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Socioeconomic factors associated with liver-related mortality from 1985 to 2015 in 36 developed countries

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Title: Socioeconomic factors associated with liver-related mortality from 1985 to 2015 in 36 developed countries
Authors: Li, W
Kemos, P
Salciccioli, J
Marshall, D
Shalhoub, J
Alazawi, W
Item Type: Journal Article
Abstract: Background & Aims There is increasing disparity in liver-related mortality worldwide. Although there are many biologic and lifestyle risk factors for liver-related mortality, the effects of inequalities in social and economic determinants of health have received little attention. We investigated changes in liver-related mortality from 1985 through 2015 in 36 countries, using 4 international health and economic databases, and searched for socioeconomic factors that might influence these trends. Methods We collected information on sex- and country-specific liver-related mortality from countries with designated high usability data from the World Health Organization mortality database. We obtained data on alcohol consumption per capita, percentage of adults with body mass index greater than 30kg/m2, health expenditure per capita, gross domestic product per capita, Gini index, national unemployment estimates and diabetes prevalence from the World Health Organization global health observatory data repository, the World Bank database, and the International Diabetes Federation. We examined changes in mortality using Joinpoint regression analysis. Univariate analysis and a mixed-effects linear model were used to identify factors associated with liver-related mortality. Results From 1985 to 2015, mean liver-related deaths per 100,000 persons increased in men, from 23.8 to 26.1, and women, from 9.7 to 11.9. Increased liver-related mortality was associated with male sex, high level of alcohol consumption, obesity, and indicators of national wealth and government health expenditure gross domestic product or government expenditure on health. Conclusions In addition to established risk factors for liver mortality, this study identified addressable economic factors associated with liver-related mortality trends. Healthcare professionals and policy makers may wish to consider these factors to reduce liver-related mortality.
Issue Date: 22-Aug-2020
Date of Acceptance: 19-Aug-2020
URI: http://hdl.handle.net/10044/1/82520
DOI: 10.1016/j.cgh.2020.08.047
ISSN: 1542-3565
Publisher: Elsevier
Start Page: 1698
End Page: 1707.e13
Journal / Book Title: Clinical Gastroenterology and Hepatology
Volume: 19
Issue: 8
Copyright Statement: © 2020 by the AGA Institute. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Keywords: Cirrhosis
Gastroenterology & Hepatology
1103 Clinical Sciences
Publication Status: Published
Online Publication Date: 2020-08-22
Appears in Collections:Department of Surgery and Cancer
National Heart and Lung Institute
Faculty of Medicine

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