Abstract:
BACKGROUND:It is generally acknowledged that conventional estimates of the potential number of life years to be gained by elimination of causes of death are too generous. This is because these estimates fail to take into account the fact that those who are saved from the cause are likely to have one or more other conditions ("competing" causes of death), which may increase their risks of dying. It is unknown to what extent this introduces bias in comparisons of life years to be gained between underlying causes of death. The purpose of the study was to assess this bias. DATA AND METHODS:A sample of 5975 death certificates from the Netherlands, 1990, was coded for the presence of diseases that, according to a set of explicit rules, could be regarded as potential causes of death "competing" with the underlying cause. Logistic regression analysis was used to quantify age and sex adjusted differences between four main underlying causes of death (neoplasms, cardiovascular diseases, respiratory diseases, all other diseases) in prevalence of the six most frequent competing causes of death (neoplasms, ischaemic heart disease, cerebrovascular disease, other cardiovascular diseases, chronic obstructive lung disease, all other diseases). These prevalence differences were then used to revise conventional calculations of gains in life expectancy, by taking them to indicate differences in risk of dying from these competing causes after the underlying cause has been eliminated. RESULTS:The prevalence of competing causes of death is relatively low among persons dying from neoplasms as the underlying cause, about average among persons dying from cardiovascular diseases, and relatively high among persons dying from respiratory diseases. Taking this into account results in substantial decreases of potential life years to be gained by elimination of cardiovascular diseases and respiratory diseases, relative to the number of years to be gained by elimination of neoplasms. Specifically, while according to the conventional calculations the gain in life expectancy by elimination of cardiovascular diseases exceeds that for neoplasms by more than one year, in the revised calculations the number of life years to be gained is approximately equal. CONCLUSIONS:Despite its limitations, mainly relating to reliance on death certificate data, this study suggests that conventional estimates of differences between underlying causes of death in life years to be gained by elimination are seriously biased by ignoring the effects of competing causes. Specifically, the relative impacts of eliminating cardiovascular diseases and respiratory diseases, as compared with eliminating neoplasms, seem to be overestimated. The implications are discussed.
journal_name
J Epidemiol Community Healthjournal_title
Journal of epidemiology and community healthauthors
Mackenbach JP,Kunst AE,Lautenbach H,Oei YB,Bijlsma Fdoi
10.1136/jech.53.1.32keywords:
subject
Has Abstractpub_date
1999-01-01 00:00:00pages
32-7issue
1eissn
0143-005Xissn
1470-2738journal_volume
53pub_type
杂志文章abstract:STUDY OBJECTIVES:The main aim of the study was to discover if a midwife home visiting programme has a significant effect on the prevalence of health problems and breast feeding behaviour of mothers who delivered normally and their healthy fullterm newborn babies, during a period of 42 days after delivery. Another aim w...
journal_title:Journal of epidemiology and community health
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/jech.52.6.385
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:Two competing hypotheses, cumulative advantage/disadvantage and age-as-leveller, have been proposed to explain the contradictory findings on socioeconomic differences in health over the lifespan. To test these hypotheses, this investigation examined the influence of educational attainment and material condit...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2015-206548
更新日期:2016-11-01 00:00:00
abstract::Uncertainty analysis is a method, established in engineering and policy analysis but relatively new to epidemiology, for the quantitative assessment of biases in the results of epidemiological studies. Each uncertainty analysis is situation specific, but usually involves four main steps: (1) specify the target paramet...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech.2006.053660
更新日期:2007-07-01 00:00:00
abstract::A commonly used estimate of a screening test's sensitivity, based on the prevalence at screening and the incidence of interval cancers, is shown to be logically unsound and quantitatively poor. An alternative simple estimate is proposed, based only on incidence rates. ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.39.4.364
更新日期:1985-12-01 00:00:00
abstract:BACKGROUND:Previous research suggests that first-generation immigrants have a lower suicide risk than those both born in Sweden and with both parents born in Sweden (natives), while the suicide risk in the second generation seems higher. The aim of this study was to investigate to what extent suicide risk in first-gene...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2014-204648
更新日期:2015-05-01 00:00:00
abstract::A study was carried out to assess the feasibility of using record linkage for drug monitoring. For two years, three types of records were collected for a total of 43 117 people: (1) details of basic attributes, such as sex and age; (2) details of prescriptions dispensed; and (3) records of hospital admissions, obstetr...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.35.1.25
更新日期:1981-03-01 00:00:00
abstract:BACKGROUND:Light to moderate alcohol intake lowers the risk of cardiovascular mortality, but whether this protective effect can be attributed to a specific type of beverage remains unclear. Moreover, little is known about the effects of long-term alcohol intake on life expectancy. METHODS:The impact of long-term alcoh...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2008.082198
更新日期:2009-07-01 00:00:00
abstract:BACKGROUND:Underserved women (rural, minority or poor) are disproportionally diagnosed with late-stage cervical cancer, indicative of inadequate access to, and use of, preventative healthcare. The Institute of Medicine (IOM) has proposed that nurse practitioners (NP) can address provider shortages among underserved pop...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech-2018-210709
更新日期:2019-03-01 00:00:00
abstract:OBJECTIVE:To raise compliance in a general practice based colorectal cancer screening programme by the use of a simple health educational leaflet. DESIGN:A randomised controlled trial of the leaflet's effect on completion of faecal occult blood tests. The leaflet explained the high frequency of colorectal cancer, the ...
journal_title:Journal of epidemiology and community health
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/jech.51.2.187
更新日期:1997-04-01 00:00:00
abstract::Base line data together with data in public registers and a structured phone interview of 94 of the 121 non-attenders was used for an assessment of factors influencing participation in the prospective population study 'Men born in 1914' in Malmö, Sweden. The overall attendance rate was 80.5% but varied among areas in ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.40.2.174
更新日期:1986-06-01 00:00:00
abstract:BACKGROUND AND AIMS:Many economic factors are associated with diet, yet the evidence is generally cross-sectional. Older people are considered especially vulnerable to poor diets from negative changes to varied economic factors. This review extends current knowledge on known correlates to decipher actual economic deter...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech-2013-202513
更新日期:2013-09-01 00:00:00
abstract:STUDY OBJECTIVE:To assess the potential for substituting alternative forms of care for admission to an acute hospital in particular groups of patients. DESIGN:A screening tool, the intensity-severity-discharge review system with adult criteria (ISD-A), developed for hospital utilisation review in the USA, was used in ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.49.2.194
更新日期:1995-04-01 00:00:00
abstract::Numerous commentaries plea for the use of methods that take into account complexity when evaluating health programmes. These commentaries provide compelling arguments on why evaluations of health programmes should not rely exclusively on methods that were designed for making universal claims about whether and to what ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2020-214027
更新日期:2021-01-01 00:00:00
abstract::Average paternal age in the UK is increasing. The public health implications of this trend have not been widely anticipated or debated. This commentary aims to contribute to such a debate. Accumulated chromosomal aberrations and mutations occurring during the maturation of male germ cells are thought to be responsible...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2005.045179
更新日期:2006-10-01 00:00:00
abstract:INTRODUCTION:Lifestyle factors in combination have been hypothesised to be associated with the prevention of type 2 diabetes (T2D) and mortality among individuals with T2D. The aim was to conduct a systematic review and meta-analysis to quantify the association between lifestyle indices and incident T2D as well as mort...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,meta分析
doi:10.1136/jech-2019-213415
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Incarceration is simultaneously a public health opportunity and a public health concern. We examined the association between maternal/partner incarceration in the year prior to birth and perinatal smoking. METHODS:We pooled 2006-2010 data from the Centers for Disease Control and Prevention's Pregnancy Risk ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2014-204820
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:The Great East Japan Earthquake and subsequent tsunami and nuclear disaster on 11 March 2011 had a short-term influence on the increase in emergency department visits and hospital admissions due to various diseases. However, it remains unclear whether the earthquake and tsunami disaster affected the long-ter...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2016-207413
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:There are concerns that COVID-19 mitigation measures, including the 'lockdown', may have unintended health consequences. We examined trends in mental health and health behaviours in the UK before and during the initial phase of the COVID-19 lockdown and differences across population subgroups. METHODS:Repea...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2020-215060
更新日期:2020-09-25 00:00:00
abstract:STUDY OBJECTIVE:There is little information on the potential benefit of immunising all patients with chronic lung disease in the community against influenza. The clinical effectiveness and economic benefit was established of the influenza vaccination programme in a general practice based cohort of adult patients with c...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.52.2.120
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:The effects of six income types (household post-government income, Organisation for Economic Cooperation and Development-weighted household post-government income, individual net income, corrected monthly household income and household net income from wages) on subjective health were compared in order to exa...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2009.103390
更新日期:2011-06-01 00:00:00
abstract:STUDY OBJECTIVE:To determine whether methadone maintenance treatment (MMT) is effective in reducing the levels of HIV risk-taking behaviour (borrowing and lending of injection equipment, irregular condom use) among injecting drug users (IDUs), and to identify independent predictors of the borrowing of used syringes. D...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.50.5.534
更新日期:1996-10-01 00:00:00
abstract:STUDY OBJECTIVE:To examine the completion rate, internal reliability, and external validity of a home affluence scale based on adolescents' reports of material circumstances in the home as a measure of family socioeconomic status. DESIGN:Cross sectional survey. SETTING:Data were collected from a school based study in...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究
doi:10.1136/jech.56.8.595
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Housing is an important environmental influence on population health, and there is growing evidence of health effects from indoor environment characteristics such as low indoor temperatures. However, there is relatively little research, and thus little firm guidance, on the cost-effectiveness of public polic...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,随机对照试验
doi:10.1136/jech.2007.070037
更新日期:2009-04-01 00:00:00
abstract:STUDY OBJECTIVE:To investigate and evaluate published data on cost effectiveness of cholesterol lowering interventions, and how this information could be interpreted in a rational approach of cholesterol management in general practice. DESIGN:A systematic review of the literature. SETTING:No restriction on setting. ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,评审
doi:10.1136/jech.52.9.586
更新日期:1998-09-01 00:00:00
abstract::The epidemiology of migraine and non-migrainous headaches (NMH) was investigated in a community survey in a neighbourhood of western Jerusalem in 1969-71. Diagnoses were based on histories taken by physicians. Prevalence rates among persons aged 15 and over were 10.1% for migraine (including classical migraine, 2.1%) ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.34.3.188
更新日期:1980-09-01 00:00:00
abstract::Growing concern about the global burden of child mental health disorders has generated an increased interest in population-level efforts to improve child mental health. This in turn has led to a shift in emphasis away from treatment of established disorders and towards prevention and promotion. Prevention efforts are ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2013-203712
更新日期:2014-10-01 00:00:00
abstract::A retrospective questionnaire and interview study of 10 year survivors of uncomplicated myocardial infarction examined smoking, diet, exercise, weight, medication, and treatment since discharge from hospital in 1973-4 and made comparisons with controls (using the same questionnaire) and with normal populations (as rep...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.40.2.103
更新日期:1986-06-01 00:00:00
abstract:BACKGROUND:Socioeconomic factors may influence changes in hip fracture (HF) incidence over time. We analysed HF temporal trends during the Bone and Joint Decade in Portugal (BJD-Portugal), 2000-2010, by regional socioeconomic status (SES), sex and age. METHODS:We selected registers of patients aged 50+ years with HF (...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2015-206508
更新日期:2016-08-01 00:00:00
abstract::Many cancers and other chronic diseases are associated with a long delay between exposure to a putative risk factor and subsequent diagnosis. This presents well recognised problems in the elucidation of suspected risk factors by epidemiological methods. In this paper we discuss the interpretation in epidemiological st...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.40.4.289
更新日期:1986-12-01 00:00:00
abstract:BACKGROUND:Evidence of racial/ethnic inequalities in tobacco outlet density is limited by: (1) reliance on studies from single counties or states, (2) limited attention to spatial dependence, and (3) an unclear theory-based relationship between neighbourhood composition and tobacco outlet density. METHODS:In 97 counti...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2016-208475
更新日期:2017-05-01 00:00:00