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Start Over Author "Laura Dwyer-Lindgren" Topic 030212 general & internal medicine
23 results on '"Laura Dwyer-Lindgren"'

1. Mapping male circumcision for HIV prevention efforts in sub-Saharan Africa

Author

Krista M. Steuben, Michael A. Cork, Simon I. Hay, Lauren E. Schaeffer, Jonathan F. Mosser, Amber Sligar, John D. VanderHeide, Samantha Perkins, Damaris K. Kinyoki, Benjamin K. Mayala, Jessica Justman, Christopher J L Murray, Emily Haeuser, Peter Piot, Michael Collison, Frank Tanser, Benn Sartorius, Jeffrey W. Eaton, John N. Nkengasong, Laura Dwyer-Lindgren, Audrey L. Serfes, Mingyou Yang, Katherine F. Wilson, Aniruddha Deshpande, Lucas Earl, Njeri Wabiri, and Bill & Melinda Gates Foundation

Subjects
Male, Human immunodeficiency virus (HIV), Psychological intervention, lcsh:Medicine, HIV Infections, 030204 cardiovascular system & hematology, medicine.disease_cause, law.invention, 0302 clinical medicine, law, Prevalence, 030212 general & internal medicine, Geostatistics, 11 Medical and Health Sciences, biology, Spatial statistics, General Medicine, Middle Aged, Medical male circumcision, Voluntary medical male circumcision, Transmission (mechanics), Mapping, Male circumcision, Female, B990 Subjects Allied to Medicine not elsewhere classified, Research Article, Adult, Sub saharan, Adolescent, HIV prevention, Intervention, 03 medical and health sciences, Young Adult, Acquired immunodeficiency syndrome (AIDS), General & Internal Medicine, medicine, Humans, Disease burden, business.industry, lcsh:R, Geospatial, HIV, biology.organism_classification, medicine.disease, Tanzania, Circumcision, Male, Africa, business, Demography
Abstract

Background HIV remains the largest cause of disease burden among men and women of reproductive age in sub-Saharan Africa. Voluntary medical male circumcision (VMMC) reduces the risk of female-to-male transmission of HIV by 50–60%. The World Health Organization (WHO) and Joint United Nations Programme on HIV/AIDS (UNAIDS) identified 14 priority countries for VMMC campaigns and set a coverage goal of 80% for men ages 15–49. From 2008 to 2017, over 18 million VMMCs were reported in priority countries. Nonetheless, relatively little is known about local variation in male circumcision (MC) prevalence. Methods We analyzed geo-located MC prevalence data from 109 household surveys using a Bayesian geostatistical modeling framework to estimate adult MC prevalence and the number of circumcised and uncircumcised men aged 15–49 in 38 countries in sub-Saharan Africa at a 5 × 5-km resolution and among first administrative level (typically provinces or states) and second administrative level (typically districts or counties) units. Results We found striking within-country and between-country variation in MC prevalence; most (12 of 14) priority countries had more than a twofold difference between their first administrative level units with the highest and lowest estimated prevalence in 2017. Although estimated national MC prevalence increased in all priority countries with the onset of VMMC campaigns, seven priority countries contained both subnational areas where estimated MC prevalence increased and areas where estimated MC prevalence decreased after the initiation of VMMC campaigns. In 2017, only three priority countries (Ethiopia, Kenya, and Tanzania) were likely to have reached the MC coverage target of 80% at the national level, and no priority country was likely to have reached this goal in all subnational areas. Conclusions Despite MC prevalence increases in all priority countries since the onset of VMMC campaigns in 2008, MC prevalence remains below the 80% coverage target in most subnational areas and is highly variable. These mapped results provide an actionable tool for understanding local needs and informing VMMC interventions for maximum impact in the continued effort towards ending the HIV epidemic in sub-Saharan Africa.

Published
2020

2. Mapping HIV prevalence in sub-Saharan Africa between 2000 and 2017

Author

Roy Burstein, Austin Carter, Christopher J L Murray, Robert Reiner, Peter Piot, Jason B. Hall, Alex Opio, John D. VanderHeide, Benn Sartorius, Nathaniel J Henry, Michael A. Cork, Benjamin K. Mayala, Lauren E. Schaeffer, Molly R Nixon, Charbel El Bcheraoui, Krista M. Steuben, Laura Dwyer-Lindgren, Damaris K. Kinyoki, Tamer H. Farag, Lucas Earl, Laurie B. Marczak, Simon I. Hay, Jessica Justman, Jennifer M. Ross, Aniruddha Deshpande, Michael Collison, Kirsten E. Wiens, Jeffrey W. Eaton, Daniel C Casey, Amber Sligar, Nicole Davis Weaver, Dirk Douwes-Schultz, Tahvi Frank, Njeri Wabiri, Katherine F. Wilson, David L. Smith, Molly H Biehl, Aaron Osgood-Zimmerman, Frank Tanser, David M. Pigott, Naomi R. Provost, and National Institutes of Health

Subjects
0301 basic medicine, Male, Epidemiology, Psychological intervention, Geographic Mapping, HIV Infections, 0302 clinical medicine, ANTIRETROVIRAL THERAPY, Prevalence, 030212 general & internal medicine, Young adult, Multidisciplinary, Geography, virus diseases, Middle Aged, Hiv prevalence, Multidisciplinary Sciences, Science & Technology - Other Topics, HIV/AIDS, SEX, Female, TERRITORIES, Public Health, Adult, medicine.medical_specialty, Sub saharan, Adolescent, General Science & Technology, 195 COUNTRIES, Article, 03 medical and health sciences, Young Adult, Acquired immunodeficiency syndrome (AIDS), SURVEILLANCE, parasitic diseases, medicine, SYSTEMATIC ANALYSIS, Humans, Disease burden, Africa South of the Sahara, Science & Technology, MORTALITY, POPULATION-BASED SURVEYS, GLOBAL BURDEN, medicine.disease, Local variation, 030104 developmental biology, Demography
Abstract

HIV/AIDS is a leading cause of disease burden in sub-Saharan Africa. Existing evidence has demonstrated that there is substantial local variation in the prevalence of HIV; however, subnational variation has not been investigated at a high spatial resolution across the continent. Here we explore within-country variation at a 5 × 5-km resolution in sub-Saharan Africa by estimating the prevalence of HIV among adults (aged 15–49 years) and the corresponding number of people living with HIV from 2000 to 2017. Our analysis reveals substantial within-country variation in the prevalence of HIV throughout sub-Saharan Africa and local differences in both the direction and rate of change in HIV prevalence between 2000 and 2017, highlighting the degree to which important local differences are masked when examining trends at the country level. These fine-scale estimates of HIV prevalence across space and time provide an important tool for precisely targeting the interventions that are necessary to bringing HIV infections under control in sub-Saharan Africa., Fine-scale estimates of the prevalence of HIV in adults across sub-Saharan Africa reveal substantial within-country variation and local differences in both the direction and rate of change in the prevalence of HIV between 2000 and 2017.

Published
2019

3. Mapping subnational HIV mortality in six Latin American countries with incomplete vital registration systems

Author

Simachew Animen Bante, Carlo Eduardo Medina-Solís, Rodrigo Sarmiento-Suárez, Deniz Yuce, Ninuk Hariyani, Virginia Núñez-Samudio, Zhi-Jiang Zhang, Lucas Guimarães Abreu, Sindhura Lakshmi Koulmane Laxminarayana, Ejaz Ahmad Khan, Natalie Maria Cormier, Ghulam Mustafa, Arielle Wilder Eagan, Shirin Djalalinia, Jalal Arabloo, Bay Vo, Mukhammad David Naimzada, Farahnaz Joukar, Arvin Haj-Mirzaian, Julia Moreira Pescarini, Getinet Kassahun, Robert Ancuceanu, Mohammad Ali Mansournia, Amin Soheili, Félix Carvalho, Edgar Denova-Gutiérrez, Aubrey J. Cook, Jasvinder A. Singh, Maysaa El Sayed Zaki, Sergio I. Prada, Seyedeh Zahra Masoumi, Rajesh Sagar, Emmanuel Peprah, Fenta Hun Y. Beyene, Mikhail Sergeevich Zastrozhin, Dimas Ria Angga Pribadi, Yun Jin Kim, Maryam Adabi, Feleke Mekonnen Demeke, Valentin Yurievich Skryabin, Mathew M. Baumann, Bárbara Niegia Garcia de Goulart, Ali Kazemi Karyani, Nooshin Abbasi, Eyayou Girma Tadesse, Sanjay Basu, Hadi Hassankhani, Keyghobad Ghadiri, Keshab Deuba, Dilshad Manzar, Robert L. Thompson, Keivan Ahmadi, Rahmatollah Moradzadeh, Shaimaa I. El-Jaafary, Alessandra C. Goulart, Diana Fernanda Bejarano Ramirez, Samata Nepal, Marcos Roberto Tovani-Palone, Gebiyaw Wudie Tsegaye, Irina Filip, Ian D. Letourneau, Ramesh Holla, Neda Kianipour, Maha El Tantawi, Lucas Earl, Paul S. F. Yip, Miguel A Barboza, Rajan Nikbakhsh, Nauman Khalid, Kimberly B. Johnson, Iván Landires, Manasi Kumar, Babak Moazen, Rohol Lah Kalhor, Dinh-Toi Chu, Lauren E. Schaeffer, Nima Rezaei, Alexandre C. Pereira, Susan F. Rumisha, Mehdi Hosseinzadeh, Xuefeng Liu, Feng Sha, Mahaveer Golechha, Davood Anvari, Urvish K Patel, Bing-Fang Hwang, Samath D Dharmaratne, Muhammad Aqeel, Kebede Deribe, Nelsensius Klau Fauk, Lillian Mwanri, Nuruzzaman Khan, Yunquan Zhang, Paula Moraga, Ai Koyanagi, Abdallah M. Samy, Nithin Kumar, Rahul Gupta, Samad Azari, Soheil Hassanipour, Archith Boloor, Kiana Ramezanzadeh, Andrew J. Croneberger, Enrico Rubagotti, Jaykaran Charan, Khezar Hayat, Amir Masoud Rahmani, Kio Mars Sharafi, Ionut Negoi, Simon I. Hay, Deborah Carvalho Malta, Yasser Vasseghian, Yihienew M. Bezabih, Jean Jacques Noubiap, Nazir Fattahi, Adnan Kisa, Alok Atreya, Devasahayam J. Christopher, Ayenew Kassie Tesema, Nuwan Darshana Wickramasinghe, Jaffar Abbas, Daniel Diaz, Desta Debalkie Atnafu, Malke Asaad, Arief Hargono, Zahid A Butt, Dharmesh Kumar Lal, Pankaj Bhardwaj, Amir Radfar, Salman Rawaf, Vardhmaan Jain, Amir Almasi-Hashiani, Krittika Bhattacharyya, João Mauricio Castaldelli-Maia, Behzad Karami Matin, Mohammad Rifat Haider, Emily Haeuser, S. Mohammad Sajadi, Francisco Rogerlândio Martins-Melo, Jagadish Rao Padubidri, Carlos Alberto Marrugo Arnedo, Beatriz Paulina Ayala Quintanilla, Tomislav Mestrovic, Hawraz Ibrahim M. Amin, Bhaskaran Unnikrishnan, Seithikurippu R. Pandi-Perumal, Arash Ziapour, Samantha Perkins, Deepa Jahagirdar, Akshaya Srikanth Bhagavathula, Eduarda Fernandes, Nataliya Foigt, Audrey L. Serfes, Fissaha Tekulu Welay, Savita Lasrado, Saad M.A. Dahlawi, Segun Emmanuel Ibitoye, Hedayat Abbastabar, Om P Kurmi, Hung Chak Ho, Faheem Hyder Pottoo, Priya Rathi, Chukwuma David Umeokonkwo, Ali Bijani, Shanshan Li, Reza Rawassizadeh, Vishnu Renjith, Barthelemy Kuate Defo, Giang Thu Vu, Farah Daoud, Tudorel Andrei, Ricardo de Souza Kuchenbecker, Fakher Rahim, Adeyinka Emmanuel Adegbosin, Sezer Kisa, Rajesh Elayedath, Shafiu Mohammed, Vinod C. Nayak, Fisaha Haile Tesfay, Cuong Tat Nguyen, Masoud Foroutan, Mingyou Yang, Yousef Mohammad, Abdul-Aziz Seidu, Benjamin K. Mayala, Diego Augusto Santos Silva, Amin Mousavi Khaneghah, Nikha Bhardwaj, Masoud Moradi, Charles Ugochukwu Ibeneme, Olatunji O. Adetokunboh, Carlo La Vecchia, Tesfay B.B. Gebremariam, Ritesh G. Menezes, Olatunde Aremu, Bogdan Oancea, Mohiuddin Ahsanul Kabir Chowdhury, Stefanie Watson, Yousef Moradi, Souranshu Chatterjee, Ugo Gori, Isabela M. Benseñor, Khem Narayan Pokhrel, Hailay Abrha Gesesew, Paul Ward, Carlos A Castañeda-Orjuela, Usman Iqbal, Rekha Thapar, Naser Mohammad Gholi Mezerji, Yasir Waheed, Ziad A. Memish, Vijay Kumar Chattu, Daiane Borges Machado, Shrikant Pawar, Soosanna Kumary Chattu, Sanni Yaya, Ketema Bizuwork Gebremedhin, Naohiro Yonemoto, Ahmad Ghashghaee, Marcela Agudelo-Botero, Amber Sligar, Nicole Davis Weaver, Kenji Shibuya, Claudiu Herteliu, Andreea Mirica, André Karch, Asif Hanif, Atif Amin Baig, Salah Eddin Karimi, Gulfaraz Khan, David Laith Rawaf, Andrew T Olagunju, Chuanhua Yu, Darshan B B, Olayinka Stephen Ilesanmi, Takeshi Fukumoto, Neeraj Bedi, Claudio Alberto Dávila-Cervantes, Muktar Beshir Ahmed, Deepak Madi, Ione Jayce Ceola Schneider, Masood Ali Shaikh, Juwel Rana, Tanuj Kanchan, Mohamed M. Gad, Syed Amir Gilani, Victor Adekanmbi, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Tadele G. Adal, Mohammad Hifz Ur Rahman, Leila R Kalankesh, Gbenga A. Kayode, Bach Xuan Tran, Ana Isabel Ribeiro, Basavaprabhu Achappa, Andem Effiong, André Faro, Javad Nazari, Abdollah Mohammadian-Hafshejani, Soewarta Kosen, Vahid Alipour, Sowmya J. Rao, Rosario Cárdenas, Milena Ilic, Ravi Prakash Jha, Zebenay Workneh Bitew, Nelson Alvis-Guzman, Dian Kusuma, Yum Ing Guo, Mowafa Househ, Arya Haj-Mirzaian, Krista M. Steuben, Hadush Negash, Ahamarshan Jayaraman Nagarajan, Irena Ilic, Laura Dwyer-Lindgren, Godfrey Mutashambara Rwegerera, Florian Fischer, Gebreamlak Gebremedhn Gebremeskel, Kate E. LeGrand, Ravishankar Nagaraja, Reza Mohammadpourhodki, Mark Drew Crosland Guimarães, Kewal Krishan, Maryam Zamanian, Paul H. Lee, Emerito Jose A. Faraon, Rafael Alves Guimarães, Aziz Sheikh, Marwa Rashad Salem, Michael A. Cork, Francesco Saverio Violante, Bright Opoku Ahinkorah, Liliana Preotescu, Somayeh Bohlouli, Aziz Rezapour, Ana Melisa Pardo-Montaño, Huong Lan Thi Nguyen, Khaled Khatab, Teklehaimanot Gereziher Haile, Mohammad Ali Moni, Govinda Prasad Dhungana, Leonardo Roever, Carlos Magis-Rodriguez, Andre R. Brunoni, Nathaniel J. Henry, Brijesh Sathian, Bingyu Li, Maciej Banach, Hasan Yusefzadeh, Nikita Otstavnov, Bruno Ramos Nascimento, Fernando de la Hoz, Georges Nguefack-Tsague, Zulfiqar A Bhutta, Robert Kaba Alhassan, Jae Il Shin, Andre Rodrigues Duraes, Yuan-Pang Wang, Felix Akpojene Ogbo, Mihajlo Jakovljevic, Eman Abu-Gharbieh, Vaman Kulkarni, Anna Aleksandrovna Skryabina, Sait Mentes Birlik, Maarten J. Postma, Chhabi Lal Ranabhat, Walter Mendoza, Yanzhong Wang, Maryam Keramati, Mahesh P A, Ali H. Mokdad, Muhammad Naveed, Nitin Joseph, Ronny Westerman, Bill & Melinda Gates Foundation, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Value, Affordability and Sustainability (VALUE), Microbes in Health and Disease (MHD), Cork M.A., Henry N.J., Watson S., Croneberger A.J., Baumann M., Letourneau I.D., Yang M., Serfes A.L., Abbas J., Abbasi N., Abbastabar H., Abreu L.G., Abu-Gharbieh E., Achappa B., Adabi M., Adal T.G., Adegbosin A.E., Adekanmbi V., Adetokunboh O.O., Agudelo-Botero M., Ahinkorah B.O., Ahmadi K., Ahmed M.B., Alhassan R.K., Alipour V., Almasi-Hashiani A., Alvis-Guzman N., Ancuceanu R., Andrei T., Anvari D., Aqeel M., Arabloo J., Aremu O., Asaad M., Atnafu D.D., Atreya A., Quintanilla B.P.A., Azari S., B D.B., Baig A.A., Banach M., Bante S.A., Barboza M.A., Basu S., Bedi N., Ramirez D.F.B., Bensenor I.M., Beyene F.-H.Y., Bezabih Y.M., Bhagavathula A.S., Bhardwaj N., Bhardwaj P., Bhattacharyya K., Bhutta Z.A., Bijani A., Birlik S.M., Bitew Z.W., Bohlouli S., Boloor A., Brunoni A.R., Butt Z.A., Cardenas R., Carvalho F., Castaldelli-Maia J.M., Casta-neda-orjuela C.A., Charan J., Chatterjee S., Chattu V.K., Chattu S.K., Chowdhury M.A.K., Christopher D.J., Chu D.-T., Cook A.J., Cormier N.M., Dahlawi S.M.A., Daoud F., Davila-Cervantes C.A., Weaver N.D., De la Hoz F.P., Demeke F.M., Denova-Gutierrez E., Deribe K., Deuba K., Dharmaratne S.D., Dhungana G.P., Diaz D., Djalalinia S., Duraes A.R., Eagan A.W., Earl L., Effiong A., Zaki M.E.S., Tantawi M.E., Elayedath R., El-Jaafary S.I., Faraon E.J.A., Faro A., Fattahi N., Fauk N.K., Fernandes E., Filip I., Fischer F., Foigt N.A., Foroutan M., Fukumoto T., Gad M.M., Gebremariam T.B.B., Gebremed-Hin K.B., Gebremeskel G.G., Gesesew H.A., Ghadiri K., Ghashghaee A., Gilani S.A., Golechha M., Gori U., Goulart A.C., Goulart B.N.G., Gugnani H.C., Guimaraes M.D.C., Guimaraes R.A., Guo Y.-I., Gupta R., Haeuser E., Haider M.R., Haile T.G., Haj-Mirzaian A., Hanif A., Hargono A., Hariyani N., Hassanipour S., Hassankhani H., Hayat K., Herteliu C., Ho H.C., Holla R., Hosseinzadeh M., Househ M., Hwang B.-F., Ibeneme C.U., Ibitoye S.E., Ile-Sanmi O.S., Ilic M.D., Ilic I.M., Iqbal U., Jahagir-Dar D., Jain V., Jakovljevic M., Jha R.P., Johnson K.B., Joseph N., Joukar F., Kalankesh L.R., Kalhor R.-L., Kanchan T., Matin B.K., Karch A., Karimi S.E., Kassahun G., Kayode G.A., Karyani A.K., Keramati M., Khalid N., Khan E.A., Khan G., Khan M.N.N., Khatab K., Kianipour N., Kim Y.J., Kisa S., Kisa A., Kosen S., Laxminarayana S.L.K., Koyanagi A., Krishan K., Defo B.K., Kuchenbecker R.S., Kulkarni V., Kumar N., Kumar M., Kurmi O.P., Kusuma D., Vecchia C.L., Lal D.K., Landires I., Lasrado S., Lee P.H., Legrand K.E., Li B., Li S., Liu X., Amin H.I.M., Machado D.B., Madi D., Magis-Rodriguez C., Malta D.C., Mansournia M.A., Manzar M.D., Arnedo C.A.M., Martins-Melo F.R., Masoumi S.Z., Mayala B.K., Medina-Solis C.E., Memish Z.A., Mendoza W., Menezes R.G., Mestrovic T., Mirica A., Moazen B., Mohammad Y., Mezerji N.M.G., Mohammadian-Hafshejani A., Mohammadpourhodki R., Mohammed S., Mokdad A.H., Moni M.A., Moradi M., Moradi Y., Moradzadeh R., Moraga P., Khaneghah A.M.-S., Mustafa G., Mwanri L., Nagaraja R., Nagarajan A.J., Naim-Zada M.D., Nascimento B.R., Naveed D.M., Nayak V.C., Nazari J., Negash H., Negoi I., Nepal S., Nguefack-Tsague G., Nguyen C.T., Nguyen H.L.T., Nikbakhsh R., Noubiap J.J., Nunez-Samudio V., Oancea B., Ogbo F.A., Olagunju A.T., Otstav-Nov N., A M.P., Padubidri J.R., Pandi-Perumal S.R., Pardo-Montano A.M., Patel U.K., Pawar S., Peprah E.K., Pereira A., Perkins S., Pescarini J.M., Pokhrel K.N., Postma M.J., Pot-Too F.H., Prada S.I., Preotescu L., Pribadi D.R.A., Radfar A., Rahim F., Rahman M.H.U., Rahmani A.M., Ramezanzadeh K., Rana J., Ranabhat C.L., Rao S.J., Rathi P., Rawaf S., Rawaf D.L., Rawassizadeh R., Renjith V., Rezaei N., Rezapour A., Ribeiro A.I., Roever L., Rubagotti E., Rumisha S.F., Rwegerera G.M., Sagar R., Sajadi S.M., Salem M.R., Samy A.M., Sarmiento-Suarez R., Sathian B., Schaeffer L.E., Schneider I.J.C., Seidu A.-A., Sha F., Shaikh M.A., Sharafi K.-M., Sheikh A., Shibuya K., Shin J.I., Silva D.A.S., Singh J.A., Skryabin V.Y., Skryabina A.A., Sligar A., Soheili A., Steuben K.M., Sufiyan M.B., Tadesse E.G., Tesema A.K.T., Tesfay F.H., Thapar R., Thompson R.L., Tovani-Palone M.R., Tran B.X., Tsegaye G.W., Umeokonkwo C.D., Unnikrish-Nan B., Vasseghian Y., Violante F.S., Vo B., Vu G.T., Waheed Y., Wang Y.-P., Wang Y., Ward P., Welay F.T., Westerman R., Wickramasinghe N.D., Yaya S., Yip P., Yonemoto N., Yu C., Yuce D., Yusefzadeh H., Zamanian M., Zastroz-Hin M.S., Zhang Z.-J., Zhang Y., Ziapour A., Hay S.I., Dwyer-Lindgren L., Local Burden of Disease HIV Collaborators, Clinicum, HUS Comprehensive Cancer Center, Cork, Michael A, Henry, Nathaniel J, Watson, Stefanie, Croneberger, Andrew J, Ahmed, Muktar B, Dwyer-Lindgren, Laura, Instituto de Saúde Pública da Universidade do Porto, and Collaborators, Local Burden of Disease HIV

Subjects
Male, Latin Americans, lcsh:Medicine, LOW-INCOME, HIV Infections, HIV mortality, HIV/AIDS, Latin America, Mapping, Small area estimation, Spatial statistics, Vital registration, Vital registrations, 0302 clinical medicine, ANTIRETROVIRAL THERAPY, Medicine, 030212 general & internal medicine, Registries, 11 Medical and Health Sciences, media_common, Mortality rate, 1. No poverty, DEATH, Regression analysis, General Medicine, Middle Aged, BRAZIL, Local Burden of Disease HIV Collaborators, 3. Good health, AIDS, SEX, A990 Medicine and Dentistry not elsewhere classified, Female, HEALTH, 0305 other medical science, Life Sciences & Biomedicine, Research Article, Adult, medicine.medical_specialty, Inequality, Adolescent, media_common.quotation_subject, TUBERCULOSIS, Small area estimations, 03 medical and health sciences, Medicine, General & Internal, Sex Factors, Acquired immunodeficiency syndrome (AIDS), HIV mortalities, General & Internal Medicine, Humans, Aged, Science & Technology, 030505 public health, business.industry, Public health, lcsh:R, Ecological study, HIV, Bayes Theorem, GLOBAL BURDEN, medicine.disease, TRENDS, Vital Statistics, Spatial statistic, 3121 General medicine, internal medicine and other clinical medicine, Human medicine, business, Demography
Abstract

Background Human immunodeficiency virus (HIV) remains a public health priority in Latin America. While the burden of HIV is historically concentrated in urban areas and high-risk groups, subnational estimates that cover multiple countries and years are missing. This paucity is partially due to incomplete vital registration (VR) systems and statistical challenges related to estimating mortality rates in areas with low numbers of HIV deaths. In this analysis, we address this gap and provide novel estimates of the HIV mortality rate and the number of HIV deaths by age group, sex, and municipality in Brazil, Colombia, Costa Rica, Ecuador, Guatemala, and Mexico. Methods We performed an ecological study using VR data ranging from 2000 to 2017, dependent on individual country data availability. We modeled HIV mortality using a Bayesian spatially explicit mixed-effects regression model that incorporates prior information on VR completeness. We calibrated our results to the Global Burden of Disease Study 2017. Results All countries displayed over a 40-fold difference in HIV mortality between municipalities with the highest and lowest age-standardized HIV mortality rate in the last year of study for men, and over a 20-fold difference for women. Despite decreases in national HIV mortality in all countries—apart from Ecuador—across the period of study, we found broad variation in relative changes in HIV mortality at the municipality level and increasing relative inequality over time in all countries. In all six countries included in this analysis, 50% or more HIV deaths were concentrated in fewer than 10% of municipalities in the latest year of study. In addition, national age patterns reflected shifts in mortality to older age groups—the median age group among decedents ranged from 30 to 45 years of age at the municipality level in Brazil, Colombia, and Mexico in 2017. Conclusions Our subnational estimates of HIV mortality revealed significant spatial variation and diverging local trends in HIV mortality over time and by age. This analysis provides a framework for incorporating data and uncertainty from incomplete VR systems and can help guide more geographically precise public health intervention to support HIV-related care and reduce HIV-related deaths.

Published
2021

4. Mapping disparities in education across low- and middle-income countries

Author

Lauren E. Schaeffer, Belay Tessema, Reza Malekzadeh, Olatunde Aremu, Mehdi Hosseinzadeh, Milena M Santric Milicevic, Seyyed Meysam Mousavi, Azeem Majeed, Badr Hasan Sobaih, Jalal Arabloo, Philimon Gona, Aliasghar Ahmad Kiadaliri, Mostafa Qorbani, Fatemeh Rajati, Ipsita Sutradhar, Giuseppe Remuzzi, Babak Eshrati, Olufemi Ajumobi, Lauren Woyczynski, Parul Puri, Vinay Nangia, Guoqing Hu, Yousef Khader, Suzanne Barker-Collo, Hamideh Salimzadeh, Félix Carvalho, Yun Jin Kim, Moslem Soofi, Ali Bijani, Shanshan Li, Catalina Liliana Andrei, Ali Kazemi Karyani, Mehran Asadi-Aliabadi, Andrea Sylvia Winkler, Arya Haj-Mirzaian, Maziar Moradi-Lakeh, Farnam Mohebi, Mohamad-Hani Temsah, Kala M. Mehta, Simon I. Hay, Benjamin B. Massenburg, Sanjay Zodpey, Tuomo J. Meretoja, Ireneous N. Soyiri, Bach Xuan Tran, George C Patton, Kavumpurathu Raman Thankappan, Engida Yisma, Vasily Vlassov, Samer Hamidi, Ghulam Mustafa, André Faro, Eduarda Fernandes, Chandrashekhar T Sreeramareddy, Rajat Gupta, Shirin Djalalinia, Dina Nur Anggraini Ningrum, Sheikh Mohammed Shariful Islam, Juan Sanabria, Leonardo Roever, Dayane Gabriele Alves Silveira, Samad Azari, Vahid Alipour, Gabrielle B. Britton, Luca Ronfani, Rosario Cárdenas, Maarten J. Postma, Hamid Yimam Hassen, Pn Sylaja, Brijesh Sathian, Paul S. F. Yip, Vegard Skirbekk, Chhabi Lal Ranabhat, Paramjit Gill, Walter Mendoza, Lorenzo Monasta, Dara K. Mohammad, Naznin Hossain, Dhirendra N Sinha, Ali H. Mokdad, Aziz Rezapour, Megan F. Schipp, Ziyad Al-Aly, Takeshi Fukumoto, Kebede Deribe, Paula Moraga, Mohammad Ebrahimi Kalan, Ai Koyanagi, Andre M. N. Renzaho, Cyrus Cooper, Ghobad Moradi, Ruth W Kimokoti, Swayam Prakash, Rafael Tabarés-Seisdedos, Zahra Jorjoran Shushtari, Zemenu Tadesse Tessema, Amir Radfar, Jean Jacques Noubiap, Emmanuela Gakidou, Mahdi Afshari, Suleman Atique, Reza Majdzadeh, Kiomars Sharafi, Seyed-Mohammad Fereshtehnejad, Foad Abd-Allah, Zahid A Butt, Beruk Berhanu Desalegn, Ruxandra Irina Negoi, Marek Majdan, Yoshan Moodley, Jianrong Zhang, Farid Najafi, Aso Mohammad Darwesh, Benn Sartorius, Amber Sligar, Nicole Davis Weaver, Naohiro Yonemoto, Jacob Olusegun Olusanya, Olayinka Stephen Ilesanmi, Neeraj Bedi, Suraj Bhattarai, Sadaf G. Sepanlou, Francisco Rogerlandio Martins-Melo, Malihe Nourollahpour Shiadeh, Bernardo Hernández Prado, Masood Ali Shaikh, Khalid A Altirkawi, Carlos Rios-Gonzalez, Claudiu Herteliu, Jason B. Hall, Irina Filip, Abdullah Sulieman Terkawi, Sojib Bin Zaman, Nathaniel J Henry, Eleonora Dubljanin, Jasvinder A. Singh, Pushpendra Kumar, Akram Pourshams, Jung-Chen Chang, Irfan Ullah, Lorainne Tudor Car, Franz Castro, George A. Mensah, Delia Hendrie, Mehran Shams-Beyranvand, Zulfiqar A Bhutta, Jaifred Christian F. Lopez, Laura Dwyer-Lindgren, Lee Ling Lim, Charles D.A. Wolfe, Adnan Kisa, Seyed Sina Naghibi Irvani, Alaa Badawi, Bolajoko O. Olusanya, Tomohide Yamada, Gholamreza Roshandel, Jonathan F. Mosser, Jose A. Garcia, Andre Rodrigues Duraes, Mohammadreza Amiresmaili, Krittika Bhattacharyya, Yuan-Pang Wang, Sebastian Vollmer, Felix Akpojene Ogbo, Birkneh Tilahun Tadesse, Mihajlo Jakovljevic, Songhomitra Panda-Jonas, Paul H. Lee, Michael Collison, Sanghamitra Pati, Aziz Sheikh, Kalkidan Hassen Abate, Anthony Barnett, Ejaz Ahmad Khan, Michael A. Cork, Meghnath Dhimal, Norberto Perico, Francesco Saverio Violante, Daniel N. Kiirithio, Ted R. Miller, Arundhati R. Sawant, Olalekan A. Uthman, Kewal Krishan, Ashish Awasthi, Anthony Masaka, Katherine F. Wilson, Padukudru Anand Mahesh, Roy Burstein, Amir Kasaeian, Yuming Guo, Peter Nyasulu, Chuanhua Yu, Pascual R. Valdez, Josephine W. Ngunjiri, Vipin Gupta, Tomislav Mestrovic, Long Hoang Nguyen, Neda Izadi, Faris Lami, Marcos Roberto Tovani-Palone, Azin Nahvijou, Jun She, Christopher J L Murray, Krishna K. Aryal, Payman Salamati, Mona M. Khater, Rajeev Gupta, Robert Reiner, Mustafa Z. Younis, Ali Rostami, Duduzile Ndwandwe, Obinna Onwujekwe, Manasi Kumar, Nafis Sadat, Nahla Anber, Joan B. Soriano, Victor Adekanmbi, John C. Wilkinson, Babak Moazen, Andrew T Olagunju, Nicholas Graetz, Andualem Henok, Mina Anjomshoa, Boris Bikbov, Melaku Desta, Yahya Safari, Jan-Walter De Neve, Carlos A Castañeda-Orjuela, Mohammad Fareed, Ayman Grada, Eduardo Ortiz-Panozo, Rajesh Sharma, Beatriz Paulina Ayala Quintanilla, Enrico Rubagotti, John S. Ji, Mika Shigematsu, Fakher Rahim, Randah R. Hamadeh, G. K. Mini, Yasir Waheed, Meghdad Pirsaheb, Yousef Veisani, Daniel Diaz, Adrian Pana, Salman Rawaf, Ehsan Sadeghi, Yahya Salimi, Joseph Adel Mattar Banoub, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, David M. Pigott, Fares Alahdab, Vafa Rahimi-Movaghar, Anbissa Muleta Senbeta, Tomi Akinyemiju, Damaris K. Kinyoki, Morteza Shamsizadeh, Ziad El-Khatib, Abdallah M. Samy, Roman Topor-Madry, Farah Daoud, Cuong Tat Nguyen, Aubrey J. Levine, Sameer Vali Gopalani, Ravi Prakash Jha, Mesfin Tadese Dinberu, Shafiu Mohammed, Simon Øverland, David Laith Rawaf, Arvin Haj-Mirzaian, Satar Rezaei, Oladimeji Adebayo, Nasir Salam, Mohammad Ali Mansournia, Rajesh Sagar, Alex Yeshaneh, Michael K. Hole, Agus Sudaryanto, Yunquan Zhang, Mahbobeh Faramarzi, Natalia V. Bhattacharjee, Aniruddha Deshpande, Soewarta Kosen, Mahmoud Yousefifard, Jacek Jerzy Jozwiak, Mehedi Hasan, Shane D. Morrison, Erkin M. Mirrakhimov, Marcel Ausloos, Ionut Negoi, Jacqueline Elizabeth Alcalde Rabanal, Barthelemy Kuate Defo, Giang Thu Vu, Lucas Earl, Doris D. V. Ortega-Altamirano, Yu Liao, Peter Njenga Keiyoro, Tanuj Kanchan, Chandrasekharan Nair Kesavachandran, Mu'awiyyah Babale Sufiyan, Mohammad Hifz Ur Rahman, Lidia Morawska, Tiffany K. Gill, Manisha Dubey, David C. Schwebel, Jost B. Jonas, Ester Cerin, Mehran Alijanzadeh, Florian Fischer, Stefan Listl, Benjamin K. Mayala, Mahmood Moosazadeh, Soraya Siabani, Derrick A Bennett, Collaborators, Local Burden of Disease Educational Attainment, Institute for Molecular Medicine Finland, HUS Comprehensive Cancer Center, Clinicum, Helsinki University Hospital Area, University of Helsinki, Local Burden Dis Educ Attainment C, Graetz N., Woyczynski L., Wilson K.F., Hall J.B., Abate K.H., Abd-Allah F., Adebayo O.M., Adekanmbi V., Afshari M., Ajumobi O., Akinyemiju T., Alahdab F., Al-Aly Z., Rabanal J.E.A., Alijanzadeh M., Alipour V., Altirkawi K., Amiresmaili M., Anber N.H., Andrei C.L., Anjomshoa M., Antonio C.A.T., Arabloo J., Aremu O., Aryal K.K., Asadi-Aliabadi M., Atique S., Ausloos M., Awasthi A., Quintanilla B.P.A., Azari S., Badawi A., Banoub J.A.M., Barker-Collo S.L., Barnett A., Bedi N., Bennett D.A., Bhattacharjee N.V., Bhattacharyya K., Bhattarai S., Bhutta Z.A., Bijani A., Bikbov B., Britton G., Burstein R., Butt Z.A., Cardenas R., Carvalho F., Castaneda-Orjuela C.A., Castro F., Cerin E., Chang J.-C., Collison M.L., Cooper C., Cork M.A., Daoud F., Das Gupta R., Weaver N.D., De Neve J.-W., Deribe K., Desalegn B.B., Deshpande A., Desta M., Dhimal M., Diaz D., Dinberu M.T., Djalalinia S., Dubey M., Dubljanin E., Duraes A.R., Dwyer-Lindgren L., Earl L., Kalan M.E., El-Khatib Z., Eshrati B., Faramarzi M., Fareed M., Faro A., Fereshtehnejad S.-M., Fernandes E., Filip I., Fischer F., Fukumoto T., Garcia J.A., Gill P.S., Gill T.K., Gona P.N., Gopalani S.V., Grada A., Guo Y., Gupta R., Gupta V., Haj-Mirzaian A., Hamadeh R.R., Hamidi S., Hasan M., Hassen H.Y., Hendrie D., Henok A., Henry N.J., Prado B.H., Herteliu C., Hole M.K., Hossain N., Hosseinzadeh M., Hu G., Ilesanmi O.S., Irvani S.S.N., Islam S.M.S., Izadi N., Jakovljevic M., Jha R.P., Ji J.S., Jonas J.B., Shushtari Z.J., Jozwiak J.J., Kanchan T., Kasaeian A., Karyani A.K., Keiyoro P.N., Kesavachandran C.N., Khader Y.S., Khafaie M.A., Khan E.A., Khater M.M., Kiadaliri A.A., Kiirithio D.N., Kim Y.J., Kimokoti R.W., Kinyoki D.K., Kisa A., Kosen S., Koyanagi A., Krishan K., Defo B.K., Kumar M., Kumar P., Lami F.H., Lee P.H., Levine A.J., Li S., Liao Y., Lim L.-L., Listl S., Lopez J.C.F., Majdan M., Majdzadeh R., Majeed A., Malekzadeh R., Mansournia M.A., Martins-Melo F.R., Masaka A., Massenburg B.B., Mayala B.K., Mehta K.M., Mendoza W., Mensah G.A., Meretoja T.J., Mestrovic T., Miller T.R., Mini G.K., Mirrakhimov E.M., Moazen B., Mohammad D.K., Darwesh A.M., Mohammed S., Mohebi F., Mokdad A.H., Monasta L., Moodley Y., Moosazadeh M., Moradi G., Moradi-Lakeh M., Moraga P., Morawska L., Morrison S.D., Mosser J.F., Mousavi S.M., Murray C.J.L., Mustafa G., Nahvijou A., Najafi F., Nangia V., Ndwandwe D.E., Negoi I., Negoi R.I., Ngunjiri J.W., Nguyen C.T., Nguyen L.H., Ningrum D.N.A., Noubiap J.J., Shiadeh M.N., Nyasulu P.S., Ogbo F.A., Olagunju A.T., Olusanya B.O., Olusanya J.O., Onwujekwe O.E., Ortega-Altamirano D.D.V., Ortiz-Panozo E., Overland S., Mahesh P.A., Pana A., Panda-Jonas S., Pati S., Patton G.C., Perico N., Pigott D.M., Pirsaheb M., Postma M.J., Pourshams A., Prakash S., Puri P., Qorbani M., Radfar A., Rahim F., Rahimi-Movaghar V., Rahman M.H.U., Rajati F., Ranabhat C.L., Rawaf D.L., Rawaf S., Reiner R.C., Remuzzi G., Renzaho A.M.N., Rezaei S., Rezapour A., Rios-Gonzalez C., Roever L., Ronfani L., Roshandel G., Rostami A., Rubagotti E., Sadat N., Sadeghi E., Safari Y., Sagar R., Salam N., Salamati P., Salimi Y., Salimzadeh H., Samy A.M., Sanabria J., Santric Milicevic M.M., Sartorius B., Sathian B., Sawant A.R., Schaeffer L.E., Schipp M.F., Schwebel D.C., Senbeta A.M., Sepanlou S.G., Shaikh M.A., Shams-Beyranvand M., Shamsizadeh M., Sharafi K., Sharma R., She J., Sheikh A., Shigematsu M., Siabani S., Silveira D.G.A., Singh J.A., Sinha D.N., Skirbekk V., Sligar A., Sobaih B.H., Soofi M., Soriano J.B., Soyiri I.N., Sreeramareddy C.T., Sudaryanto A., Babale Sufiyan M., Sutradhar I., Sylaja P., Tabares-Seisdedos R., Tadesse B.T., Temsah M.-H., Terkawi A.S., Tessema B., Tessema Z.T., Thankappan K.R., Topor-Madry R., Tovani-Palone M.R., Tran B.X., Car L.T., Ullah I., Uthman O.A., Valdez P.R., Veisani Y., Violante F.S., Vlassov V., Vollmer S., Thu Vu G., Waheed Y., Wang Y.-P., Wilkinson J.C., Winkler A.S., Wolfe C.D.A., Yamada T., Yeshaneh A., Yip P., Yisma E., Yonemoto N., Younis M.Z., Yousefifard M., Yu C., Bin Zaman S., Zhang J., Zhang Y., Zodpey S., Gakidou E., Hay S.I., Graetz, Nicholas, Woyczynski, Lauren, Wilson, Katherine F, Hall, Jason B, Yisma, Engida, Hay, Simon I, Local Burden of Disease Educational Attainment Collaborators, Microbes in Health and Disease (MHD), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), and Value, Affordability and Sustainability (VALUE)

Subjects
Male, ATTAINMENT, Health Status, Disease, education, low- and middle-income countries, 0302 clinical medicine, WORLD, gender, Global health, risk factors, 030212 general & internal medicine, Aetiology, 10. No inequality, media_common, Developing world, Pediatric, Multidisciplinary, 1. No poverty, Multidisciplinary Sciences, Geography, Science & Technology - Other Topics, Female, HEALTH, developing world, social and economic factors, Engineering sciences. Technology, disparitie, AFRICA, medicine.medical_specialty, Inequality, General Science & Technology, media_common.quotation_subject, MODELS, Developing country, Local Burden of Disease Educational Attainment Collaborators, Article, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], Education, 03 medical and health sciences, 2.3 Psychological, medicine, Humans, Society, Social determinants of health, Developing Countries, Science & Technology, Equity (economics), MORTALITY, Public health, Bayes Theorem, Educational attainment, 3141 Health care science, society, Good Health and Well Being, Risk factors, Socioeconomic Factors, Demographic economics, 030217 neurology & neurosurgery
Abstract

Educational attainment is an important social determinant of maternal, newborn, and child health1–3. As a tool for promoting gender equity, it has gained increasing traction in popular media, international aid strategies, and global agenda-setting4–6. The global health agenda is increasingly focused on evidence of precision public health, which illustrates the subnational distribution of disease and illness7,8; however, an agenda focused on future equity must integrate comparable evidence on the distribution of social determinants of health9–11. Here we expand on the available precision SDG evidence by estimating the subnational distribution of educational attainment, including the proportions of individuals who have completed key levels of schooling, across all low- and middle-income countries from 2000 to 2017. Previous analyses have focused on geographical disparities in average attainment across Africa or for specific countries, but—to our knowledge—no analysis has examined the subnational proportions of individuals who completed specific levels of education across all low- and middle-income countries12–14. By geolocating subnational data for more than 184 million person-years across 528 data sources, we precisely identify inequalities across geography as well as within populations., Analyses of the proportions of individuals who have completed key levels of schooling across all low- and middle-income countries from 2000 to 2017 reveal inequalities across countries as well as within populations.

Published
2020

5. Assessing the Contribution of Malaria Vector Control and Other Maternal and Child Health Interventions in Reducing All-Cause Under-Five Mortality in Zambia, 1990–2010

Author

Nancy Fullman, Marie Ng, Emmanuela Gakidou, Matthew T. Schneider, Felix Masiye, Tom Achoki, Peter Hangoma, Laura Dwyer-Lindgren, K. Ellicott Colson, and Peter Mulenga

Subjects
Counterfactual thinking, business.industry, Transmission (medicine), 030231 tropical medicine, Psychological intervention, Infant mortality, Child mortality, Pentavalent vaccine, 03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, Environmental protection, Virology, Environmental health, parasitic diseases, Medicine, Parasitology, 030212 general & internal medicine, business, Socioeconomic status, Health impact assessment
Abstract

Under-five mortality in Zambia has declined since 1990, with reductions accelerating after 2000. Zambia's scale-up of malaria control is viewed as the driver of these gains, but past studies have not fully accounted for other potential factors. This study sought to systematically evaluate the impact of malaria vector control on under-five mortality. Using a mixed-effects regression model, we quantified the relationship between malaria vector control, other priority health interventions, and socioeconomic indicators and district-level under-five mortality trends from 1990 to 2010. We then conducted counterfactual analyses to estimate under-five mortality in the absence of scaling up malaria vector control. Throughout Zambia, increased malaria vector control coverage coincided with scaling up three other interventions: the pentavalent vaccine, exclusive breast-feeding, and prevention of mother-to-child transmission of HIV services. This simultaneous scale-up made statistically isolating intervention-specific impact infeasible. Instead, in combination, these interventions jointly accelerated declines in under-five mortality by 11% between 2000 and 2010. Zambia's scale-up of multiple interventions is notable, yet our findings highlight challenges in quantifying program-specific impact without better health data and information systems. As countries aim to further improve health outcomes, there is even greater need-and opportunity-to strengthen routine data systems and to develop more rigorous evaluation strategies.

Published
2017

6. Variation in life expectancy and mortality by cause among neighbourhoods in King County, WA, USA, 1990–2014: a census tract-level analysis for the Global Burden of Disease Study 2015

Author

Eli Kern, Shreya Shirude, Ali H. Mokdad, Samuel Finegold, Christopher J L Murray, Abraham D. Flaxman, Jeffrey S. Duchin, Rebecca W. Stubbs, Charlton S K H Callender, Amelia Bertozzi-Villa, David Fleming, Amy Laurent, Chloe Morozoff, and Laura Dwyer-Lindgren

Subjects
Male, Washington, Gerontology, Inequality, media_common.quotation_subject, Population health, 030204 cardiovascular system & hematology, Global Burden of Disease, 03 medical and health sciences, Life Expectancy, 0302 clinical medicine, Residence Characteristics, Cause of Death, Humans, 030212 general & internal medicine, Mortality, Aged, media_common, Cause of death, Aged, 80 and over, lcsh:Public aspects of medicine, Mortality rate, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, Censuses, Health Status Disparities, Redistribution (cultural anthropology), Census, Geography, Years of potential life lost, Life expectancy, Female, Demography
Abstract

Summary Background Health outcomes are known to vary at both the country and local levels, but trends in mortality across a detailed and comprehensive set of causes have not been previously described at a very local level. Life expectancy in King County, WA, USA, is in the 95th percentile among all counties in the USA. However, little is known about how life expectancy and mortality from different causes of death vary at a local, neighbourhood level within this county. In this analysis, we estimated life expectancy and cause-specific mortality within King County to describe spatial trends, quantify disparities in mortality, and assess the contribution of each cause of death to overall disparities in all-cause mortality. Methods We applied established so-called garbage code redistribution algorithms and small area estimation methods to death registration data for King County to estimate life expectancy, cause-specific mortality rates, and years of life lost (YLL) rates from 152 causes of death for 397 census tracts from Jan 1, 1990, to Dec 31, 2014. We used the cause list developed for the Global Burden of Disease 2015 study for this analysis. Deaths were tabulated by age group, sex, census tract, and cause of death. We used Bayesian mixed-effects regression models to estimate mortality overall and from each cause. Findings Between 1990 and 2014, life expectancy in King County increased by 5·4 years (95% uncertainty interval [UI] 5·0–5·7) among men (from 74·0 years [73·7–74·3] to 79·3 years [79·1–79·6]) and by 3·4 years (3·0–3·7) among women (from 80·0 years [79·7–80·2] to 83·3 years [83·1–83·5]). In 2014, life expectancy ranged from 68·4 years (95% UI 66·9–70·1) to 86·7 years (85·0–88·2) for men and from 73·6 years (71·6–75·5) to 88·4 years (86·9–89·9) for women among census tracts within King County. Rates of YLL by cause also varied substantially among census tracts for each cause of death. Geographical areas with relatively high and relatively low YLL rates differed by cause. In general, causes of death responsible for more YLLs overall also contributed more significantly to geographical inequality within King County. However, certain causes contributed more to inequality than to overall YLLs. Interpretation This census tract-level analysis of life expectancy and cause-specific YLL rates highlights important differences in health among neighbourhoods in King County that are masked by county-level estimates. Efforts to improve population health in King County should focus on reducing geographical inequality, by targeting those health conditions that contribute the most to overall YLLs and to inequality. This analysis should be replicated in other locations to more fully describe fine-grained local-level variation in population health and contribute to efforts to improve health while reducing inequalities. Funding John W Stanton and Theresa E Gillespie.

Published
2017

7. Seat-Belt Use In US Counties: Limited Progress Toward Healthy People 2020 Objectives

Author

Ali H. Mokdad, Laura Dwyer-Lindgren, Alan Chen, and Jacob E. Sunshine

Subjects
Male, Automobile Driving, Injury control, Poison control, Automobile safety, Suicide prevention, Occupational safety and health, law.invention, Behavioral Risk Factor Surveillance System, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, law, Environmental health, 0502 economics and business, Injury prevention, Seat belt, Humans, Medicine, 030212 general & internal medicine, 050210 logistics & transportation, business.industry, Health Policy, 05 social sciences, Accidents, Traffic, Human factors and ergonomics, Seat Belts, Healthy People Programs, Female, business
Abstract

Spikes in automobile fatalities in 2015 and 2016 have renewed discussions about automobile safety. We measured the prevalence of reported seat-belt compliance in every US county from 2002 to 2012 and found considerable variation.

Published
2017

8. Inequalities in Life Expectancy Among US Counties, 1980 to 2014 Temporal Trends and Key Drivers

Author

Chloe Morozoff, Amelia Bertozzi-Villa, Rebecca W. Stubbs, Laura Dwyer-Lindgren, Christopher J L Murray, Ali H. Mokdad, Johan P. Mackenbach, Frank J. van Lenthe, and Public Health

Subjects
Gerontology, education.field_of_study, business.industry, media_common.quotation_subject, Population, Ethnic group, Longevity, 030204 cardiovascular system & hematology, Race and health, 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Health care, Internal Medicine, Life expectancy, Medicine, Residence, 030212 general & internal medicine, business, education, Socioeconomic status, Original Investigation, Demography, media_common
Abstract

Importance Examining life expectancy by county allows for tracking geographic disparities over time and assessing factors related to these disparities. This information is potentially useful for policy makers, clinicians, and researchers seeking to reduce disparities and increase longevity. Objective To estimate annual life tables by county from 1980 to 2014; describe trends in geographic inequalities in life expectancy and age-specific risk of death; and assess the proportion of variation in life expectancy explained by variation in socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors. Design, Setting, and Participants Annual county-level life tables were constructed using small area estimation methods from deidentified death records from the National Center for Health Statistics (NCHS), and population counts from the US Census Bureau, NCHS, and the Human Mortality Database. Measures of geographic inequality in life expectancy and age-specific mortality risk were calculated. Principal component analysis and ordinary least squares regression were used to examine the county-level association between life expectancy and socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors. Exposures County of residence. Main Outcomes and Measures Life expectancy at birth and age-specific mortality risk. Results Counties were combined as needed to create stable units of analysis over the period 1980 to 2014, reducing the number of areas analyzed from 3142 to 3110. In 2014, life expectancy at birth for both sexes combined was 79.1 (95% uncertainty interval [UI], 79.0-79.1) years overall, but differed by 20.1 (95% UI, 19.1-21.3) years between the counties with the lowest and highest life expectancy. Absolute geographic inequality in life expectancy increased between 1980 and 2014. Over the same period, absolute geographic inequality in the risk of death decreased among children and adolescents, but increased among older adults. Socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors explained 60%, 74%, and 27% of county-level variation in life expectancy, respectively. Combined, these factors explained 74% of this variation. Most of the association between socioeconomic and race/ethnicity factors and life expectancy was mediated through behavioral and metabolic risk factors. Conclusions and Relevance Geographic disparities in life expectancy among US counties are large and increasing. Much of the variation in life expectancy among counties can be explained by a combination of socioeconomic and race/ethnicity factors, behavioral and metabolic risk factors, and health care factors. Policy action targeting socioeconomic factors and behavioral and metabolic risk factors may help reverse the trend of increasing disparities in life expectancy in the United States.

Published
2017

9. Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Author

Mohsen Bayati, Arvin Haj-Mirzaian, Mehran Asadi-Aliabadi, Maziar Moradi-Lakeh, Nasir Salam, Mohamad-Hani Temsah, Fatemeh Heydarpour, Davide Rasella, Kavumpurathu Raman Thankappan, Ghulam Mustafa, Sergey Konstantinovitch Vladimirov, Fereshteh Ansari, Dina Nur Anggraini Ningrum, Leonardo Roever, Oghenowede Eyawo, Koustuv Dalal, Ana-Laura Manda, Ritesh G. Menezes, Molly K. Miller-Petrie, Javad Yoosefi Lebni, Gebreamlak Gebremedhn Gebremeskel, Aziz Eftekhari, Oleguer Plana-Ripoll, Jon Wakefield, Sanjay Zodpey, Birhanu Geta, Amaha Kahsay, Edris Hasanpoor, Brijesh Sathian, Kala M. Mehta, Moritz U. G. Kraemer, Saeed Amini, Hesham M. Al-Mekhlafi, Abbas Yadegar, João Pedro Silva, Desmond Kuupiel, Anvar Asadi, Hamid Sharifi, Ebrahim Babaee, Dessalegn Ajema Berbada, Taddese Alemu Zerfu, Ian Davis, Mostafa Qorbani, Fatemeh Rajati, Samer Hamidi, Parvaiz A Koul, Foad Abd-Allah, Mojisola Oluwasanu, Syed Mohamed Aljunid, Elias Merdassa Roro, Mihaela Hostiuc, Robert S. Bernstein, Vahid Yazdi-Feyzabadi, Gebre Teklemariam Demoz, Irina Filip, Mu'awiyyah Babale Sufiyan, Amir Khater, Lidia Morawska, Sangram Kishor Patel, Robert C. Reiner, Joshua O. Akinyemi, Telma Zahirian Moghadam, Ali Akbar Fazaeli, Reza Malekzadeh, Olatunde Aremu, Mohammad Reza Salahshoor, Irfan Ullah, Gabrielle B. Britton, Gelin Xu, Nathaniel J Henry, Thomas R. Hird, Ronny Westerman, Vera Marisa Costa, Reza Assadi, Tiffany K. Gill, Chhabi Lal Ranabhat, Meysam Olfatifar, Sezer Kisa, Grant Rodgers Kemp, Mahmoud Yousefifard, Aleksandra Barac, Simon I. Hay, Walter Mendoza, Mohammad Zamani, Nader Jafari Balalami, Mahdi Safdarian, Manfred S. Green, Mahesh P A, Nahid Neamati, Pallab K. Maulik, Ali H. Mokdad, Joshua Longbottom, Somayeh Bohlouli, Ahmad Daryani, Ibrahim Abdollahpour, Mostafa Hosseini, Deborah Carvalho Malta, Nick Golding, Sheikh Mohammed Shariful Islam, Shirin Nosratnejad, Haidong Wang, Shadi Rahimzadeh, Pushpendra Kumar, Mehdi Noroozi, Andre M. N. Renzaho, Brent Bell, Huong Lan Thi Nguyen, Khaled Khatab, Meghdad Pirsaheb, Yousef Veisani, Katie R Nielsen, Ionut Negoi, Seyyed Meysam Mousavi, Amir Ashraf-Ganjouei, Mohammad Hassan Emamian, Joseph L Ward, Sharath Burugina Nagaraja, Songhomitra Panda-Jonas, Ettore Beghi, Azeem Majeed, Ivy Shiue, Delia Hendrie, Roghiyeh Faridnia, Seyed Mostafa Mir, Moslem Soofi, Ghobad Moradi, Mahsa Ghajarzadeh, Chandrashekhar T Sreeramareddy, Milad Hasankhani, Mohamed I Hegazy, Mika Shigematsu, Bryan L. Sykes, Vahid Alipour, Ruth W Kimokoti, Afshin Maleki, Nafiseh Baheiraei, Noore Alam, Jalal Arabloo, Mariam Molokhia, Kimberly B. Johnson, Amber Sligar, Nicole Davis Weaver, Kerem Shuval, Malede Mequanent Sisay, Paul H. Lee, Reza Ghadimi, Mahbobeh Faramarzi, Natalia V. Bhattacharjee, Ehsan Sadeghi, Brandon V. Pickering, Animika Pandey, Ana Isabel Ribeiro, Felix Greaves, Sameer Vali Gopalani, Joel M. Francis, Alyssa N. Sbarra, Yun Jin Kim, Agus Sudaryanto, Hebat Allah Salah A. 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C.J.L., and Hay S.I.

Subjects
Survival, RJ101, Mortalidad Infantil, HB, UNDER-5 MORTALITY, Global Health, Pediatrics, 0302 clinical medicine, 3123 Gynaecology and paediatrics, Child death, Infant Mortality, Epidemiology, Global health, Middle income country, Nacimiento vivo, 030212 general & internal medicine, 10. No inequality, Child, POPULATION, Developing world, education.field_of_study, Public health, Multidisciplinary, Geography, Mortality rate, wa_900, 1. No poverty, SUCCESS, Pediatrik, A900 Others in Medicine and Dentistry, 3142 Public health care science, environmental and occupational health, 3. Good health, Child Mortality, Death children, VACCINATION, HEALTH, ws_100, INTERVENTIONS, AFRICA, medicine.medical_specialty, United Nations, General Science & Technology, 030231 tropical medicine, Population, Developing country, Article, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], ITC-HYBRID, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, Social Justice, Recién nacido, Neonatal deaths, medicine, SYSTEMATIC ANALYSIS, Organizational Objectives, Humans, education, Developing Countries, business.industry, Infant, Newborn, Infant, CIVIL REGISTRATION, Paediatrics, Child survival, Newborn, PREVENTION, Infant mortality, wa_320, ws_200, Child mortality, Socioeconomic Factors, ITC-ISI-JOURNAL-ARTICLE, Human medicine, Paediatrics, Public health, Developing world, business, Demography
Abstract

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations., A high-resolution, global atlas of mortality of children under five years of age between 2000 and 2017 highlights subnational geographical inequalities in the distribution, rates and absolute counts of child deaths by age.

Published
2019

10. Mapping diphtheria-pertussis-tetanus vaccine coverage in Africa, 2000–2016: a spatial and temporal modelling study

Author

Daniel C Casey, Robert C. Reiner, William C. Gagne-Maynard, Freya M Shearer, Peter W. Gething, Daniel J. Weiss, Roy Burstein, Elizabeth A. Cromwell, Aniruddha Deshpande, Nancy Fullman, Christopher J L Murray, Aaron Osgood-Zimmerman, Lucas Earl, Nicholas Graetz, Stephen S Lim, Patrick Y Liu, Jonathan F. Mosser, Heidi J. Larson, Sarah E Ray, David M. Pigott, Samir Bhatt, Puja C Rao, Simon I. Hay, Rachel L Updike, and Laura Dwyer-Lindgren

Subjects
Vaccination Coverage, Inequality, Somalia, media_common.quotation_subject, Childhood vaccination, 030204 cardiovascular system & hematology, Health outcomes, Article, 03 medical and health sciences, Spatio-Temporal Analysis, 0302 clinical medicine, Cost of Illness, medicine, Humans, 030212 general & internal medicine, Socioeconomics, Diphtheria-Tetanus-Pertussis Vaccine, media_common, Tetanus, Immunization Programs, Diphtheria, Vaccination, Rwanda, Infant, General Medicine, Models, Theoretical, medicine.disease, Morocco, Geography, Angola, Socioeconomic Factors, Action plan, Africa, Diphtheria-Pertussis-Tetanus Vaccine, Guinea, Immunization, Ethiopia, Geographical inequalities, Delivery of Health Care
Abstract

Summary Background Routine childhood vaccination is among the most cost-effective, successful public health interventions available. Amid substantial investments to expand vaccine delivery throughout Africa and strengthen administrative reporting systems, most countries still require robust measures of local routine vaccine coverage and changes in geographical inequalities over time. Methods This analysis drew from 183 surveys done between 2000 and 2016, including data from 881 268 children in 49 African countries. We used a Bayesian geostatistical model calibrated to results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017, to produce annual estimates with high-spatial resolution (5 × 5 km) of diphtheria-pertussis-tetanus (DPT) vaccine coverage and dropout for children aged 12–23 months in 52 African countries from 2000 to 2016. Findings Estimated third-dose (DPT3) coverage increased in 72·3% (95% uncertainty interval [UI] 64·6–80·3) of second-level administrative units in Africa from 2000 to 2016, but substantial geographical inequalities in DPT coverage remained across and within African countries. In 2016, DPT3 coverage at the second administrative (ie, district) level varied by more than 25% in 29 of 52 countries, with only two (Morocco and Rwanda) of 52 countries meeting the Global Vaccine Action Plan target of 80% DPT3 coverage or higher in all second-level administrative units with high confidence (posterior probability ≥95%). Large areas of low DPT3 coverage (≤50%) were identified in the Sahel, Somalia, eastern Ethiopia, and in Angola. Low first-dose (DPT1) coverage (≤50%) and high relative dropout (≥30%) together drove low DPT3 coverage across the Sahel, Somalia, eastern Ethiopia, Guinea, and Angola. Interpretation Despite substantial progress in Africa, marked national and subnational inequalities in DPT coverage persist throughout the continent. These results can help identify areas of low coverage and vaccine delivery system vulnerabilities and can ultimately support more precise targeting of resources to improve vaccine coverage and health outcomes for African children. Funding Bill & Melinda Gates Foundation.

Published
2019

11. Identifying residual hotspots and mapping lower respiratory infection morbidity and mortality in African children from 2000 to 2017

Author

Joseph Frostad, Simon I. Hay, Kirsten E. Wiens, Brigette F. Blacker, Grant Rodgers Kemp, Peter W. Gething, Roy Burstein, Nicholas Graetz, Sandra B. Munro, Ibrahim A Khalil, Robert C. Reiner, Mathew M. Baumann, Christopher J L Murray, Catherine A. Welgan, Jonathan F. Mosser, Molly K. Miller-Petrie, Samir Bhatt, David L. Smith, Paulina A. Lindstedt, Scott J. Swartz, Oliver J. Brady, Aaron Osgood-Zimmerman, Aniruddha Deshpande, Nicholas J Kassebaum, Puja C Rao, Lucas Earl, Christopher Troeger, Laura Dwyer-Lindgren, Tamer H. Farag, Laurie B. Marczak, Sarah E Ray, Daniel J. Weiss, Moritz U. G. Kraemer, Ian Davis, Jennifer M. Ross, David M. Pigott, QuynhAnh P. Nguyen, Nicole Davis Weaver, Ali H. Mokdad, and Daniel C Casey

Subjects
Microbiology (medical), Change over time, medicine.medical_specialty, Epidemiology, Immunology, 030204 cardiovascular system & hematology, Disease cluster, Applied Microbiology and Biotechnology, Microbiology, Policy and public health in microbiology, Article, 03 medical and health sciences, Health services, 0302 clinical medicine, Environmental health, Genetics, medicine, Prevalence, Humans, 030212 general & internal medicine, Lower respiratory infection, Respiratory Tract Infections, Health policy, Cause of death, Respiratory tract diseases, Infectious-disease epidemiology, business.industry, Incidence (epidemiology), Incidence, Infant, Newborn, Infant, Bayes Theorem, Cell Biology, Risk factors, Child, Preschool, Africa, Public Health, Morbidity, business
Abstract

Lower respiratory infections (LRIs) are the leading cause of death in children under the age of 5, despite the existence of vaccines against many of their aetiologies. Furthermore, more than half of these deaths occur in Africa. Geospatial models can provide highly detailed estimates of trends subnationally, at the level where implementation of health policies has the greatest impact. We used Bayesian geostatistical modelling to estimate LRI incidence, prevalence and mortality in children under 5 subnationally in Africa for 2000–2017, using surveys covering 1.46 million children and 9,215,000 cases of LRI. Our model reveals large within-country variation in both health burden and its change over time. While reductions in childhood morbidity and mortality due to LRI were estimated for almost every country, we expose a cluster of residual high risk across seven countries, which averages 5.5 LRI deaths per 1,000 children per year. The preventable nature of the vast majority of LRI deaths mandates focused health system efforts in specific locations with the highest burden., Geospatial modelling shows an overall decline in morbidity and mortality due to lower respiratory infections in Africa from 2000 to 2017, but also identifies subnational areas with residual high risk.

Published
2019

12. Global, regional, and national incidence, prevalence, and mortality of HIV, 1980–2017, and forecasts to 2030, for 195 countries and territories: a systematic analysis for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017

Author

Ephrem Tsegay Asfaw, Irina Filip, Maciej Banach, Amjad Mohamadi-Bolbanabad, Girmay Teklay Weldesamuel, Joshua A. Salomon, Anemaw A Asrat, Zahra Jorjoran Shushtari, Hamidreza Komaki, Mekdes Tigistu Yilma, Reza Shirkoohi, Mostafa Qorbani, Ahamarshan Jayaraman Nagarajan, Don C. Des Jarlais, Adnan Kisa, Gebreamlak Gebremedhn Gebremeskel, Kidu Gidey Weldegwergs, Amir Kasaeian, Peter Memiah, Son Hoang Nguyen, Segun Emmanuel Ibitoye, Ali Kabir, Subash Thapa, Diego Augusto Santos Silva, Kefyalew Addis Alene, Alireza Rafiei, Huong Lan Thi Nguyen, Erlyn Rachelle King Macarayan, Kelali Kalaye Gebreyohannes, Khaled Khatab, Ghobad Moradi, Noore Alam, Aletta E. Schutte, Sharareh Eskandarieh, H. Dean Hosgood, Rakhi Dandona, Taye Abuhay Zewale, Sezer Kisa, Gessessew Bugssa Hailu, Hedayat Abbastabar, Ketema Bizuwork Gebremedhin, Smita Pakhale, Govinda Prasad Dhungana, Dina Nur Anggraini Ningrum, Bakhtiar Piroozi, Yaschilal Muche Belayneh, Tesfaye Dessale Kassa, Irfan Ullah, Sahar Saeedi Moghaddam, Jean Jacques Noubiap, Mojtaba Bagherzadeh, Akram Pourshams, Alberto L. García-Basteiro, Helen Bitew, Kindie Fentahun Muchie, Mehdi Sayyah, Kevin S Ikuta, Moses K. Muriithi, Aliasghar Ahmad Kiadaliri, Zerihun Menlkalew Zenebe, Cesar Reis, Themba G. Ginindza, Jagadish Rao Padubidri, Yoosik Youm, Saba Abraham Belay, Olayinka Stephen Ilesanmi, Neeraj Bedi, Maziar Moradi-Lakeh, Hamid Sharifi, Nefsu Awoke, Manasi Kumar, Carlos Magis-Rodriguez, Muhammad Shahdaat Bin Sayeed, Maheswar Satpathy, Andrew Blinov, Fiseha Wadilo Wada, Babak Moazen, Hadi Hassankhani, Jae Il Shin, Sanjay Basu, Aziz Eftekhari, Masood Ali Shaikh, Arya Haj-Mirzaian, Laura Dwyer-Lindgren, Haileab Fekadu Wolde, Habtamu Abera Areri, Krista M. Steuben, Lalit Dandona, Keivan Ahmadi, Aso Mohammad Darwesh, Belete Kassa, Keyghobad Ghadiri, Arash Ziapour, Raquel Crider, Alaa Badawi, Tahvi Frank, Amir Hasanzadeh, Marcel Yotebieng, Jemal Abdu Mohammed, Marcos Roberto Tovani-Palone, Emmanuel Peprah, Mekonnen Sisay, Ghulam Mustafa, Oghenowede Eyawo, Seyed Sina Naghibi Irvani, Vahid Alipour, Reza Malekzadeh, Bereket Duko Adema, Direslgne Misker Abyu, Tinuke O Olagunju, Olatunde Aremu, Roghayeh Mohammadibakhsh, Linh Phuong Doan, Mihiretu Kebede, Aman Yesuf Endries, Amira Shaheen, Belete Biadgo, Ali Rostami, Marwa Rashad Salem, Getnet Gedefaw, Stein Emil Vollset, Gurudatta Naik, Veincent Christian Filipino Pepito, Duduzile Ndwandwe, Melese Abate Reta, Aleksandra Barac, Simon I. Hay, Vishnu Renjith, Seifadin Ahmed Shallo, Kebede Deribe, Malihe Nourollahpour Shiadeh, Tewodros Eshete Wonde, Nuno Taveira, Mohammad Ali Sahraian, Marilita M Moschos, Masoud Foroutan, Alebachew Fasil Ashagre, Félix Carvalho, Yun Jin Kim, Farid Najafi, Tukur Dahiru, Chinwe Juliana Iwu, Dharmesh Kumar Lal, Varshil Mehta, Molly R Nixon, Nahla Anber, Seyedmojtaba Seyedmousavi, Mohammad Rabiee, Nauman Khalid, Felix Akpojene Ogbo, Anselm Okoro, Sanjay Zodpey, Birhanu Geta, Kebede Embaye Gezae, Shirin Djalalinia, Amanda E. Smith, Naser Mohammad Gholi Mezerji, Arvin Haj-Mirzaian, Birkneh Tilahun Tadesse, Yared Belete Belay, Saeed Amini, Ziad A. Memish, Stephanie M. Topp, Eduarda Fernandes, Mohammed Suleiman Obsa, Junaid Khan, Andem Effiong, Jane Jean-Hee Lee, Emmanuel Ngassa Laurent Mayenga, Abdallah M. Samy, Anton Sokhan, Rajesh Sagar, Dawit Zewdu Wondafrash, Atalay Goshu Muluneh, Birhan Alemnew, Asmamaw Demis, Samer Hamidi, Getnet Mengistu, Michael Tamene Haile, Gbenga A. Kayode, Huyen Phuc Do, Yoshan Moodley, Mehdi Hosseinzadeh, Moslem Mohammadi, Dayane Gabriele Alves Silveira, Samad Azari, Gulfaraz Khan, Maysaa El Sayed Zaki, Emmanuel Ankrah Odame, Anusha Ganapati Bhat, Louisa Degenhardt, Mu'awiyyah Babale Sufiyan, Harish Chander Gugnani, Sadaf G. Sepanlou, Ai Koyanagi, Ebrahim M Yimer, Maryam Adabi, Javad Nazari, Saravanan Muthupandian, Evanson Z. Sambala, Salman Khazaei, Nelson Alvis-Guzman, Hunduma Amensisa Bojia, Anwar Rafay, Richard Ofori-Asenso, Ehsan Ahmadpour, José Neves, Desalegn Tadese Mengistu, Shafiu Mohammed, Hamid Yimam Hassen, Navid Rabiee, Dinh-Toi Chu, Zoubida Zaidi, Sajjad Ur Rahman, Tilahun Belete Mossie, Olanrewaju Oladimeji, Krittika Bhattacharyya, Gebrekiros Gebremichael Meles, Hassan Magdy Abd El Razek, Stanislav S. Otstavnov, Shaimaa I. El-Jaafary, Habtamu Temesgen, Lolemo Kelbiso Hanfore, Milad Mohammadoo-Khorasani, Muktar Beshir Ahmed, Karzan Abdulmuhsin Mohammad, Carl Abelardo T. Antonio, Morteza Abdullatif Khafaie, Spencer L. James, Bhaskaran Unnikrishnan, Morteza Shamsizadeh, Kenean Getaneh Tlaye, Ziad El-Khatib, Zohreh Anbari, Aisha Elsharkawy, Nancy Fullman, Cuong Tat Nguyen, Chalachew Genet Akal, Chabila C Mapoma, Amir H. Pakpour, Rafael Alves Guimarães, Jalal Arabloo, Eyasu Ejeta Duken, Hailay Abrha Gesesew, Koku Sisay Tamirat, Batool Fatima, Tissa Wijeratne, Addisu Gize Yeshanew, Benn Sartorius, Kathryn H. Jacobsen, Abdullah T Khoja, Morenike Oluwatoyin Folayan, Phetole Walter Mahasha, Takeshi Fukumoto, Maryam Moossavi, Bahram Mohajer, Ravi Prakash Jha, Oladimeji Adebayo, Farshad Farzadfar, Francisco Rogerlândio Martins-Melo, Solomon Sisay, Ensiyeh Jenabi, Bach Xuan Tran, Eleonora Dubljanin, Farnam Mohebi, Jasvinder A. Singh, Barthelemy Kuate Defo, Masoud Behzadifar, Yousef Mohammad, Feleke Mekonnen Demeke, G Anil Kumar, Jan-Walter De Neve, Afshin Zarghi, Hosein Shabaninejad, Trang Huyen Nguyen, Degena Bahrey Tadesse, Monika Sawhney, Eyal Oren, Bayu Begashaw Bekele, Saeed Safari, Salvatore Rubino, Kenji Shibuya, Daniel Diaz, Salman Rawaf, Demelash Woldeyohannes Handiso, Ted R. Miller, Fares Alahdab, Vafa Rahimi-Movaghar, Seyyed Meysam Mousavi, Sonali Kochhar, Azeem Majeed, Till Bärnighausen, Zubair Kabir, Devasahayam J. Christopher, Malede Mequanent Sisay, Adane Teshome Kefale, Shishay Wahdey Tekelemedhin, Tsegaye Lolaso Lenjebo, Yousef Khader, Ali Bijani, Kebreab Paulos, Hagazi Gebre Meles, Euripide Frinel G Arthur Avokpaho, Alireza Ahmadi, Tuomo J. Meretoja, Padukudru Anand Mahesh, Florian Fischer, Mulugeta Melku, Fakher Rahim, Manisha Dubey, Cheru Tesema Leshargie, Vijay Kumar Chattu, Yasir Waheed, Mehdi Noroozi, Austin Carter, Chuanhua Yu, Ronny Westerman, Andualem Henok, Yousef Veisani, Sharath Burugina Nagaraja, Reta Tsegaye Gayesa, Mina Anjomshoa, Andrew T Olagunju, Getachew Mullu Kassa, Belayneh K Gelaw, Jost B. Jonas, Ejaz Ahmad Khan, Adugnaw Berhane, Chukwudi A Nnaji, Daniel Asmelash, Tomislav Mestrovic, Addisu Melese, Stephen S Lim, Yahya Salimi, Chi Linh Hoang, Christopher J L Murray, Mohammad Sadegh Rezai, Bruno F. Sunguya, Herbert C. Duber, Senad Handanagic, Ashish Awasthi, Anthony Masaka, Megha Arora, Sergey Soshnikov, Sangram Kishor Patel, Kwaku Oppong Asante, Haidong Wang, Rajendra Kadel, Bryan L. Sykes, Lucero Cahuana-Hurtado, Afarin Rahimi-Movaghar, Deepa Jahagirdar, Manaye Yihune Teshale, Samantha Leigh Larson, Martin Amogre Ayanore, Sergey K Vladimirov, Gebre Teklemariam Demoz, Fisaha Haile Tesfay, Mohsen Naghavi, Chhabi Lal Ranabhat, Walter Mendoza, Kassawmar Angaw Bogale, Khanh Bao Tran, Berhanu Yazew Wondmagegn, Carlos Miguel Rios González, Ahmad Daryani, Ali H. Mokdad, Julio Cesar Campuzano Rincon, Alemayehu Toma Mena, Navid Manafi, Andre Pascal Kengne, Victor Adekanmbi, Netsanet Fentahun, Olalekan A. Uthman, Desmond Kuupiel, Olatunji O. Adetokunboh, Zahid A Butt, Mohamed Hsairi, Bulat Idrisov, Ranjani Somayaji, Dan J. Stein, Molly H Biehl, Samuel B. Albertson, Laith J. Abu-Raddad, Parvaiz A Koul, Elias Merdassa Roro, Marek Majdan, Dereje Bayissa Demissie, Emilie R Maddison, Naohiro Yonemoto, Ahmad Ghashghaee, Young-Ho Khang, Solomon Olum, Hmwe H Kyu, Amir Radfar, Dirk Douwes-Schultz, Elham Ahmadian, Graduate School, AII - Infectious diseases, APH - Global Health, APH - Methodology, GBD 2017 HIV Collaborators, Clinicum, Institute for Molecular Medicine Finland, HUS Comprehensive Cancer Center, Staff Services, University of Helsinki, Department of Oncology, Adema, Bereket Duko, GBD 2017 HIV collaborators, and Public Health

Subjects
0301 basic medicine, A300 Clinical Medicine, Epidemiology, CITIES, HIV Infections, Mortalities, Global Burden of Disease, 0302 clinical medicine, Risk Factors, Seroepidemiologic Studies, Cause of Death, Prevalences, Prevalence, Global health, LIFE EXPECTANCY, 030212 general & internal medicine, 10. No inequality, education.field_of_study, CHALLENGES, Incidence, Incidence (epidemiology), Incidences, 1. No poverty, MEN, 3. Good health, AIDS, Infectious Diseases, Life Sciences & Biomedicine, GBD 2017 HIV collaborators, medicine.medical_specialty, Forecasts, Immunology, Population, Cause of Death/trends, UNITED-STATES, Context (language use), History, 21st Century, 03 medical and health sciences, SDG 3 - Good Health and Well-being, Acquired immunodeficiency syndrome (AIDS), Virology, Environmental health, medicine, Humans, education, Global Burden of Disease/trends, Estimation, Science & Technology, SEX-SPECIFIC MORTALITY, business.industry, DISABILITY, Public health, HIV, coverage of antiretroviral therapy, History, 20th Century, medicine.disease, mortality, R1, PREVENTION, TRENDS, 030112 virology, HIV Infections/mortality, 3121 General medicine, internal medicine and other clinical medicine, Life expectancy, Human medicine, business, Forecasting
Abstract

BACKGROUND: Understanding the patterns of HIV/AIDS epidemics is crucial to tracking and monitoring the progress of prevention and control efforts in countries. We provide a comprehensive assessment of the levels and trends of HIV/AIDS incidence, prevalence, mortality, and coverage of antiretroviral therapy (ART) for 1980-2017 and forecast these estimates to 2030 for 195 countries and territories.METHODS: We determined a modelling strategy for each country on the basis of the availability and quality of data. For countries and territories with data from population-based seroprevalence surveys or antenatal care clinics, we estimated prevalence and incidence using an open-source version of the Estimation and Projection Package-a natural history model originally developed by the UNAIDS Reference Group on Estimates, Modelling, and Projections. For countries with cause-specific vital registration data, we corrected data for garbage coding (ie, deaths coded to an intermediate, immediate, or poorly defined cause) and HIV misclassification. We developed a process of cohort incidence bias adjustment to use information on survival and deaths recorded in vital registration to back-calculate HIV incidence. For countries without any representative data on HIV, we produced incidence estimates by pulling information from observed bias in the geographical region. We used a re-coded version of the Spectrum model (a cohort component model that uses rates of disease progression and HIV mortality on and off ART) to produce age-sex-specific incidence, prevalence, and mortality, and treatment coverage results for all countries, and forecast these measures to 2030 using Spectrum with inputs that were extended on the basis of past trends in treatment scale-up and new infections.FINDINGS: Global HIV mortality peaked in 2006 with 1·95 million deaths (95% uncertainty interval 1·87-2·04) and has since decreased to 0·95 million deaths (0·91-1·01) in 2017. New cases of HIV globally peaked in 1999 (3·16 million, 2·79-3·67) and since then have gradually decreased to 1·94 million (1·63-2·29) in 2017. These trends, along with ART scale-up, have globally resulted in increased prevalence, with 36·8 million (34·8-39·2) people living with HIV in 2017. Prevalence of HIV was highest in southern sub-Saharan Africa in 2017, and countries in the region had ART coverage ranging from 65·7% in Lesotho to 85·7% in eSwatini. Our forecasts showed that 54 countries will meet the UNAIDS target of 81% ART coverage by 2020 and 12 countries are on track to meet 90% ART coverage by 2030. Forecasted results estimate that few countries will meet the UNAIDS 2020 and 2030 mortality and incidence targets.INTERPRETATION: Despite progress in reducing HIV-related mortality over the past decade, slow decreases in incidence, combined with the current context of stagnated funding for related interventions, mean that many countries are not on track to reach the 2020 and 2030 global targets for reduction in incidence and mortality. With a growing population of people living with HIV, it will continue to be a major threat to public health for years to come. The pace of progress needs to be hastened by continuing to expand access to ART and increasing investments in proven HIV prevention initiatives that can be scaled up to have population-level impact.FUNDING: Bill & Melinda Gates Foundation, National Institute of Mental Health of the US National Institutes of Health (NIH), and the National Institute on Aging of the NIH.

Published
2019

13. Diagnosed and Undiagnosed Diabetes Prevalence by County in the US, 1999-2012

Author

Ali H. Mokdad, Abraham D. Flaxman, Frank J. van Lenthe, Laura Dwyer-Lindgren, Johan P. Mackenbach, and Public Health

Subjects
Gerontology, Research design, Adult, Male, medicine.medical_specialty, National Health and Nutrition Examination Survey, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, 03 medical and health sciences, Behavioral Risk Factor Surveillance System, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Diabetes mellitus, Internal Medicine, medicine, Diabetes Mellitus, Prevalence, Humans, 030212 general & internal medicine, Advanced and Specialized Nursing, business.industry, Public health, Diabetes prevalence, Health Status Disparities, Middle Aged, medicine.disease, Nutrition Surveys, United States, Rate of increase, Female, Undiagnosed diabetes, business, Demography
Abstract

OBJECTIVE Previous analyses of diabetes prevalence in the U.S. have considered either only large geographic regions or only individuals in whom diabetes had been diagnosed. We estimated county-level trends in the prevalence of diagnosed, undiagnosed, and total diabetes as well as rates of diagnosis and effective treatment from 1999 to 2012. RESEARCH DESIGN AND METHODS We used a two-stage modeling procedure. In the first stage, self-reported and biomarker data from the National Health and Nutrition Examination Survey (NHANES) were used to build models for predicting true diabetes status, which were applied to impute true diabetes status for respondents in the Behavioral Risk Factor Surveillance System (BRFSS). In the second stage, small area models were fit to imputed BRFSS data to derive county-level estimates of diagnosed, undiagnosed, and total diabetes prevalence, as well as rates of diabetes diagnosis and effective treatment. RESULTS In 2012, total diabetes prevalence ranged from 8.8% to 26.4% among counties, whereas the proportion of the total number of cases that had been diagnosed ranged from 59.1% to 79.8%, and the proportion of successfully treated individuals ranged from 19.4% to 31.0%. Total diabetes prevalence increased in all counties between 1999 and 2012; however, the rate of increase varied widely. Over the same period, rates of diagnosis increased in all counties, while rates of effective treatment stagnated. CONCLUSIONS Our findings demonstrate substantial disparities in diabetes prevalence, rates of diagnosis, and rates of effective treatment within the U.S. These findings should be used to target high-burden areas and select the right mix of public health strategies.

Published
2016

14. Trends and Patterns of Geographic Variation in Mortality From Substance Use Disorders and Intentional Injuries Among US Counties, 1980-2014

Author

Christopher J L Murray, Mohsen Naghavi, Amelia Bertozzi-Villa, Ali H. Mokdad, Jürgen Unützer, Shreya Shirude, Chloe Morozoff, Laura Dwyer-Lindgren, and Rebecca W. Stubbs

Subjects
Adult, Male, Adolescent, Substance-Related Disorders, Population, Alcohol use disorder, Violence, 03 medical and health sciences, Interpersonal relationship, Young Adult, 0302 clinical medicine, Environmental health, Medicine, Humans, Interpersonal Relations, 030212 general & internal medicine, Young adult, education, Child, Geographic difference, Aged, Original Investigation, Estimation, Aged, 80 and over, education.field_of_study, business.industry, Mortality rate, General Medicine, Middle Aged, medicine.disease, United States, Suicide, Child, Preschool, Residence, Female, business, Alcohol-Related Disorders, Self-Injurious Behavior, 030217 neurology & neurosurgery
Abstract

Importance Substance use disorders, including alcohol use disorders and drug use disorders, and intentional injuries, including self-harm and interpersonal violence, are important causes of early death and disability in the United States. Objective To estimate age-standardized mortality rates by county from alcohol use disorders, drug use disorders, self-harm, and interpersonal violence in the United States. Design and Setting Validated small-area estimation models were applied to deidentified death records from the National Center for Health Statistics (NCHS) and population counts from the US Census Bureau, NCHS, and the Human Mortality Database to estimate county-level mortality rates from 1980 to 2014 for alcohol use disorders, drug use disorders, self-harm, and interpersonal violence. Exposures County of residence. Main Outcomes and Measures Age-standardized mortality rates by US county (N = 3110), year, sex, and cause. Results Between 1980 and 2014, there were 2 848 768 deaths due to substance use disorders and intentional injuries recorded in the United States. Mortality rates from alcohol use disorders (n = 256 432), drug use disorders (n = 542 501), self-harm (n = 1 289 086), and interpersonal violence (n = 760 749) varied widely among counties. Mortality rates decreased for alcohol use disorders, self-harm, and interpersonal violence at the national level between 1980 and 2014; however, over the same period, the percentage of counties in which mortality rates increased for these causes was 65.4% for alcohol use disorders, 74.6% for self-harm, and 6.6% for interpersonal violence. Mortality rates from drug use disorders increased nationally and in every county between 1980 and 2014, but the relative increase varied from 8.2% to 8369.7%. Relative and absolute geographic inequalities in mortality, as measured by comparing the 90th and 10th percentile among counties, decreased for alcohol use disorders and interpersonal violence but increased substantially for drug use disorders and self-harm between 1980 and 2014. Conclusions and Relevance Mortality due to alcohol use disorders, drug use disorders, self-harm, and interpersonal violence varied widely among US counties, both in terms of levels of mortality and trends. These estimates may be useful to inform efforts to target prevention, diagnosis, and treatment to improve health and reduce inequalities.

Published
2018

15. Alcohol-impaired driving in US counties, 2002–2012

Author

Eileen M. Bulger, Alan Chen, Sam R. Sharar, Erin B. Palmisano, Laura Dwyer-Lindgren, Jacob E. Sunshine, and Ali H. Mokdad

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Alcohol Drinking, Epidemiology, Impaired driving, lcsh:Computer applications to medicine. Medical informatics, Trauma, 01 natural sciences, Behavioral Risk Factor Surveillance System, 03 medical and health sciences, Risk-Taking, Wisconsin, 0302 clinical medicine, Prevalence, medicine, Humans, 030212 general & internal medicine, 0101 mathematics, Driving Under the Influence, Public health, Ethanol, Montana, business.industry, Research, lcsh:Public aspects of medicine, 010102 general mathematics, Motor vehicle crash, Public Health, Environmental and Occupational Health, Health services research, Nebraska, lcsh:RA1-1270, Excessive alcohol consumption, Borough, North Dakota, Population Surveillance, lcsh:R858-859.7, Female, Self Report, Health behavior, Alcohol, business, Alaska, Demography
Abstract

Background Excessive alcohol consumption and alcohol-impaired driving remain significant public health problems, leading to considerable morbidity and mortality, particularly among younger populations. Methods Using data from the Behavioral Risk Factor Surveillance System (BRFSS), we employed a small areas modeling strategy to estimate the county-level annual prevalence of alcohol-impaired driving in every United States county for the years 2002 through 2012, the latest year in which county identifiers were publicly available. Results Alcohol-impaired driving episodes declined from 157.0 million in 2002 (prevalence 3.8%: 95% uncertainty interval [UI], 3.7%–4.0%) to 129.7 million in 2012 (prevalence 3.7%: 95% UI, 3.5%–3.8%), a 17.4% decline. There is considerable variation in the prevalence of alcohol-impaired driving at the county level, ranging from 2.0% in the Sitka City Borough of Alaska to 9.3% in Nance County, Nebraska. Clusters of increased alcohol-impaired driving were observed in Northern Wisconsin (Marinette, Florence, Forest, Vilas, Oneida, Iron counties), North Dakota (Cavalier, Pembina, Walsh, Ramsey, Nelson, Benson, Eddy counties) and Montana (Sheridan, Daniels, Roosevelt, Valley, Phillips, Petroleum, Garfield counties). Conclusions This study showed guarded progress with respect to the occurrence of alcohol-impaired driving episodes in the US from 2002 to 2012. Because these data rely on self-report, this likely represents an underestimate of the true prevalence of alcohol-impaired driving in the US. As the US continues to have several million episodes of alcohol-impaired driving each month, renewed efforts are needed to mitigate this high-risk health behavior.

Published
2018

16. Considerations for County-Level Inequalities in Life Expectancy-Reply

Author

Ali H. Mokdad, Laura Dwyer-Lindgren, and Christopher J L Murray

Subjects
Gerontology, Inequality, business.industry, media_common.quotation_subject, 010102 general mathematics, MEDLINE, Health Status Disparities, 01 natural sciences, 03 medical and health sciences, 0302 clinical medicine, Life Expectancy, Socioeconomic Factors, Internal Medicine, Life expectancy, Medicine, 030212 general & internal medicine, 0101 mathematics, County level, business, media_common
Published
2017

17. Trends and Patterns of Geographic Variation in Cardiovascular Mortality Among US Counties, 1980-2014

Author

Gregory A. Roth, Mohsen Naghavi, Ali H. Mokdad, Amelia Bertozzi-Villa, Rebecca W. Stubbs, Chloe Morozoff, Laura Dwyer-Lindgren, and Christopher J L Murray

Subjects
Male, medicine.medical_specialty, Heart disease, Heart Diseases, Population, 030204 cardiovascular system & hematology, 03 medical and health sciences, Peripheral Arterial Disease, 0302 clinical medicine, Sex Factors, Internal medicine, Cause of Death, Atrial Fibrillation, medicine, Humans, 030212 general & internal medicine, Geography, Medical, education, Geographic difference, Cause of death, education.field_of_study, Endocarditis, business.industry, Mortality rate, Age Factors, Rheumatic Heart Disease, Atrial fibrillation, General Medicine, medicine.disease, Hypertensive heart disease, United States, Aortic Aneurysm, Stroke, Years of potential life lost, Cardiovascular Diseases, Small-Area Analysis, Hypertension, Cardiology, Female, Quality-Adjusted Life Years, business, Cardiomyopathies, Demography
Abstract

Importance In the United States, regional variation in cardiovascular mortality is well-known but county-level estimates for all major cardiovascular conditions have not been produced. Objective To estimate age-standardized mortality rates from cardiovascular diseases by county. Design and Setting Deidentified death records from the National Center for Health Statistics and population counts from the US Census Bureau, the National Center for Health Statistics, and the Human Mortality Database from 1980 through 2014 were used. Validated small area estimation models were used to estimate county-level mortality rates from all cardiovascular diseases, including ischemic heart disease, cerebrovascular disease, ischemic stroke, hemorrhagic stroke, hypertensive heart disease, cardiomyopathy, atrial fibrillation and flutter, rheumatic heart disease, aortic aneurysm, peripheral arterial disease, endocarditis, and all other cardiovascular diseases combined. Exposures The 3110 counties of residence. Main Outcomes and Measures Age-standardized cardiovascular disease mortality rates by county, year, sex, and cause. Results From 1980 to 2014, cardiovascular diseases were the leading cause of death in the United States, although the mortality rate declined from 507.4 deaths per 100 000 persons in 1980 to 252.7 deaths per 100 000 persons in 2014, a relative decline of 50.2% (95% uncertainty interval [UI], 49.5%-50.8%). In 2014, cardiovascular diseases accounted for more than 846 000 deaths (95% UI, 827-865 thousand deaths) and 11.7 million years of life lost (95% UI, 11.6-11.9 million years of life lost). The gap in age-standardized cardiovascular disease mortality rates between counties at the 10th and 90th percentile declined 14.6% from 172.1 deaths per 100 000 persons in 1980 to 147.0 deaths per 100 000 persons in 2014 (posterior probability of decline >99.9%). In 2014, the ratio between counties at the 90th and 10th percentile was 2.0 for ischemic heart disease (119.1 vs 235.7 deaths per 100 000 persons) and 1.7 for cerebrovascular disease (40.3 vs 68.1 deaths per 100 000 persons). For other cardiovascular disease causes, the ratio ranged from 1.4 (aortic aneurysm: 3.5 vs 5.1 deaths per 100 000 persons) to 4.2 (hypertensive heart disease: 4.3 vs 17.9 deaths per 100 000 persons). The largest concentration of counties with high cardiovascular disease mortality extended from southeastern Oklahoma along the Mississippi River Valley to eastern Kentucky. Several cardiovascular disease conditions were clustered substantially outside the South, including atrial fibrillation (Northwest), aortic aneurysm (Midwest), and endocarditis (Mountain West and Alaska). The lowest cardiovascular mortality rates were found in the counties surrounding San Francisco, California, central Colorado, northern Nebraska, central Minnesota, northeastern Virginia, and southern Florida. Conclusions and Relevance Substantial differences exist between county ischemic heart disease and stroke mortality rates. Smaller differences exist for diseases of the myocardium, atrial fibrillation, aortic and peripheral arterial disease, rheumatic heart disease, and endocarditis.

Published
2017

18. Self-reported general health, physical distress, mental distress, and activity limitation by US county, 1995-2012

Author

Ali H. Mokdad, Frank J. van Lenthe, Laura Dwyer-Lindgren, Johan P. Mackenbach, and Public Health

Subjects
Male, medicine.medical_specialty, Small area estimation, Epidemiology, Health Status, Health-related quality of life, Disparities, Population health, lcsh:Computer applications to medicine. Medical informatics, Race and health, Behavioral Risk Factor Surveillance System, 03 medical and health sciences, Mental distress, Life Expectancy, 0302 clinical medicine, Risk Factors, Environmental health, Activities of Daily Living, Humans, Medicine, 030212 general & internal medicine, Models, Statistical, business.industry, lcsh:Public aspects of medicine, Research, Public health, Healthy Days, Public Health, Environmental and Occupational Health, Health services research, lcsh:RA1-1270, United States, Health equity, 030220 oncology & carcinogenesis, Chronic Disease, Life expectancy, lcsh:R858-859.7, Female, Self Report, Morbidity, Inequalities, Self-reported health, business, Stress, Psychological
Abstract

Background Metrics based on self-reports of health status have been proposed for tracking population health and making comparisons among different populations. While these metrics have been used in the US to explore disparities by sex, race/ethnicity, and socioeconomic position, less is known about how self-reported health varies geographically. This study aimed to describe county-level trends in the prevalence of poor self-reported health and to assess the face validity of these estimates. Methods We applied validated small area estimation methods to Behavioral Risk Factor Surveillance System data to estimate annual county-level prevalence of four measures of poor self-reported health (low general health, frequent physical distress, frequent mental distress, and frequent activity limitation) from 1995 and 2012. We compared these measures of poor self-reported health to other population health indicators, including risk factor prevalence (smoking, physical inactivity, and obesity), chronic condition prevalence (hypertension and diabetes), and life expectancy. Results We found substantial geographic disparities in poor self-reported health. Counties in parts of South Dakota, eastern Kentucky and western West Virginia, along the Texas-Mexico border, along the southern half of the Mississippi river, and in southern Alabama generally experienced the highest levels of poor self-reported health. At the county level, there was a strong positive correlation among the four measures of poor self-reported health and between the prevalence of poor self-reported health and the prevalence of risk factors and chronic conditions. There was a strong negative correlation between prevalence of poor self-reported health and life expectancy. Nonetheless, counties with similar levels of poor self-reported health experienced life expectancies that varied by several years. Changes over time in life expectancy were only weakly correlated with changes in the prevalence of poor self-reported health. Conclusions This analysis adds to the growing body of literature documenting large geographic disparities in health outcomes in the United States. Health metrics based on self-reports of health status can and should be used to complement other measures of population health, such as life expectancy, to identify high need areas, efficiently allocate resources, and monitor geographic disparities. Electronic supplementary material The online version of this article (doi:10.1186/s12963-017-0133-5) contains supplementary material, which is available to authorized users.

Published
2017

19. Trends and Patterns of Disparities in Cancer Mortality Among US Counties, 1980-2014

Author

Rebecca W. Stubbs, Christopher J L Murray, Mohsen Naghavi, Chloe Morozoff, Ali H. Mokdad, Laura Dwyer-Lindgren, Christine Allen, Christina Fitzmaurice, Raghid Charara, and Amelia Bertozzi-Villa

Subjects
Oncology, Male, medicine.medical_specialty, Time Factors, Population, Geographic Mapping, 03 medical and health sciences, 0302 clinical medicine, Breast cancer, Uterine cancer, Risk Factors, Internal medicine, Cause of Death, Neoplasms, medicine, Humans, 030212 general & internal medicine, education, Cancer Death Rate, education.field_of_study, business.industry, Mortality rate, Cancer, General Medicine, medicine.disease, United States, 030220 oncology & carcinogenesis, Regression Analysis, Female, Skin cancer, business, Kidney cancer, Demography
Abstract

Introduction Cancer is a leading cause of morbidity and mortality in the United States and results in a high economic burden. Objective To estimate age-standardized mortality rates by US county from 29 cancers. Design and Setting Deidentified death records from the National Center for Health Statistics (NCHS) and population counts from the Census Bureau, the NCHS, and the Human Mortality Database from 1980 to 2014 were used. Validated small area estimation models were used to estimate county-level mortality rates from 29 cancers: lip and oral cavity; nasopharynx; other pharynx; esophageal; stomach; colon and rectum; liver; gallbladder and biliary; pancreatic; larynx; tracheal, bronchus, and lung; malignant skin melanoma; nonmelanoma skin cancer; breast; cervical; uterine; ovarian; prostate; testicular; kidney; bladder; brain and nervous system; thyroid; mesothelioma; Hodgkin lymphoma; non-Hodgkin lymphoma; multiple myeloma; leukemia; and all other cancers combined. Exposure County of residence. Main Outcomes and Measures Age-standardized cancer mortality rates by county, year, sex, and cancer type. Results A total of 19 511 910 cancer deaths were recorded in the United States between 1980 and 2014, including 5 656 423 due to tracheal, bronchus, and lung cancer; 2 484 476 due to colon and rectum cancer; 1 573 593 due to breast cancer; 1 077 030 due to prostate cancer; 1 157 878 due to pancreatic cancer; 209 314 due to uterine cancer; 421 628 due to kidney cancer; 487 518 due to liver cancer; 13 927 due to testicular cancer; and 829 396 due to non-Hodgkin lymphoma. Cancer mortality decreased by 20.1% (95% uncertainty interval [UI], 18.2%-21.4%) between 1980 and 2014, from 240.2 (95% UI, 235.8-244.1) to 192.0 (95% UI, 188.6-197.7) deaths per 100 000 population. There were large differences in the mortality rate among counties throughout the period: in 1980, cancer mortality ranged from 130.6 (95% UI, 114.7-146.0) per 100 000 population in Summit County, Colorado, to 386.9 (95% UI, 330.5-450.7) in North Slope Borough, Alaska, and in 2014 from 70.7 (95% UI, 63.2-79.0) in Summit County, Colorado, to 503.1 (95% UI, 464.9-545.4) in Union County, Florida. For many cancers, there were distinct clusters of counties with especially high mortality. The location of these clusters varied by type of cancer and were spread in different regions of the United States. Clusters of breast cancer were present in the southern belt and along the Mississippi River, while liver cancer was high along the Texas-Mexico border, and clusters of kidney cancer were observed in North and South Dakota and counties in West Virginia, Ohio, Indiana, Louisiana, Oklahoma, Texas, Alaska, and Illinois. Conclusions and Relevance Cancer mortality declined overall in the United States between 1980 and 2014. Over this same period, there were important changes in trends, patterns, and differences in cancer mortality among US counties. These patterns may inform further research into improving prevention and treatment.

Published
2017

20. US County-Level Trends in Mortality Rates for Major Causes of Death, 1980-2014

Author

Rebecca W. Stubbs, Christopher J L Murray, Katya Anne Shackelford, Frank J. van Lenthe, Abraham D. Flaxman, Mohsen Naghavi, Ryan M Barber, Ali H. Mokdad, Chloe Morozoff, Laura Dwyer-Lindgren, Michael Kutz, Amelia Bertozzi-Villa, Johan P. Mackenbach, Chantal Huynh, and Public Health

Subjects
Gerontology, Estimation, education.field_of_study, medicine.medical_specialty, business.industry, Public health, Mortality rate, Population, General Medicine, Social epidemiology, 030204 cardiovascular system & hematology, United States, 03 medical and health sciences, 0302 clinical medicine, Cause of Death, Epidemiology of cancer, Epidemiology, Medicine, Humans, 030212 general & internal medicine, Mortality, education, business, Cause of death, Demography
Abstract

Importance County-level patterns in mortality rates by cause have not been systematically described but are potentially useful for public health officials, clinicians, and researchers seeking to improve health and reduce geographic disparities. Objectives To demonstrate the use of a novel method for county-level estimation and to estimate annual mortality rates by US county for 21 mutually exclusive causes of death from 1980 through 2014. Design, Setting, and Participants Redistribution methods for garbage codes (implausible or insufficiently specific cause of death codes) and small area estimation methods (statistical methods for estimating rates in small subpopulations) were applied to death registration data from the National Vital Statistics System to estimate annual county-level mortality rates for 21 causes of death. These estimates were raked (scaled along multiple dimensions) to ensure consistency between causes and with existing national-level estimates. Geographic patterns in the age-standardized mortality rates in 2014 and in the change in the age-standardized mortality rates between 1980 and 2014 for the 10 highest-burden causes were determined. Exposure County of residence. Main Outcomes and Measures Cause-specific age-standardized mortality rates. Results A total of 80 412 524 deaths were recorded from January 1, 1980, through December 31, 2014, in the United States. Of these, 19.4 million deaths were assigned garbage codes. Mortality rates were analyzed for 3110 counties or groups of counties. Large between-county disparities were evident for every cause, with the gap in age-standardized mortality rates between counties in the 90th and 10th percentiles varying from 14.0 deaths per 100 000 population (cirrhosis and chronic liver diseases) to 147.0 deaths per 100 000 population (cardiovascular diseases). Geographic regions with elevated mortality rates differed among causes: for example, cardiovascular disease mortality tended to be highest along the southern half of the Mississippi River, while mortality rates from self-harm and interpersonal violence were elevated in southwestern counties, and mortality rates from chronic respiratory disease were highest in counties in eastern Kentucky and western West Virginia. Counties also varied widely in terms of the change in cause-specific mortality rates between 1980 and 2014. For most causes (eg, neoplasms, neurological disorders, and self-harm and interpersonal violence), both increases and decreases in county-level mortality rates were observed. Conclusions and Relevance In this analysis of US cause-specific county-level mortality rates from 1980 through 2014, there were large between-county differences for every cause of death, although geographic patterns varied substantially by cause of death. The approach to county-level analyses with small area models used in this study has the potential to provide novel insights into US disease-specific mortality time trends and their differences across geographic regions.

Published
2016

21. Variation in Deaths From Intentional Injury and Substance Use—Reply

Author

Christopher J L Murray, Laura Dwyer-Lindgren, and Mohsen Naghavi

Subjects
medicine.medical_specialty, business.industry, 010102 general mathematics, General Medicine, 01 natural sciences, Intentional injury, 03 medical and health sciences, 0302 clinical medicine, Variation (linguistics), medicine, 030212 general & internal medicine, 0101 mathematics, Substance use, Psychiatry, business
Published
2018

22. Trends and Patterns of Differences in Infectious Disease Mortality Among US Counties, 1980-2014

Author

Shreya Shirude, Chloe Morozoff, Laura Dwyer-Lindgren, Mohsen Naghavi, Ali H. Mokdad, Rebecca W. Stubbs, Christopher J L Murray, Charbel El Bcheraoui, and Amelia Bertozzi-Villa

Subjects
0301 basic medicine, medicine.medical_specialty, Tuberculosis, Population, Communicable Diseases, 03 medical and health sciences, 0302 clinical medicine, Acquired immunodeficiency syndrome (AIDS), Humans, Medicine, 030212 general & internal medicine, Investments, education, Original Investigation, Hepatitis, education.field_of_study, Respiratory tract infections, business.industry, Mortality rate, Public health, General Medicine, medicine.disease, United States, 030104 developmental biology, Infectious disease (medical specialty), business, Demography
Abstract

Importance Infectious diseases are mostly preventable but still pose a public health threat in the United States, where estimates of infectious diseases mortality are not available at the county level. Objective To estimate age-standardized mortality rates and trends by county from 1980 to 2014 from lower respiratory infections, diarrheal diseases, HIV/AIDS, meningitis, hepatitis, and tuberculosis. Design and Setting This study used deidentified death records from the National Center for Health Statistics (NCHS) and population counts from the US Census Bureau, NCHS, and the Human Mortality Database. Validated small-area estimation models were applied to these data to estimate county-level infectious disease mortality rates. Exposures County of residence. Main Outcomes and Measures Age-standardized mortality rates of lower respiratory infections, diarrheal diseases, HIV/AIDS, meningitis, hepatitis, and tuberculosis by county, year, and sex. Results Between 1980 and 2014, there were 4 081 546 deaths due to infectious diseases recorded in the United States. In 2014, a total of 113 650 (95% uncertainty interval [UI], 108 764-117 942) deaths or a rate of 34.10 (95% UI, 32.63-35.38) deaths per 100 000 persons were due to infectious diseases in the United States compared to a total of 72 220 (95% UI, 69 887-74 712) deaths or a rate of 41.95 (95% UI, 40.52-43.42) deaths per 100 000 persons in 1980, an overall decrease of 18.73% (95% UI, 14.95%-23.33%). Lower respiratory infections were the leading cause of infectious diseases mortality in 2014 accounting for 26.87 (95% UI, 25.79-28.05) deaths per 100 000 persons (78.80% of total infectious diseases deaths). There were substantial differences among counties in death rates from all infectious diseases. Lower respiratory infection had the largest absolute mortality inequality among counties (difference between the 10th and 90th percentile of the distribution, 24.5 deaths per 100 000 persons). However, HIV/AIDS had the highest relative mortality inequality between counties (10.0 as the ratio of mortality rate in the 90th and 10th percentile of the distribution). Mortality from meningitis and tuberculosis decreased over the study period in all US counties. However, diarrheal diseases were the only cause of infectious diseases mortality to increase from 2000 to 2014, reaching a rate of 2.41 (95% UI, 0.86-2.67) deaths per 100 000 persons, with many counties of high mortality extending from Missouri to the northeastern region of the United States. Conclusions and Relevance Between 1980 and 2014, there were declines in mortality from most categories of infectious diseases, with large differences among US counties. However, over this time there was an increase in mortality for diarrheal diseases.

Published
2018

23. Trends and Patterns of Differences in Chronic Respiratory Disease Mortality Among US Counties, 1980-2014

Author

Amelia Bertozzi-Villa, Shreya Shirude, Christopher J L Murray, Mohsen Naghavi, Ali H. Mokdad, Chloe Morozoff, Laura Dwyer-Lindgren, and Rebecca W. Stubbs

Subjects
medicine.medical_specialty, Respiratory Tract Diseases, Population, Asbestosis, Pulmonary Disease, Chronic Obstructive, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, 030212 general & internal medicine, Mortality, Intensive care medicine, education, Cause of death, Asthma, education.field_of_study, business.industry, Mortality rate, Respiratory disease, Interstitial lung disease, General Medicine, medicine.disease, United States, 030228 respiratory system, Small-Area Analysis, Chronic Disease, Respiration Disorders, Lung Diseases, Interstitial, business, Demography
Abstract

Importance Chronic respiratory diseases are an important cause of death and disability in the United States. Objective To estimate age-standardized mortality rates by county from chronic respiratory diseases. Design, Setting, and Participants Validated small area estimation models were applied to deidentified death records from the National Center for Health Statistics and population counts from the US Census Bureau, National Center for Health Statistics, and Human Mortality Database to estimate county-level mortality rates from 1980 to 2014 for chronic respiratory diseases. Exposure County of residence. Main Outcomes and Measures Age-standardized mortality rates by county, year, sex, and cause. Results A total of 4 616 711 deaths due to chronic respiratory diseases were recorded in the United States from January 1, 1980, through December 31, 2014. Nationally, the mortality rate from chronic respiratory diseases increased from 40.8 (95% uncertainty interval [UI], 39.8-41.8) deaths per 100 000 population in 1980 to a peak of 55.4 (95% UI, 54.1-56.5) deaths per 100 000 population in 2002 and then declined to 52.9 (95% UI, 51.6-54.4) deaths per 100 000 population in 2014. This overall 29.7% (95% UI, 25.5%-33.8%) increase in chronic respiratory disease mortality from 1980 to 2014 reflected increases in the mortality rate from chronic obstructive pulmonary disease (by 30.8% [95% UI, 25.2%-39.0%], from 34.5 [95% UI, 33.0-35.5] to 45.1 [95% UI, 43.7-46.9] deaths per 100 000 population), interstitial lung disease and pulmonary sarcoidosis (by 100.5% [95% UI, 5.8%-155.2%], from 2.7 [95% UI, 2.3-4.2] to 5.5 [95% UI, 3.5-6.1] deaths per 100 000 population), and all other chronic respiratory diseases (by 42.3% [95% UI, 32.4%-63.8%], from 0.51 [95% UI, 0.48-0.54] to 0.73 [95% UI, 0.69-0.78] deaths per 100 000 population). There were substantial differences in mortality rates and changes in mortality rates over time among counties, and geographic patterns differed by cause. Counties with the highest mortality rates were found primarily in central Appalachia for chronic obstructive pulmonary disease and pneumoconiosis; widely dispersed throughout the Southwest, northern Great Plains, New England, and South Atlantic for interstitial lung disease; along the southern half of the Mississippi River and in Georgia and South Carolina for asthma; and in southern states from Mississippi to South Carolina for other chronic respiratory diseases. Conclusions and Relevance Despite recent declines in mortality from chronic respiratory diseases, mortality rates in 2014 remained significantly higher than in 1980. Between 1980 and 2014, there were important differences in mortality rates and changes in mortality by county, sex, and particular chronic respiratory disease type. These estimates may be helpful for informing efforts to improve prevention, diagnosis, and treatment.

Published
2017

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