What are the long-term health effects of earthquakes? Meta-analysis results and implications for epidemiological practice

Alba Ripoll Gallardo, Barbara Pacelli and Elias Allara

authors

Population growth and urbanisation of seismic areas are leading to a constant increase in the health-related and economic toll of earthquakes. In 2014 alone, 324 natural disasters were reported worldwide, resulting in 141 million casualties and nearly $100 billion in damage. Geophysical disasters, including earthquakes, accounted for about 10% of these events.

Although the impact of earthquakes in the response phase – that is, immediately or shortly after the main seismic event – has been well studied, we have little knowledge of the effects of earthquakes in the medium and long term. This uncertainty may cause inefficient planning of post-earthquake epidemiological surveillance, resulting in potential underestimation of public health needs.

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Lower risk of cerebral palsy in the child if the parents have higher education

Ingeborg Forthun

Ingeborg Forthun

Cerebral palsy is the most common physical disability among children, with about two per 1000 live-born infants being diagnosed with the disorder. In most children with cerebral palsy, the disability is caused by damage to the immature brain during pregnancy or birth that results in problems with movement.

Denmark and Norway have low income inequality and free access to education and offer high-quality antenatal care to pregnant women free of charge. Nevertheless, in our study recently published in the International Journal of Epidemiology, we found that the risk of having a child with cerebral palsy in these two countries varies by the parents’ educational level, and this educational gradient has been surprisingly stable over time.

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Does correcting for bias caused by unequal survival in the treatment arms of a randomised controlled trial matter?

Anwar T Merchant and Bryn E Davis

Merchant Davis

The Obstetrics and Periodontal Therapy (OPT) Study was an NIH-funded randomised controlled trial designed to evaluate whether periodontal treatment in pregnant women had any effect on preterm birth; its findings were published in 2006. The investigators randomly assigned about 800 women who had been pregnant for less than 16 weeks, and had periodontal disease, to one of two groups. One group received periodontal treatment during pregnancy, whereas the other group received treatment after pregnancy.

Although the study found that treatment controlled periodontal infection and reduced the microorganism load, there was no difference in preterm birth rates between the two groups. The investigators concluded that treating periodontal disease during pregnancy did not affect the risk of preterm birth. However, they also found that there were more stillbirths in the group that received treatment after pregnancy, suggesting that periodontal treatment may improve survival of fetuses. The potential bias resulting from the intervention affecting both the outcome (in this case, preterm birth) and survival (in this case, stillbirth) was acknowledged as a limitation.

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Junk food in childhood contributes to socioeconomic inequalities in overweight and obesity

Alexandra_Chung_imageAlexandra Chung

Childhood overweight and obesity are a global public health problem. In high-income countries, obesity follows socioeconomic patterns, in that people with a lower socioeconomic position are more likely to be overweight or obese than those with a higher socioeconomic position. Poor diet is a key risk factor for excess weight gain. It is also a risk factor that we can do something about.

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Can we promote physical activity at the population level?

Findings from a community-based 5-year cluster randomised trial

Masamitsu Kamada, I-Min Lee and Ichiro Kawachi

Kamada authors

Despite the well-known health benefits of physical activity, physical inactivity remains highly prevalent globally. Effective population strategies to promote physical activity are needed to reduce the global burden of non-communicable diseases stemming from physical inactivity. But the question is: how do we effectively promote physical activity at the population level, such as in entire communities?

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What has contributed to the reduction in mortality rate for children aged under 5 in sub-Saharan Africa?

Yoko Akachi, Maria Steenland and Günther Fink

Akachi authors

Reducing child mortality remains one of the key objectives of the Sustainable Development Goals. Remarkable progress has been made over the past 25 years, with the global number of deaths of children aged under 5 falling from 13 million in 1990 to six million in 2015. Yet little is known about the relative contributions of specific public health interventions and general improvements in socioeconomic status and educational attainment over the same period.

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Punishing the poor, killing the poor: punitive political responses to economic decline deepen health inequalities in the United States

Elias Nosrati, Michael Ash, Michael Marmot, Martin McKee and Lawrence P King

Nosrati authors

Health inequalities are on the rise in the United States: the gap in life expectancy between those at the top and the bottom of the income spectrum has increased rapidly since the dawn of the century, to the point where the lives of the poor are cut short by up to a decade and a half compared with those of the wealthy. Moreover, while the rich tend to live longer everywhere, life expectancy among the poor varies significantly by geographical region.

In our article recently published in the IJE, we show that these patterns of health are the product of powerful political and economic forces. Over the past few decades, neoliberal politics, the decline of unions and economic globalisation have resulted in rapid industrial restructuring and economic dislocation in the US. Organised labour has been eroded in the industrial heartland, and manufacturing operations have been shifted to the non-unionised south and to foreign countries.

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Asthma and type 1 diabetes in childhood: new insights into their association

Johanna Metsälä, Jaakko Nevalainen and Suvi M Virtanen

Metsaela_authors

Traditionally, asthma and type 1 diabetes have been considered distinct immune-mediated diseases in which the underlying immune responses counteract each other, resulting in an inverse association between the diseases. In our study, recently published in the IJE, we explored the association between asthma and type 1 diabetes in childhood in a novel way, and observed that the direction of the association is dependent on the order of appearance of the diseases.

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Having more frequent social contact is associated with better cognitive performance

Andrew Sommerlad and Marko Elovainio

Sommerlad Elovainio

Dementia is the most feared aspect of ageing and is a major global health challenge, so identifying lifestyle factors that can reduce memory decline, and possibly prevent dementia from occurring, is a research priority. In our study, recently published in the IJE, we explored whether having more frequent contact with friends and family, or being married, is linked to better memory and language in older age.

We found that having more social contact and being married in mid-life were both linked to having better cognitive performance over the next 20 years. In particular, we found that verbal fluency was the cognitive area with the strongest link to social contact.

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Deaths of despair? Recent trends present a more complicated picture of mortality among White Americans

Daniel H Simon, Andrea M Tilstra and Ryan K Masters

Simon authors

Rising mortality among young and middle-aged White Americans has alarmed researchers, public health professionals and the broader public. These concerns were amplified by a 2015 study in which the authors attributed rising mortality rates among White Americans to increases in deaths from chronic liver disease, suicide and drug overdoses. The authors argued that increased mortality from these causes of death is likely a result of the “same underlying epidemic” that is affecting a “lost generation” of Americans. The underlying epidemic was said to be “deaths of despair”, originating from rising distress, economic insecurity and chronic pain.

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