11 February 2019 - 13 February 2019
There is a substantial and fairly uniform extension of the average life span in similarly prosperous countries, going hand in hand with an enormous change in the distribution of causes-of-death during that extension of the life span. Moreover there are much larger, persistent differences in the incidence of single causes of death from country to country than in general mortality. This inconsistency is even more impressive if one focuses on the countries of the European Union plus the European Free Trade Association, which forms one economic space with converging prosperity levels and whose citizens are protected by similar social security systems.
In this seminar of the IUSSP Scientific Panel on Lifespan extension with Varying Cause-of-Death Trajectories participants will discuss the underlying causes of varying cause-of-death trajectories leading to the same high life expectancy levels by identifying and describing different types of specific mortality trajectories, and explaining how different trajectories in European Societies may have originated from.
This seminar will bring together senior researchers in population genetics, epidemiology, demography, health care economics and sociology and related fields as well as a limited number of doctoral students or otherwise advanced graduates.
IIASA researcher Nandita Saikia will give two presentations during the seminar. The first presentation looks at the neonatal and under-five mortality rate in Indian districts with reference to Sustainable Development Goal 3, and in the second presentation Saikia will discuss socio-economic patterns and determinants of adult deaths due to external-cause in India. Saikia joined IIASA's World Population Program in August 2017 as an IIASA Postdoctoral researcher to work on indoor air pollution and mortality.
For more information please visit the event website.
Neonatal and under-five mortality rate in Indian districts with reference to Sustainable Development Goal 3
Jayanta Kumar Bora
Background and objective: India contribute the highest global share of deaths among the under-fives. Continuous monitoring of the reduction in the under-five mortality rate (U5MR) at local level is thus essential to set priorities for policy-makers and health professionals. In this study, we aimed to provide an update on district-level disparities in the neonatal mortality rate (NMR) and the U5MR with special reference to Sustainable Development Goal 3 (SDG3) on preventable deaths among new-borns and children under five.
Data and methods: We used recently released population-based cross-sectional data from the National Family Health Survey (NFHS) conducted in 2015–2016. We used the synthetic cohort probability approach to analyze the full birth history information of women aged 15–49 to estimate the NMR and U5MR for the ten years preceding the survey.
Results: Both the NMR and U5MR vary enormously across Indian districts. With respect to the SDG3 target for 2030 for the NMR and the U5MR, the estimated NMR for India for the period studied is about 2.4 times higher, while the estimated U5MR is about double. At district level, while 9% of the districts have already reached the NMR targeted in SDG3, nearly half (315 districts) are not likely to achieve the 2030 target even if they realize the NMR reductions achieved by their own states between the last two rounds of National Family Health Survey of India. Similarly, less than one-third of the districts (177) of India are unlikely to achieve the SDG3 target on the U5MR by 2030. While the majority of high-risk districts for the NMR and U5MR are located in the poorer states of north-central and eastern India, a few high-risk districts for NMR also fall in the rich and advanced states. About 97% of districts from Chhattisgarh and Uttar Pradesh, for example, are unlikely to meet the SDG3 target for preventable deaths among new-borns and children under age five, irrespective of gender.
Conclusions: To achieve the SDG3 target on preventable deaths by 2030, the majority of Indian districts clearly need to make a giant leap to reduce their NMR and U5MR.
Socio-economic patterns and determinants of adult deaths due to external-cause in India: Analysis of nationally representative population-based survey data
Nandita Saikia, Vladimir Shkolnikov, Domantas Jasilionis, Moradhvaj
Objective: To analyze the pattern and risk factors of all-cause and external-cause mortality among adults in India.
Data and method: Using nationally representative population based survey, known as National Family Health Survey, 2015-2016, we calculated age specific death rates among adults aged 15-64 for all-cause and external-cause in three years prior to the survey. We estimated the cause eliminated life expectancy due to external-cause of death by sex. Further, we did logistic regression analysis to investigate the socio-economic determinants of all-cause and external-cause mortality in India.
Results: Male disadvantage in external-cause mortality is higher than all-cause mortality as male external-cause mortality is about 2.24 times higher than that of female (male:10.10 vs female:4.50 per 10,000). 21,340 overall adult deaths yielded 2,898 (22.03% of total male deaths) and 1,128 (13.78% of total female deaths) external deaths among men and women respectively. For all-cause mortality, caste and household wealth quintile (WQ) are significant determinants for both sexes. Caste is not a significant determinant of external-cause mortality except for Scheduled Caste males. Hindus experience excess external-cause mortality (adjusted odds ratio (aOR) men: 1.21, CI:1.00-1.46 Vs women: 1.35, CI: 1.02-1.78). Rural excess mortality in all-cause mortality reverses (aOR men: 0.80, CI: 0.76-0.85) and become insignificant in external-cause mortality for both sexes. Finally, the risk of external deaths elevates as household WQ reduces from the richest to the poorest category (aOR for poorest WQ male: 2.24, CI: 1.82-2.75; female: 1.84, CI:1.34:2.54).
Conclusion: Share of external deaths to total deaths in India is higher than previously estimated. The people belonging to lower socio-economic strata carry the burden disproportionately.
Last edited: 22 January 2019
Diamond-Smith N, Saikia N , Bishai D, & Canudas-Romo V (2020). What has contributed to improvements in the child sex ratio in select districts of India? A decomposition of the sex ratio at birth and child mortality. Journal of Biosocial Science 52 (1): 27-36. DOI:10.1017/S0021932019000221.
Bora J, Saikia N , & Lutz W (2019). Revisiting the causes of fertility decline in Bangladesh: Family planning program or female education? IIASA Working Paper. Laxenburg, Austria: WP-19-011
Moradhvaj & Saikia N (2019). Gender Disparities in Health-care Expenditure (HCE) and Financing Strategies (HCFS) for In-patient Care in India. SSM - Population Health 9: e100372. DOI:10.1016/j.ssmph.2019.100372.
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