By David A. Leon
Making a difference to the health of populations, however small, is what most people in public health hope they are doing. Epidemiologists are no exception. But often caught up in the minutiae of our day-to-day work, it is easy to lose sight of the bigger picture. Is health improving, mortality declining, are things moving in a positive direction? Getting out and taking in the view (metaphorically as well as literally) can have a salutary effect. It broadens our perspectives and challenges our assumptions. Looking at recent trends in European life expectancy is a case in point.
Since 1950 estimated life expectancy at birth of the world’s population has been increasing. Initially, this was accompanied by a convergence in mortality experience across the globe—with gains in all regions. However, in the final 15 years of the 20th century, convergence was replaced with divergence, in part due to declines in life expectancy in sub-Saharan Africa. However, this global divergence was also the result of declining life expectancy in Europe. Home to 1 in 10 of the world’s population, and mainly comprised of industrialized, high-income countries, Europe has over 50 states. These include Sweden and Iceland that have consistently been ranked among the countries with the highest life expectancies in the world. But while for the past 60 years all Western European countries have shown increases in life expectancy, the countries of Central and Eastern Europe (CEE), Russia and other parts of the former Soviet Union have had a very different, and altogether more negative experience.
Trends in life expectancy between 1970 and the latest year available are shown in the Figure 1 for an illustrative selection of countries. These data were taken from one of two open sources : (i) the WHO Health for All Database or (ii) the Human Mortality Database, depending on which one had the longest time series. Differences between the sources are minimal for the purposes of this editorial. It is important to emphasize at the outset, that with one exception (discussed below), the trends shown in the Figure 1 are overwhelmingly driven by changes in mortality in adult life, not in infancy or childhood and are not the result of artefact.
Former communist countries of Eastern Europe
Between 1970 and the end of the 1980s, life expectancy at birth in the former communist countries of CEE (Czech Republic, Hungary, Poland and Slovakia), Russia and the Baltic states (Estonia, Latvia and Lithuania) stagnated or declined (Figure 1). This led to an increasing gap between them and Western European countries as the latter steadily improved. However, within a few years of the collapse of the Berlin wall in 1989, life expectancy started to steadily increase in the countries of CEE. This vividly illustrates that mortality can decline rapidly in response to political, social and economic change. Interestingly, once underway, the post-1989 increase in life expectancy in these countries has continued at a steady rate that is very similar to Western Europe. These parallel trajectories mean that the East–West gap, measured in terms of absolute differences in years of life expectancy, is proving very difficult to eliminate, despite earnest hopes to the contrary.
The trajectories of Russia and other Soviet countries, including the three Baltic States in the Figure 1, were strikingly different to those of the CEE countries. The anti-alcohol
Early today we posted an article about health care reform by Lawrence J. Schneiderman, M.D, a Professor Emeritus at UCSD Medical School and Visiting Scholar in the Program in Medicine and Human Values at the California Pacific Medical Center in San Francisco. His new book, Embracing Our Mortality: Hard Choices in an Age of Medical Miracles, looks at end of life decisions from both the medical and philosophical perspectives and advises on how to best make tough decisions. In the excerpt below Schneiderman emphasizes the importance of communicating your end-of-life preferences.
One of my patients, Earl Adams (not his real name), an African-American in his late seventies, was afflicted with severe Parkinsonism. Not only could he no longer play the organ for Sunday church services, he could barely move and relied on his devoted wife for even the most basic needs. She got him out of bed in the morning, helped him to the toilet, bathed him, fed him, kept him upright during the day, and returned him to bed at night. So successful was she at these tasks that whenever she brought him to see me he was always clean-shaven and meticulously dressed, complete with jacket and tie. (more…)
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I'm currently working on a CD cover for a band. I've included a "slice" of the illustration. I thought I was finished but have decided to make some changes to the composition as the effect was not really what I was looking for. I'll post the final work when I've completed the changes. Most likely this slice will also change. I really enjoy creating CD covers. A while back I did a remake of Madonna's "Confessions on the Dance Floor" which you can see here.
I wear so many hats in my profession and found this a fun illustration to create.
While in a business meeting offsite I noticed the decorating style of the room I was in and fell in love with the wall lighting fixtures and thought they would be perfect in one of the new rooms in our home so I quickly did a sketch on the hotel's signature paper they supplied for the meeting. Don't you just love it? And I have the perfect spot for it.
Ok, so your thinking I should have been paying more attention in the meeting? I was! I actually have created some of my best illustrations while watching a movie or listening to a program or music. It's part of my multi-tasking personality. And, the CEO was watching me sketch and seemed to like the sketch too when I showed it to him.
Dance with me at the "Stitch In Time Valentines Day Ball."
For Illustration Friday's "stitch" word of the week. I'm not sure if I will be able to finish it by Friday so I am posting the work in progress.
Kari at
Artsy Mama's is having an Artful Blogging party in celebration of
Stampington's new Artful Blogging magazine. I'm joining Kari's party with an illustration created in my own vintage-modern style. I always love a good party and hope you'll join in the fun too! Mind if this fellow joins the party to help serve up the cake and treats~we ladies need to be pampered don't we? And for all those who have a birthday this month,
Happy Birthday to you!
If you'd like to see more of my work visit my
Flickr account.
Today I opened the most incredible package from the "Queen of Treasures",
my Mom. I haven't even had a chance to photograph everything but I can tell you I was just squealing with delight. Vintage, antique, heirloom, you name it! Thank you so much Mom, I can hardly wait to start working with everything. In the bottom of the box was a beautiful white cotton chenille George Washington bedspread. I've already put it on the bed and it looks simply gorgeous!
Love your drawing style! I'm hopping along the guests list, it's such a great idea to discover new talents like you!!
I love your style! The illustration is perfect!
Karla
love your sytle.. wow! So happy to meet u... hugs
great illustration.
Maggie
Love the drawing, wonderful!!!!
Lovely drawing - I wholeheartedly concur, let's put the men to work while we ladies party!
I also loved your snail in a previous post - I, too, would be happy if time would slow down a bit from this point on.
And like you, I share my sons with other women, fortunately with some I really love.
Ohhh, I love your drawing! He looks like he would be so handy! Thanks for sharing!
I've joined the artful blogger party too and have a free giveaway.
Your drawing is delightful :)
What lovely treats he's whipping up! Wonderful illustration .. love your style!
I'm still putzing around Kari's party list! Love your work :)