Is austerity responsible for the recent change in mortality trends across high-income nations? A protocol for an observational study.
epidemiology
international health services
public health
statistics & research methods
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
23 01 2020
23 01 2020
Historique:
entrez:
26
1
2020
pubmed:
26
1
2020
medline:
10
2
2021
Statut:
epublish
Résumé
Mortality rates in many high-income countries have changed from their long-term trends since around 2011. This paper sets out a protocol for testing the extent to which economic austerity can explain the variance in recent mortality trends across high-income countries. This is an ecological natural experiment study, which will use regression adjustment to account for differences in exposure, outcomes and confounding. All high-income countries with available data will be included in the sample. The timing of any changes in the trends for four measures of austerity (the Alesina-Ardagna Fiscal Index, real per capita government expenditure, public social spending and the cyclically adjusted primary balance) will be identified and the cumulative difference in exposure to these measures thereafter will be calculated. These will be regressed against the difference in the mean annual change in life expectancy, mortality rates and lifespan variation compared with the previous trends, with an initial lag of 2 years after the identified change point in the exposure measure. The role of underemployment and individual incomes as outcomes in their own right and as mediating any relationship between austerity and mortality will also be considered. Sensitivity analyses varying the lag period to 0 and 5 years, and adjusting for recession, will be undertaken. All of the data used for this study are publicly available, aggregated datasets with no individuals identifiable. There is, therefore, no requirement for ethical committee approval for the study. The study will be lodged within the National Health Service research governance system. All results of the study will be published following sharing with partner agencies. No new datasets will be created as part of this work for deposition or curation.
Identifiants
pubmed: 31980513
pii: bmjopen-2019-034832
doi: 10.1136/bmjopen-2019-034832
pmc: PMC7044814
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e034832Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Ann N Y Acad Sci. 2010 Feb;1186:56-68
pubmed: 20201868
Am J Public Health. 2019 Jun;109(6):e1-e12
pubmed: 31067117
Annu Rev Public Health. 2017 Mar 20;38:39-56
pubmed: 28125392
PLoS Med. 2007 Oct 16;4(10):e296
pubmed: 17941714
BMJ Open. 2017 Mar 9;7(3):e015559
pubmed: 28280000
Lancet. 2013 Apr 13;381(9874):1323-31
pubmed: 23541059
Public Health. 2016 Mar;132:13-23
pubmed: 26917268
Int J Health Serv. 2011;41(3):501-23
pubmed: 21842575
BMJ. 2012 Aug 13;345:e5142
pubmed: 22893569
Gerontology. 2020;66(1):95-104
pubmed: 31390630
J Epidemiol Community Health. 2017 May;71(5):461-467
pubmed: 28062643
Econ Hum Biol. 2019 May;33:211-223
pubmed: 31003198
Scand J Public Health. 2019 Aug;47(6):635-654
pubmed: 30301437
Eur J Public Health. 2016 Apr;26(2):360-2
pubmed: 26614636
BMJ Open. 2012 Oct 17;2(5):
pubmed: 23075569
Int J Epidemiol. 2011 Apr;40(2):503-12
pubmed: 21247886
J Epidemiol Community Health. 2019 Oct;73(10):971-974
pubmed: 31326891
Public Health. 2017 Oct;151:1-12
pubmed: 28697372
Lancet. 2011 Jul 9;378(9786):124-5
pubmed: 21742166
Sociol Health Illn. 2018 May;40(4):750-768
pubmed: 29500841
BMJ Open. 2019 Oct 31;9(10):e029936
pubmed: 31676648
Curr Epidemiol Rep. 2016 Mar;3(1):81-91
pubmed: 27239427
BMJ. 2019 Mar 26;364:l1042
pubmed: 30957776
BMJ. 2018 Aug 13;362:k3491
pubmed: 30104287
J R Soc Med. 2016 Mar;109(3):109-16
pubmed: 26980412
PLoS Med. 2014 Aug 26;11(8):e1001711
pubmed: 25158064
BMJ. 2016 Sep 06;354:i4588
pubmed: 27601477
Am J Public Health. 2019 May;109(5):768-770
pubmed: 30897000
J R Soc Med. 2013 Nov;106(11):432-6
pubmed: 24025229
J R Soc Med. 2018 Jun;111(6):199-202
pubmed: 29877771
Int J Epidemiol. 2013 Aug;42(4):1164-76
pubmed: 24062300
Lancet Public Health. 2018 Jul;3(7):e333-e340
pubmed: 29976327
Public Health. 2019 Jul;172:22-30
pubmed: 31154234
Int J Health Serv. 2014;44(1):53-71
pubmed: 24684084
Soc Sci Med. 2011 Mar;72(6):840-54
pubmed: 21330027
J Public Health (Oxf). 2016 Sep;38(3):417-425
pubmed: 26364320
BMJ. 2018 Aug 15;362:k3096
pubmed: 30111554
Health Aff (Millwood). 2013 Mar;32(3):459-67
pubmed: 23459724
BMJ Open. 2017 Nov 15;7(11):e017722
pubmed: 29141897
PLoS One. 2018 Feb 23;13(2):e0193165
pubmed: 29474377
Eur J Public Health. 2015 Jun;25(3):404-9
pubmed: 25287115