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- Chen-Xu, José, et al.
(author)
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Subnational inequalities in years of life lost and associations with socioeconomic factors in pre-pandemic Europe, 2009-19 : an ecological study
- 2024
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In: The Lancet Public Health. - : Elsevier. - 2468-2667. ; 9:3, s. e166-e177
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Journal article (peer-reviewed)abstract
- BACKGROUND: Health inequalities have been associated with shorter lifespans. We aimed to investigate subnational geographical inequalities in all-cause years of life lost (YLLs) and the association between YLLs and socioeconomic factors, such as household income, risk of poverty, and educational attainment, in countries within the European Economic Area (EEA) before the COVID-19 pandemic.METHODS: In this ecological study, we extracted demographic and socioeconomic data from Eurostat for 1390 small regions and 285 basic regions for 32 countries in the EEA, which was complemented by a time-trend analysis of subnational regions within the EEA. Age-standardised YLL rates per 100 000 population were estimated from 2009 to 2019 based on methods from the Global Burden of Disease study. Geographical inequalities were assessed using the Gini coefficient and slope index of inequality. Socioeconomic inequalities were assessed by investigating the association between socioeconomic factors (educational attainment, household income, and risk of poverty) and YLLs in 2019 using negative binomial mixed models.FINDINGS: Between Jan 1, 2009, and Dec 31, 2019, YLLs lowered in almost all subnational regions. The Gini coefficient of YLLs across all EEA regions was 14·2% (95% CI 13·6-14·8) for females and 17·0% (16·3 to 17·7) for males. Relative geographical inequalities in YLLs among women were highest in the UK (Gini coefficient 11·2% [95% CI 10·1-12·3]) and among men were highest in Belgium (10·8% [9·3-12·2]). The highest YLLs were observed in subnational regions with the lowest levels of educational attainment (incident rate ratio [IRR] 1·19 [1·13-1·26] for females; 1·22 [1·16-1·28] for males), household income (1·35 [95% CI 1·19-1·53]), and the highest poverty risk (1·25 [1·18-1·34]).INTERPRETATION: Differences in YLLs remain within, and between, EEA countries and are associated with socioeconomic factors. This evidence can assist stakeholders in addressing health inequities to improve overall disease burden within the EEA.
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| 3. |
- Ballesteros, Soledad, et al.
(author)
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Effects of chronic physical exercise on executive functions and episodic memory in clinical and healthy older adult populations : a systematic review and meta-analysis protocol
- 2024
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In: Systematic Reviews. - : BioMed Central (BMC). - 2046-4053. ; 13:1
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Research review (peer-reviewed)abstract
- BACKGROUND: Executive functions (EFs) and episodic memory are fundamental components of cognition that deteriorate with age and are crucial for independent living. While numerous reviews have explored the effect of exercise on these components in old age, these reviews screened and analyzed selected older adult populations, or specific exercise modes, thus providing only limited answers to the fundamental question on the effect of exercise on cognition in old age. This article describes the protocol for a systematic review and multilevel meta-analytic study aiming at evaluating the effectiveness of different types of chronic exercise in improving and/or maintaining EFs and long-term episodic memory in older adults.METHODS AND ANALYSIS: The study protocol was written in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Several databases will be searched. Randomized controlled trials (RCTs) conducted in older adults aged ≥ 60 years providing any kind of planned, structured, and repetitive exercise interventions, and EFs and/or episodic memory measures as outcomes, published in English in peer-reviewed journals and doctoral dissertations will be included. Two independent reviewers will screen the selected articles, while a third reviewer will resolve possible conflicts. The Cochrane risk-of-bias tool will be used to assess the quality of the studies. Finally, data will be extracted from the selected articles, and the formal method of combining individual data from the selected studies will be applied using a random effect multilevel meta-analysis. The data analysis will be conducted with the metafor package in R.DISCUSSION AND CONCLUSION: This review will synthesize the existing evidence and pinpoint gaps existing in the literature on the effects of exercise on EFs and episodic memory in healthy and unhealthy older adults. Findings from this meta-analysis will help to design effective exercise interventions for older adults to improve and/or maintain EFs and episodic memory. Its results will be useful for many researchers and professionals working with older adults and their families.SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42022367111.
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| 4. |
- Baravelli, C. M., et al.
(author)
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Subnational inequalities in YLLs and associated socioeconomic factors : a disease burden study
- 2023
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In: European Journal of Public Health. - : Oxford University Press. - 1101-1262 .- 1464-360X. ; 33:Suppl. 2, s. ii142-ii143
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Journal article (other academic/artistic)abstract
- Background: Health inequalities are an unjust and avoidable problem. Thiss tudy examines subnational geographical inequalities in all-cause years of life lost (YLLs) and the association of socioeconomic factors in pre-coronavirus European Economic Area (EEA) countries.Methods: In this ecological study complimented with a longitudinal analysis, demographic and socioeconomic data for 1390 small regions and 285 basic regions of 32 EEA countries were extracted from Eurostat. Age-standardised YLL rates per 100,000 population were estimated from 2009 to 2019 based on methods from the Global Burden of Disease Study. Inequalities were assessed using the Gini coefficient (GC) and slope index of inequality (SII). The association between socioeconomic factors by YLLs were assessed using negative binomial mixed models in 2019.Findings: Over the period 2009-2019, YLLs have decreased in almost all subnational regions. The GC of YLLs across EEA regions was 14% for females (95% CI = 135 to 146%) and 17% for males (CI = 161 to 175%). Greece (GC = 101%, CI = 78 to 25%) and Belgium (GC = 108%, CI = 95 to 120%) had the highest relative inequalities in YLLs for women and men, respectively. Subnational regions with the lowest income (incident rate ratio (IRR) = 139, CI = 123 to 158) and levels of educational attainment (IRRfemales = 119, CI = 113 to 126; IRRmales = 122, CI = 116 to 128), and highest poverty risk (IRR = 118, CI = 112 to 125) were associated with increased YLLs, with stronger associations observed in Central and Eastern Europe.Interpretation: Differences in YLLs remain within and between EEA countries and are associated with socioeconomic factors. This evidence can assist stakeholders in addressing specific health inequities to improve overall disease burden within the EEA.Key messages:The study highlights the need for public health policies targeted at the subnational level to reduce health inequalities in the EEA.The study describes the effect of existing public health policies targeting socioeconomic factors.
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