Improvements in the incidence and survival of cancer and cardiovascular but not infectious disease have driven recent mortality improvements in Scotland: nationwide cohort study of linked hospital admission and death records 2001–2016

Abstract

Objectives: To identify the causes and future trends underpinning improvements in life expectancy in Scotland and quantify the relative contributions of disease incidence and survival. Design: Population-based study. Setting: Linked secondary care and mortality records across Scotland. Participants: 1,967,130 individuals born between 1905 and 1965, and resident in Scotland throughout 2001-2016. Main outcome measures: Hospital admission rates and survival in the five years following admission for 28 diseases, stratified by sex and socioeconomic status. Results: The five hospital admission diagnoses associated with the greatest burden of death were "Influenza and pneumonia", "Symptoms and signs involving the circulatory and respiratory systems", "Malignant neoplasm of respiratory and intrathoracic organs", "Symptoms and signs involving the digestive system and abdomen", and "General symptoms and signs". Using trends in disease, we modelled a mean mortality hazard ratio of 0.737 (95% CI 0.730-0.745) across decades of birth, equivalent to a life extension of ~3 years per decade. This improvement was 61% (30%-93%) accounted for by improvements in disease survival after hospitalisation (principally cancer) with the remainder accounted for by a fall in hospitalisation incidence (principally heart disease and cancer). In contrast, deteriorations in the incidence and survival of infectious diseases reduced mortality improvements by 9% (~3.3 months per decade). Overall, health-driven mortality improvements were slightly greater for men than women (due to greater falls in disease incidence), and generally similar across socioeconomic deciles. We project mortality improvements will continue over the next decade but will slow down by 21% because much of the progress in disease survival has already been achieved. Conclusion: Morbidity improvements broadly explain observed improvements in overall mortality, with progress on the prevention and treatment of heart disease and cancer making the most significant contributions. The gaps between men and women's morbidity and mortality are closing, but the gap between socioeconomic groups is not. A slowing trend in improvements in morbidity may explain the stalling in improvements of period life expectancies observed in recent studies in the UK. However, our modelled slowing of improvements could be offset if we achieve even faster improvements in the major diseases contributing to the burden of death, or if we improve prevention and survival of diseases which have deteriorated recently, such as infectious disease, in the future.

Electromagnetic Environment Created by Mobile Communication as a Risk Factor Causing Higher Prevalence of Circulatory Diseases

“…Thus, an authors' team conducted a research work based on analyz-ing trends in morbidity over 2001-2016 in Great Britain and as a result it was established that life expectancy grew approximately by 3 years per a decade. The primary factor here was a decrease in frequency of hospitalizations, first of all, due to diseases of the circulatory system [2].…”

“…Diseases of the circulatory system have significant influence on labor and life potential of the contemporary world society as well as demographic safety of any state; they are a vital issue for contemporary medicine since such diseases are among primary causes of population mortality [1,2]. However, morbidity with diseases of the circulatory system and its outcomes for population are different in different countries.…”

“…Experimental studies on electromagnetic environment created by mobile communications in the region from March 2019 to February 2020 (4,204 measurements accomplished at points where people used mobile communications quite actively) yielded the results given in Table . Calculated average EFD values varied from 0.94 ± 0.03 µW/cm 2 (Belogorskiy district) to 2.04 ± 0.06 µW/cm 2 (Simferopol); average value in Crimea was 1.43 ± 0.04 µW/cm 2 Next, we applied Kendall correlation procedure to statistically calculate correlations between EFD, IEB, ADEE, and basic parameters of morbidity with diseases of the circulatory system in Crimea. We managed to detect authentic correlations between average annual EFD and total morbidity with diseases of the circulatory system (Тau = 0.399; p < 0.01) and primary morbidity with hypertensive diseases (Тau = 0.304; p = 0.04); we also detected authentic correlations between IEB and total morbidity with diseases of the circulatory system (Тau = 0.437; p < 0.01), total morbidity with hypertensive diseases (Тau = 0.377; p = 0.01), and primary morbidity with hypertensive diseases (Тau = 0.342; p = 0.02).…”