Many people around the world are still using biomass as a fuel for cooking and heating. Inefficient combustion of solid fuels is the primary cause of indoor household air pollution, estimated to be responsible for 4.3 million premature deaths in 2012 (7.7% of total mortality).
The World Health Organization’s latest global air quality guidelines point out that indoor air pollution causes a health burden that mostly affects people in low- and middle-income countries. Many global development agencies are working with governments of developing countries to reduce household air pollution. For example, China’s Relocation Program in the poorest provinces is a significant part of China’s poverty eradication plans. This large-scale program relocates millions of residents in absolute poverty to places with better living conditions, including fuel type.
Smoking, alcohol misuse and behaviours that result in obesity (such as an unhealthy diet and insufficient physical activity) have strong negative effects on individual health. Because these health behaviours are very common among people in Europe, smoking, alcohol and obesity also largely influence mortality rates and life expectancy in Europe.
However, the impact of these three lifestyle factors on life expectancy is likely changing over time. Smoking, obesity and alcohol misuse, like true epidemics, tend to first become more common in a population, followed (eventually) by a decline in their prevalence and associated mortality.
Our study, published recently in the IJE, looks at the relationship between experience of violence, in the form of physical assault in the previous 12 months, and premature mortality in a sample of working-age Russian men living in Izhevsk in the Southern Urals.
In contrast, we found that population-based research on the physical health effects of exposure to violence was limited, and we decided to focus on possible associations between assault and mortality in our study.
Rheumatic Heart Disease (RHD) is caused by a bacterial (streptococcal) throat infection acquired in childhood. Although this type of infection is common and widespread, a small proportion of children so affected go on to develop an inflammatory condition that leads to scarring and narrowing of the heart valves and, in time, heart failure. Early on in the course of the disease the joints may be affected – hence the term “rheumatic”.
Still an important disease At one time Rheumatic Heart Disease was common throughout the UK, Europe and the US; it was the most important cause of heart disease among young adults in Victorian Britain and probably caused the death of Mozart. Although rare now in most developed countries, it remains an important public health problem in many low and middle income countries. The disease is widespread in the Middle East and Asia, and the the poor indigenous populations of some wealthy countries, for example among Australian Aboriginees and New Zealand Maoris. It is particularly prevalent in sub-Saharan Africa, where it is one of the commonest causes of heart disease, typically affecting children or young adults. There it carries a grim prognosis because of the lack of specialised treatment. Continue reading “Smoke exposure in early life and Rheumatic Heart Disease”→
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”→
This article originally appeared on the OUPblog on 31 October 2012: http://blog.oup.com/2012/10/parental-height-children-health/
What can the height of a person tell us about them and their children? Although determined to an extent by genes, the height of a fully grown man or woman can be considered as a ‘marker’ of the circumstances they experienced early in life. These childhood circumstances include illness, living conditions, diet, and maybe even stress. Such early life circumstances have been shown to be linked to health risks later in life. In fact, the height of an individual is also linked with their chance of developing chronic health conditions. Taller people are at lower risk of heart disease, for example.
But what about the height of their parents? One may wonder if that could have an effect? Evidence from studies of animals indicates that poor health which is caused by challenging circumstances during development early in life may be transmitted from generation to generation. Continue reading “Parents: does size matter?”→
This article originally appeared on the OUPblog on 19 September 2013: http://blog.oup.com/2013/09/demographic-landscape-bad-news/. It is reproduced here with updated figures and captions.
In the first part of this post, I showed how we used a classic mapping technique — contour plots — to explore the demographic landscape, examining the texture of the lives and deaths of billions of people from more than forty countries. Our maps showed how a third variable, mortality rates, varied against two others: age and time. Just as the coordinates of physical terrain are latitude and longitude, so the coordinates of mortality terrain are age and year, or age-time.
Previously, we saw how these contour maps highlighted the good news we found in demographic changes. Today we explore the bad news.
Period effects: The dinosaurs of the twentieth century
Our demography has been scarred by the two World Wars. In our maps these appear as two thin clusters of ovals, like onions that have been flattened then cut open. Topographically, these oval clusters show mortality risk jutting shard-like out of the lowlands of early adulthood like the kite-shaped plates of a stegosaurus. These are period effects, disruptions to the usual order. The bathtub-shaped age-specific mortality risks for the cohorts of men who had come of age by the onset of these wars had spikes in them. Women of the same age, though protected by patriarchal gender inequality from the front line, were still exposed to much of this additional risk, especially if they had the misfortune of having one’s home located in what turned into a battlefield. Continue reading “The demographic landscape, part II: The bad news”→
This article originally appeared on the OUPblog on 18 September 2013: http://blog.oup.com/2013/09/demographic-landscape-good-news/. It is reproduced here with some updated figures and captions.
If demography were a landscape, what would it look like? Every country has a different geographical shape and texture, visible at high relief, like an extra-terrestrial fingerprint. But what about the shape and texture revealed by the demographic records of the people who live and die on these tracts of land?
Maps show the fingerprints of the physical landscape on a human scale, letting us see the forests for the trees, the regions for the forests, and the countries for the regions. They are powerful visualisation techniques, knowledge tools for comprehending enormity.
This article originally appeared on the OUPblog on 14 April 2011: http://blog.oup.com/2011/04/life-expectancy/
Making a difference to the health of populations, however small, is what most people in public health hope they are doing. Epidemiologists are no exception. But often caught up in the minutiae of our day-to-day work, it is easy to lose sight of the bigger picture. Is health improving, mortality declining, are things moving in a positive direction? Getting out and taking in the view (metaphorically as well as literally) can have a salutary effect. It broadens our perspectives and challenges our assumptions. Looking at recent trends in European life expectancy is a case in point.
Since 1950 estimated life expectancy at birth of the world’s population has been increasing. Initially, this was accompanied by a convergence in mortality experience across the globe—with gains in all regions. However, in the final 15 years of the 20th century, convergence was replaced with divergence, in part due to declines in life expectancy in sub-Saharan Africa. However, this global divergence was also the result of declining life expectancy in Europe. Home to 1 in 10 of the world’s population, and mainly comprised of industrialized, high-income countries, Europe has over 50 states. These include Sweden and Iceland that have consistently been ranked among the countries with the highest life expectancies in the world. But while for the past 60 years all Western European countries have shown increases in life expectancy, the countries of Central and Eastern Europe (CEE), Russia and other parts of the former Soviet Union have had a very different, and altogether more negative experience. Continue reading “Trends in European life expectancy: a salutary view”→