Abstract:
BACKGROUND:Many youth deaths occur in the first year of life, from prematurity and anomalies. Detailing mortality after age 1 year may differentially guide preventive strategies in children, adolescents and young adults. METHODS:A cohort study in Ontario, Canada comprised 3 139 698 children born from 1990 to 2016. Adjusted HR (aHR) for death between 1 and 24 years were generated, comparing demographic variables and parity. RESULTS:After a median of 13.7 years of follow-up, 6930 deaths occurred between ages 1 and 24 years (incidence rate 17.0 per 100 000 person-years), peaking at age 23 years (43.7 per 100 000). The aHR for death was higher among males than females (1.44, 95% CI 1.37 to 1.51), rural versus urban areas (1.48, 95% CI 1.39 to 1.58), lowest versus highest income areas (1.39, 95% CI 1.29 to 1.51) and at parity 1 (1.16, 95% CI 1.10 to 1.23), parity 2 (1.34, 95% CI 1.23 to 1.45), parity 3+ (1.96, 95% CI 1.74 to 2.21), each relative to a child without an older sibling. Among males, the proportion of deaths due to injury jumped from 30% before age 15 years to 65% thereafter, and in females, from 28% to 51%. Intentional self-harm/assault explained 11% of injury-related deaths among males before age 15 years, and 20% thereafter, with respective figures of 18% and 17% for females. Deaths outside of hospital increased with age, from 35% at age 1 year, to 66% at age 22 years. CONCLUSION:There is a heightened susceptibility of dying starting at age 15 years, especially among males, from injury, and arising outside of hospital.
journal_name
J Epidemiol Community Healthjournal_title
Journal of epidemiology and community healthauthors
Ray JG,Guttmann A,Silveira J,Park ALdoi
10.1136/jech-2019-213365subject
Has Abstractpub_date
2020-03-01 00:00:00pages
260-268issue
3eissn
0143-005Xissn
1470-2738pii
jech-2019-213365journal_volume
74pub_type
杂志文章abstract:BACKGROUNDS:The debate on health selection which describes the influence of health on subsequent social mobility is highly contested. The authors set out to examine the effect of health selection by looking at the effect of previous health status on changes in socio-economic position (SEP) over two time periods. METHO...
journal_title:Journal of epidemiology and community health
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journal_title:Journal of epidemiology and community health
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journal_title:Journal of epidemiology and community health
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章,多中心研究
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journal_title:Journal of epidemiology and community health
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journal_title:Journal of epidemiology and community health
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journal_title:Journal of epidemiology and community health
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