“Smothered” Infants—Neglect,Infanticide or SIDS? A Fresh Look at the 19th Century Mortality Schedules

Based on the U.S. Federal Mortality Schedules from the years 1850–1880 infant deaths <1 year were investigated in order to determine whether mortality attributed to “smothering” or “overlaying” followed known SIDS trajectories. By comparing a case sample of 2,236 smothered/overlaid deaths with an age-, regionally and time-matched control sample of all-cause infant deaths (N = 58,293), striking similarities with SIDS became apparent, which were not mimicked in the control sample. These epidemiological traits included a disproportionate vulnerability during the second to fourth month of life (Poisson RR 12.94, p < 0.001), a remarkable birth and death seasonality, as well as pronounced racial disparities. The study could also corroborate sex-specific discrepancies—such as differential impact of month of birth on age-at-death. Results of a Cox regression furthermore indicate that age, sex, race and death season were significant predictors of mortality. This strongly supports the hypothesis that these infant deaths represent empirical evidence of 19th century SIDS.     

Improving the reporting of cancer-specific mortality and survival in research using cancer registry data

Population-based registries are increasingly used in cancer research. In such studies, cancer-specific mortality or survival is frequently used as the primary outcome. To determine whether a putative cancer was part of the causal chain of events leading to death, cancer registries primarily rely on death certificates. Hence, they depend on the subjective interpretation of information available to medical examiners at the time of death. Misclassification may occur: studies report misclassification of cancer as a cause of death in 15%–35% of death certificates based on evaluation by expert panels and/or autopsy reports. Further misclassification may occur when coding death causes in the cancer registry. Researchers should be aware of potential misclassification bias when using cancer registry data. Differential misclassification may bias the results towards or away from the null hypothesis, depending on whether there is relative over- or under-reporting of cancer-related deaths in one group. Strategies to improve reporting of cancer-specific survival/mortality include (1) describing the procedure used to identify cancer-specific deaths; (2) considering the use of multiple definitions of cancer-related deaths (strict/liberal definitions of cancer-specific deaths, and/or addition of relative survival as an outcome); and (3) reporting cancer-specific survival/mortality together with the objectively measured parameters overall survival or all-cause mortality.     

The influence of the use of improved sanitation facilities and improved drinking-water sources on the diarrhea-associated deaths in children under 5 years

Diarrhea is one of the main causes of children's death. Due to the importance of health in children under 5 years, this study has been conducted to determine the influence of the use of improved sanitation facilities (UISF) and the use of improved drinking-water sources (UIDWS) on the diarrhea-associated deaths per 1000 live births in this age group. An ecologic study was conducted in 75 countries, and the data on UIDWS and UISF information have been collected by World Health Organization (WHO) under a program named “Global Analysis and Assessment of Sanitation and Drinking-Water” (GLAAS). To determine the correlation between UIDWS and UISF with the diarrhea-associated deaths in children, Pearson correlation was applied. Besides, a linear regression analysis was used to investigate the relationship between UIDWS and UISF with the diarrhea-associated deaths in children. According to the findings, there was a significant statistical relationship between UIDWS and UISF with the diarrhea-associated deaths in children (p < 0.001). The diarrhea-associated deaths in children under 5 years are influenced by factors such as UIDWS and UISF, and this rate can be reduced making UISF and UIDWS available for people and especially people of rural areas.     

Free to die: Economic freedoms and influenza mortality

Seasonal influenzas are annually responsible for hundreds of thousands of deaths worldwide, often because of insufficient care, which may depend on orientations of economic policy. Yet, the empirical evidence on the relations existing between policies based on different degrees of economic liberalism and flu mortality is still scarce. This paper contributes to filling the gap by proposing an empirical investigation into the effects of various dimensions of liberalism, proxied by the different components of the Fraser Index of Economic Freedom, on deaths from seasonal influenzas in a sample of 38 OECD countries observed from 1970 to 2018. A dynamic panel System-GMM estimator is used to alleviate endogeneity concerns, while alternative models, specifications and subsamples check the robustness of findings. Findings show that: a) not every component of economic freedom has an effect on flu mortality; b) more economic freedom not always means less or more deaths from flu. In particular, stronger protection of property rights and smaller government consumption are associated with higher flu mortality, which is instead lower when people and capital are freer to move. Such results give rise to policy considerations and contribute to inform policymakers about actions that can limit the mortality of a globally widespread disease like flu.     

Work-Related and Non-Work-Related Injury Deaths in the U.S.: A Comparative Study

This study assesses the percentage of traumatic fatalities attributable to work-related causes in the US, by cause of death and population demographics. The 1993-1998 Vital Statistics Mortality data from the National Center for Health Statistics were used. There were 848,945 traumatic fatalities (E800-E999) among the general population 16 years or older in the US during this time; of these, 32,044 were work-related accounting for 3.8% of all the fatalities. The work-related percentage varied from 62.7% for machine-related deaths to 0.7% for suicides, from 4.9% for males to 1.0% for females, from 9.8% in Alaska to 1.5% in Arizona, from 4.2% for decedents with 1 to 4 year college educations to 2.9% for decedents with high school or less, from 4.4% for races other than white and black to 2.6% for black. Mean age-at-death was 42 years for work-related vs. 48 years for non-work-related fatalities. This difference is more pronounced for deaths from falls (45 years vs. 78 years). Conversely, victims of work-related homicide were older than non-work-related (41 years vs. 33 years). A more complete understanding of the burden of traumatic fatalities attributable to work-related causes requires consideration of the total work-related percentage, causes of death, and population demographics.     

A Retrospective Study of Mortality in Varanid Lizards (Reptilia:Squamata:Varanidae) at the Bronx Zoo: Implications for Husbandry and Reproductive Management in Zoos

Varanid lizards have been maintained in zoological parks for more than a century, yet few studies to date have attempted to pinpoint significant health issues affecting their management or areas of captive husbandry that are in need of improvement. In an effort to identify and better understand some of the husbandry‐related challenges and health issues specifically affecting varanids in zoos, this study examined mortality in 16 species maintained at the Bronx Zoo between 1968 and 2009. Out of 108 records reviewed, complete necropsy reports were available for 85 individuals. Infection‐related processes including bacterial (15.3%), protozoal (12.9%), nematode (9.4%), and fungal (3.5%) infections accounted for the greatest number of deaths (47.1%). Noninfectious diseases including female reproductive disorders (7.1%), neoplasia (7.1%), gout (10.8%), and hemipenal prolapse (1.3%) accounted for 29.4% of deaths. Multiple disease agents were responsible for 5.9% of deaths, and a cause for death could not be determined for 17.7% of individuals. Reproductive complications accounted for 11.5% of female deaths, but were identified in 23.1% of females. Although not necessarily the cause for death, gout was present in 18.8% of individuals. Differences in mortality between species, genders, and origin (captive‐bred vs. wild‐caught) were also evaluated. The results of this study corroborate earlier findings that identify bacterial infections, neoplasia, female reproductive disorders, gout, and endoparasitism as major sources of mortality in captive varanids. In light of these results, we discuss potential etiologies and offer recommendations for improving captive management practices in zoos. Zoo Biol. 32:152–162, 2013. © 2012 Wiley Periodicals, Inc.     

The potential effects of climate change on winter mortality in England and Wales

In Britain death rates from several important causes, particularly circulatory and respiratory diseases, rise markedly during the colder winter months. This close association between temperature and mortality suggests that climate change as a result of global warming may lead to a future reduction in excess winter deaths. This paper gives a brief introductory review of the literature on the links between cold conditions and health, and statistical models are subsequently developed of the associations between temperature and monthly mortality rates for the years 1968 to 1988 for England and Wales. Other factors, particularly the occurrence of influenza epidemics, are also taken into account. Highly significant negative associations were found between temperature and death rates from all causes and from chronic bronchitis, pneumonia, ischaemic heart disease and cerebrovascular disease. The statistical models developed from this analysis were used to compare death rates for current conditions with those that might be expected to occur in a future warmer climate. The results indicate that the higher temperatures predicted for 2050 might result in nearly 9000 fewer winter deaths each year with the largest contribution being from mortality from ischaemic heart disease. However, these preliminary estimates might change when further research is able to make into account a number of additional factors affecting the relationship between mortality and climate.     

Hospital cardiovascular deaths and total distribution of deaths in 180 consecutive months with different cosmic physical activity: a correlative study (1974–1988)

The dynamics of total hospital deaths from different kinds of cardiovascular diseases in one 1000-bed hospital were compared with 10 monthly cosmic/solar and geomagnetic physical activity parameters. Data used were of 180 consecutive months; 15601 deaths including 5667 from cardiovascular diseases were included in this study. It was concluded that the number of monthly hospital deaths shows a highly significant correlation with monthly solar physical activity.     

Mortality Patterns of Asian Elephants in a Region of Human–Elephant Conflict

Many wildlife species suffer from human–wildlife conflict, especially crop-raiding. Long-term analyses of mortality patterns are needed to assess the efficacy of management strategies that address this issue. We report mortality patterns from necropsies of 498 Asian elephants from 2009–2018 in an area of northwestern Sri Lanka. Deaths were lowest in July and highest in October, a period of peak crop availability. Most (about 70%) deaths were human-related, and males were killed in these incidents more frequently than females. As gunshot deaths decreased, other forms of human-related deaths increased. Additionally, causes of death differed between districts, with more intentional human-related mortality observed in the district with the highest percent of protected land. These results highlight the importance of understanding the long-term spatial and temporal variation in wildlife mortality to effectively address human–wildlife conflict. © 2021 The Wildlife Society.     

The cost of premature death from cancer attributable to alcohol: Productivity losses in Europe in 2018

BackgroundMore than 1.9 million people die from cancer each year in Europe. Alcohol use is a major modifiable risk factor for cancer and poses an economic burden on society. We estimated the cost of productivity lost due to premature death (under 65 years of age) from alcohol-attributable cancer in the European Union (EU) plus Iceland, Norway, Switzerland, and the United Kingdom (UK) in 2018.MethodsWe estimated cancer deaths attributable to alcohol using a Levin-based population attributable fractions method and cancer deaths in 2018 from the Global Cancer Observatory. Lost productivity was estimated for all alcohol-attributable cancer deaths by sex, cancer site, and country. Productivity losses were valued using the human capital approach.ResultsAn estimated 23,300 cancer deaths among people aged less than 65 in the EU plus Iceland, Norway, Switzerland and the UK in 2018 were attributable to alcohol (18,200 males, 5100 females). This equated to €4.58 billion in total productivity losses in the region and 0.027 % of the European Gross Domestic Product (GDP). The average cost per alcohol-attributable cancer death was €196,000. Productivity lost to alcohol-attributable cancer per capita was highest in Western Europe. Hungary, Romania, Slovakia, Latvia, Lithuania, and Portugal had the highest rate of premature mortality from alcohol-attributable cancer and the highest productivity lost as a share of national GDP.ConclusionOur study provides estimates of lost productivity from alcohol-attributable cancer death in Europe. Cost-effective strategies to prevent alcohol-attributable cancer deaths could result in economic benefits for society and must be prioritised.     

Death at the zoo: the media,science, and reality

Media characterizations of zoo and aquarium animal deaths were randomly monitored on the internet for a 20‐month period (September 2003–May 2005). Based on 148 samples collected, it was possible to classify articles into one of four categories, which were operationally defined: 1) dispassionate observers; 2) accusers; 3) sympathizers; and 4) balancers. In addition, with the notable exception of seven cases, all of the articles examined focused on large, charismatic mammals, such as gorillas, dolphins, lions, and elephants. Although a majority of the articles examined (70.4%) were either dispassionate and objective or sympathetic, nearly a third (29.6%) were either accusatory or attempted to balance the accusatory statements of animal rights activists with sympathetic statements from zoo professionals. Recommendations are offered for how zoos should deal with the increasing media and public interest in zoo animal deaths, including: 1) a greater commitment to studying the reasons for mortality in a wide variety of species; and 2) an increased investment in record keeping and analysis, which should allow zoos to calculate average life spans in animal populations and to monitor and assess the risk of certain lethal diseases on a real‐time basis. Comparisons are drawn between zoo veterinary practices and human medicine, which are both inexact sciences. Suggestions are made for how the public and key decision‐makers can distinguish between media reports on zoo animal deaths that are legitimate cause for concern vs. those that are sensationalist and meant to generate controversy and sell papers. A greater focus on the science of zoo animal death is necessary for accredited zoos to maintain the public's confidence in their animal care practices. Zoo Biol 0:1–15, 2006. © 2006 Wiley‐Liss, Inc.     

Trivers-Willard at birth and one year: evidence from US natality data 1983-2001

Trivers & Willard (TW) hypothesized that evolution would favour deviations from the population sex ratio in response to parental condition: parents in good condition would have more sons and parents in poor condition would have more daughters. We analyse the universe of US linked births and infant deaths to white mothers 1983-2001, covering 48 million births and 310,000 deaths. We find that (i) married, better educated and younger mothers bore more sons and (ii) infant deaths were more male if the mother was unmarried and young. Our findings highlight the potential role of offspring sex ratio as an indicator of maternal status, and the role of infant mortality in shaping a TW pattern in the breeding population.     

Reducing discard mortality in an estuarine trawl fishery

A purpose-built, water-filled sorting tray was compared against a conventional dry tray for its utility in reducing discard mortality across a range of conditions in an Australian estuarine penaeid-trawl fishery, including the limits of typical delays in starting sorting (2 vs. 15 min). During nine days of fishing, up to 10 replicate deployments were done for each sorting method and delay. Bycatches (44 389 teleosts comprising 15 species) were assessed for their immediate mortalities, before 1346 live individuals (10 species) were released (to simulate discarding) into replicate cages and monitored for their short-term mortalities over five days. Appropriate controls were included for the most abundant economically-important species, yellowfin bream, Acanthopagrus australis. Most trawled-and-discarded teleosts followed a pattern of minimal differences in immediate mortalities between sorting methods for the short delay, but generally fewer deaths in the water tray than in the conventional tray during the longer delay. However, owing to a dominant and slightly protracted influence of the trawling process, comparable rates of deaths were observed for caged fish irrespective of their post-capture treatment. Mixed-effects logistic models applied to four key species (A. australis; silver biddy, Gerres subfasciatus; southern herring, Herklotsichthys castelnaui; and Port Jackson glassfish, Ambassis jacksoniensis) revealed that in addition to the method and delay in sorting, the weights of total catch and jellyfish, salinity and the size of fish also had significant impacts on mortality. For the longer delay in sorting in the water tray, the influences of some of the other factors were negated so that total mortalities of three of the modelled species were reduced by almost one quarter. We conclude that while unaccounted fishing mortality can be reduced via changes to onboard sorting procedures, this approach should only be applied ancillary to efficient gear selectivity.     

UNOBSERVED KILL OF NURSING DOLPHIN CALVES IN A TUNA PURSE-SEINE FISHERY

The kill of dolphins ( Stenella attenuata and S. longirostris ) in the eastern tropical Pacific tuna purse-seine fishery has been underestimated because of unobserved deaths of nursing calves due to separation from their mothers during fishing. Based on an analysis of dolphins killed from 1973 to 1990, and depending on the length at which calves are assumed to become independent, there was a deficit of calves relative to the number of lactating females killed in 24%–32% of 1,847 spotted-dolphin sets and in 13%–19% of 563 spinner-dolphin sets. We found a deficit of 0.31–0.45 spotted dolphin and 0.15–0.26 spinner dolphin calves per set. If these missing calves were added to the observed kill, it would represent an increase in the kill of 10%–15% for spotted dolphins and 6%–10% for spinner dolphins in the sets we examined. We did not attempt to estimate the actual number of unobserved calf deaths due to purse-seine fishing on dolphins, either in the sets we examined or in all dolphin sets. The actual number of unobserved calf deaths is likely to be higher than the calf deficit we found. Separation of dolphin mothers from calves could occur at any of several points in the fishing process, but most of these would be invisible to us and not produce a calf deficit. Estimation of the actual number of unobserved calf deaths would require further information on how frequently permanent mother-calf separations occur, the fraction of calves that survive after separation, the fraction of lactating females set upon that are carrying calves, and the fraction of calves killed that are actually related to lactating females killed in the same set. In any case, the observation of a calf deficit indicates that the reported dolphin kill fails to measure the full impact of purse-seine fishing on spotted and spinner dolphin populations.     

Air pollution and infant mortality: Evidence from China

Using a newly assembled prefecture-city level dataset from 2004 to 2015, this paper examines the impact of air pollution on child mortality in China. To identify the causal effect, we exploit ventilation coefficient as the instrument for urban air pollution. We find that a 10 μg/m³ increase in annual PM_2.5 concentration causes 163 infant deaths per 100,000 live births per year in a city.     

Cancer mortality in a population-based cohort of American Indians – The strong heart study

BackgroundCancer mortality among American Indian (AI) people varies widely, but factors associated with cancer mortality are infrequently assessed.MethodsCancer deaths were identified from death certificate data for 3516 participants of the Strong Heart Study, a population-based cohort study of AI adults ages 45–74 years in Arizona, Oklahoma, and North and South Dakota. Cancer mortality was calculated by age, sex and region. Cox proportional hazards model was used to assess independent associations between baseline factors in 1989 and cancer death by 2010.ResultsAfter a median follow-up of 15.3 years, the cancer death rate per 1000 person-years was 6.33 (95 % CI 5.67–7.04). Cancer mortality was highest among men in North/South Dakota (8.18; 95 % CI 6.46–10.23) and lowest among women in Arizona (4.57; 95 % CI 2.87–6.92). Factors independently associated with increased cancer mortality included age, current or former smoking, waist circumference, albuminuria, urinary cadmium, and prior cancer history. Factors associated with decreased cancer mortality included Oklahoma compared to Dakota residence, higher body mass index and total cholesterol. Sex was not associated with cancer mortality. Lung cancer was the leading cause of cancer mortality overall (1.56/1000 person-years), but no lung cancer deaths occurred among Arizona participants. Mortality from unspecified cancer was relatively high (0.48/100 person-years; 95 % CI 0.32−0.71).ConclusionsRegional variation in AI cancer mortality persisted despite adjustment for individual risk factors. Mortality from unspecified cancer was high. Better understanding of regional differences in cancer mortality, and better classification of cancer deaths, will help healthcare programs address cancer in AI communities.     

Cytomegalovirus infection is associated with increased mortality in the older population

Cytomegalovirus (CMV) is a common herpesvirus infection and stimulates the expansion of very large numbers of CMV‐specific T cells that reduce the CD4/CD8 ratio and suppress the number of naïve T cells. CMV infection has been associated with frailty and impaired survival. We investigated the correlates of CMV and the impact of the CMV infection on mortality within a cohort of 511 individuals aged at least 65 years who were followed up for 18 years. The mean age of the participants was 74 years of which 70% were CMV‐seropositive. CMV was strongly linked to socio‐economic status, and CMV infection increased the annual mortality rate by 42% (Hazard ratio = 1.42, 95% CI: 1.11–1.76 after adjusting for age, sex and baseline socio‐economic and health variables) corresponding to 3.7 years lower life expectancy from age 65. Infection was associated with a near doubling of cardiovascular deaths, whereas there was no increase in mortality from other causes. These results show that CMV infection markedly increases the mortality rate in healthy older individuals due to an excess of vascular deaths. These findings may have significant implications for the study of immune senescence and if confirmed more generally could have important implications for measures to optimize the health of the elderly.     

Early neonatal lamb mortality: postmortem findings

An investigation of stillbirth and early neonatal lamb mortality was conducted in sheep flocks in Norway. Knowledge of actual causes of death are important to aid the interpretation of results obtained during studies assessing the risk factors for lamb mortality, and when tailoring preventive measures at the flock, ewe and individual lamb level. This paper reports on the postmortem findings in 270 liveborn lambs that died during the first 5 days after birth. The lambs were from 17 flocks in six counties. A total of 27% died within 3 h after birth, 41% within 24 h and 80% within 2 days. Most lambs (62%) were from triplet or higher order litters. In 81% of twin and larger litters, only one lamb died. The most frequently identified cause of neonatal death was infectious disease (n=97, 36%); 48% (n=47) of these died from septicaemia, 25% (n=24) from pneumonia, 22% (n=21) from gastrointestinal infections and 5% (n=5) from other infections. Escherichia coli accounted for 65% of the septicaemic cases, and were the most common causal agent obtained from all cases of infection (41%). In total, 14% of neonatal deaths resulted from infection by this bacterium. Traumatic lesions were the primary cause of death in 20% (n=53) of the lambs. A total of 46% of these died within 3 h after birth and 66% within 24 h. Severe congenital malformations were found in 10% (n=27) of the lambs, whereas starvation with no concurrent lesions was the cause of death in 6% (n=17). In 16% (n=43) of the lambs, no specific cause of death was identified, lambs from triplet and higher order litters being overrepresented among these cases. In this study, the main causes of neonatal lamb mortality were infection and traumatic lesions. Most neonatal deaths occurred shortly after birth, suggesting that events related to lambing and the immediate post-lambing period are critical for lamb survival.     

Biodemographic analysis of male honey bee mortality

Biodemographic studies of insects have significantly enhanced our understanding of the biology of aging. Eusocial insects have evolved to form different groups of colony members that are specialized for particular tasks and highly dependent on each other. These different groups (castes and sexes) also differ strongly in their life expectancy but relatively little is known about their mortality dynamics. In this study we present data on the age-specific flight activity and mortality of male honey bees from two different genetic lines that are exclusively dedicated to reproduction. We show that males initiating flight at a young age experience more flight events during their lifetime. No (negative) relation between the age at flight initiation and lifespan exists, as might be predicted on the basis of the antagonistic pleiotropy theory of aging. Furthermore, we fit our data to different aging models and conclude that overall a slight deceleration of the age-dependent mortality increase at advanced ages occurs. However, mortality risk increases according to the Gompertz-Makeham model when only days with flight activity (active days) are taken into account. Our interpretation of the latter is that two mortality components act on honey bee males during flight: increasing, age-dependent deaths (possibly from wear-and-tear), and age-independent deaths (possibly due to predation). The overall mortality curve is caused by the interaction of the distribution of age at foraging initiation and the mortality function during the active (flight) lifespan.     

Population dynamics of two sympatric antelope species, grey rhebok (Pelea capreolus) and mountain reedbuck (Redunca fulvorufula), in a highveld grassland region of South Africa

Population dynamics of grey rhebok Pelea capreolus and mountain reedbuck Redunca fulvorufula were monitored at Sterkfontein Dam Nature Reserve in South Africa over three breeding seasons. Birth and death rates were recorded in both species, and causes of death were investigated. Immigration and emigration were monitored in grey rhebok. Grey rhebok bred seasonally, with 91% of lambs being born between November and February. The average fecundity rate was 74% and lamb sex ratios were 22M:19F. Mountain reedbuck also bred seasonally, with a birth peak between October and December. The average fecundity rate was 92%, and lamb sex ratios were 12M:8F. Most deaths in both species occurred between June and November each year. Sixteen grey rhebok deaths occurred during the study, of which 10 resulted from hypothermia during one spring snowfall event. This represented 27% of the population at the time. Males and females were affected to the same degree by the snow, but juveniles suffered more than adults. There was no evidence of infectious disease or predation. Forty-three mountain reedbuck deaths occurred during the study, of which 32 resulted from hypothermia following the snowfall. This represented 51% of the population at the time. Females were affected by hypothermia more than males. There was no evidence of disease in the population from the examination of 41 culled animals, and no evidence of predation. Immigration and emigration within the grey rhebok population were uncommon, but dispersal of yearling males occurred every year between October and December when they were evicted from their natal herds. Herd structure of adult animals was very stable. In mountain reedbuck, emigration was very hard to detect.