Trends in Mortality from Septicaemia and Pneumonia with Economic Development: An Age-Period-Cohort Analysis
Open Access
- 14 June 2012
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 7 (6), e38988
- https://doi.org/10.1371/journal.pone.0038988
Abstract
Hong Kong population has experienced drastic changes in its economic development in the 1940s. Taking advantage of Hong Kong’s unique demographic and socioeconomic history, characterized by massive, punctuated migration waves from Southern China, and recent, rapid transition from a pre-industrialized society to the first ethnic Chinese community reaching “first world” status over the last 60 years (i.e., in two or three generations), we examined the longitudinal trends in infection related mortality including septicemia compared to trends in non-bacterial pneumonia to generate hypotheses for further testing in other recently transitioned economies and to provide generalized aetiological insights on how economic transition affects infection-related mortality. We used deaths from septicemia and pneumonia not specified as bacterial, and population figures in Hong Kong from 1976–2005. We fitted age-period-cohort models to decompose septicemia and non-bacterial pneumonia mortality rates into age, period and cohort effects. Septicaemia-related deaths increased exponentially with age, with a downturn by period. The birth cohort curves had downward inflections in both sexes in the 1940s, with a steeper deceleration for women. Non-bacterial pneumonia-related deaths also increased exponentially with age, but the birth cohort patterns showed no downturns for those born in the 1940s. The observed changes appeared to suggest that better early life conditions may enable better development of adaptive immunity, thus enhancing immunity against bacterial infections, with greater benefits for women than men. Given the interaction between the immune system and the gonadotropic axis, these observations are compatible with the hypothesis that upregulation of the gonadotropic axis underlies some of the changes in disease patterns with economic development.This publication has 41 references indexed in Scilit:
- Childhood meat eating and inflammatory markers: The Guangzhou Biobank Cohort StudyBMC Public Health, 2011
- Parental Death during Childhood and Adult Cardiovascular Risk in a Developing Country: The Guangzhou Biobank Cohort StudyPLOS ONE, 2011
- Emerging strategies to boost thymic functionCurrent Opinion in Pharmacology, 2010
- Life course socioeconomic position is associated with inflammatory markers: The Framingham Offspring StudySocial Science & Medicine (1982), 2010
- Lifecourse socioeconomic trajectories and C-reactive protein levels in young adults: Findings from a Brazilian birth cohortSocial Science & Medicine (1982), 2010
- Proportional hazards models and age–period–cohort analysis of cancer ratesStatistics in Medicine, 2010
- Evidence of premature immune aging in patients thymectomized during early childhoodJCI Insight, 2009
- Thymic involution and immune reconstitutionTrends in Immunology, 2009
- Strategies to Reduce Mortality from Bacterial Sepsis in Adults in Developing CountriesPLoS Medicine, 2008
- Having it all: historical energy intakes do not generate the anticipated trade-offs in fecundityProceedings. Biological sciences, 2006