Health Equity: 01/23/12

Monday, January 23, 2012

[EQ] Modeling causes of death: an integrated approach using CODEm

Modeling causes of death: an integrated approach using CODEm

Kyle J Foreman; Rafael Lozano, Alan D Lopez, Christopher JL Murray
Institute for Health Metrics and Evaluation, IHME University of Washington, Seattle, WA

School of Population Health, University of Queensland, Australia

Population Health Metrics – January 2012, 10:1 doi:10.1186/1478-7954-10-1

Available online at : http://bit.ly/xYZWgM

“……..Data on causes of death by age and sex are a critical input into health decision-making.
Priority setting in public health should be informed not only by the current magnitude of health problems but by trends in them. However, cause of death data are often not available or are subject to substantial problems of comparability. We propose five general principles for cause of death model development, validation, and reporting.

Methods

We detail a specific implementation of these principles that is embodied in an analytical tool - the Cause of Death Ensemble model (CODEm) - which explores a large variety of possible models to estimate trends in causes of death. Possible models are identified using a covariate selection algorithm that yields many plausible combinations of covariates, which are then run through four model classes.

The model classes include mixed effects linear models and spatial-temporal Gaussian Process Regression models for cause fractions and death rates. All models for each cause of death are then assessed using out-of-sample predictive validity and combined into an ensemble with optimal out-of-sample predictive performance.

Results

Ensemble models for cause of death estimation outperform any single component model in tests of root mean square error, frequency of predicting correct temporal trends, and achieving 95% coverage of the prediction interval.
We present detailed results for CODEm applied to maternal mortality and summary results for several other causes of death, including cardiovascular disease and several cancers.

Conclusions

CODEm produces better estimates of cause of death trends than previous methods and is less susceptible to bias in model specification.
We demonstrate the utility of CODEm for the estimation of several major causes of death…………..”

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[EQ] Health economic assessment tools (HEAT) for walking and cycling -transport infrastructure and policies

Health economic assessment tools (HEAT) for
walking and cycling -transport infrastructure and policies

Methodology and user guide

Sonja Kahlmeier, University of Zurich, Switzerland

Nick Cavill, Cavill Associates, United Kingdom

Hywell Dinsdale, National Obesity Observatory England, United Kingdom

Harry Rutter, National Obesity Observatory England, United Kingdom

Thomas Götschi, University of Zurich, Switzerland

Charlie Foster, University of Oxford, United Kingdom

Paul Kelly, University of Oxford, United Kingdom

Dushy Clarke, University of Oxford, United Kingdom

Pekka Oja, UKK Institute for Health Promotion Research, Finland

Richard Fordham, University of East Anglia, United Kingdom

Dave Stone, Natural England, United Kingdom

Francesca Racioppi, WHO Regional Office for Europe

WHO Regional Office for Europe.2011

Available online PDF [46p.] at: http://bit.ly/zJVPYm

“…..The promotion of cycling and walking for everyday physical activity not only promotes health but can also have positive effects on the environment.

This booklet summarizes the tools and guidance developed to facilitate this shift: the methodology for the economic assessment of transport infrastructure and policies in relation to the health effects of walking and cycling; systematic reviews of the economic and health literature; and guidance on applying the health economic assessment tools and the principles underlying it.

This methodology and user guide will be of key interest to professionals at both national and local levels: transport planners, traffic engineers, and special interest groups working on transport, walking, cycling or the environment, as well as health economists, physical activity experts and health promotion experts….”

Content

1. Introduction .

2. Methodological guidance on economic appraisal of health effects related to walking and cycling

2.1. Walking and cycling data .

2.2. Time needed to reach full level of walking or cycling

2.3. Interactions between transport-related physical activity, air pollution and road traffic injuries

2.4. Mortality or morbidity?

2.5. The nature of the relationship between physical activity and health

2.6. Age groups .

2.7. Sex

2.8. Time needed for health benefits to build up .

2.9. Activity substitution

2.10. Static vs life tables approach

2.11. Costs applied

2.12. Discounting

2.13. Sensitivity analysis .

3. Reviews of the literature: summary

3.1. Economic literature

3.2. Epidemiological literature

4. The HEAT for walking and for cycling: introduction .

5. HEAT for walking: instructions for users

6. HEAT for cycling: instructions for users

References

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[EQ] Silent Killer, Economic Opportunity: Rethinking Non-Communicable Diseases

Silent Killer, Economic Opportunity: Rethinking Non-communicable Diseases

Sudeep Chand
The Chatham House Centre on Global Health Security, 2012

Available online at: http://bit.ly/wn1xVx

Summary points

· Non-communicable diseases (NCDs) are the greatest cause of deaths and disability for humans. Usually slowly developing conditions such as heart disease, cancer, asthma, diabetes and depression, some are preventable and others amenable to cost-effective treatment.

· Cumulative losses in global economic output due to NCDs will total $47 trillion, or 5% of GDP, by 2030. Modest investments to prevent and treat NCDs could bring major economic returns and save tens of millions of lives.

· As populations urbanize and grow, tobacco and alcohol use, poor diet and inactive lives will drive up deaths globally by 17% in the next 10 years.

· A coherent response might prioritize tobacco control and child nutrition, focus innovation on efficient community-based models of care, and ensure access to basic off-patent medicines.

· Although the most effective interventions on tobacco, food and alcohol contain fiscal and regulatory threats for individual industries, these merit consideration given the positive economic effects for businesses in general.

· Sustainable, balanced economic policy can consider low rates of NCDs as a measure of success. Where the economic benefits outweigh the costs, civil society has a major role to play in harnessing an effective response to NCDs.

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