Month: September 2017

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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“Not-so-good-anymore” cholesterol linked to vision loss in the elderly

Joe Maranville, Qiao Fan, Tien Yin Wong, Ching–Yu Chen and Heiko Runz

Maranville authors

Only a few years ago, doctors would advise their patients that elevated blood levels of high-density lipoprotein cholesterol (HDL-C), then termed the “good cholesterol”, were beneficial and would protect them against coronary heart disease. This belief has been called into question, however, as neither genetics nor clinical trials could demonstrate that raising HDL-C levels would protect against cardiovascular disease. Our study, published recently in the IJE, casts further doubt on this “not-so-good-anymore” cholesterol by showing that genetic variants that cause higher HDL-C levels also increase the risk for age-related macular degeneration (AMD).

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Can women talking save lives? Reducing inequalities in newborn mortality in India, Nepal, Bangladesh and Malawi

Tanja AJ Houweling, David Osrin, Kishwar Azad, Dharma S Manandhar, Prasanta Tripathy, Tambosi Phiri, Joanna Morrison and Anthony Costello

In low- and middle-income countries, the odds of surviving the first 28 days of life are grossly unequal between infants born in deprived and better-off families, even among children living in the same community. In our study, recently published in the IJE, we have shown that women’s groups are able to address this problem. Under the guidance of a facilitator, women came together every month to discuss problems during pregnancy, delivery and the newborn period, and then designed and implemented strategies to overcome these problems with the help of the entire community.

Ekjut
Ekjut women’s group in rural India

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The relevance of a local cohort: the case for generalisability over representativeness

Eleonora Uphoff, Neil Small, Rosie McEachan and Kate Pickett

For some years, our research has been based in the city of Bradford in northern England. We are often asked to justify our research setting. There seems to be a concern that a cohort population that is not representative of the nation as a whole or of the ‘average person’ cannot produce valuable insights beyond its local setting.

While such concerns are not new, they now seem more present, perhaps due to the rise of Big Data or the increased sharing of and access to data from national surveys and cohorts. Do these reservations represent a push for representativeness and generalisability in epidemiology? If so, this might come at the expense of research aiming to paint a more detailed picture of population health.

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