Tuesday, March 29, 2011

[EQ] Altitude, life expectancy and mortality from ischaemic heart disease, stroke, COPD and cancers

Altitude, life expectancy and mortality from ischaemic heart disease, stroke, COPD and cancers:
national population-based analysis of US counties

Majid Ezzati1,2, Mara E M Horwitz3, Deborah S K Thomas4, Ari B Friedman5, Robert Roach6, Timothy Clark7, Christopher J L Murray3, Benjamin Honigman6


1MRC-HPA Centre for Environment and Health, Imperial College, London, UK

2Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK

3Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA

4Department of Geography and Environmental Sciences, University of Colorado Denver, Denver, Colorado, USA

5University of Pennsylvania, Philadelphia, Pennsylvania, USA

6Altitude Research Center and Department of Emergency Medicine, University of Colorado Denver School of Medicine, Aurora, Colorado, USA

7US Army Corps of Engineers, Engineering Research and Development Center, Topographic Engineering Center, Alexandria, Virginia, USA

J Epidemiol Community Health 15 March 2011

Website: http://bit.ly/hxRDxO

There is a substantial variation in life expectancy across US counties, primarily owing to differentials in chronic diseases. The authors' aim was to examine the association of life expectancy and mortality from selected diseases with altitude.

The authors used data from the National Elevation Dataset, National Center for Heath Statistics and US Census. The authors analysed the crude association of mean county altitude with life expectancy and mortality from ischaemic heart disease (IHD), stroke, chronic obstructive pulmonary disease (COPD) and cancers, and adjusted the associations for socio-demographic factors, migration, average annual solar radiation and cumulative exposure to smoking in multivariable regressions.

Counties above 1500 m had longer life expectancies than those within 100 m of sea level by 1.2–3.6 years for men and 0.5–2.5 years for women. The association between altitude and life expectancy became non-significant for women and non-significant or negative for men in multivariate analysis. After adjustment, altitude had a beneficial association with IHD mortality and harmful association with COPD, with a dose–response relationship. IHD mortality above 1000 m was 4–14 per 10000 people lower than within 100 m of sea level; COPD mortality was higher by 3–4 per 10000. The adjusted associations for stroke and cancers were not statistically significant.

Living at higher altitude may have a protective effect on IHD and a harmful effect on COPD. At least in part due to these two opposing effects, living at higher altitude appears to have no net effect on life expectancy.

Twitter http://twitter.com/eqpaho

 *      *      *     *
This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ KMC Area]

"Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members".


PAHO/WHO Website: http://new.paho.org/equity/

EQUITY List - Archives - Join/remove: http://listserv.paho.org/Archives/equidad.html

Twitter http://twitter.com/eqpaho

IMPORTANT: This transmission is for use by the intended
recipient and it may contain privileged, proprietary or
confidential information. If you are not the intended
recipient or a person responsible for delivering this
transmission to the intended recipient, you may not
disclose, copy or distribute this transmission or take
any action in reliance on it. If you received this transmission
in error, please dispose of and delete this transmission.

Thank you.