More Like this

1. Intelligent Mortality Reporting With FHIR

   https://doi.org/10.1109/jbhi.2017.2780891  

   Hoffman, Ryan A.; Wu, Hang; Venugopalan, Janani; Braun, Paula; Wang, May D. (September 2018, IEEE Journal of Biomedical and Health Informatics)
2. Reducing childhood mortality extends mothers’ lives

   https://doi.org/10.1038/s41598-024-61217-w  

   Zipple, Matthew N (December 2024, Scientific Reports)

   Abstract During the twentieth century, childhood mortality was dramatically reduced globally, falling by more than 90% in the United States and much of Europe. Total fertility also fell, with the combined result that many parents who otherwise would have experienced the loss of a child were spared the trauma and negative health consequences that accompany such a loss. Here I use mathematical modeling to argue that the reduction in the frequency of child death that occurred in the twentieth century indirectly led to a substantial reduction in female mortality, resulting in an extension of female lifespan. I estimate that the reduction in maternal bereavement in the US during the twentieth century indirectly increased mean female lifespan after age 15 by approximately 1 year. I discuss implications for our understanding of the persistence of the sex gap in longevity and approaches to improving maternal health outcomes in countries that still face high levels of childhood mortality. 

   more » « less
3. Epidemiological impacts of post-infection mortality

   https://doi.org/10.1098/rspb.2023.0343  

   Saad-Roy, Chadi M.; Levin, Simon A.; Grenfell, Bryan T.; Boots, Mike (July 2023, Proceedings of the Royal Society B: Biological Sciences)

   Infectious diseases may cause some long-term damage to their host, leading to elevated mortality even after recovery. Mortality due to complications from so-called ‘long COVID’ is a stark illustration of this potential, but the impacts of such post-infection mortality (PIM) on epidemic dynamics are not known. Using an epidemiological model that incorporates PIM, we examine the importance of this effect. We find that in contrast to mortality during infection, PIM can induce epidemic cycling. The effect is due to interference between elevated mortality and reinfection through the previously infected susceptible pool. In particular, robust immunity (via decreased susceptibility to reinfection) reduces the likelihood of cycling; on the other hand, disease-induced mortality can interact with weak PIM to generate periodicity. In the absence of PIM, we prove that the unique endemic equilibrium is stable and therefore our key result is that PIM is an overlooked phenomenon that is likely to be destabilizing. Overall, given potentially widespread effects, our findings highlight the importance of characterizing heterogeneity in susceptibility (via both PIM and robustness of host immunity) for accurate epidemiological predictions. In particular, for diseases without robust immunity, such as SARS-CoV-2, PIM may underlie complex epidemiological dynamics especially in the context of seasonal forcing. 

   more » « less
4. The evolution of post-infection mortality

   https://doi.org/10.1098/rspb.2024.1854  

   Saad-Roy, Chadi M; White, Andy; Boots, Mike (November 2024, Proceedings of the Royal Society B: Biological Sciences)

   COVID-19 infections have underlined that there can be substantial impacts on health after recovery, including elevated mortality. While such post-infection mortality (PIM) is clearly widespread, we do not yet have any understanding of its evolutionary dynamics. To address this gap, we use an eco-evolutionary model to determine conditions where PIM is evolutionarily favoured. Importantly, from a pathogen perspective, there are two potential ‘resources’: never-infected susceptibles and previously infected susceptibles (provided some reinfection is possible), and PIM only occurs in the latter. A key insight is that unlike classic virulence (i.e. during-infection mortality, DIM) PIM is neutral and not selected against in the absence of other trade-offs. However, PIM modulates characteristics of endemicity, and may also vary with other pathogen-specific components. If PIM is only correlated with transmission, recovery or DIM, it simply acts to modulate their impacts on the evolutionary outcome. On the other hand, if PIM trades off with the relative susceptibility to reinfection, there are important evolutionary implications that contrast with DIM. We find settings where a susceptibility–mortality trade-off (i.e. an increase in mortality leads to higher relative susceptibility to reinfection) can select against DIM but favour PIM. This provides a potential explanation for the ubiquity of PIM. Overall, our work illustrates that PIM can readily evolve in certain settings and highlights the importance of considering different sources of mortality. 

   more » « less
5. The US Mortality Crisis: An Examination of Non-Hispanic White Mortality and Morbidity in Yavapai County, Arizona

   https://doi.org/10.1007/s10900-019-00648-3  

   Parsons, Michelle Anne; Barger, Steven D. (March 2019, Journal of Community Health)

   Midlife non-Hispanic white mortality in the United States is rising, particularly in small metro and rural counties. This article responds to calls for county-level studies. We examine social determinants of morbidity and mortality among adult non-Hispanic whites in Yavapai County, Arizona, as part of an integrative study. We report overall mortality trends in Yavapai County using CDC Wonder data and then examine social determinants of reported physical health and mental distress in Yavapai County data using 6 years (2011–2016) of the Arizona Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS includes 1,024 non-Hispanic white respondents aged 25–64. We also present data from the recently established Yavapai County Overdose Fatality Review Board (YCOFRB). Mortality trends indicate that suicide and drug and alcoholrelated mortality have all increased since 1999. These increases affect all 5-year age groups from 25 to 64 and both men and women. BRFSS data show that low education and unemployment, but not number of children or home ownership, are significantly associated with worse reported health and frequent mental distress in multivariate analyses. The YCOFRB point to the importance of homelessness and mental health. The mortality crisis in Yavapai County is not restricted to midlife or to drug-related deaths. The unemployed and those with low levels of education are particularly at risk. There is a need for integrative approaches that use local data to elucidate social determinants of morbidity and mortality and to reveal structural determinants. 

   more » « less