So, what causes wellness? Life expectancy trends Portugal Scotland.
Life expectancy trends
-
Upload
yoshio-wallace -
Category
Documents
-
view
41 -
download
2
description
Transcript of Life expectancy trends
![Page 1: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/1.jpg)
Life expectancy trendsLife expectancy: Scotland & other Western European Countries, 1851-2005
Source: Human Mortality Database
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
1851
-185
3
1855
-185
7
1859
-186
1
1863
-186
5
1867
-186
9
1871
-187
3
1875
-187
7
1879
-188
1
1883
-188
5
1887
-188
9
1891
-189
3
1895
-189
7
1899
-190
1
1903
-190
5
1907
-190
9
1911
-191
3
1915
-191
7
1919
-192
1
1923
-192
5
1927
-192
9
1931
-193
3
1935
-193
7
1939
-194
1
1943
-194
5
1947
-194
9
1951
-195
3
1955
-195
7
1959
-196
1
1963
-196
5
1967
-196
9
1971
-197
3
1975
-197
7
1979
-198
1
1983
-198
5
1987
-198
9
1991
-199
3
1995
-199
7
1999
-200
1
2003
-200
5
Portugal
Scotland
![Page 2: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/2.jpg)
Trends in male life expectancy: Scotland
Richest 20%
Poorest 20%
![Page 3: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/3.jpg)
World Health Organization (1997 and 2003)
www.heartstats.org
Prevalence of smoking by country, in 15 year olds by sex, 2000/01, Europe
0
5
10
15
20
25
30
35
40
45
50
Ukraine
Lith
uania
Ger
man
y
Eston
ia
Slove
nia
Czech
Repu
blic
Latvi
a
Finlan
d
Hungar
y
Russia
n Fede
ratio
n
Austri
a
Franc
e
Polan
d
Switzer
land
Spain
Belgiu
m -
Flemish
spe
aking
Croat
ia
Nether
land
s
Belgiu
m -
Frenc
h sp
eakin
gIta
ly
United
Kin
gdom
- Eng
land
Irelan
d
Norway
Portu
gal
Denm
arkIs
rael
Malt
a
United
Kin
gdom
- Sco
tland
United
Kin
gdom
- W
ales
Mac
edonia,
FYR
Gre
ece
Sweden
% r
egu
lar
smo
kers
Boys
Girls
![Page 4: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/4.jpg)
Smoking prevalence - Males
Males
![Page 5: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/5.jpg)
Smoking prevalence - Females
Females
![Page 6: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/6.jpg)
Income deprivation - LiverpoolLiverpool LSOAs: income deprivation distribution
Source: DWP
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
Total city: 24.6%
![Page 7: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/7.jpg)
Income deprivation - GlasgowGlasgow merged DZs: income deprivation distribution
Source: GCPH, based on SIMD/DWP data
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
Total city: 24.8%
![Page 8: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/8.jpg)
Standardised mortality rates by cause, all ages: Glasgow relative to Liverpool & Manchester
All ages, both sexes: cause-specific standardised mortality ratios 2003-07, Glasgow relative to Liverpool & Manchester, standardised by age, sex and deprivation decile
Calculated from various sources
112.2 111.9126.7
248.5
131.7
168.0
229.5
0
50
100
150
200
250
300
350
All cancers(malignantneoplasms)
Circulatory system Lung cancer External causes Suicide (inc.undetermined intent)
Alcohol Drugs-relatedpoisonings
Sta
ndar
dise
d m
orta
lity
ratio
Source: Walsh D, Bendel N., Jones R, Hanlon P. It’s not ‘just deprivation’: why do equally deprived UK cities experience different health outcomes? Public Health, 2010
![Page 9: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/9.jpg)
All cause mortality males 15-44
![Page 10: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/10.jpg)
Cirrhosis mortality males 15-44
![Page 11: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/11.jpg)
Workers in the 1950s
![Page 12: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/12.jpg)
Alvin Toffler – Future Shock 1970 “To survive, to avert what we have termed future
shock, the individual must become infinitely more adaptable and capable than ever before. We must search out totally new ways to anchor ourselves, for all the old roots - religion, nation, community, family, or profession - are now shaking under the hurricane impact of the accelerative thrust.
![Page 13: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/13.jpg)
Aaron Antonovsky 1923-1994
![Page 14: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/14.jpg)
“.....expresses the extent to which one has a feeling of confidence that the stimuli deriving from one's internal and external environments in the course of living are structured, predictable and explicable, that one has the internal resources to meet the demands posed by these stimuli and, finally, that these demands are seen as challenges, worthy of investment and engagement."
Sense of coherence....
![Page 15: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/15.jpg)
For the creation of health....
....the social and physical environment must be:
Comprehensible Manageable Meaningful ......or the individual would experience
chronic stress
![Page 16: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/16.jpg)
“A child who lacks a sense of coherence interprets all the events around him as noise not as information. This he finds very stressful”
Antonovsky
![Page 17: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/17.jpg)
00-046
-1.2
-1
-0.8
-0.6
-0.4
-0.2
0 10 20 30 40 50
Months of Orphanage Rearing
*linear trendline
Evening Cortisol Levels Increase withMonths of Orphanage Rearing *
The Founders’ Network
![Page 18: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/18.jpg)
![Page 19: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/19.jpg)
STRESS AND GRADE OF EMPLOYMENT: MEN
Salivary Cortisol
Time of DaySteptoe et al. 2003, Psychosomatic Medicine, 65, 461-470
![Page 20: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/20.jpg)
![Page 21: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/21.jpg)
Depcat % smokers Never-smokers Smokers
1 36.8 0.71 1.42
2 35.9 1.00 2.34
3 39.1 1.11 2.25
4 44.1 1.21 2.44
5 46.6 1.13 2.53
6 49.3 1.25 3.07
7 55.5 1.48 3.29
Environmental determinants of inflammatory status
CRP (median) mg/dl
affluent
deprived
![Page 22: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/22.jpg)
Inflammation in plaques
Inflammatory cells
MMPs, IL-6, IL-15, IL-18, CRP
Lumen
Core
Cap
Thin Fibrous Cap
InflammatoryCells
SMC apoptosis
Degradedmatrix
Unstable
cytokines MMP
![Page 23: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/23.jpg)
0
1
2
3
4
5
0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Q1 : <0.66 mg/l
Q5: > 4.18 mg/l
Years in study
% diabetic
CRP and cumulative risk of type 2 diabetes
Freeman et al. Diabetes 2002,51;1596
![Page 24: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/24.jpg)
Adipocyte programming insulin resistance, inflammation and ALP
Adipose stores
NEFAs
liver
CRPSAA
IL-6/IL-6sR
TNF- / aTNF- a sR-I
triglyceride
Low HDLsmall LDL
AtherogenicLipoproteinPhenotype
Pro-inflammatorystate
skeletal muscleInsulin resistance
![Page 25: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/25.jpg)
Persistence hunting
![Page 26: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/26.jpg)
![Page 27: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/27.jpg)
![Page 28: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/28.jpg)
![Page 29: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/29.jpg)
Adding insult to injury…….
![Page 30: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/30.jpg)
![Page 31: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/31.jpg)
![Page 32: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/32.jpg)
![Page 33: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/33.jpg)
![Page 34: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/34.jpg)
![Page 35: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/35.jpg)
The molecular biology of a cuddle
![Page 36: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/36.jpg)
![Page 37: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/37.jpg)
Attachment theory
Ainsworth Deep emotional connection that infant develops with
primary caregiver Reflects an “internal working model”expressing the
infant’s expectations of parental behaviour in meaningful situations
Basis for development of later relationships Increasingly recognised as determinant of later emotional,
cognitive and social outcomes
![Page 38: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/38.jpg)
Adverse childhood events study
Physical/sexual/emotional abuse Neglect (physical/emotional) Domestic substance abuse Domestic violence Parental mental illness Parental criminality
![Page 39: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/39.jpg)
Adverse childhood events risk of alcoholism
Hillis et al 2011
![Page 40: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/40.jpg)
Adverse childhood eventsrisk of perpetrating violenceBoys experiencing physical abuse
Duke et al 2010
![Page 41: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/41.jpg)
Risk of heart disease and early adversity
![Page 42: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/42.jpg)
The Dunedin cohort
1000 children recruited in late 1972/3 At age 3, “at risk” children identified on the basis of
chaotic circumstances, emotional behaviour, negativity and poor attentiveness
As adults, those “at risk” were more likely to : be unemployed have criminal convictions (especially for violence) been pregnant as a teenager have a substance abuse problem exhibit signs of insulin resistance and metabolic syndrome
![Page 43: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/43.jpg)
Creating wellbeing
Sense of coherence
Seeing the world as:StructuredPredictable
Feeling that it is:ManageableMeaningful
Wanting to engage
Generalised resistance resources
Family Intelligence
WorkMaterialIdentity
Cultural stabilityOptimism
Stable set of answers
Events
Stress
Resolution
Wellbeing
![Page 44: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/44.jpg)
Do social conditions determine the incidence of disease? For centuries they have and they still do in
the developing world–Plague, leprosy, polio, diphtheria,
typhoid, tuberculosis–BUT in the developed countries
It is mainly our physiological response to social conditions which largely determines our risk of chronic ill health
![Page 45: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/45.jpg)
Health Deficits approach Focuses on problems, needs and
deficiencies in a community such as deprivation, illness and health damaging behaviours. It designs services to fill the gaps and fix the problems. As a result, communities can feel disempowered. People become passive recipients of services rather than active agents in their own lives
![Page 46: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/46.jpg)
Social connectedness 148 studies comprising 308,849
participants, high levels of social integration conferred a 50% increased likelihood of survival.
Complex patterns of social integration conferred a 90% increase in survival.
Simple indicators such as living alone versus living with others conferred a survival benefit of only 19%.
![Page 47: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/47.jpg)
Health Assets
A health asset is any factor or resource which enhances the ability of individuals, communities and populations to maintain their health and sustain wellbeing. The assets can operate…as protective and promoting factors to buffer against life’s stresses
Morgan 2009
![Page 48: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/48.jpg)
Alienation and Frankenstein
"I came across people, other beings which I could see were almost like myself. Or so I thought at first when I approached them, though, I found that they did not consider me as one of their own kind. As soon as they saw me, their faces became twisted with fear. They shouted at me and threw things and ran away from me, just as my own maker had done. So this is what I learned about myself - that I was a disgusting creature. Even though I had given them no cause, all men hated me."
![Page 49: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/49.jpg)
The pathology of poverty
24th European Congress of Pathology
Prague11th September 2012
![Page 50: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/50.jpg)
Jimmy Reid 1971
![Page 51: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/51.jpg)
Rectorial Address
“Let me right at the outset define what I mean by alienation. It is the cry of men who feel themselves the victims of blind economic forces beyond their control. It's the frustration of ordinary people excluded from the processes of decision making. The feeling of despair and hopelessness that pervades people who feel with justification that they have no real say in shaping or determining their own destinies....”
![Page 52: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/52.jpg)
Improving complex systems
Build secure knowledge of the problem Build the will to change Execute the change Drive the change with data
![Page 53: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/53.jpg)
Central line infection rate (per thousand line days)
0
0.5
1
1.5
2
2.5
3
3.5
4
Jan-
08
Mar
-08
May
-08
Jul-0
8
Sep
-08
Nov
-08
Jan-
09
Mar
-09
May
-09
Jul-0
9
Sep
-09
Nov
-09
Jan-
10
Mar
-10
May
-10
Jul-1
0
Sep
-10
Nov
-10
Jan-
11
Mar
-11
May
-11
Jul-1
1
Sep
-11
Nov
-11
2.8
0.84
70% reduction
![Page 54: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/54.jpg)
% ICU mortality
18.2%
13.9%
24% improvement
![Page 55: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/55.jpg)
Oct-Dec 200
6
Jan-Mar 200
7
Apr-Jun 200
7
Jul-Sep 200
7
Oct-Dec 200
7
Jan-Mar 200
8
Apr-Jun 200
8
Jul-Sep 200
8
Oct-Dec 200
8
Jan-Mar 200
9
Apr-Jun 200
9
Jul-Sep 200
9
Oct-Dec 200
9
Jan-Mar 201
0
Apr-Jun 201
0
Jul-Sep 201
0
Oct-Dec 201
0
Jan-Mar 201
1
Apr-Jun 201
1
Jul-Sep 201
1
Oct-Dec 201
1
Jan-Mar 201
2
Apr-Jun 201
2
Jul-Sep 2012p
0.8
0.9
1.0
1.1
Sta
nd
ard
ise
d M
ort
alit
y R
ati
o
HSMR up to September 2012
12.4% reduction
![Page 56: Life expectancy trends](https://reader036.fdocuments.in/reader036/viewer/2022062304/56812ebc550346895d945cb8/html5/thumbnails/56.jpg)