Author: ijeeditorial

Lexis Cubes 2 – Case-study: Log mortality for males in Finland, 1878 to 2012

Jon Minton16 - 138 Jon Minton

In my earlier blog post, I introduced the concept first of thinking about demographic data like spatial data, and like spatial data producing ‘maps’ of the data’s demographic topography; and secondly, of reifying and rendering these statistical surfaces as three dimensional objects, either using computer generated imagery or 3D printers. This blog post will describe just one of these surfaces, a ‘statistical sculpture’ showing how the logarithm of mortality risk has changed for males in Finland from 1878 to 2012. Continue reading “Lexis Cubes 2 – Case-study: Log mortality for males in Finland, 1878 to 2012” →

Lexis cubes 1: From maps of space to maps of time

Jon Minton16 - 138 Jon Minton

Introduction
A Lexis surface is a Cartesian mapping of three attributes to three dimensions:

  • year (or another measure of absolute time) to the x axis,
  • age (or another measure of relative time) to the y axis,
  • a third variable, which co-varies with year and age, to the z axis.

Put another way: a Lexis surface is a way of visualising temporal change as if it were spatial change, of thinking about time as if it were space: of absolute time as if it were latitude, relative time as if it were longitude, and a third variable as if it were a height above sea level. Continue reading “Lexis cubes 1: From maps of space to maps of time” →

Increased risk of heart attacks – An unmeasured cost of the war on drugs in Mexico

Eileen Lee and Tim Bruckner

Bruckner PicLee Pic 3_croppedSince the start of the Mexican Drug War in December 2006, over 100,000 people have been murdered and over 20,000 are still missing. The escalation of violence has led to questions regarding the legitimacy and ability of political institutions, including law enforcement, to protect the public. A yet unmeasured cost of the drug war, related to living in an insecure environment, is the increased risk of dying from a heart attack.

We recently found that heart attack deaths among the elderly rose in months when Mexico’s homicide rate also rose. Our study adds to the growing literature on the collateral consequences of violence among persons who do not directly know the perpetrators or the victims. We believe that a threat, or perceived threat, to security from Mexico’s rising homicides, and the attendant media coverage, may have induced a stress response that triggered an excess of heart attacks. Given the high homicide rate in Mexico, the country provided a reasonable setting for us to test how population health responds to threats to security. Continue reading “Increased risk of heart attacks – An unmeasured cost of the war on drugs in Mexico” →

Did extending compulsory education in the 1950s improve cognitive and emotional outcomes?

Anton LagerLager_Anton_DSC_0051_SIR.jpg

Extending compulsory education from 8 to 9 years had a postive effect on intelligence in our large study of boys exposed to a school reform in Sweden in the 1950s. Extending education benefited sons of farmers and workers most, reducing socioeconomic differences in intelligence. In contrast, the reform seems to have led to reduced emotional control, suggesting that for this outcome alternative activities (e.g. working or attending the old lower secondary school) was better. Continue reading “Did extending compulsory education in the 1950s improve cognitive and emotional outcomes?” →

Are We There Yet? Assessing the Burden of Travel on Maternal Health Care Utilization and Child Mortality in Developing Countries

Mahesh Karra, Günther Fink, David Canning

David Canning Guenther FinkMahesh Karra

 

The problem
Over the past two decades, low- and middle-income countries (LMICs) have made considerable progress towards reducing child mortality. In spite of these achievements, almost six million children under the age of five are estimated to have died in 2015. Many of these deaths could likely be avoided if high quality antenatal care and delivery at health facilities were available to mothers and their children. Yet access to high quality health services remains low in many settings.

Distance to health care facilities has been identified as one of the main potential barriers to health service access. However, while there is strong evidence that long distances to facilities lead to lower utilization of health services, the evidence is less clear about whether long distances to facilities are linked to poor health outcomes. Continue reading “Are We There Yet? Assessing the Burden of Travel on Maternal Health Care Utilization and Child Mortality in Developing Countries” →

Waterpipe smoking might be just as harmful as smoking cigarettes

Reem Waziry and Elie Akl

Elie_Akl[1] Reem Waziry headshotWaterpipe, also known as shisha, goza, narghile, arghile and hookah, is a traditional method for smoking tobacco. While it originated in Turkey, India and Iran, its use has spread on a global level over the past decade to the point of being labelled a global epidemic.

There are a number of explanations for the global spread of waterpipe tobacco smoking. First, people use it as a way to socialize, as it is smoked in groups. Second, the production of sweetened and flavoured tobacco (Maassel), resulting in aromatic and smooth smoke, can make it more appealing than cigarette smoking. Another major reason is a common misconception that waterpipe tobacco smoking is not harmful, or is less harmful than smoking cigarettes. Continue reading “Waterpipe smoking might be just as harmful as smoking cigarettes” →

Parkinson’s disease and cancer risk: is there a relationship?

Freedman_Michal_2015_ORIG_160x140WEBD. Michal Freedman

Some previous epidemiologic studies have suggested that having Parkinson’s disease decreases your risk of developing cancer, and vice versa. If true, this finding could provide insight into underlying biologic mechanisms for the two diseases.

How we set out to answer the question
In a study published in the International Journal of Epidemiology we used data from Medicare, a U.S. federal health insurance programme for those aged ≥65 years, linked to U.S. cancer registry data to examine the relationship between Parkinson’s disease and cancer. Because we used Medicare data, we were limited to people aged 65 years and older. However, as the Medicare database is very large, we were able to examine relationships in whites and non-whites, in men and women, and in different age groups (all above 65 years).

We hypothesized that previous studies may have found a lower risk of cancer after Parkinson’s disease because cancer screening or medical work-ups were less frequent in people with a debilitating condition such as Parkinson’s than in people without such a condition. Continue reading “Parkinson’s disease and cancer risk: is there a relationship?” →

Genome-wide association study gives rise to a new breed of disease network

 

Daniel HimmelsteinDaniel Himmelstein

A puzzling similarity
Researchers have long noted puzzling similarities between Hodgkin lymphoma and multiple sclerosis. Although the first is a cancer and the second is an autoimmune disease, risk for both diseases appears to increase due to the Epstein–Barr virus and a lack of sunlight. In fact having a family member with multiple sclerosis may place you at increased risk for Hodgkin lymphoma and vice versa. Now, a recent study, on which I am a co-author, has identified genetic similarities. Continue reading “Genome-wide association study gives rise to a new breed of disease network” →

Lessons from the recent trial of a pay-for-performance programme in Afghanistan

Elina Dale, Anubhav Agarwal, Cyrus Engineer
Dale et al

Significant resources in global health are spent on pay-for-performance (P4P), also known under a more general term as results-based financing (RBF). Originating in the UK and USA, P4P has now become – to borrow a phrase from Cheryl Cashin – the new “it-girl” in health financing. However, as recent experience from Afghanistan shows, implementation is not always easy and P4P interventions must be better designed if they are to achieve real population health gains.

From 2010 to 2012 a P4P programme in Afghanistan provided quarterly bonus payments to health-care providers for increases in the use of maternal and child health (MCH) services, adjusted by a quality of care score. Our study, a large-scale cluster randomized trial, demonstrates that the programme did not produce the intended results. There were no observable improvements in any of the five key MCH coverage indicators measuring contraceptive prevalence, skilled birth attendances, vaccinations, and antenatal and postnatal check-ups. No changes were observed in the equity of care. While the programme appeared to increase time spent with patients, resulting in more complete histories and physical examinations, and improved patient counselling, other measures of quality, such as availability of medicines and supplies, did not substantially change. Continue reading “Lessons from the recent trial of a pay-for-performance programme in Afghanistan” →

Economic recession, mental health and suicide

DGphoto 2014_0052David Gunnell

It’s over seven years since the onset of the 2008 Global Financial Crisis and we’re beginning to get a clear idea of its impact on mental health and suicide.

In keeping with previous economic recessions, the 2008 financial crisis was followed by rises in suicide deaths in many affected countries. As documented in an article published in the British Medical Journal in 2013, younger men appear to have been particularly badly affected.

Recently published research in the International Journal of Epidemiology has provided new insights into the impact of economic down turns on mental health. Using Ireland’s impressive National Registry of Deliberate Self-Harm and national suicide data, Paul Corcoran and colleagues found that there were increases in suicide and self-harm in men and women in Ireland in the years after recession began. The greatest rises were seen in men. There were an estimated 8,800 excess episodes of self-harm (mainly suicide attempts) and 560 suicide deaths in 2008-12 compared to pre-recession trends.  Continue reading “Economic recession, mental health and suicide” →