Esperanza de vida

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    La medición de la mortalidad a partir de información recogida en una encuesta
    (Población y Salud en Mesoamérica, Volume 12, número 2, documento histórico, enero-julio, 2015) Somoza, Jorge L.
    Estas notas están dirigidas a un lector poco familiarizado con los esfuerzos que realizan los demógrafos en la actualidad, encaminados a lograr estimaciones de la mortalidad de una población para la cual no hay información disponible sobre las defunciones anuales.En el sentido estricto que se utiliza en este documento, conocer la mortalidad es equivalente a disponer de una tabla de vida. Este conocimiento es elemental ya que constituye un dato indispensable en cualquier análisis demográfico que se quiera intentar de una población.Pese a lo señalado, a su naturaleza elemental, no se tiene dicho conocimiento de la mayor parte de los países de América Latina, menos aun de regiones dentro de ellos. En países en los que existen mediciones de aceptable calidad a nivel nacional, no se cuenta generalmente con estimaciones de mortalidad satisfactorias para regiones o provincias.Es necesario, por lo tanto, resolver el problema de estimar la mortalidad de una población. Descartados los métodos directos que imponen exigencias muy difíciles de satisfacer (la organización eficiente de registros, la disponibilidad de censos), se han ensayado con ese propósito, procedimientos indirectos. En lugar de calcular la tasa central de mortalidad por edades con datos provenientes de registros anuales y de un censo, se recoge información en una encuesta, de la que se deriva una tabla de vida.En este documento se hace una exposición de estas ideas en forma esquemática, las cuales tienen un desarrollo reciente. En las referencias que se acompañan al final podrá el lector interesado imponerse debidamente de los fundamentos y de los detalles de los procedimientos que se esbozan aquí
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    Epidemiología, medio ambiente y desigualdades por género en Tarragona, unaprovincia de Cataluña (España), 1960-1990 = Epidemiology, environment and gender inequalities in Tarragona, a province of Catalonian(Spain), 1960-1990
    (Población y Salud en Mesoamérica, Volumen 10, número 2, artículo 6, ene-jun, 2013) Gonzalvo Cirac; Albareda Tiana
    La presente investigación describe y analiza la evolución de la tendencia de la esperanza de vida en Tarragona, en Cataluña y en España entre 1960 y 1990. Tarragona es la que más aumenta. Existe una diferencia de mortalidad entre sexos con tendencia a un crecimiento distancial entre ambos. Para entender esta desigualdad territorial y entre sexos se utiliza el marco conceptual de la Teoría de la Transición Epidemiológica. La información de estadísticas consultada es del Instituto Nacional de Estadística de España (INE) y del Instituto Nacional d’Estadistica de Catalunya (IDESCAT) y se utiliza la metodología de la estandarización indirecta. Mediante la Clasificación Internacional de Enfermedades se ha elaborado una agrupación conjunta de grandes causas de muerte. En las tres zonas comparadas se produce un aumento de esperanza de vida de casi 8 años aunque con una diferencia cada vez mayor entre sexos a favor de las mujeres. En cuanto a las enfermedades, Tarragona presenta en este período una gran incidencia de muertes provocadas por enfermedades respiratorias y cánceres y tumores, mayor que en España a nivel de los dos sexos. Finalmente, la estandarización indirecta es un buen método para el análisis epidemiológico y los factores determinantes. Algunas causas que provocan enfermedades respiratorias y cánceres, pueden estar producidas por industrias nucleares y petroquímicas y son debidas problemas ambientales. En Tarragona pueden estar afectando estas causas y su mejora en la década de 1980-1990 puede ser el resultado de la disminución de este tipo de enfermedades. This research describes and analyzes the evolution of the trend in life expectancy in Tarragona, Catalonia and Spainbetween 1960 and 1990. Tarragona shows the biggest increase and for both sexes. There is a difference in mortalitybetween sexes but with a tendency showing the rates becoming increasingly to each other. To understand this inequalitybetween different geographical and sexes we have been used the conceptual framework of the Theory of EpidemiologicTransition. Information of Instituto Nacional de Estadística de España (INE) and Institut Nacional d’Estadistica deCatalunya (IDESCAT) and methodology of indirect standardization were analyzed. Furthermore, a joint grouping of theleading causes of death has been created based on the International Classification of Diseases. During this period a largeincrease in life expectancy for both sexes takes place, but with a favourable difference for women. During this period,Tarragona had a high incidence of deaths from respiratory diseases and cancers and tumors, greater than in the rest ofSpain, for both sexes. The epidemiology through indirect standardization is a good way to describe in greater detail thechanges in the structure of the population and its impact on health inequality. Some causes of respiratory diseases andcancers are due to the lack of care of the environment, particularly through the nuclear and petrochemical industries. In Tarragona, these causes may be responsible for some of the effects, and measures to improve the environment during thedecade from 1980-1990 may be causing their decline.
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    Una aproximación a la mortalidad adulta de las poblaciones indígenas costarricences 1990-2000
    (Caja Costarricense de Seguro Social, 2001) Salazar Figueroa, Virginia
    El propósito del presente trabajo es identificar, mediante una aproximación, las particularidades más importantes de la mortalidad asociada a las poblaciones indígenas costarricenses. Como una forma de contextualizar el comportamiento de esta variable, en el documento también se incluyen referencias importantes relativas a las características de orden sociocultural y geográfico de las localidades en donde están ubicadas las distintas etnias. Sin que pretenda ser un estudio integral, si se constituye en un esfuerzo por proporcionar mayores elementos al saber sobre las particularidades que identifican la mortalidad ocurrida al interior de estos colectivos.
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    Obesidad y esperanza de vida en México = Obesity and life expectancy in Mexico
    (Población y Salud en Mesoamérica, vol. 6, no. 1, art. 4, julio - diciembre, 2008) Monteverde Malena; Novak Beatriz
    La alta y creciente prevalencia de personas obesas y con sobrepeso en los países de América Latina y el Caribe y los mayores riesgos asociados con el padecimiento de ciertas enfermedades crónicas, podrían estar modificando los patrones de mortalidad así como la esperanza de vida de dichas poblaciones. El principal objetivo de nuestro estudio es medir el efecto del sobrepeso y la obesidad sobre la mortalidad en México centrándonos en la población de edades mayores (60 y más años de edad). Nuestro estudio utiliza la información que brinda el Estudio Nacional sobre Salud y Envejecimiento en México (ENASEM, 2001 y 2003). El ENASEM es un estudio de panel con representatividad nacional de las personas de 50 y más años en México. Nuestros resultados indican que el exceso de peso (definido por los dos quintiles superiores del Índice de Masa Corporal –IMC-) incrementa el riesgo de mortalidad a los 60 años de edad y más en México. Hasta un 11% de las muertes registradas durante el período 2001-2003 en México dentro del grupo de edad de 60 y más años habrían sido evitables si las personas con exceso de peso (pertenecientes a los dos quintiles superiores de IMC) hubiesen tenido el peso ideal (quintil medio o tercer quintil de IMC). A nivel individual se estima que las personas de 60 años con exceso de peso (cuarto y quinto quintiles de IMC) viven cuatro años menos, en promedio, que las personas con peso normal (tercer quintil de IMC).
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    Genetic, dietary, and other lifestyle determinants of serum homocysteine levels in young adults in Costa Rica
    (Revista Panamericana de Salud Pública, vol17(4), 2005) Holst Schumacher, Ileana; Monge Rojas, Rafael; Cambronero Gutiérrez, Priscilla; Brenes Camacho, Gilbert
    Objective: Elevated serum total homocysteine (tHcy) is considered an independent risk factor for cardiovascular disease. The objective of this study was to develop the first-ever information on the prevalence of hyperhomocysteinemia and its determinants in a population in Costa Rica. Methods: A cross-sectional study was conducted to determine serum levels of tHcy, vitamin B12, folate and creatinine, as well as the presence of the genotype TT for the methylentetratrahydrofolate reductase (MTHFR) enzyme. Additionally, dietary vitamin intakes and other lifestyle risk factors were assessed. A total of 399 Costa Rican adults from the central valley of the country (where the capital city, San José, is located), aged 20 to 40 years, participated in this study in the year 2000. Analyses of variance were performed for continuous variables, and the chi-square test was used for categorical data. Spearman correlation tests were calculated to determine associations between variables. Three linear regression analyses and one binary logistic model were developed in order to determine the predictors for homocysteine levels in the population studied. Results: The overall prevalence of hyperhomocysteinemia ( over 15 umol/L) in the population was 6%, 31% of the population were in the range of 10 to 15 umol/L, 29% had the genotype TT for the enzyme MTHFR, 18% presented a vitamin B12 deficiency ( less 165 pmol/L), and none of the persons had low serum folate levels (less 7,0 nmol/l). No significant associations were found between tHcy and age, smoking, consuming alcohol, or dietary vitamin intake. Conclusions: Only serum vitamin B12 levels and the genotype TT of the enzyme MTHFR were considered significant predictors of high serum tHcy levels in the Costa Rica population studied.
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    The vanishing advantage of longevity in Nicoya, Costa Rica: A cohort shif
    (Demographic Research, vol.49 (27, 2023) Rosero Bixby, Luis
    BACKGROUND The Nicoya region in Costa Rica has been identified as one of a handful of hotspots of extreme longevity. The evidence supporting this status comes mostly from observing the 1990 and 2000 decades and cohorts born before 1930. OBJECTIVE To determine how the longevity advantage of older men in Nicoya has progressed in the period 1990 to 2020 and in cohorts born from 1900 to 1950. METHODS Remaining length of life and adult mortality were estimated using new public administrative records from the electoral system and a Gompertz regression model. A new nationwide survival-time database of 550,000 adult Costa Ricans who were alive at any point during 1990–2020 was put together. RESULTS The longevity advantage of Nicoya is disappearing in a trend driven mostly by cohort effects. While Nicoyan males born in 1905 had 33% lower adult mortality rates than other Costa Ricans, those born in 1945 had 10% higher rates. The original geographic hotspot of low elderly mortality, coined the Nicoya blue zone, has decreased to a small area south of the peninsula around the corridor from Hojancha inland to the beach town of Sámara. However, Nicoyans born before 1930 who are still alive continue to show exceptionally high longevity. CONCLUSIONS Surviving Nicoyan males born before 1930 are exceptional human beings living longer than expected lives. Not so for more recent cohorts. The window of opportunity to meet and study pre-1930 individuals is closing.
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    Epigenome-Wide Association Study and Epigenetic Age Acceleration Associated with Cigarette Smoking among Costa Rican Adults
    (Scientific Reports, Vol. 12 Núm, 2022) Cárdenas, Andrés; Ecker, Simone; Fadadu, Raj P.; Huen, Karen; Orozco, Allan; McEwen, Lisa M.; Engelbrecht, Hannah Ruth; Gladish, Nicole; Kobor, Michael S.; Rosero Bixby, Luis; Dow, William H.; Rehkopf, David H.
    Smoking-associated DNA methylation (DNAm) signatures are reproducible among studies of mostly European descent, with mixed evidence if smoking accelerates epigenetic aging and its relationship to longevity. We evaluated smoking-associated DNAm signatures in the Costa Rican Study on Longevity and Healthy Aging (CRELES), including participants from the high longevity region of Nicoya. We measured genome-wide DNAm in leukocytes, tested Epigenetic Age Acceleration (EAA) from five clocks and estimates of telomere length (DNAmTL), and examined effect modification by the high longevity region. 489 participants had a mean (SD) age of 79.4 (10.8) years, and 18% were from Nicoya. Overall, 7.6% reported currently smoking, 35% were former smokers, and 57.4% never smoked. 46 CpGs and five regions (e.g. AHRR, SCARNA6/SNORD39, SNORA20, and F2RL3) were differentially methylated for current smokers. Former smokers had increased Horvath’s EAA (1.69-years; 95% CI 0.72, 2.67), Hannum’s EAA (0.77-years; 95% CI 0.01, 1.52), GrimAge (2.34-years; 95% CI1.66, 3.02), extrinsic EAA (1.27-years; 95% CI 0.34, 2.21), intrinsic EAA (1.03-years; 95% CI 0.12, 1.94) and shorter DNAmTL (− 0.04-kb; 95% CI − 0.08, − 0.01) relative to non-smokers. There was no evidence of effect modification among residents of Nicoya. Our findings recapitulate previously reported and novel smoking-associated DNAm changes in a Latino cohort.
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    Derivation, internal validation, and recalibration of a cardiovascular risk score for Latin America and the Caribbean (Globorisk-LAC): A pooled analysis of cohort studies
    (The Lancet Regional Health - Americas, 9, 2022) Stern, Dalia; Hambleton, Ian R.; Lotufo, Paulo Andrade; Di Cesare, Mariachiara; Hennis, Anselm; Ferreccio, Catterina; Irazola, Vilma; Perel, Pablo; Gregg, Edward W.; Aguilar Salinas, Carlos Alberto; Álvarez Vaz, Ramón; Amadio, Marselle Bevilacqua; Baccino, Cecilia; Bambs S., Claudia; Bastos, João Luiz Dornelles; Beckles, Gloria; Bernabé Ortiz, Antonio; Bernardo, Carla; Bloch, Katia Vergetti; Blümel, Juan Enrique; Boggia, José G.; Borges, Pollyana Kássia de Oliveira; Bravo, Miguel; Brenes Camacho, Gilbert; Carbajal, Horacio A.; Casas Vásquez, Paola; Castillo Rascón, María Susana; Ceballos, Blanca H.; Colpani, Verônica; Cooper, Jackie A.; Cortés, Sandra; Cortés Valencia, Adrián; de Sá Cunha, Roberto; d'Orsi, Eleonora; Dow, William H.; Espeche, Walter G.; Fuchs, Flavio Danni; Pereira Costa Fuchs, Sandra Cristina; Godoy Agostinho Gimeno, Suely; Gómez Velasco, Donaji Verónica; González Chica, David Alejandro; González Villalpando, Clicerio; González Villalpando, María Elena; Grazioli, Gonzalo; Guerra, Ricardo Oliveira; Gutierrez, Laura E.; Herkenhoff Vieira, Fernando Luiz; Horimoto, Andrea Roseli Vancan Russo; Huidobro Muñoz, Laura Andrea; Koch, Elard S.; Lajous Loaeza, Martin; Furtado de Lima e Costa, Maria Fernanda; López Ridaura, Ruy; Campos Cavalcanti Maciel, Álvaro; Maestre, Gladys Elena; Manrique Espinoza, Betty Soledad; Marques, Larissa Pruner; Melgarejo Arias, Jesus David; Mena Camaré, Luis Javier; Mill, Jose Gerardo; Moreira, Leila Beltrami; Muñoz Velandia, Oscar Mauricio; Ono, Lariane Mortean; Oppermann, Karen; Ortiz Saavedra, Pedro José; de Paiva, Karina Mary; Viana Peixoto, Sérgio William; da Costa Pereira, Alexandre; Peres, Karen G.; de Anselmo Peres, Marco Aurelio; Ramírez Palacios, Paula; Rech, Cassiano Ricardo; Rivera Paredez, Berenice; Rodríguez Guerrero, Nohora Inés; Rojas Martínez, Maria Rosalba; Rosero Bixby, Luis; Rubinstein, Adolfo; Ruiz Morales, Álvaro de Jesus; Salazar, Martin R.; Salinas Rodríguez, Aarón; Nájera Salmerón, Jorge Alberto; Sánchez, Ramón Augusto; de Souza e Silva, Nelson Albuquerque; Nogueira da Silva, Thiago Luiz; Smeeth, Liam; Spritzer, Poli Mara; Tartaglione, Fiorella; Tartaglione, Jorge; Tello Rodríguez, Tania; Velázquez Cruz, Rafael; Cohorts Consortium of Latin America and the Caribbean (CC-LAC); Carrillo Larco, Rodrigo Martín; Miranda Montero, Juan J.; Ezzati, Majid; Danaei, Goodarz
    Background: Risk stratification is a cornerstone of cardiovascular disease (CVD) prevention and a main strategy proposed to achieve global goals of reducing premature CVD deaths. There are no cardiovascular risk scores based on data from Latin America and the Caribbean (LAC) and it is unknown how well risk scores based on European and North American cohorts represent true risk among LAC populations. Methods: We developed a CVD (including coronary heart disease and stroke) risk score for fatal/non-fatal events using pooled data from 9 prospective cohorts with 21,378 participants and 1,202 events. We developed laboratory based (systolic blood pressure, total cholesterol, diabetes, and smoking), and office-based (body mass index replaced total cholesterol and diabetes) models. We used Cox proportional hazards and held back a subset of participants to internally validate our models by estimating Harrell’s C-statistic and calibration slopes. Findings: The C-statistic for the laboratory-based model was 72% (70−74%), the calibration slope was 0.994 (0.934−1.055) among men and 0.852 (0.761−0.942) among women; for the office-based model the C-statistic was 71% (69−72%) and the calibration slope was 1.028 (0.980−1.076) among men and 0.811 (0.663−0.958) among women. In the pooled sample, using a 20% risk threshold, the laboratory-based model had sensitivity of 21.9% and specificity of 94.2%. Lowering the threshold to 10% increased sensitivity to 52.3% and reduced specificity to 78.7%. Interpretation: The cardiovascular risk score herein developed had adequate discrimination and calibration. The Globorisk-LAC would be more appropriate for LAC than the current global or regional risk scores. This work provides a tool to strengthen risk-based cardiovascular prevention in LAC.
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    Impact of common cardio-metabolic risk factors on fatal and non-fatal cardiovascular disease in Latin America and the Caribbean: an individual-level pooled analysis of 31 cohort studies
    (The Lancet Regional Health - Americas, vol.4, 2021) Cohorts Consortium of Latin America and the Caribbean (CC-LAC)
    Background: Estimates of the burden of cardio-metabolic risk factors in Latin America and the Caribbean (LAC) rely on relative risks (RRs) from non-LAC countries. Whether these RRs apply to LAC remains un- known. Methods: We pooled LAC cohorts. We estimated RRs per unit of exposure to body mass index (BMI), systolic blood pressure (SBP), fasting plasma glucose (FPG), total cholesterol (TC) and non-HDL cholesterol on fatal (31 cohorts, n = 168,287) and non-fatal (13 cohorts, n = 27,554) cardiovascular diseases, adjusting for regression dilution bias. We used these RRs and national data on mean risk factor levels to estimate the number of cardiovascular deaths attributable to non-optimal levels of each risk factor. Results: Our RRs for SBP, FPG and TC were like those observed in cohorts conducted in high-income countries; however, for BMI, our RRs were consistently smaller in people below 75 years of age. Across risk factors, we observed smaller RRs among older ages. Non-optimal SBP was responsible for the largest number of attributable cardiovascular deaths ranging from 38 per 10 0,0 0 0 women and 54 men in Peru, to 261 (Dominica, women) and 282 (Guyana, men). For non-HDL cholesterol, the lowest attributable rate was for women in Peru (21) and men in Guatemala (25), and the largest in men (158) and women (142) from Guyana. Interpretation: RRs for BMI from studies conducted in high-income countries may overestimate disease burden metrics in LAC; conversely, RRs for SBP, FPG and TC from LAC cohorts are similar to those esti- mated from cohorts in high-income countries.
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    Mortalidad según tipos de ocupación en México, 2014
    (Poblaciòn y Salud en Mesoamcérica, volumen 17, Número 1 (julio-diciembre 2019), 2019) Román Sánchez, Yuliana Gabriela; Montoya Arce, Bernardino Jaciel; Lozano Keymolen, Daniel; Robles Linares, Sergio Cuauhtémoc Gaxiola
    El presente artículo tiene como objetivo analizar los niveles de la mortalidad tomando en cuenta el tipo de ocupación de la población empleada en México. Método: se estimaron tablas de vida para cuatro grupos de ocupación: manual de baja calificación, manual de alta calificación, no manual de baja calificación y no manual de alta calificación, a partir de estas se estimaron las esperanzas de vida según ocupación para el año 2014. Resultados: la mortalidad se concentra en ocupaciones de alta calificación y mejor pagadas que se asocian con un mayor estrés y una vida sedentaria, relacionadas con la nueva dinámica de la globalización, flexibilidad y precariedad laboral.

SIBDI, UCR - San José, Costa Rica.

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