and cerebrovascular mortality; one-fifth was due to the decrease in genitourinary mortality. The male death rates in neoplasms and in violent causes increased during the period under study. Over one-half of the decrease from 1960-1969 to 1970-1979 among elderly females was attributable to the decrease in cardiovascular and cerebrovascular mortality. Lessening genitourinary mortality, gastrointestinal mortality, respiratory mortality, mortality from neoplasms and from violent causes accounted for less than 5% decrease in overall mortality.     

Cardiovascular and cerebrovascular mortality among the elderly Finnish population 1960–79

Cardiovascular and cerebrovascular diseases are the leading cause of death among thepopulation 65 years and over. This retrospective study based on mortality statistics examined the deaths of Finns 65 years and over from these diseases during 1960–79. In the early 1960s, mortality was still relatively high, but since the mid-60s and throughout the 1970s death rates have continuously decreased. Female mortality began to drop earlier than male mortality, and the decrease in female mortality has also been more rapid. Both cerebrovascular mortality and mortality from ischaemic and arteriosclerotic heart diseases decreased in all 5-year age groups. Mortality from cerebrovascular diseases declined more sharply than mortality in ischaemic and arteriosclerotic heart diseases.     

Mortality from violent causes among the elderly population in Finland in 1951-1979

The changes in violence-related mortality rates among the population aged 65 years or older in Finland from 1951-1979 were studied with the help of the official mortality statistics. Factors underlying these changes were also examined. The most distinctive findings were, first, the increase in accident-related mortality rates of both males and females in the 1950s and, second, the sharp decrease of those rates with respect to women from 1960-1975 compared to the decrease for males during that same period. The changes in mortality for males were mainly due to changes in frequency of motor-vehicle fatalities, whereas the changes for females were mainly due to changes in mortality caused by accidental falls and limb fractures. Improvements in classification methods resulting in the decrease of unspecified causes of death were apparently the main cause of the recorded increase in violent mortality in the early 1950s. The incidence of traffic accidents has decreased in the latter half of the 1970s. Thus, the minor decrease in motor-vehicle accident mortality for men most evidently was due to a decreased incidence. The incidence of hip and limb fractures in women increased. Thus, it was not a lowered incidence but instead a decreased case-fatality rate which caused the decreased mortality in females. Early mobilization after hip operations and decreased dependence level among the elderly apparently resulted in the decreased fatality rates.     

Determinants of health service use and expenditure among the elderly Finnish population

Background: There is a need to identify significant determinantsof physician and public health nurse visits, hospital in-patientand home care, use of prescribed medication and total expenditureamong elderly people for planning of health policy. Methods:The data were obtained from three annual computer-assisted telephoneinterview surveys in 1992–1994. Each year a systematicsample of approximately 2,300 non-institutionalized people aged25-79 years were interviewed. The 60-79 year old respondentswere included in our analysis (n=1,707); the response ratesin this age group were approximately 75% each year. In thisstudy we tested the suitability of four regression models: Poisson,negative binomial, logit plus zero-truncated Poisson and logitplus zero-truncated negative binomial. Results: The use of servicesincreased with age, particularly hospital in-patient and homecare. Although women were more likely to use services, particularlyprimary care, their share of total expenditure was lower thanthat for men. Significant predictors of higher expenditure wereown personal doctor, other specific doctor, perceived healthstatus, psychosomatic symptoms, chronic illness and difficultiesin functional ability. Those living alone had significantlyhigher expenditures. Conclusion: It emerged that, while a largenumber of elderly people had used services, only a small minorityhad accounted for the majority of expenditure. Although thepersonal doctor system may produce high quality of care, itcannot achieve cost savings.     

Suicide risk factors among the elderly

The author offers a brief overview of suicide risk factors among the elderly such as depression, all manner of abuse of the elderly, as well as medical, psychological and social risk factors, etc. By way of conclusion, a practical guide to evaluate suicide risk among the elderly is provided.     

Injury mortality among non-US residents in the United States 1979-1984

More than 20 million non-US residents visit the United States each year. Data on deaths in this country among these non-US residents were obtained from US vital records. These data showed that from 1979 through 1984, 17,988 deaths occurred. Cardiovascular disease (International Classification of Diseases [ICD-9] 390-459) was the leading cause of death among non-residents. Injuries (ICD-9 E800-E999) ranked second as a cause of death and accounted for 23% of the deaths (4078). More than half of these injury deaths occurred among people aged 15-34 years and 79% of the people who died from injuries were males. The most frequent causes of injury deaths were motor vehicle traffic crashes (37%), drownings (15%), and homicides (11%). Although general patterns of injury mortality among non-US residents and US residents were similar, there were differences in the proportion of deaths due to homicides, drownings, and falls. Prevention efforts targeted to the major causes of injury mortality in the US will affect both US and non-US residents.     

Coffee consumption and mortality in a 14-year follow-up of an elderly northern Finnish population

The present study assessed the relationship between coffee consumption and mortality in a home-dwelling elderly population. A population-based cohort of 817 men and women born in 1920 or earlier and living in northern Finland provided complete data on daily coffee consumption and other variables at the baseline examination in 1991-1992. Deaths were monitored through to the end of 2005 by national death certificates, resulting in 6960 person-years of follow-up. Hazard rate ratios for mortality by daily coffee intake were estimated by Poisson regression models adjusted for some known predictors of mortality. During 14.5 years of follow-up, 623 deaths occurred. The total mortality rate was inversely related to the number of cups (average volume, 125 ml) of coffee consumed daily. After adjustment for age, sub-period of follow-up, sex, marital status, basic educational level, previous occupational group, current smoking, BMI, history of myocardial infarction, self-rated health and presence of diabetes, cognitive impairment or physical disability, the estimated relative risk reduction of total mortality per an increment of one more cup of coffee per d reported at baseline was 4 (95% CI 0, 8) %. The observed associations between coffee consumption and mortality from CVD, cancer, and other or unknown causes, respectively, were qualitatively similar to that of total mortality but the estimates were less precise. The effect of coffee consumption at baseline appeared to attenuate after 10 years since the start of follow-up. The present study provides evidence for daily (caffeine-containing) coffee intake being inversely associated with mortality in the elderly.     

Plasma lutein and zeaxanthin and the risk of age-related nuclear cataract among the elderly Finnish population

Oxidative stress plays an important role in cataractogenesis. Previous studies have shown that long-term dietary intake of antioxidants (lutein and zeaxanthin) may decrease the risk of age-related cataracts. The aim of the present study was to examine whether plasma concentrations of lutein and zeaxanthin are related to age-related nuclear cataract in the elderly population. Subjects were participants in the Kuopio Ischaemic Heart Disease Risk Factor Study and they were classified into tertiles according to plasma concentrations of lutein and zeaxanthin. The association of plasma lutein and zeaxanthin concentrations with age-related nuclear cataract in 1689 elderly subjects (aged 61-80 years) was investigated in the present cross-sectional study by using the Cox proportional hazards model. A total of 113 cases of incident age-related cataracts were confirmed, of which 108 cases were nuclear cataracts. After adjustment for age, examination year, sex, BMI, smoking, alcohol consumption, serum LDL-cholesterol, serum HDL-cholesterol, years of education, use of oral corticosteroids, history of diabetes and history of hypertension with current use of antihypertensive medication, subjects in the highest tertiles of plasma concentrations of lutein and zeaxanthin had 42 and 41 % lower risks of nuclear cataract, respectively, compared with those in the lowest tertiles (relative risk (RR) = 0·58, 95 % CI 0·35, 0·98; P = 0·041 for lutein and RR = 0·59, 95 % CI 0·35, 0·99; P = 0·046 for zeaxanthin). In conclusion, we suggest that high plasma concentrations of lutein and zeaxanthin were associated with a decreased risk of age-related nuclear cataract in the elderly population.     

Smoking cessation and mortality trends among 118,000 Californians, 1960-1997.

We assessed the impact of smoking cessation on subsequent death rates among a cohort of 51,343 men and 66,751 women in California enrolled in late 1959 in the original American Cancer Society (ACS) Cancer Prevention Study (CPS I) and followed for 38 years. We compared the age-adjusted death rate, expressed as deaths per 1,000 person-years, among all subjects who smoked cigarettes in 1959 but who had largely quit as of 1997 with the death rate among never smokers over a 38-year period. The all causes death rate for males decreased from 20.67 during 1960-1969 to 18.68 during 1960-1997 for smokers and decreased from 10.51 to 9.46 for never smokers. The lung cancer death rate for males increased from 1.558 to 1.728 for smokers and increased from 0.127 to 0.133 for never smokers. The all causes death rate for females increased from 9.54 to 10.14 for smokers and decreased from 6.95 to 6.44 for never smokers. The lung cancer death rate for females increased greatly from 0.208 to 0.806 for smokers and increased from 0.094 to 0.116 for never smokers. These results indicate there has been no important decline in either the absolute or relative death rates from all causes and lung cancer for cigarette smokers as a whole compared with never smokers in this large cohort, in spite of a substantial degree of smoking cessation. While cessation clearly reduces the mortality risk among long-term former smokers, the population impact of cessation appears to be less than currently believed.     

Suicide mortality among electricians in the Swedish construction industry

Methods: This is a cohort study. Electricians were identified through a computerised register of construction workers who had participated in health examinations in 1971–92. In this register, 33 719 male electricians were identified together with a reference group consisting of 72 653 male glass or woodworkers. Through a linkage with the Swedish Death Register, the cause of death was identified to the end of 1997. Mortality as a result of suicide was also compared with the general population with adjustments for sex, age, and period.

Results: The risk of mortality from suicide was decreased for electricians (standardised mortality ratio (SMR) 0.58, 95% confidence interval (95% CI) 0.47 to 0.71) and for the reference group of construction workers (SMR 0.81, 95% CI 0.72 to 0.91) compared with the general population.

Conclusion: Contrary to some other studies, risk of suicide was not increased among electricians in the construction industry.

     

Suicide,cancer, and other causes of death among california veterinarians, 1960-1992

Previous studies reporting on mortality patterns in veterinarians have been restricted to deaths among white male veterinarians. In an effort to examine the mortality of male and female veterinarians of all races, we conducted a standardized proportionate mortality ratio (SPMR) analysis of 450 California veterinarians who died between January 1960 and December 1992. In comparison to State of California general population statistics, white male veterinarians had significantly elevated mortality from malignant melanoma of the skin (SPMR 3.47, 95% CI 1.74. 6.94), cancer of the large intestine (SPMR 1.74, 95% CI 1.04, 2.09), rheumatic heart disease (SPMR 3.50, 95% CI 1.90, 6.43), and suicide (SPMR 2.50, 95% CI 1.84, 3.38). White female veterinarians had significantly elevated mortality from suicide (SPMR 5.89, 95% CI 3.02, 11.48). We also examined veterinary mortality for different lengths of time in the profession. Significantly elevated SPMRs were noted for suicide in veterinarians in the profession for less than 30 years; deaths due to malignant melanoma of the skin and rheumatic heart disease in veterinarians in the profession 20 years or more; and cancer of the large intestine in veterinarians in the profession 30 years or more. Because of significant findings in mortality from suicide among veterinarians of both sexes, it was recommended that future studies and efforts toward suicide prevention include both male and female veterinarians.     

Consumption of special diet among Finnish adolescents in 1979-2001: repeated national cross-sectional surveys

Summary. Objective: To study consumption of special diet (disease-related and non disease-related) among Finnish adolescents during 1979–2001.Methods: Self-administered questionnaires were mailed to nationally representative samples of 12- (except in 1979), 14-, 16-, and 18-year-olds in 1979, 1993, 1997, 1999 and 2001.Results: The total number of respondents was 33998. The response rate declined from 78% in 1979 to 70% in 2001. Consumption of special diet increased from 1979 to 2001: in 14- year-old girls from 4% to 24%, boys from 1% to 12%; 16-yearold girls from 5% to 29%, boys from 3% to 11%; and 18-year-old girls from 9% to 30%, boys from 3% to 16%. An increase was observed both in the consumption of disease-related diets (diabetic, lactose intolerance, allergies), and in non disease-related diets (weight reducing, sports and body-building, vegetarianism, other).Conclusions: Adherence to special diet is partly explained by an increased prevalence of certain diseases (lactose intolerance, allergies, diabetes). Increase in vegetarianisms and diets related to body weight or shape are most likely explained by fads, ideals created by media, and by growing ecological awareness.

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Zusammenfassung. Das Einhalten spezieller Diäten durch finnische Jugendliche: wiederholte nationale Querschnittserhebung, 1979–2001Fragestellung: Untersuchung der Einhaltung von Diäten durch finnische Jugendliche im Zeitraum von 1979–2001.Methoden: Schriftliche Befragung ausgewählter Stichproben von 12-, 14-, 16-, und 18-Jährigen in ganz Finnland in den Jahren 1979 (ohne 12-Jährige), 1993, 1997, 1999 und 2001.Ergebnisse: Insgesamt 33998 Jugendliche antworteten. Die Rücklaufquote sank von 78% im Jahr 1979 auf 70% im Jahr 2001. Der Anteil an Jugendlichen, die eine spezielle Diät einhalten, stieg zwischen 1979 und 2001 bei 14-jährigen Mädchen von 4% auf 24%, bei 14-jährigen Jungen von 1% auf 12%; bei 16-jährigen Mädchen und Jungen von 5% auf 29% resp. von 3% auf 11%; bei 18-jährigen Mädchen von 9% auf 30% und bei gleichaltrigen Jungen von 3% auf 16%. Sowohl die Einhaltung von krankheitsbedingten Diäten (Diabetes, Laktose-Intoleranz, Allergien) als auch von Diäten ohne Krankheitsbezug (Gewichtsabnahme, Sport und Bodybuilding, Vegetarismus o.ä.) ist häufiger geworden. Die beobachtete Zunahme könnte aufgrund einer geringfügigen Modifikation der Fragestellung im Jahr 1999 etwas grösser als in Realität ausfallen.Schlussfolgerungen: Die wachsende Bedeutung von Diäten im Jugendalter lässt sich zum Teil durch eine steigende Prävalenz gewisser Krankheiten erklären (Laktose-Intoleranz, Diabetes). Der zunehmende Vegetarismus und das Einhalten von Diäten zur Kontrolle von Körpergewicht oder -form dürften vor allem durch Modeerscheinungen, von Medien geschaffene Ideale und ein wachsendes ökologisches Bewusstsein zu erklären sein.

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Résumée. Suivi d’un régime spécifique parmi les adolescents finlandais: enquêtes nationales répétées (1979–2001)Objectifs: Etudier le suivi de régimes spécifiques par les adolescents finnois entre 1979 et 2001.Méthodes: Des questionnaires auto-administrés ont été envoyés à des échantillons nationaux représentatifs d’adolescents de 12, 14, et 18 ans en 1979, 1993, 1997, 1999, 2001 (12 ans pas inclus en 1979).Résultats: 33998 réponses ont été reçues. Le taux de réponse est passé de 78% en 1979 à 70% en 2001. Le suivi d’un régime spécifique a augmenté entre 1979 et 2001: chez les adolescentes de 14 ans de 4 à 24%, chez les garçons de 1 à 12%; chez les adolescentes de 16 ans de 5 à 29%, chez les garçons de 3 à 11%; chez les adolescentes de 18 ans de 9 à 30%, chez les garçons de 3 à 16%. Cette augmentation a été observée aussi bien pour les régimes en lien avec une maladie (diabète, intolérance au lactose, allergie) que pour d’autres régimes (régime amaigrissant, en lien avec la pratique d’un sport ou de body-building, régime végétarien, etc.)Conclusions: Le fait de suivre un régime spécifique s’explique partiellement par une prévalence augmentée de certaines maladies (intolérance au lactose, allergies, diabète). L’augmentation de la pratique d’un régime végétarien et de régimes en lien avec le poids corporel est très probablement à mettre en lien avec la mode, les idéaux relayés par les médias et par une conscience écologique de plus en plus répandue.

     

Suicide mortality and pesticide use among Canadian farmers

Background An exploratory, case-control study was used to investigate a new hypothesis about suicide among farm operators. This hypothesis suggested a biologically plausible link between exposures to certain pesticides and the occurrence of suicide among farm operators. These analyses were based on data from the Canadian Farm Operator Cohort. Methods Canadian male farm operators who committed suicide between 1971–1987 (n = 1,457) were compared with a frequency matched (by age and province) sample of control farm operators (n = 11,656) who were alive at the time of death of individual cases. Comparisons focused on past exposures to pesticides reported to the 1971 Canada Census of Agriculture. Results Multivariate logistic regression analyses indicated no associations between suicide and (1) acres sprayed with herbicides, (2) acres sprayed with insecticides, and (3) the costs of agricultural chemicals purchased; after controlling for important covariates. There was, however, a suggestive increase in risk for suicide associated with herbicide and insecticide spraying among a subgroup of farm operators who were most likely to be directly exposed to pesticides: OR = 1.71 (95% CI = 1.08–2.71) for 1–48 vs. 0 acres sprayed. Additional risk factors that were identified included seasonal vs. year-round farm work (OR = 1.68; 95% CI = 1.15–2.46); and high levels of paid labor on the farm (e.g., OR = 1.61; 95% CI = 1.24–2.10, for >13 vs. 0 weeks per year). Factors that were protective included marriage (odds ratio (OR) = 0.69; 95% confidence interval (CI) = 0.58–0.81), having more than one person resident in the farm house (e.g., two vs. one person; OR = 0.62; 95% CI = 0.42–0.92); and higher levels of education (e.g., postsecondary vs. primary; OR = 0.40; 95% CI = 0.17–0.96). Conclusions This study does not provide strong support for the main hypothesis under study, that exposure to pesticides is an important risk factor for suicide among farmers. Although secondary to the main hypothesis, a number of other risk factors for suicide were suggested. These have implications for the future study and targeting of suicide prevention programs in rural Canada. Am. J. Ind. Med. 34:364–372, 1998. © 1998 Wiley-Liss, Inc.     

Disability, psychosocial factors and mortality among the elderly in a rural French population

The purpose of this work is to identify risk markers of mortality in a cohort of 645 people aged 60 and over. The study was carried out in rural areas in south west France. Data were collected by questionnaire in 1982. Mortality was determined 4 years later; 111 deaths were registered. The analysis of age-adjusted odds ratios (OR) showed strong relationships between mortality and disability (OR = 7.75), compared health (OR = 3.94), self-rated health (OR = 2.47), home comfort (OR = 0.52), physical activity (OR = 0.32), sociability (OR = 0.43) and two subjective well-being items: the feeling of uselessness (OR = 3.51), and the lack of projects for the future (OR = 2.35). By contrast, no significant association was observed with reported morbidity and social support. Two multivariate analyses were performed: the first on longevity using Cox's regression model, the second on mortality using a linear discriminant analysis. The results of these analyses were translated into a simple set of 8 independent risk markers for the identification of a "high risk group" of mortality within 4 years. The sensitivity of this mortality risk indicator was 73% and its specificity 77%.     

Alaska native mortality, 1979-1998

OBJECTIVES: This study compares mortality patterns for the Alaska Native population and the U.S. white population for 1989-1998 and examines trends for the 20-year period 1979-1998. METHODS: The authors used death certificate data and Indian Health Service population estimates to calculate mortality rates for the Alaska Native population, age-adjusted to the U.S. 1940 standard million. Data on population and mortality for U.S. whites, aggregated by 10-year age groups and by gender, were obtained from the National Center for Health Statistics, and U.S. white mortality rates were age-adjusted to the U.S. 1940 standard million. RESULTS: Overall, 1989-1998 Alaska Native mortality rates were 60% higher than those for the U.S. white population for the same period. There were significant disparities for eight of 10 leading causes of death, particularly unintentional injury, suicide, and homicide/legal intervention. Although declines in injury rates can be documented for the period 1979-1998, large disparities still exist. Alaska Native death rates for cancer, cerebrovascular disease, chronic obstructive pulmonary disease, and diabetes increased from 1979 to 1998. Given decreases in some cause-specific mortality rates in the U.S. white population, increased rates among Alaska Natives have resulted in new disparities. CONCLUSIONS: These data indicate that improvements in injury mortality rates are offset by marked increases in chronic disease deaths.