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Journal Cover International Journal of Epidemiology
  [SJR: 4.381]   [H-I: 145]   [147 followers]  Follow
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0300-5771 - ISSN (Online) 1464-3685
   Published by Oxford University Press Homepage  [370 journals]
  • Making epidemiology matter
    • Authors: Galea S.
      First page: 1083
      PubDate: 2017-08-07
      DOI: 10.1093/ije/dyx154
  • Traumatic spinal cord injury in Uganda: a prevention strategy and
           mechanism to improve home care
    • Authors: Stothers L; Macnab A, Mukisa R, et al.
      First page: 1086
      Abstract: In low- and middle-income countries (LMICs), the burden of traumatic spinal cord injury (TSCI) is largely unknown. The estimated incidence of TSCI in LMICs is 25.5/million/year, and the impact on affected patients and their families is presumed to be immense due to the social structure, limited health system resources and reliance on family to care for those that survive injury to return home. In sub-Saharan Africa, extrapolated regional figures for incidence range from 21 – 29/million/year, and the occurrence of a spinal injury is likely to be fatal within a year.
      PubDate: 2017-04-27
      DOI: 10.1093/ije/dyx058
  • Data Resource Profile: National electronic medical record data from the
           Canadian Primary Care Sentinel Surveillance Network (CPCSSN)
    • Authors: Garies S; Birtwhistle R, Drummond N, et al.
      First page: 1091
      PubDate: 2017-02-28
      DOI: 10.1093/ije/dyw248
  • Data Resource Profile: Hospital Episode Statistics Admitted Patient Care
           (HES APC)
    • Authors: Herbert A; Wijlaars L, Zylbersztejn A, et al.
      First page: 1093
      PubDate: 2017-03-15
      DOI: 10.1093/ije/dyx015
  • HDSS Profile: The Dande Health and Demographic Surveillance System (Dande
           HDSS, Angola)
    • Authors: Rosário E; Costa D, Francisco D, et al.
      First page: 1094
      PubDate: 2017-05-23
      DOI: 10.1093/ije/dyx072
  • Cohort Profile Update: The Janus Serum Bank Cohort in Norway
    • Authors: Hjerkind K; Gislefoss R, Tretli S, et al.
      First page: 1101
      PubDate: 2017-01-12
      DOI: 10.1093/ije/dyw302
  • Cohort Profile: The AMORIS cohort
    • Authors: Walldius G; Malmström H, Jungner I, et al.
      First page: 1103
      PubDate: 2017-02-02
      DOI: 10.1093/ije/dyw333
  • Cohort Profile: The German Ageing Survey (DEAS)
    • Authors: Klaus D; Engstler H, Mahne K, et al.
      First page: 1105
      PubDate: 2017-02-08
      DOI: 10.1093/ije/dyw326
  • Cohort Profile: The Healthy Aging Longitudinal Study in Taiwan (HALST)
    • Authors: Hsu C; Chang H, Wu I, et al.
      First page: 1106
      PubDate: 2017-02-27
      DOI: 10.1093/ije/dyw331
  • Long-term exposure to transportation noise and air pollution in relation
           to incident diabetes in the SAPALDIA study
    • Authors: Eze I; Foraster M, Schaffner E, et al.
      First page: 1115
      Abstract: BackgroundEpidemiological studies have inconsistently linked transportation noise and air pollution (AP) with diabetes risk. Most studies have considered single noise sources and/or AP, but none has investigated their mutually independent contributions to diabetes risk.MethodsWe investigated 2631 participants of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA), without diabetes in 2002 and without change of residence between 2002 and 2011. Using questionnaire and biomarker data, incident diabetes cases were identified in 2011. Noise and AP exposures in 2001 were assigned to participants’ residences (annual average road, railway or aircraft noise level during day-evening-night (Lden), total night number of noise events, intermittency ratio (temporal variation as proportion of event-based noise level over total noise level) and nitrogen dioxide (NO2) levels. We applied mixed Poisson regression to estimate the relative risk (RR) of diabetes and their 95% confidence intervals (CI) in mutually-adjusted models.ResultsDiabetes incidence was 4.2%. Median [interquartile range (IQR)] road, railway, aircraft noise and NO2 were 54 (10) dB, 32 (11) dB, 30 (12) dB and 21 (15) μg/m3, respectively. Lden road and aircraft were associated with incident diabetes (respective RR: 1.35; 95% CI: 1.02–1.78 and 1.86; 95% CI: 0.96–3.59 per IQR) independently of Lden railway and NO2 (which were not associated with diabetes risk) in mutually adjusted models. We observed stronger effects of Lden road among participants reporting poor sleep quality or sleeping with open windows.ConclusionsTransportation noise may be more relevant than AP in the development of diabetes, potentially acting through noise-induced sleep disturbances.
      PubDate: 2017-03-13
      DOI: 10.1093/ije/dyx020
  • Satellite-based estimates of long-term exposure to fine particulate matter
           are associated with C-reactive protein in 30 034 Taiwanese adults
    • Authors: Zhang Z; Chang L, Lau A, et al.
      First page: 1126
      Abstract: BackgroundParticulate matter (PM) air pollution is associated with the risk of cardiovascular morbidity and mortality. However, the biological mechanism underlying the associations remains unclear. Atherosclerosis, the underlying pathology of cardiovascular disease, is a chronic inflammatory process. We therefore investigated the association of long-term exposure to fine PM (PM2.5) with C-reactive protein (CRP), a sensitive marker of systemic inflammation, in a large Taiwanese population.MethodsParticipants were from a large cohort who participated in a standard medical examination programme with measurements of high-sensitivity CRP between 2007 and 2014. We used a spatiotemporal model to estimate 2-year average PM2.5 exposure at each participant’s address, based on satellite-derived aerosol optical depth data. General regression models were used for baseline data analysis and mixed-effects linear regression models were used for repeated data analysis to investigate the associations between PM2.5 exposure and CRP, adjusting for a wide range of potential confounders.ResultsIn this population of 30 034 participants with 39 096 measurements, every 5 μg/m3 PM2.5 increment was associated with a 1.31% increase in CRP [95% confidence interval (CI): 1.00%, 1.63%) after adjusting for confounders. For those participants with repeated CRP measurements, no significant changes were observed between the first and last measurements (0.88 mg/l vs 0.89 mg/l, P = 0.337). The PM2.5 concentrations remained stable over time between 2007 and 2014.ConclusionsLong-term exposure to PM2.5 is associated with increased level of systemic inflammation, supporting the biological link between PM2.5 air pollution and deteriorating cardiovascular health. Air pollution reduction should be an important strategy to prevent cardiovascular disease.
      PubDate: 2017-05-25
      DOI: 10.1093/ije/dyx069
  • Economic growth and mortality: do social protection policies matter'
    • Authors: Bilal U; Cooper R, Abreu F, et al.
      First page: 1147
      Abstract: BackgroundIn the 20th century, periods of macroeconomic growth have been associated with increases in population mortality. Factors that cause or mitigate this association are not well understood. Evidence suggests that social policy may buffer the deleterious impact of economic growth. We sought to explore associations between changing unemployment (as a proxy for economic change) and trends in mortality over 30 years in the context of varying social protection expenditures.MethodsWe model change in all-cause mortality in 21 OECD (Organization for Economic Cooperation and Development) countries from 1980 to 2010. Data from the Comparative Welfare States Data Set and the WHO Mortality Database were used. A decrease in the unemployment rate was used as a proxy for economic growth and age-adjusted mortality rates as the outcome. Social protection expenditure was measured as percentage of gross domestic product expended.ResultsA 1% decrease in unemployment (i.e. the proxy for economic growth) was associated with a 0.24% increase in the overall mortality rate (95% confidence interval: 0.07;0.42) in countries with no changes in social protection. Reductions in social protection expenditure strengthened this association between unemployment and mortality. The magnitude of the association was diminished over time.ConclusionsOur results are consistent with the hypothesis that social protection policies that accompany economic growth can mitigate its potential deleterious effects on health. Further research should identify specific policies that are most effective.
      PubDate: 2017-02-27
      DOI: 10.1093/ije/dyx016
  • Exposure to the Chinese famine of 1959–61 in early life and long-term
           health conditions: a systematic review and meta-analysis
    • Authors: Li C; Lumey L.
      First page: 1157
      Abstract: BackgroundMost Chinese people over 55 years old today have experienced the Great Leap Forward Famine of 1959–61. Many reports suggested that the famine could have profound long-term health effects for exposed birth cohorts. A systematic review and meta-analysis was carried out to summarize reported famine effects on long-term health.MethodsRelevant reports were identified by searching PubMed, Embase, Chinese Wanfang Data and Chinese National Knowledge Infrastructure databases. Long-term health conditions were compared in exposed birth cohorts and unexposed controls. Fixed-effects models and random-effects models were used to combine results on adult overweight, obesity, type 2 diabetes, hyperglycaemia, hypertension, the metabolic syndrome and schizophrenia. The heterogeneity across reports was assessed. Subgroup analyses were carried out using reported famine severity, provincial mortality during famine, sex and other report characteristics.ResultsIn all, 36 reports were eligible for systematic review and 21 could be used for meta-analysis. The number of events we analysed ranged from 1029 for hyperglycaemia to 8973 for hypertension. As reported by others, overweight, type 2 diabetes, hyperglycaemia, the metabolic syndrome, and schizophrenia were more common among adults born during the famine compared with controls born after the famine. By contrast, there were no increases in overweight [odds ratio (OR) 0.68; 95% confidence interval (CI): 0.27–1.72], type 2 diabetes (OR 0.96; 95% CI: 0.73–1.28), hyperglycaemia (OR 0.99; 95% CI: 0.72–1.36) or the metabolic syndrome (OR 1.11; 95% CI: 1.00–1.22) comparing adults born during the famine with controls born either after or before the famine. For schizophrenia, the effect estimates (OR 1.60; 95% CI: 1.50–1.70, combining control groups) were similar in the two scenarios.ConclusionsOur findings suggest that uncontrolled age differences between famine and post-famine births could explain most effects commonly attributed to the famine. For more reliable estimates of long-term famine effects in China, other analyses will be needed with age-appropriate controls and better information on the severity and timing of the famine in the populations included.
      PubDate: 2017-03-03
      DOI: 10.1093/ije/dyx013
  • A review of the evidence linking child stunting to economic outcomes
    • Authors: McGovern M; Krishna A, Aguayo V, et al.
      First page: 1171
      Abstract: BackgroundTo understand the full impact of stunting in childhood it is important to consider the long-run effects of undernutrition on the outcomes of adults who were affected in early life. Focusing on the costs of stunting provides a means of evaluating the economic case for investing in childhood nutrition.MethodsWe review the literature on the association between stunting and undernutrition in childhood and economic outcomes in adulthood. At the national level, we also evaluate the evidence linking stunting to economic growth. Throughout, we consider randomized controlled trials (RCTs), quasi-experimental approaches and observational studies.ResultsLong-run evaluations of two randomized nutrition interventions indicate substantial returns to the programmes (a 25% and 46% increase in wages for those affected as children, respectively). Cost-benefit analyses of nutrition interventions using calibrated return estimates report a median return of 17.9:1 per child. Assessing the wage premium associated with adult height, we find that a 1-cm increase in stature is associated with a 4% increase in wages for men and a 6% increase in wages for women in our preferred set of studies which attempt to address unobserved confounding and measurement error. In contrast, the evidence on the association between economic growth and stunting is mixed.ConclusionsCountries with high rates of stunting, such as those in South Asia and sub-Saharan Africa, should scale up policies and programmes aiming to reduce child undernutrition as cost-beneficial investments that expand the economic opportunities of their children, better allowing them and their countries to reach their full potential. However, economic growth as a policy will only be effective at reducing the prevalence of stunting when increases in national income are directed at improving the diets of children, addressing gender inequalities and strengthening the status of women, improving sanitation and reducing poverty and inequities.
      PubDate: 2017-03-30
      DOI: 10.1093/ije/dyx017
  • Impact of energy efficiency interventions in public housing buildings on
           cold-related mortality: a case-crossover analysis
    • Authors: Peralta A; Camprubí L, Rodríguez-Sanz M, et al.
      First page: 1192
      Abstract: BackgroundInterventions to mitigate fuel poverty and particularly energy efficiency façade retrofitting (EEFR) have demonstrated positive impacts on health but the impacts of EEFR interventions on cold-related mortality have not been studied in depth. We evaluated the impact of EEFR interventions in Barcelona on the association between cold outdoor temperatures and mortality (from all natural causes and from neoplasms, circulatory system and respiratory system causes) from 1986 to 2012.MethodsA time-stratified case-crossover analysis was used. Relative risks (RR) for death related to extreme cold (lowest fifth percentile) in the no-intervention and intervention groups were obtained for temperature lag windows covering the day of the death and the previous 20 days (0–2, 3–5, 6–8, 9–11, 12–14, 15–17, 18–20). The statistical significance of the observed changes was evaluated using the RR for the cold temperature–intervention interaction.ResultsIn men, interventions significantly increased the extreme cold–death association for the lag window 15–17 [interaction RR 2.23, 95% confidence interval (CI) 1.14–4.36]. The impacts were stronger for respiratory system causes and in men aged 75 or older. In women, on lag window 0–2, the extreme cold–death association was not significantly reduced when analysing all natural causes of death (interaction RR 0.46, 95% CI 0.21–1.01), but it was reduced significantly when analysing only deaths from neoplasms, circulatory system and respiratory system causes together. The impacts were stronger in women who died from circulatory system causes, in women with no education and in those aged 75 or older.ConclusionsEEFR interventions had differentiated effects on cold-related mortality in men and women. Differentiated effects were also observed by cause, educational level and age.
      PubDate: 2017-01-04
      DOI: 10.1093/ije/dyw335
  • Association between Native American-owned casinos and the prevalence of
           large-for-gestational-age births
    • Authors: Jones-Smith J; Dow W, Oddo V.
      First page: 1202
      Abstract: BackgroundA small number of studies have used a natural experiment approach to examine the health impacts of increased economic resources stemming from Native American-owned casinos. We build on this work by examining whether casinos are associated with obesity-related health in utero.MethodsWe examined whether casino openings or expansion (as proxy for increased economic resources) are associated with a decreased likelihood of infants being born large-for-gestational-age (LGA), an important risk factor for childhood overweight/obesity. We used repeated cross-sectional data from California birth records (1987-2011) to assess the prevalence of LGA births among Native Americans (n = 21 011). Using zip code fixed-effect regression models, we compared how prevalence of LGA births changed in association with casino openings or expansions, while controlling for secular trends through the inclusion of a comparison group of Native American newborns in zip codes that were eligible to open or expand casinos, but did not do so. In sensitivity analyses, we evaluated whether there was any change in small-for-gestational-age births (SGA).ResultsAverage prevalence of LGA births over the period was 11%. Every one slot machine per capita increase was associated with a 0.13 percentage point decrease (95% confidence interval: −0.25, −0.01) in the prevalence of LGA births but was not associated with SGA prevalence.ConclusionsCasino expansion in California is associated with a lower prevalence of LGA births. Interpreted in combination with previous work showing that California casino expansions were associated with a lower body mass index (BMI) among schoolchildren, these results suggest that casinos are associated with improvement in a surrogate marker of excess adiposity. Further studies are needed to elucidate the mechanisms by which casinos might be associated with obesity-related health outcomes among Native Americans.
      PubDate: 2017-04-19
      DOI: 10.1093/ije/dyx054
  • Family aggregation of cardiovascular disease mortality: a register-based
           prospective study of pooled Nordic twin cohorts
    • Authors: Silventoinen K; Hjelmborg J, Möller S, et al.
      First page: 1223
      Abstract: BackgroundFamilial factors play an important role in the variation of risk factors of cardiovascular diseases (CVD), but less is known about how they affect the risk of death from CVD. We estimated familial aggregation of CVD mortality for twins offering the maximum level of risk due to genetic and other familial factors.MethodsAltogether, 132 771 twin individuals, including 65 196 complete pairs from Denmark, Finland and Sweden born in 1958 or earlier, participated in this study. During the register-based follow-up, 11 641 deaths occurred from coronary heart disease (CHD), including 6280 deaths from myocardial infarct and 4855 deaths occurred from stroke, with 1092 deaths from ischaemic stroke and 1159 deaths from haemorrhagic stroke. Relative recurrence risk ratios (RRRs) with 95% confidence intervals (95% CIs) for monozygotic and dizygotic twins were calculated.ResultsIn the analyses pooling men and women, the RRR for monozygotic twins was 1.49 (95% CI 1.40–1.57) for CHD and 1.81 for any stroke (95% CI 1.54–2.09). The highest RRR was found for haemorrhagic stroke (3.53 95% CI 2.01–5.04). For dizygotic twins, the RRRs were generally lower.ConclusionsFamily aggregation was found for CHD and haemorrhagic stroke. Clustering of risk factors in families increases the risk of CVD.
      PubDate: 2017-02-28
      DOI: 10.1093/ije/dyx012
  • Epidemiology of sudden cardiac death in Cameroon: the first
           population-based cohort survey in sub-Saharan Africa
    • Authors: Bonny A; Tibazarwa K, Mbouh S, et al.
      First page: 1230
      Abstract: BackgroundIncidence estimates of sudden cardiac death (SCD) in sub-Saharan Africa (SSA) are unknown.MethodOver 12 months, the household administrative office and health community committee within neighbourhoods in two health areas of Douala, Cameroon, registered all deaths among 86 188 inhabitants aged >18 years. As part of an extended multi-source surveillance system, the Emergency Medical Service (EMS), local medical examiners and district hospital mortuaries were also surveyed. Whereas two physicians investigated every natural death, two cardiologists reviewed all unexpected natural deaths.ResultsThere were 288 all-cause deaths and 27 (9.4%) were SCD. The crude incidence rate was 31.3 [95% confidence interval (CI): 20.3–40.6]/100 000 person-years. The age-standardized rate by the African standard population was 33.6 (95% CI: 22.4–44.9)/100 000 person-years. Death occurred at night in 37% of cases, including 11% of patients who died while asleep. Out-of-hospital sudden cardiac arrest occurred in 63% of cases, 55.5% of which occurred at home. Of the 88.9% cases of witnessed cardiac arrest, 63% occurred in the presence of a family member and cardiopulmonary resuscitation was attempted only in 3.7%.ConclusionThe burden of SCD in this African population is heavy with distinct characteristics, whereas awareness of SCD and prompt resuscitation efforts appear suboptimal. Larger epidemiological studies are required in SSA in order to implement preventive measures, especially in women and young people.
      PubDate: 2017-04-26
      DOI: 10.1093/ije/dyx043
  • Commentary: New York City: measuring progress as it’s made
    • Authors: Narayan R; Gwynn R, Bassett M.
      First page: 1248
      PubDate: 2017-02-27
      DOI: 10.1093/ije/dyx018
  • Spillover effects on health outcomes in low- and middle-income countries:
           a systematic review
    • Authors: Benjamin-Chung J; Abedin J, Berger D, et al.
      First page: 1251
      Abstract: BackgroundMany interventions delivered to improve health may benefit not only direct recipients but also people in close physical or social proximity. Our objective was to review all published literature about the spillover effects of interventions on health outcomes in low-middle income countries and to identify methods used in estimating these effects.MethodsWe searched 19 electronic databases for articles published before 2014 and hand-searched titles from 2010 to 2013 in five relevant journals. We adapted the Cochrane Collaboration’s quality grading tool for spillover estimation and rated the quality of evidence.ResultsA total of 54 studies met inclusion criteria. We found a wide range of terminology used to describe spillovers, a lack of standardization among spillover methods and poor reporting of spillovers in many studies. We identified three primary mechanisms of spillovers: reduced disease transmission, social proximity and substitution of resources within households. We found the strongest evidence for spillovers through reduced disease transmission, particularly vaccines and mass drug administration. In general, the proportion of a population receiving an intervention was associated with improved health. Most studies were of moderate or low quality. We found evidence of publication bias for certain spillover estimates but not for total or direct effects. To facilitate improved reporting and standardization in future studies, we developed a reporting checklist adapted from the CONSORT framework specific to reporting spillover effects.ConclusionsWe found the strongest evidence for spillovers from vaccines and mass drug administration to control infectious disease. There was little high quality evidence of spillovers for other interventions.
      PubDate: 2017-04-24
      DOI: 10.1093/ije/dyx039
  • Change in organizational justice as a predictor of insomnia symptoms:
           longitudinal study analysing observational data as a non-randomized
    • Authors: Lallukka T; Halonen J, Sivertsen B, et al.
      First page: 1277
      Abstract: BackgroundDespite injustice at the workplace being a potential source of sleep problems, longitudinal evidence remains scarce. We examined whether changes in perceived organizational justice predicted changes in insomnia symptoms.MethodsData on 24 287 Finnish public sector employees (82% women), from three consecutive survey waves between 2000 and 2012, were treated as ‘pseudo-trials’. Thus, the analysis of unfavourable changes in organizational justice included participants without insomnia symptoms in Waves 1 and 2, with high organizational justice in Wave 1 and high or low justice in Wave 2 (N = 6307). In the analyses of favourable changes in justice, participants had insomnia symptoms in Waves 1 and 2, low justice in Wave 1 and high or low justice in Wave 2 (N = 2903). In both analyses, the outcome was insomnia symptoms in Wave 3. We used generalized estimating equation models to analyse the data.ResultsAfter adjusting for social and health-related covariates in Wave 1, unfavourable changes in relational organizational justice (i.e. fairness of managerial behaviours) were associated with increased odds of developing insomnia symptoms [odds ratio = 1.15; 95% confidence interval (CI) 1.02-1.30]. A favourable change in relational organizational justice was associated with lower odds of persistent insomnia symptoms (odds ratio = 0.83; 95% CI 0.71-0.96). Changes in procedural justice (i.e. the fairness of decision-making procedures) were not associated with insomnia symptoms.ConclusionsThese data suggest that changes in perceived relational justice may affect employees’ sleep quality. Decreases in the fairness of managerial behaviours were linked to increases in insomnia symptoms, whereas rises in fairness were associated with reduced insomnia symptoms.
      PubDate: 2017-01-08
      DOI: 10.1093/ije/dyw293
  • Mortality selection in a genetic sample and implications for association
    • Authors: Domingue B; Belsky D, Harrati A, et al.
      First page: 1285
      Abstract: BackgroundMortality selection occurs when a non-random subset of a population of interest has died before data collection and is unobserved in the data. Mortality selection is of general concern in the social and health sciences, but has received little attention in genetic epidemiology. We tested the hypothesis that mortality selection may bias genetic association estimates, using data from the US-based Health and Retirement Study (HRS).MethodsWe tested mortality selection into the HRS genetic database by comparing HRS respondents who survive until genetic data collection in 2006 with those who do not. We next modelled mortality selection on demographic, health and social characteristics to calculate mortality selection probability weights. We analysed polygenic score associations with several traits before and after applying inverse-probability weighting to account for mortality selection. We tested simple associations and time-varying genetic associations (i.e. gene-by-cohort interactions).ResultsWe observed mortality selection into the HRS genetic database on demographic, health and social characteristics. Correction for mortality selection using inverse probability weighting methods did not change simple association estimates. However, using these methods did change estimates of gene-by-cohort interaction effects. Correction for mortality selection changed gene-by-cohort interaction estimates in the opposite direction from increased mortality selection based on analysis of HRS respondents surviving through 2012.ConclusionsMortality selection may bias estimates of gene-by-cohort interaction effects. Analyses of HRS data can adjust for mortality selection associated with observables by including probability weights. Mortality selection is a potential confounder of genetic association studies, but the magnitude of confounding varies by trait.
      PubDate: 2017-04-11
      DOI: 10.1093/ije/dyx041
  • Volunteering and mortality risk: a partner-controlled quasi-experimental
    • Authors: O’Reilly D; Rosato M, Moriarty J, et al.
      First page: 1295
      Abstract: BackgroundThe consensus that volunteering is associated with a lower mortality risk is derived from a body of observational studies and therefore vulnerable to uncontrolled or residual confounding. This potential limitation is likely to be particularly problematic for volunteers who, by definition, are self-selected and known to be significantly different from non-volunteers across a range of factors associated with better survival.MethodsThis is a census-based record-linkage study of 308 733 married couples aged 25 and over, including 100 571 volunteers, with mortality follow-up for 33 months. We used a standard Cox model to examine whether mortality risk in the partners of volunteers was influenced by partner volunteering status—something expected if the effects of volunteering on mortality risk were due to shared household or behavioural characteristics.ResultsVolunteers were general more affluent, better educated and more religious than their non-volunteering peers; they also had a lower mortality risk [hazard ratio (HR)adj = 0.78: 95% confidence interval (CI) = 0.71, 0.85 for males and HRadj = 0.77: 95% CI = 0.68, 0.88 for females]. However, amongst cohort members who were not volunteers, having a partner who was a volunteer was not associated with a mortality advantage (HRadj = 1.01: 95% CI = 0.92, 1.11 for men and HRadj = 1.00: 95% CI = 0.88, 1.13 women).ConclusionsThis study provides further evidence that the lower mortality associated with volunteering is unlikely to be due to health selection or to residual confounding arising from unmeasured selection effects within households. It therefore increases the plausibility of a direct causal effect.
      PubDate: 2017-03-19
      DOI: 10.1093/ije/dyx037
  • Assessing the impact of unmeasured confounding for binary outcomes using
           confounding functions
    • Authors: Kasza J; Wolfe R, Schuster T.
      First page: 1303
      Abstract: A critical assumption of causal inference is that of no unmeasured confounding: for estimated exposure effects to have valid causal interpretations, a sufficient set of predictors of exposure and outcome must be adequately measured and correctly included in the respective inference model(s). In an observational study setting, this assumption will often be unsatisfied, and the potential impact of unmeasured confounding on effect estimates should be investigated. The confounding function approach allows the impact of unmeasured confounding on estimates to be assessed, where unmeasured confounding may be due to unmeasured confounders and/or biases such as collider bias or information bias. Although this approach is easy to implement and pertains to the sum of all bias, its use has not been widespread, and discussion has typically been limited to continuous outcomes. In this paper, we consider confounding functions for use with binary outcomes and illustrate the approach with an example. We note that confounding function choice encodes assumptions about effect modification: some choices encode the belief that the true causal effect differs across exposure groups, whereas others imply that any difference between the true causal parameter and the estimate is entirely due to imbalanced risks between exposure groups. The confounding function approach is a useful method for assessing the impact of unmeasured confounding, in particular when alternative approaches, e.g. external adjustment or instrumental variable approaches, cannot be applied. We provide Stata and R code for the implementation of this approach when the causal estimand of interest is an odds or risk ratio.
      PubDate: 2017-03-03
      DOI: 10.1093/ije/dyx023
  • The Health Gap: The Challenge of an Unequal World: the argument
    • Authors: Marmot M.
      First page: 1312
      PubDate: 2017-09-01
      DOI: 10.1093/ije/dyx163
  • Commentary: The inescapability of the ethical
    • Authors: Baggini J.
      First page: 1318
      PubDate: 2017-09-01
      DOI: 10.1093/ije/dyx164
  • Commentary: Beyond the socioeconomic in The Health Gap : gender and
    • Authors: Ravindran T.
      First page: 1321
      PubDate: 2017-09-01
      DOI: 10.1093/ije/dyx165
  • Commentary: Inequalities and health: an opportunity missed'
    • Authors: Savage M.
      First page: 1323
      PubDate: 2017-09-01
      DOI: 10.1093/ije/dyx166
  • Commentary: Uncertainties in addressing the ‘health gap’
    • Authors: Reeves A.
      First page: 1324
      Abstract: Health inequalities appear to be both universal and persistent. Looking across Europe since the 1990s, there has been some decline in absolute inequalities in health but relative inequalities have actually widened.1 Professor Sir Michael Marmot’s new book, The Health Gap,2 is a popular re-statement of the deeply troubling differences between health outcomes among the affluent and the disadvantaged. Inequalities in health are found in almost every country for which we have data, but the extent of these inequalities varies. Marmot argues that inequalities in power, empowerment and material resources are driving inequalities in health and that these are unjust because they are amenable to change. Moreover, inequalities in health affect almost everyone because there is a social gradient in health; people in the middle of the income distribution have poorer health than those at the top but better health than those at the bottom.
      PubDate: 2017-09-01
      DOI: 10.1093/ije/dyx183
  • Commentary: Tackling the health gap: the role of psychosocial processes
    • Authors: Adler N; Tan J.
      First page: 1329
      Abstract: In The Health Gap, Michael Marmot describes how, starting even before birth, social conditions set individuals on trajectories that eventuate in inequities in health and longevity. In addition to race and ethnicity, socioeconomic status linked to income and education plays a major role in determining health trajectories. The effects emerge not only at the very bottom of the socioeconomic spectrum, but across the whole range.1
      PubDate: 2017-09-01
      DOI: 10.1093/ije/dyx167
  • Commentary: A multi-factorial and dynamic approach to health
           inequalities–lessons from Marmot’s The Health Gap
    • Authors: Lundberg O.
      First page: 1332
      Abstract: Michael Marmot’s book, The Health Gap: The Challenge of an Unequal World,1 combines autobiographical notes with epidemiological and other scientific evidence, topped with moral concern. It examines the scientific arguments on the generation of health inequalities and how they might be addressed. It also shows Marmot’s ‘trademark’ energy and profound determination to contribute scientifically to policy making.
      PubDate: 2017-08-16
      DOI: 10.1093/ije/dyx101
  • Commentary: Social determinants, social discrimination, social justice,
           and social responsibility
    • Authors: Bhugra D.
      First page: 1333
      PubDate: 2017-09-01
      DOI: 10.1093/ije/dyx159
  • Commentary: Social determinants and the health gap: creating a social
    • Authors: Marmot M.
      First page: 1335
      PubDate: 2017-09-01
      DOI: 10.1093/ije/dyx182
  • On wagging tales about causal inference
    • Authors: Naimi A.
      First page: 1340
      Abstract: Krieger and Davey Smith (KDS) have written a lengthy polemic on the increasingly popular use of methods for causal modelling (‘causal inference’) in epidemiology.1 This paper has instigated a lively discussion on the use of counterfactual modelling in epidemiology.2–8 Yet much confusion remains. For example, in their last editorial for the Journal, Ebrahim et al.9 state that ‘the potential outcomes approach can be seen as … too far removed from many of the complex ‘dirty’ problems … of social epidemiology’ (page 1704), but also note that ‘(c)ounterfactual methods … might help drive a new wave of social epidemiology focused on reducing social inequalities in health’ (page 1708).
      PubDate: 2017-05-30
      DOI: 10.1093/ije/dyx086
  • Reply to Naimi
    • Authors: Krieger N; Smith G.
      First page: 1342
      Abstract: Naimi’s letter,1 which criticizes an article we have written about causal inference in epidemiology,2 repeats many of the arguments and errors in the response to our article by Daniel et al.,3 involving mischaracterization of our critique of uncritical use of directed acyclic graphs (DAGs) and misunderstandings of what a critical analysis of racial/ethnic health inequities entails. Rather than repeat ourselves to correct these errors, we refer readers to our response4 to the Daniel et al. article and the other commentaries, as well as to our original article.2 The problematic treatment of race/ethnicity in epidemiologic research–including but not limited to research premised on a potential outcomes approach–has long been a mutual concern of ours2,5 and this concern is reinforced, not rebutted, by the problematic approaches and assertions of both the Daniel et al. article3 and Naimi’s letter.1
      PubDate: 2017-05-30
      DOI: 10.1093/ije/dyx087
  • Using remote sensing technology to measure environmental determinants of
           non-communicable diseases
    • Authors: Jia P; Stein A.
      First page: 1343
      Abstract: Remote sensing (RS) technology is the acquisition of information by space-borne satellites or airborne sensors, without making physical contact with the object or phenomenon. We suggest that it could refine non-communicable disease (NCD) studies.
      PubDate: 2017-02-27
      DOI: 10.1093/ije/dyw365
  • Health Divides. Where you live can kill you
    • Authors: Baum F.
      First page: 1345
      Abstract: Health Divides. Where you live can kill you.BambraClare. Bristol: Policy Press, 2016, pp 320, £12.99, ISBN 978-1447330356
      PubDate: 2017-07-02
      DOI: 10.1093/ije/dyx111
  • Concepts of Epidemiology
    • Authors: Young J.
      First page: 1347
      Abstract: Concepts of Epidemiology: Integrating the Ideas, Theories, Principles, and Methods of Epidemiology.Third edition. BhopalRaj S. Oxford, UK: Oxford University Press, 2016, pp 441, ISBN: 978-0-19-873968-5
      PubDate: 2017-06-30
      DOI: 10.1093/ije/dyx112
  • Population Health Science
    • Authors: Salkeld G.
      First page: 1348
      Abstract: Population Health Science.KeyesKatherine M. and GaleaSandro. Oxford, UK: Oxford University Press2016, pp. 224, £29.99, ISBN-13: 9780190459376
      PubDate: 2017-06-30
      DOI: 10.1093/ije/dyx120
  • Cohort Profile: The Korean Genome and Epidemiology Study (KoGES)
    • Authors: Kim Y; Han B, .
      First page: 1350
      Abstract: First published online: 15 April 2016, Int J Epidemiol, 2016, doi:
      PubDate: 2017-06-16
      DOI: 10.1093/ije/dyx105
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