Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 2015

• Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure-the Healthcare Quality and Access (HAQ) Index-on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r= 0.88), an index of 11 universal health coverage interventions (r= 0.83), and human resources for health per 1000 (r= 0.77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Findings Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28.6 to 94.6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40.7 (95% uncertainty interval, 39.0-42.8) in 1990 to 53.7 (52.2-55.4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21.2 in 1990 to 20.1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73.8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. Interpretation This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-systemcharacteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Copyright (C) The Author(s). Published by Elsevier Ltd.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Allmänmedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- General Practice (hsv//eng)

Nyckelord

comparative risk-assessment

systematic analysis

medical-care

life

expectancy

avoidable mortality

european countries

development goals

united-states

trends

death

Univ Med Ctr Rotterdam

Rotterdam

Netherlands.

[Kulkarni

Veena S.] Arkansas State Univ

State Univ

AR USA.

[Lager

Anton Carl Jonas] Stockholm Cty Council

Ctr Epidemiol & Community Med

Solna

Sweden.

[Lal

Aparna] Australian Natl Univ

Natl Ctr Epidemiol & Populat Hlth

Canberra

ACT

Australia.

[Jeemon

Panniyammakal] Publ Hlth Fdn India

Ctr Control Chron Condit

Gurgaon

India.

[Lal

Aparna

Mathur

Manu Raj] Publ Hlth Fdn India

Gurgaon

India.

[Lallukka

Tea

Shiri

Rahman] Univ Helsinki

Fac Med

Finnish Inst Occupat Hlth Work Org

Dept Publ

[Meretoja

Tuomo J.] Univ Helsinki

Helsinki

Finland.

[Lan

Qing] NCI

Rockville

MD USA.

[Lansingh

Van C.] Help Me See Inc

New York

NY USA.

[Lansingh

Van C.] Inst Mexicano Oftalmol

Queretaro

Mexico.

[Larsson

Anders] Uppsala Univ

Dept Med Sci

Uppsala

Sweden.

[Latif

Asma Abdul] Lahore Coll Women Univ

Dept Zool

Lahore

Pakistan.

[Lawrynowicz

Alicia Elena Beatriz] Inst Nacl Epidemiol Dr Juan H Jara

Mar Del Plata

Buenos Aires

[Leasher

Janet L.] Nova Southeastern Univ

Coll Optometry

Ft Lauderdale

FL 33314 USA.

[Marks

Guy B.] Univ Sydney

Woolcock Inst Med Res

Sydney

NSW

Australia.

[Leigh

James

Mekonnen

Alemayehu B.] Univ Sydney

Sydney

NSW

Australia.

[Leinsalu

Mall] Sodertorn Univ

Stockholm Ctr Hlth & Social Change

Stockholm

Sweden.

[Leung

Ricky] SUNY Albany

Albany

NY 12222 USA.

[Levi

Miriam] Tuscany Reg Ctr Occupat Injuries & Dis

Florence

Italy.

[Liang

Xiaofeng] Chinese Ctr Dis Control & Prevent

Beijing

Peoples R China.

[Linn

Shai] Univ Haifa

Haifa

Israel.

[Lipshultz

Steven E.

Wilkinson

James D.] Wayne State Univ

Sch Med

Detroit

MI USA.

[Lipshultz

Steven E.] Childrens Hosp Michigan

Detroit

MI 48201 USA.

[Liu

Yang

Phillips

Michael Robert] Emory Univ

Atlanta

GA 30322 USA.

[Lo

Loon-Tzian] UnionHealth Associates LLC

St Louis

MO USA.

[Lo

Loon-Tzian] Alton Mental Hlth Ctr

Alton

IL USA.

[Logroscino

Giancarlo] Univ Bari

Bari

Italy.

[Lorch

Scott A.] Univ Penn

Childrens Hosp Philadelphia

Sch Med

Philadelphia

PA 19104 USA.

[Lunevicius

Raimundas] Aintree Univ Hosp Natl Hlth Serv Fdn Trust

Liverpool

Merseyside

England.

[Lunevicius

Raimundas] Univ Liverpool

Sch Med

Liverpool

Merseyside

England.

[Mackay

Mark T.

Weintraub

Robert G.] Royal Childrens Hosp

Melbourne

Vic

Australia.

[El Razek

Hassan Magdy Abd] Mansoura Fac Med

Mansoura

Egypt.

[El Razek

Mohammed Magdy Abd] Aswan Univ Hosp

Aswan Fac Med

Aswan

Egypt.

[Mahdavi

Mahdi] Erasmus Univ

Inst Hlth Policy & Management

Rotterdam

Netherlands.

[Mahdavi

Mahdi] Social Secur Org Res Inst

Tehran

Iran.

[Rego

Maria Albertina Santiago] Univ Fed Minas Gerais

Fac Med

Belo Horizonte

MG

Brazil.

[Malta

Deborah Carvalho] Univ Fed Minas Gerais

Belo Horizonte

MG

Brazil.

[Mantovani

Lorenzo G.] Univ Milano Bicocca

Monza

Italy.

[Manyazewal

Tsegahun] Ethiopian Publ Hlth Assoc

Addis Ababa

Ethiopia.

[Marcenes

Wagner] Kings Coll London

Dent Inst

Div Populat & Patient Hlth

London

England.

[Martinez-Raga

Jose] Hosp Univ Doctor Peset

Valencia

Spain.

[Martinez-Raga

Jose] CEU Cardinal Herrera Univ

Moncada

Spain.

[Marzan

Melvin Barrientos] Univ East Ramon

Magsaysay Mem Med Ctr

Quezon City

Philippines.

[Massano

Joao] ULS Matosinhos

Hosp Pedro Hispano

Matosinhos

Portugal.

[Maulik

Pallab K.] George Inst Global Hlth India

New Delhi

India.

[Mazidi

Mohsen] Chinese Acad Sci

Inst Genet & Dev Biol

Key State Lab Mol Dev Biol

Beijing

Peoples

[McAlinden

Colm] Univ Hosp Bristol NHS Fdn Trust

Bristol

Avon

England.

[McAlinden

Colm] Publ Hlth Wales

Swansea

W Glam

Wales.

[Meaney

Peter A.] Univ Penn

Perelman Sch Med

Philadelphia

PA 19104 USA.

[Meaney

Peter A.] Childrens Hosp Philadelphia

Philadelphia

PA 19104 USA.

[Mehari

Alem] Howard Univ

Coll Med

Washington

DC USA.

[Mehndiratta

Man Mohan] Janakpuri Superspecialty Hosp

New Delhi

India.

[Meier

Toni] Martin Luther Univ Halle Wittenberg

Halle

Saale

Germany.

[Memish

Ziad A.] Saudi Minist Hlth

Riyadh

Saudi Arabia.

[Memish

Ziad A.] Alfaisal Univ

Coll Med

Riyadh

Saudi Arabia.

[Mensah

George A.] NHLBI

NIH

Ctr Translat Res & Implementat Sci

Bethesda

MD 20892 USA.

[Meretoja

Tuomo J.] Helsinki Univ Hosp

Dept Neurol

Helsinki

Finland.

[Meretoja

Tuomo J.] Helsinki Univ Hosp

Ctr Comprehens Canc

Breast Surg Unit

Helsinki

Finland.

[Micha

Renata] Tufts Univ

Friedman Sch Nutr Sci & Policy

Boston

MA 02111 USA.

[Shi

Peilin] Tufts Univ

Boston

MA 02111 USA.

[Mills

Edward J.] Univ Ottawa

Ottawa

ON

Canada.

[Mirarefin

Mojde] Hunger Act Los Angeles

Los Angeles

CA USA.

[Mirrakhimov

Erkin M.] Kyrgyz State Med Acad

Bishkek

Kyrgyzstan.

[Mirrakhimov

Erkin M.] Natl Ctr Cardiol & Internal Dis

Bishkek

Kyrgyzstan.

[Mohammad

Karzan Abdulmuhsin] Univ Salahaddin

Erbil

Iraq.

[Mohammed

Shafiu] Ahmadu Bello Univ

Hlth Syst & Policy Res Unit

Zaria

Nigeria.

[Mola

Glen Liddell D.] Univ Papua New Guinea

Sch Med & Hlth Sci

Reprod Hlth & ObGyn

Boroko

[Monasta

Lorenzo

Montico

Marcella

Ronfani

Luca] IRCCS Burlo Garofolo

Inst Maternal & Child Hlth

[Moradi-Lakeh

Maziar] Iran Univ Med Sci

Preventat Med & Publ Hlth Res Ctr

Gastrointestinal & Liver

[Tehrani-Banihashemi

Arash] Iran Univ Med Sci

Prevent Med & Publ Hlth Res Ctr

Tehran

Iran.

[Morawska

Lidia] Queensland Univ Technol

Int Lab Air Qual & Hlth

Brisbane

Qld

Australia.

[Sun

Jiandong] Queensland Univ Technol

Sch Publ Hlth & Social Work

Brisbane

Qld

Australia.

[Moraga

Paula] Queensland Univ Technol

Brisbane

Qld

Australia.

[Mori

Rintaro] Natl Ctr Child Hlth & Dev

Setagaya Ku

Tokyo

Japan.

[Werdecker

Andrea] Fed Inst Populat Res

Competence Ctr Mortality Follow Up German Natl Co

[Mueller

Ulrich O.

Westerman

Ronny] Fed Inst Populat Res

Wiesbaden

Germany.

[Musa

Kamarul Imran] Univ Sci Malaysia

Sch Med Sci

Kubang Kerian

Malaysia.

[Nachega

Jean B.] Univ Pittsburgh

Grad Sch Publ Hlth

Pittsburgh

PA USA.

[Nachega

Jean B.

Seedat

Soraya

Wiysonge

Charles Shey] Univ Stellenbosch

Cape Town

South

[Nachega

Jean B.] Johns Hopkins Bloomberg Sch Publ Hlth

Baltimore

MD USA.

[Nagata

Chie] Natl Ctr Child Hlth & Dev

Setagaya Ku

Tokyo

Japan.

[Rothenbacher

Dietrich] Ulm Univ

Inst Epidemiol & Med Biometry

Ulm

Germany.

[Nagel

Gabriele] Ulm Univ

Ulm

Germany.

[Naldi

Luigi] Azienda Osped Papa Giovanni XXIII

Bergamo

Italy.

[Nangia

Vinay] Suraj Eye Inst

Nagpur

Maharashtra

India.

[Nascimento

Bruno Ramos

Ribeiro

Antonio L.] Univ Fed Minas Gerais

Hosp Clin

Belo Horizonte

MG

[Nascimento

Bruno Ramos] Hosp Univ Ciencias Med

Belo Horizonte

MG

Brazil.

[Negoi

Ionut] Carol Davila Univ Med & Pharm Bucharest

Bucharest

Romania.

[Newton

Charles R.] KEMRI Wellcome Trust

Kilifi

Kenya.

[Ngalesoni

Frida Namnyak] Minist Hlth & Social Welf

Dar Es Salaam

Tanzania.

[Ngunjiri

Josephine Wanjiku] Univ Nairobi

Nairobi

Kenya.

[Ningrum

Dina Nur Anggraini] Semarang State Univ

Dept Publ Hlth

Semarang City

Indonesia.

[Nolte

Sandra] Deakin Univ

Sch Hlth & Social Dev

Populat Hlth Strateg Res Ctr

Burwood

Vic

[Stokes

Mark Andrew] Deakin Univ

Burwood

Vic

Australia.

[Nomura

Marika] Natl Inst Publ Hlth

Saitama

Japan.

[Noubiap

Jean Jacques N.] Med Diagnost Ctr

Yaounde

Cameroon.

[Obermeyer

Carla Makhlouf] Amer Univ Beirut

Fac Hlth Sci

Ctr Res Populat & Hlth

Beirut

Lebanon.

[Ogbo

Felix Akpojene] Univ Western Sydney

Ctr Hlth Res

Penrith

NSW

Australia.

[Renzaho

Andre M. N. N.] Univ Western Sydney

Penrith

NSW

Australia.

[Oh

In-Hwan] Kyung Hee Univ

Sch Med

Dept Prevent Med

Seoul

South Korea.

[Okoro

Anselm] Soc Family Hlth

Abuja

Nigeria.

[Oladimeji

Olanrewaju] HSRC

Durban

South Africa.

[Oladimeji

Olanrewaju] Univ KwaZulu Natal

Durban

South Africa.

[Olivares

Pedro R.] Univ Autonoma Chile

Talca

Chile.

[Olusanya

Bolajoko Olubukunola

Olusanya

Jacob Olusegun] Ctr Healthy Start Initiat

Lagos

Nigeria.

[Opio

John Nelson] Lira Dist Local Govt

Lira Municipal Council

Lira

Uganda.

[Oren

Eyal] Univ Arizona

Tucson

AZ USA.

[Ortiz

Alberto] IIS Fdn Jimenez Diaz UAM

Madrid

Spain.

[Nolte

Sandra] Deakin Univ

Populat Hlth Strateg Res Ctr

Sch Hlth & Social Dev

Geelong

Vic

Australia.

[Osborne

Richard H.] Deakin Univ

Geelong

Vic

Australia.

[Osman

Majdi] YBank

Cambridge

MA USA.

[Owolabi

Mayowa O.] Dept Med

Ibadan

Nigeria.

[Owolabi

Mayowa O.] Blossom Specialist Med Ctr

Ibadan

Nigeria.

JSS Univ

JSS Med Coll

Mysore

Karnataka

India.

[Pakhale

Smita] Ottawa Hosp

Res Inst

Ottawa

ON

Canada.

[Castillo

Elizabeth Palomares] Minist Hlth

Mexico City

DF

Mexico.

[Castillo

Elizabeth Palomares] Univ Nacl Autonoma Mexico

Mexico City

DF

Mexico.

[Patel

Tejas] Mt Sinai Hlth Syst

New York

NY USA.

[Paudel

Deepak] UK Dept Int Dev

Lalitpur

Nepal.

[Pereira

David M.] Univ Porto

Fac Farm

REQUIMTE LAQV

Lab Farmacognosia

Oporto

Portugal.

[Perez-Padilla

Rogelio] Natl Inst Resp Dis

Mexico City

DF

Mexico.

[Perez-Ruiz

Fernando] Hop Univ Cruces

OSI EE Cruces

Baracaldo

Spain.

[Perez-Ruiz

Fernando] Biocruces Hlth Res Inst

Baracaldo

Spain.

[Pesudovs

Konrad] Flinders Univ S Australia

Adelaide

SA

Australia.

[Petzold

Max] Univ Gothenburg

Hlth Metr Unit

Gothenburg

Sweden.

[Petzold

Max] Univ Witwatersrand

Johannesburg

South Africa.

[Phillips

Michael Robert] Shanghai Jiao Tong Univ

Sch Med

Shanghai

Peoples R China.

[Pillay

Julian David] Durban Univ Technol

Durban

South Africa.

[Pond

Constance D.] Univ Newcastle

Callaghan

NSW

Australia.

[Prakash

V.] Charotar Univ Sci & Technol

Anand

Gujarat

India.

[Purwar

Manorama] Intergrowth 21st Study Res Ctr

Nagpur

Maharashtra

India.

[Qorbani

Mostafa] Alborz Univ Med Sci

Noncommunicable Dis Res Ctr

Karaj

Iran.

[Radfar

Amir] AT Still Univ

Kirksville

MO USA.

[Rafay

Anwar

Rana

Saleem M.] Contech Int Hlth Consultants

Lahore

Pakistan.

[Rafay

Anwar

Rana

Saleem M.] Contech Sch Publ Hlth

Lahore

Pakistan.

[Rahman

Mahfuzar] BRAC

Res & Evaluat Div

Dhaka

Bangladesh.

[Rai

Rajesh Kumar] Soc Hlth & Demog Surveillance

Suri

India.

[Rao

Paturi Vishnupriya] Diabet Res Soc

Hyderabad

Andhra Pradesh

India.

[Rao

Paturi Vishnupriya] Diabet Res Ctr

Hyderabad

Andhra Pradesh

India.

[Remuzzi

Giuseppe] Papa Giovanni XXIII

Bergamo

Italy.

[Remuzzi

Giuseppe] Univ Milan

Dept Biomed & Clin Sci L Sacco

Milan

Italy.

[Resnikoff

Serge] Univ New South Wales

Brien Holden Vision Inst

Randwick

NSW

Australia.

[Resnikoff

Serge] Univ New South Wales

Sch Optometry & Vis Sci

Randwick

NSW

Australia.

[Sachdev

Perminder S.] Univ New South Wales

Randwick

NSW

Australia.

[Roshandel

Gholamreza] Golestan Univ Med Sci

Golestan Res Ctr Gastroenterol & Hepatol

Gorgan

[Roy

Nawal K.] Holmusk

Singapore

Singapore.

[Roy

Nawal K.] Duke NUS Med Sch

Singapore

Singapore.

[Sachdev

Perminder S.] Prince Wales Hosp

Randwick

NSW

Australia.

[Sackey

Ben Benasco] World Hlth Org

Accra

Ghana.

[Saeedi

Mohammad Yahya] Minist Hlth

Riyadh

Saudi Arabia.

[Safiri

Saeid] Maragheh Univ Med Sci

Managerial Epidemiol Res Ctr

Maragheh

Iran.

[Saleh

Muhammad Muhammad] Dev Res & Projects Ctr

Abuja

Nigeria.

[Samy

Abdallah M.] Ain Shams Univ

Cairo

Egypt.

[Sanabria

Juan Ramon] Marshall Univ

J Edwards Sch Med

Huntington

WV USA.

[Sanabria

Juan Ramon] Case Western Reserve Univ

Cleveland

OH 44106 USA.

[Sanchez-Nino

Maria Dolores] IIS Fdn Jimenez Diaz

Madrid

Spain.

[Sarmiento-Suarez

Rodrigo] Univ Ciencias Aplicadas & Ambient

Bogota

Colombia.

[Sartorius

Benn] Univ KwaZulu Natal

Sch Nursing & Publ Hlth

Publ Hlth Med

Durban

South Africa.

[Yakob

Bereket] Univ KwaZulu Natal

Sch Nursing & Publ Hlth

Discipline Publ Hlth Med

Durban

South

[Sartorius

Benn] SAMRC

UKZN Gastrointestinal Canc Res Ctr

Cape Town

South Africa.

[Sawhney

Monika] Marshall Univ

Huntington

WV USA.

[Saylan

Mete I.] Bayer Turkey

Istanbul

Turkey.

[Schoettker

Ben] FOM Univ

Inst Hlth Care & Social Sci

Essen

Germany.

[Schutte

Aletta E.] North West Univ

Hypertens Africa Res Team HART

Potchefstroom

South Africa.

[Schutte

Aletta E.] South African Med Res Council

Potchefstroom

South Africa.

[Serdar

Berrin] Univ Colorado

Aurora

CO USA.

[Shaheen

Amira] Najah Univ

Dept Publ Hlth

Nablus

Palestine.

[Shahraz

Saeid] Tufts Med Ctr

Boston

MA USA.

[Sharma

Jayendra] Minist Hlth

Thimphu

Bhutan.

[Sharma

Rajesh] Indian Inst Technol Ropar

Rupnagar

India.

[Shen

Jiabin] Nationwide Childrens Hosp

Res Inst

Columbus

OH USA.

[Shigematsu

Mika] Natl Inst Infect Dis

Tokyo

Japan.

[Shigematsu

Mika] Sandia Natl Labs

Albuquerque

NM 87185 USA.

[Shin

Min-Jeong] Korea Univ

Grad Sch

Dept Publ Hlth Sci

Seoul

South Korea.

[Yoon

Seok-Jun] Korea Univ

Coll Med

Dept Prevent Med

Seoul

South Korea.

[Shoman

Haitham] Imperial Coll London

London

England.

[Sigfusdottir

Inga Dora] Reykjavik Univ

Reykjavik

Iceland.

[Silva

Diego Augusto Santos] Univ Fed Santa Catarina

Florianopolis

SC

Brazil.

[Silveira

Dayane Gabriele Alves] Brasilia Univ

Brasilia

DF

Brazil.

[Singh

Jasvinder A.] Univ Alabama Birmingham

Birmingham

AL USA.

[Singh

Jasvinder A.] Birmingham Vet Affairs Med Ctr

Birmingham

AL USA.

[Singh

Om Prakash] Banaras Hindu Univ

Inst Med Sci

Dept Med

Varanasi

Uttar Pradesh

India.

[Singh

Prashant Kumar] Inst Human Dev

New Delhi

India.

[Singh

Virendra] Asthma Bhawan

Jaipur

Rajasthan

India.

[Sinke

Abiy Hiruye] Ethiopian Med Assoc

Addis Ababa

Ethiopia.

[Sinshaw

Aklilu Endalamaw] Univ Gondar

Gondar

Ethiopia.

[Sobngwi

Eugene] Univ Yaounde

Yaounde

Cameroon.

[Sobngwi

Eugene] Yaounde Cent Hosp

Yaounde

Cameroon.

[Soneji

Samir] Dartmouth Coll

Hanover

NH 03755 USA.

[Soriano

Joan B.] Univ Autonoma Madrid

Inst Invest Hosp Univ Princesa

Madrid

Spain.

[Sousa

Tatiane Cristina Moraes] Fundacao Oswaldo Cruz

Natl Sch Publ Hlth

Rio De Janeiro

Brazil.

[Sposato

Luciano A.] Western Univ

Dept Clin Neurol Sci

London

ON

Canada.

[Sreeramareddy

Chandrashekhar T.] Int Med Univ

Dept Community Med

Kuala Lumpur

Malaysia.

[Stathopoulou

Vasiliki] Attikon Univ Hosp

Athens

Greece.

[Steel

Nicholas] Univ East Anglia

Norwich

Norfolk

England.

[Steinke

Sabine] Univ Hosp Muenster

Dept Dermatol

Munster

Germany.

[Strong

Mark] Univ Sheffield

Sch Hlth & Related Res

Sheffield

S Yorkshire

England.

[Stroumpoulis

Konstantinos] Alexandra Gen Hosp Athens

Athens

Greece.

[Stroumpoulis

Konstantinos] Ctr Hosp Publ Cotentin

Cherbourg

France.

[Sufiyan

Muawiyyah Babale] Ahmadu Bello Univ

Zaria

Nigeria.

[Suliankatchi

Rizwan Abdulkader] Minist Hlth

Riyadh

Saudi Arabia.

[Sun

Jiandong] Univ Southern Queensland

Inst Resilient Regions

Springfield

Qld

Australia.

[Swaminathan

Soumya] Indian Council Med Res

Chennai

Tamil Nadu

India.

[Sykes

Bryan L.] Univ Calif Irvine

Dept Sociol

Irvine

CA USA.

[Sykes

Bryan L.] Univ Calif Irvine

Dept Publ Hlth

Irvine

CA USA.

[Tabares-Seisdedos

Rafael] Univ Valencia

INCLIVA Hlth Res Inst

Dept Med

Valencia

Spain.

[Tabares-Seisdedos

Rafael] CIBERSAM

Valencia

Spain.

[Tabb

Karen M.] Univ Illinois

Sch Social Work

Champaign

IL USA.

[Talongwa

Roberto Tchio] Minist Hlth

MINSANTE

Yaounde

Cameroon.

[Tarajia

Musharaf] Inst Conmemorativo Gorgas Estudios Salud

Panama City

Panama.

[Tavakkoli

Mohammad] New York Med Ctr

Valhalla

NY USA.

[Taveira

Nuno] Inst Super Ciencias Saude Egas Moniz

Almada

Portugal.

[Taveira

Nuno] Univ Lisbon

Faulty Pharm

Lisbon

Portugal.

[Tekelab

Tesfalidet] Univ Newcastle

Newcastle

NSW

Australia.

[Shifa

Girma Temam] Arba Minch Univ

Arba Minch

Ethiopia.

[Terkawi

Abdullah Sulieman] Univ Virginia

Dept Anesthesiol

Charlottesville

VA USA.

[Terkawi

Abdullah Sulieman] King Fahad Med City

Dept Anesthesiol

Riyadh

Saudi Arabia.

[Terkawi

Abdullah Sulieman] Cleveland Clin

Outcomes Res Consortium

Cleveland

OH 44106 USA.

[Thakur

J. S.] Post Grad Inst Med Educ & Res

Sch Publ Hlth

Chandigarh

India.

[Thomson

Alan J.] Adapt Knowledge Management

Victoria

BC

Canada.

[Tobe-Gai

Ruoyan] Natl Ctr Child Hlth & Dev

Tokyo

Japan.

[Tonelli

Marcello] Univ Calgary

Calgary

AB

Canada.

[Topor-Madry

Roman] Jagiellonian Univ

Fac Hlth Sci

Med Coll

Inst Publ Hlth

Krakow

Poland.

[Tortajada

Miguel] Hosp Univ Dr Peset

Valencia

Spain.

[Truelsen

Thomas] Univ Copenhagen

Rigshosp

Dept Neurol

Copenhagen

Denmark.

[Uchendu

Uche S.] Washington DC

Dept Vet Affairs

Washington

DC USA.

[Ukwaja

Kingsley N.] Fed Teaching Hosp

Dept Internal Med

Abakaliki

Nigeria.

[Undurraga

Eduardo A.] Brandeis Univ

Waltham

MA USA.

[Uneke

Chigozie Jesse] Ebonyi State Univ

Abakaliki

Nigeria.

[Uthman

Olalekan A.] Univ Warwick

Warwick Med Sch

Coventry

W Midlands

England.

[Van Dingenen

Rita] Joint Res Ctr

European Commiss

Ispra

Italy.

[Vasankari

Tommi] UKK Inst Hlth Promot Res

Tampere

Finland.

[Venketasubramanian

Narayanaswamy] Raffles Hosp

Raffles Neurosci Ctr

Singapore

Singapore.

[Violante

Francesco S.] Univ Bologna

Bologna

Italy.

[Vladimirov

Sergey K.] Fed Res Inst Hlth Org & Informat

Moscow

Russia.

[Vlassov

Vasiliy Victorovich] Natl Res Univ Higher Sch Econ

Moscow

Russia.

[Waller

Stephen G.] Uniformed Serv Univ Hlth Sci

Bethesda

MD 20814 USA.

[Walson

Judd L.] Nat Hist Museum

London

England.

[Wang

Yuan-Pang] Univ Sao Paulo

Med Sch

Sao Paulo

Brazil.

[Weiderpass

Elisabete] Canc Registry Norway

Inst Populat Based Canc Res

Dept Res

Oslo

Norway.

[Weiderpass

Elisabete] Univ Tromso

Arctic Univ Norway

Fac Hlth Sci

Dept Community Med

Tromso

[Weiderpass

Elisabete] Folkhalsan Res Ctr

Genet Epidemiol Grp

Helsinki

Finland.

[Wesana

Joshua] Univ Ghent

Ghent

Belgium.

[Wesana

Joshua] Mt Moon Univ

Ft Portal

Uganda.

[Westerman

Ronny] German Natl Cohort Consortium

Heidelberg

Germany.

[Wiysonge

Charles Shey] Cochrane South Africa

South African Med Res Council

Cape Town

South

[Wolfe

Charles D. A.] Guys & St Thomas NHS Fdn Trust

Comprehens Biomed Res Ctr

Natl Inst Hlth

[Wolfe

Charles D. A.] Kings Coll London

London

England.

[Workicho

Abdulhalik] Univ Ghent

Ghent

Belgium.

[Workie

Shimelash Bitew] Wolaita Sodo Univ

Wolaita Sodo

Ethiopia.

St Pauls Hosp

Millenium Med Coll

Addis Ababa

Ethiopia.

Addis Continental Inst Publ Hlth

Addis Ababa

Ethiopia.

[Xavier

Denis] St Johns Med Coll & Res Inst

Bangalore

Karnataka

India.

[Xu

Gelin] Nanjing Univ

Jinling Hosp

Sch Med

Dept Neurol

Nanjing

Jiangsu

Peoples R China.

[Yaghoubi

Mohsen] Univ Saskatchewan

Saskatoon

SK

Canada.

[Yan

Lijing L.] Duke Kunshan Univ

Global Hlth Res Ctr

Kunshan

Peoples R China.

[Yano

Yuichiro] Northwestern Univ

Dept Prevent Med

Chicago

IL 60611 USA.

[Amini

Erfan] Univ Tehran Med Sci

Urooncol Res Ctr

Tehran

Iran.

[Esteghamati

Alireza

Sheikhbahaei

Sara] Univ Tehran Med Sci

Endocrinol & Metab Populat Sci Inst

[Farzadfar

Farshad

Parsaeian

Mahboubeh] Univ Tehran Med Sci

Noncommunicable Dis Res Ctr

[Hafezi-Nejad

Nima] Univ Tehran Med Sci

Endocrinol & Metab Res Ctr

Tehran

Iran.

[Hassanvand

Mohammad Sadegh] Univ Tehran Med Sci

Ctr Air Pollut Res Inst Environm Res

Tehran

[Kasaeian

Amir] Univ Tehran Med Sci

Hematol Oncol & Stem Cell Transplantat Res Ctr

Tehran

Iran.

[Malekzadeh

Reza

Roshandel

Gholamreza

Sepanlou

Sadaf G.] Univ Tehran Med Sci

Digest Dis Res

[Rahimi-Movaghar

Vafa] Univ Tehran Med Sci

Sina Trauma & Surg Res Ctr

Tehran

Iran.

[Sahraian

Mohammad Ali] Univ Tehran Med Sci

MS Res Ctr

Neurosci Inst

Tehran

Iran.

[Shamsipour

Mansour] Univ Tehran Med Sci

Inst Environm Res

Tehran

Iran.

[Yaseri

Mehdi] Univ Tehran Med Sci

Tehran

Iran.

[Yip

Paul] Univ Hong Kong

Social Work & Social Adm Dept

Hong Kong

Hong Kong

Peoples R China.

[Yip

Paul] Univ Hong Kong

Hong Kong Jockey Club Ctr Suicide Res & Prevent

Hong Kong

Hong Kong

[Yonemoto

Naohiro] Kyoto Univ

Sch Publ Hlth

Dept Biostat

Kyoto

Japan.

[Younis

Mustafa Z.] Jackson State Univ

Jackson

MS USA.

[Yu

Chuanhua] Wuhan Univ

Sch Publ Hlth

Dept Epidemiol & Biostat

Wuhan

Peoples R China.

[Yu

Chuanhua] Wuhan Univ

Global Hlth Inst

Wuhan

Peoples R China.

[Zaidi

Zoubida] Univ Hosp

Setif

Algeria.

[Zaki

Maysaa El Sayed] Mansoura Univ

Fac Med

Mansoura

Egypt.

[Zambrana-Torrelio

Carlos] EcoHlth Alliance

New York

NY USA.

[Zambrana-Torrelio

Carlos] Inst Ecol Bolivia

La Paz

Bolivia.

[Zapata

Tomas] World Hlth Org

Windhoek

Namibia.

[Zuhlke

Liesl Joanna] Red Cross War Mem Childrens Hosp

Cape Town

South Africa.

ikolainen k

1988

international journal of epidemiology

v17

p86

kinlay jb

1977

milbank memorial fund quarterly-health and society

v55

p405

arlton jrh

1986

british medical journal

v292

p295

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