| 1. |
- Aareleid, Tiiu, et al.
(author)
-
Lung cancer in Estonia in 1968-87 : time trends and public health implications.
- 1994
-
In: European Journal of Cancer Prevention. - 0959-8278 .- 1473-5709. ; 3:5, s. 419-425
-
Journal article (peer-reviewed)abstract
- Changes in lung cancer incidence and mortality in Estonia were studied for 20 years (1968-87). A steady upward trend was observed for men and women. The 1983-87/1968-72 age-standardized incidence rate ratio was 1.22 (95% confidence interval (CI) 1.15-1.29) in men and 1.34 (95% CI 1.16-1.54) in women. The corresponding mortality rate ratio was 1.26 (95% CI 1.18-1.34) in men and 1.35 (95% CI 1.16-1.57) in women. The age-specific incidence and mortality rates increased clearly towards the younger birth cohorts. For men and women, the increase was most evident for the age group 45-64 years. In women there was a more rapid increase in incidence and mortality than in men. It may be a result of a substantial increase of tobacco smoking, particularly among women, after the World War II. The high and still rising occurrence of lung cancer is closely related to the high prevalence of smoking; in addition, high tar yields in domestic cigarettes could have been responsible for an elevated lung cancer risk during the past decades. There is not tobacco control programme in Estonia, and existing legislation and regulations do not defend the non-smoking population.
|
|
| 2. |
- Baburin, Aleksei, et al.
(author)
-
Age, Period and Cohort Effects On Alcohol Consumption In Estonia, 1996-2018
- 2021
-
In: Alcohol and Alcoholism. - : Oxford University Press. - 0735-0414 .- 1464-3502. ; 56:4, s. 451-459
-
Journal article (peer-reviewed)abstract
- AIMS: To analyse the independent effects of age, period and cohort on estimated daily alcohol consumption in Estonia.METHODS: This study used data from nationally representative repeated cross-sectional surveys from 1996 to 2018 and included 11,717 men and 16,513 women aged 16-64 years in total. The dependent variables were consumption of total alcohol and consumption by types of beverages (beer, wine and strong liquor) presented as average daily consumption in grams of absolute alcohol. Mixed-effects negative binomial models stratified by sex were used for age-period-cohort analysis.RESULTS: Alcohol consumption was highest at ages 20-29 years for both men and women and declined in older ages. Significant period effects were found indicating that total alcohol consumption and consumption of different types of beverages had increased significantly since the 1990s for both men and women. Cohort trends differed for men and women. Men born in the 1990-2000s had significantly lower daily consumption compared to earlier cohorts, whereas the opposite was found for women.CONCLUSION: While age-related patterns of alcohol consumption are aligned with life course stages, alcohol use has increased over the study period. Although the total daily consumption among men is nearly four times higher than among women, the cohort trends suggest convergence of alcohol consumption patterns for men and women.
|
|
| 3. |
|
|
| 4. |
- Jukkala, Tanya, et al.
(author)
-
Age, period and cohort effects on suicide mortality in Russia, 1956-2005
- 2017
-
In: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 17
-
Journal article (peer-reviewed)abstract
- Background: Russian suicide mortality rates changed rapidly over the second half of the twentieth century. This study attempts to differentiate between underlying period and cohort effects in relation to the changes in suicide mortality in Russia between 1956 and 2005. Methods: Sex-and age-specific suicide mortality data were analyzed using an age-period-cohort (APC) approach. Descriptive analyses and APC modeling with log-linear Poisson regression were performed. Results: Strong period effects were observed for the years during and after Gorbachev ' s political reforms (including the anti-alcohol campaign) and for those following the break-up of the Soviet Union. After mutual adjustment, the cohort-and period-specific relative risk estimates for suicide revealed differing underlying processes. While the estimated period effects had an overall positive trend, cohort-specific developments indicated a positive trend for the male cohorts born between 1891 and 1931 and for the female cohorts born between 1891 and 1911, but a negative trend for subsequent cohorts. Conclusions: Our results indicate that the specific life experiences of cohorts may be important for variations in suicide mortality across time, in addition to more immediate effects of changes in the social environment.
|
|
| 5. |
- Reile, Rainer, et al.
(author)
-
Long-term trends in the body mass index and obesity risk in Estonia : an age-period-cohort approach
- 2020
-
In: International Journal of Public Health. - : Springer. - 1661-8556 .- 1661-8564. ; 65, s. 859-869
-
Journal article (peer-reviewed)abstract
- ObjectivesTo analyse the age, period and cohort effects on the mean body mass index (BMI) and obesity over the past two decades in Estonia.MethodsStudy used data from nationally representative repeated cross-sectional surveys on 11,547 men and 16,298 women from 1996 to 2018. The independent effects of age, period and cohort on predicted mean BMI and probability of obesity (BMI ≥ 30 kg/m2) were modelled using hierarchical age–period–cohort analysis.ResultsCurvilinear association between age and mean BMI was found for men, whereas the increase in mean BMI was almost linear for women. The predicted mean BMI for 40-year-old men had increased by 6% and probability of obesity by 1.8 times over 1996–2018; the period effects were slightly smaller for women. Men from the 1970s birth cohort had higher mean BMI compared to the average, whereas no significant cohort effects were found for obesity outcome.ConclusionsPopulation-level BMI changes in Estonia during 1996–2018 were mostly driven by period rather than cohort-specific changes.
|
|
| 6. |
- Stickley, Andrew, et al.
(author)
-
Economic cycles and inequalities in alcohol-related mortality in the Baltic countries and Finland in 2000-2015 : a register-based study
- 2021
-
In: Addiction. - : Wiley-Blackwell. - 0965-2140 .- 1360-0443. ; 16:12, s. 3357-3368
-
Journal article (peer-reviewed)abstract
- AIM: To estimate whether large macroeconomic fluctuations in the 2000s affected inequalities in alcohol-related mortality in the Baltic countries and Finland.DESIGN: Longitudinal register-based follow up study.SETTING: Estonia, Latvia, Lithuania and Finland.PARTICIPANTS: General population in the 35-74 age group.MEASUREMENTS: Socioeconomic status was measured by the highest achieved educational level and was categorised using the International Standard Classification of Education 2011 as low (included categories 0-2), middle (3-4), and high (5-8). Educational inequalities in alcohol-related mortality in 2000-2003, 2004-2007, 2008-2011 and 2012-2015 were examined using census-linked longitudinal mortality data. We estimated age-standardised mortality rates and the relative and slope index of inequality.FINDINGS: Alcohol-related mortality increased in all countries in 2004-2007 except among Estonian women and decreased/remained the same from 2008 onwards except among Latvian men. By 2012-2015 alcohol-related mortality was still higher than in 2000-2003 in Finland, Latvia and Lithuania (women only). Relative inequalities increased across the study period in all countries (significantly in Lithuania and Latvia). The 2004-2007 increase in relative inequalities was mostly driven by a larger mortality increase among the low educated, whereas in 2008-2011 and in 2012-2015 inequalities often increased because of a larger relative mortality decline among the high educated. However, these period changes in relative inequalities and between educational groups were often not statistically significant. Absolute inequalities were larger in 2012-2015 vs. 2000-2003 in all countries except Estonia (decrease).CONCLUSION: In Estonia, Latvia, Lithuania and Finland, alcohol-related mortality tended to increase faster among the low educated during a period of economic expansion (2004-2007) and tended to decrease more among the high educated during a period of economic recession (2008-2011).
|
|
| 7. |
- Stickley, Andrew, et al.
(author)
-
Educational inequalities in epilepsy mortality in the Baltic countries and Finland in 2000-2015
- 2022
-
In: Scientific Reports. - : Springer Nature. - 2045-2322. ; 12:1
-
Journal article (peer-reviewed)abstract
- Little is known about socioeconomic differences in epilepsy mortality. This study examined educational inequalities in epilepsy mortality in the general population in the Baltic countries and Finland in 2000-2015. Education-specific mortality estimates for individuals aged 30-74 in Estonia, Latvia and Lithuania were obtained from census-linked mortality datasets while data for Finland came from the register-based population and death data file of Statistics Finland. Trends and educational inequalities in epilepsy mortality were assessed using age-standardised mortality rates (ASMRs) per 100,000 person years and age-adjusted mortality rate ratios (RRs) calculated using Poisson regression. ASMRs were higher in men than women in all countries. ASMRs reduced in 2000-2015 among all men and women except for Finnish women. Among men, an inverse educational gradient in epilepsy mortality in 2000-2007 widened in 2008-2015 with ASMRs falling among high and mid educated men in all countries but increasing among low educated men in three countries. An inverse educational gradient in female mortality remained in all countries throughout 2000-2015. Although epilepsy mortality fell in the Baltic countries and Finland (men only) in 2000-2015, this masked a clear inverse educational gradient in mortality that became steeper across the period.
|
|
| 8. |
- Stickley, Andrew, et al.
(author)
-
Educational inequalities in hypothermia mortality in the Baltic countries and Finland in 2000-15
- 2023
-
In: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 33:4, s. 555-560
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Despite an increased focus on cold-related mortality in recent years, there has been comparatively little research specifically on hypothermia mortality and its associated factors.METHODS: Educational inequalities in hypothermia mortality among individuals aged 30-74 in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in 2000-15 were examined using data from longitudinal mortality follow-up studies of population censuses (the Baltics) and from a longitudinal register-based population data file (Finland).RESULTS: Age-standardized mortality rates (ASMRs) were much higher in the Baltic countries than in Finland across the study period. From 2000-07 to 2008-15, overall ASMRs declined in all countries except among Finnish women. Although a strong educational gradient was observed in hypothermia mortality in all countries in 2000-07, inequalities were larger in the Baltic countries. Between 2000-07 and 2008-15, ASMRs declined in all educational groups except for high-educated women in Finland and low-educated women in Lithuania; the changes however were not always statistically significant. The absolute mortality decline was often larger among the low educated resulting in narrowing absolute inequalities (excepting Lithuania), whereas a larger relative decline among the high educated (excepting Finnish women) resulted in a considerable widening of relative inequalities in hypothermia mortality by 2008-15.CONCLUSION: Although some reduction was observed in absolute educational inequalities in hypothermia mortality in 2000-15, substantial and widening relative inequalities highlight the need for further action in combatting factors behind deaths from excessive cold in socioeconomically disadvantaged groups, including risky alcohol consumption and homelessness.
|
|
| 9. |
- Stickley, Andrew, et al.
(author)
-
Macroeconomic changes and educational inequalities in traffic fatalities in the Baltic countries and Finland in 2000-2015 : a register-based study
- 2021
-
In: Scientific Reports. - : Springer Nature. - 2045-2322. ; 11:1
-
Journal article (peer-reviewed)abstract
- This study examined trends and inequalities in road traffic accident (RTA) mortality in the Baltic countries (Estonia, Latvia, Lithuania) and Finland in relation to large-scale macroeconomic changes in the 2000s. Educational inequalities in RTA mortality in 2000-2003, 2004-2007, 2008-2011 and 2012-2015 among 30-74 year olds were examined using census-linked longitudinal mortality data and by estimating the relative and slope index of inequality. Overall RTA mortality decreased substantially between 2000-2003 and 2012-2015. From 2004-2007 to 2008-2011, the RTA mortality decline accelerated but was larger in the Baltic countries. Among men the RTA mortality decline was mostly driven by a larger fall among the high and middle educated. Among women, the changes in RTA mortality by educational level had no clear pattern. From 2000-2003 to 2012-2015 relative educational inequalities in RTA mortality increased among men, although more in the Baltic countries. Among women the pattern was mixed across countries. Absolute inequalities fell in all countries among both sexes. Educational inequalities in male RTA mortality may be growing because of increasingly less access to safer cars and a more hazardous driving culture among the lower educated.
|
|
| 10. |
- Stickley, Andrew, et al.
(author)
-
Sociodemographic inequalities in mortality from drowning in the Baltic countries and Finland in 2000-2015 : a register-based study
- 2023
-
In: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 23:1
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Drowning is an important public health problem. Some evidence suggests that the risk of drowning is not distributed evenly across the general population. However, there has been comparatively little research on inequalities in drowning mortality. To address this deficit, this study examined trends and sociodemographic inequalities in mortality from unintentional drowning in the Baltic countries and Finland in 2000-2015.METHODS: Data for Estonia, Latvia and Lithuania came from longitudinal mortality follow-up studies of population censuses in 2000/2001 and 2011, while corresponding data for Finland were obtained from the longitudinal register-based population data file of Statistics Finland. Deaths from drowning (ICD-10 codes W65-W74) were obtained from national mortality registries. Information was also obtained on socioeconomic status (educational level) and urban-rural residence. Age-standardised mortality rates (ASMRs) per 100 000 person years and mortality rate ratios were calculated for adults aged 30-74 years old. Poisson regression analysis was performed to assess the independent effects of sex, urban-rural residence and education on drowning mortality.RESULTS: Drowning ASMRs were significantly higher in the Baltic countries than in Finland but declined by nearly 30% in all countries across the study period. There were large inequalities by sex, urban-rural residence and educational level in all countries during 2000-2015. Men, rural residents and low educated individuals had substantially higher drowning ASMRs compared to their counterparts. Absolute and relative inequalities were significantly larger in the Baltic countries than in Finland. Absolute inequalities in drowning mortality declined in all countries across the study period except between urban and rural residents in Finland. Changes in relative inequalities were more variable during 2000-2015.CONCLUSION: Despite a sharp reduction in deaths from drowning in the Baltic countries and Finland in 2000-2015, drowning mortality was still high in these countries at the end of the study period with a substantially larger risk of death seen among men, rural residents and low educated individuals. A concerted effort to prevent drowning mortality among those most at risk may reduce drownings considerably in the general population.
|
|
