Levels, trends, and determinants of cause-of-death diversity in a global perspective

Background: While much is known about the leading causes of death (CoD) and how they have evolved over time, much less is known about the diversity of such causes of death. CoD diversity is an important marker of population health heterogeneity that has been largely overlooked in the study of contem...

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Autores: Almeida Calazans, Júlia|||0000-0002-6215-3251, Permanyer, Iñaki|||0000-0002-7051-5144
Formato: artículo
Fecha de publicación:2023
País:España
Recursos:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:274792
Acesso em linha:https://ddd.uab.cat/record/274792
https://dx.doi.org/urn:doi:10.1186/s12889-023-15502-4
Access Level:acceso abierto
Palavra-chave:Cause of death diversity
Health inequality
Mortality
Fractionalization index
Ageing
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spelling Levels, trends, and determinants of cause-of-death diversity in a global perspective1990-2019Almeida Calazans, Júlia|||0000-0002-6215-3251Permanyer, Iñaki|||0000-0002-7051-5144Cause of death diversityHealth inequalityMortalityFractionalization indexAgeingBackground: While much is known about the leading causes of death (CoD) and how they have evolved over time, much less is known about the diversity of such causes of death. CoD diversity is an important marker of population health heterogeneity that has been largely overlooked in the study of contemporary health dynamics. Methods: We provide regional and national estimates of CoD diversity from 1990 to 2019. We rely on data from the Global Burden of Disease project, using information on 21 CoD. Results are presented for 204 countries and territories, for women and men separately. CoD diversity is measured with the index of Fractionalization. Results are disaggregated by age and cause of death. Results: CoD diversity has declined across world regions, except for Latin America and the Caribbean, the region of High-income countries and women in Central Europe, Eastern Europe, and Central Asia. Changes in mortality at adult and older ages have been mostly responsible for CoD diversity dynamics, except for the regions of South Asia and Sub-Saharan Africa, where infant and child mortality still play a non-negligible role. The relationship between CoD diversity, life expectancy, and lifespan inequality is strongly non-monotonic, with turning points difering by sex and indicator. Among longevity vanguard countries, further increases in life expectancy are associated with decreasing lifespan inequality but increasing CoD diversity. Conclusion As mortality declines, there is no universal pathway toward low CoD diversity, thus casting doubts on the ability of Epidemiological Transition Theory to predict prospective CoD dynamics among high- and middle-mortality countries. Despite the postponement and increasing predictability of the ages at which individuals die, low-mortality populations are composed of an increasingly heterogenous mix of robust and frail individuals, thus increasing the diversity of health profles among older persons - an issue that could potentially complicate further improvements in longevity. 22023-01-0120232023-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/274792https://dx.doi.org/urn:doi:10.1186/s12889-023-15502-4reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengEuropean Commission https://doi.org/10.13039/501100000780 ERC 2019-CoG864616Agencia Estatal de Investigación https://doi.org/10.13039/501100011033 PID2021-128892OB-I00open accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2747922026-06-06T12:50:31Z
dc.title.none.fl_str_mv Levels, trends, and determinants of cause-of-death diversity in a global perspective
1990-2019
title Levels, trends, and determinants of cause-of-death diversity in a global perspective
spellingShingle Levels, trends, and determinants of cause-of-death diversity in a global perspective
Almeida Calazans, Júlia|||0000-0002-6215-3251
Cause of death diversity
Health inequality
Mortality
Fractionalization index
Ageing
title_short Levels, trends, and determinants of cause-of-death diversity in a global perspective
title_full Levels, trends, and determinants of cause-of-death diversity in a global perspective
title_fullStr Levels, trends, and determinants of cause-of-death diversity in a global perspective
title_full_unstemmed Levels, trends, and determinants of cause-of-death diversity in a global perspective
title_sort Levels, trends, and determinants of cause-of-death diversity in a global perspective
dc.creator.none.fl_str_mv Almeida Calazans, Júlia|||0000-0002-6215-3251
Permanyer, Iñaki|||0000-0002-7051-5144
author Almeida Calazans, Júlia|||0000-0002-6215-3251
author_facet Almeida Calazans, Júlia|||0000-0002-6215-3251
Permanyer, Iñaki|||0000-0002-7051-5144
author_role author
author2 Permanyer, Iñaki|||0000-0002-7051-5144
author2_role author
dc.subject.none.fl_str_mv Cause of death diversity
Health inequality
Mortality
Fractionalization index
Ageing
topic Cause of death diversity
Health inequality
Mortality
Fractionalization index
Ageing
description Background: While much is known about the leading causes of death (CoD) and how they have evolved over time, much less is known about the diversity of such causes of death. CoD diversity is an important marker of population health heterogeneity that has been largely overlooked in the study of contemporary health dynamics. Methods: We provide regional and national estimates of CoD diversity from 1990 to 2019. We rely on data from the Global Burden of Disease project, using information on 21 CoD. Results are presented for 204 countries and territories, for women and men separately. CoD diversity is measured with the index of Fractionalization. Results are disaggregated by age and cause of death. Results: CoD diversity has declined across world regions, except for Latin America and the Caribbean, the region of High-income countries and women in Central Europe, Eastern Europe, and Central Asia. Changes in mortality at adult and older ages have been mostly responsible for CoD diversity dynamics, except for the regions of South Asia and Sub-Saharan Africa, where infant and child mortality still play a non-negligible role. The relationship between CoD diversity, life expectancy, and lifespan inequality is strongly non-monotonic, with turning points difering by sex and indicator. Among longevity vanguard countries, further increases in life expectancy are associated with decreasing lifespan inequality but increasing CoD diversity. Conclusion As mortality declines, there is no universal pathway toward low CoD diversity, thus casting doubts on the ability of Epidemiological Transition Theory to predict prospective CoD dynamics among high- and middle-mortality countries. Despite the postponement and increasing predictability of the ages at which individuals die, low-mortality populations are composed of an increasingly heterogenous mix of robust and frail individuals, thus increasing the diversity of health profles among older persons - an issue that could potentially complicate further improvements in longevity.
publishDate 2023
dc.date.none.fl_str_mv 2
2023-01-01
2023
2023-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/274792
https://dx.doi.org/urn:doi:10.1186/s12889-023-15502-4
url https://ddd.uab.cat/record/274792
https://dx.doi.org/urn:doi:10.1186/s12889-023-15502-4
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv European Commission https://doi.org/10.13039/501100000780 ERC 2019-CoG864616
Agencia Estatal de Investigación https://doi.org/10.13039/501100011033 PID2021-128892OB-I00
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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