DOCSLIB.ORG

Impact of the Economic Crises on Suicide in Italy: the Moderating Role of Active Labor Market Programs

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Impact of the Economic Crises on Suicide in Italy: the Moderating Role of Active Labor Market Programs Social Psychiatry and Psychiatric Epidemiology (2019) 54:201–208 https://doi.org/10.1007/s00127-018-1625-8 ORIGINAL PAPER Impact of the economic crises on suicide in Italy: the moderating role of active labor market programs Giorgio Mattei1,2 · Barbara Pistoresi3 · Roberto De Vogli4 Received: 21 May 2018 / Accepted: 2 November 2018 / Published online: 12 November 2018 © Springer-Verlag GmbH Germany, part of Springer Nature 2018 Abstract Purpose To analyze the association between unemployment and suicide in Italy during the years 1990–2014, with a peculiar focus on the great recession (GR) and the role played by social protection as buffering mechanism against the negative effect on health outcomes. Methods Fixed effects panel regressions were used to assess the association between changes in unemployment rate and suicide rates. Additional models investigated the role of active labor market programs (ALMPs) as possible moderators of the association. Analyses were carried out for both males and females, stratified by age and region. Results The negative time-trend displayed by suicide rate in Italy until 2007 was slowed down by changes in unemployment at the beginning of the GR, when this trend reversed and the rate of suicide started increasing. Male workers aged 25–64 and women aged 55–64 years were affected by both “normal” unemployment rate fluctuations as well as severe economic crises. Women aged 35–44 were only influenced by the latter. Men benefit from ALMPs mainly in Central Italy, while women did not benefit significantly from ALMPs. Conclusions In Italy, economic downturns were associated with increased suicides mainly among men, while severe eco- nomic crises were associated with increased suicides among both men and women. ALMPs showed to be effective in mod- erating the association between unemployment and suicide among men aged 45–54 only in Central Italy. The overall small effectiveness of such programs may be due to lack of sufficient funding. Keywords Economic crisis · Italy · Suicide · Active labor market programs · Fixed effects panel regression Introduction * Barbara Pistoresi In 2008 the world was hit by the Great Recession (GR), the [email protected] worst economic crisis since the 1929 Great Depression [1]. Giorgio Mattei The GR began in 2007 in the United States to then affect [email protected] the global economy and European countries such as Italy, Roberto De Vogli though its effect showed to vary according to the country [email protected] considered [2, 3]. In a previous study, Stuckler et al. [4] measured the 1 “Marco Biagi” Department of Economics and Marco Biagi Foundation, University of Modena and Reggio Emilia, Via J. impact of governmental policies as possible buffering Berengario, 51, 41121 Modena, Italy mechanisms for the negative health effect of economic cri- 2 Section of Psychiatry, Department of Biomedical, Metabolic ses. They focused on the role of welfare and social safety and Neural Sciences, University of Modena and Reggio nets, indicating that the relationship between suicide and Emilia, via G. Campi, 287, 41125 Modena, Italy economic fluctuations may vary according to level of 3 Department of Economics, RECent, Center for Economic expenditure in social protection, with particular reference to Research, University of Modena and Reggio Emila, Viale active labor market programs (ALMPs). According to these Berengario 51, 41121 Modena, Italy authors, recessions do not hurt per se; rather, it is the govern- 4 Department of Social Psychology and Development ments’ choice to implement economic policies of stimulus and Human Rights Centre, University of Padova, Via or austerity (favoring or reducing social safety nets) that Venezia, 12, 35131 Padova, Italy Vol.:(0123456789)1 3 202 Social Psychiatry and Psychiatric Epidemiology (2019) 54:201–208 matter the most for understanding the effect of economic in the present study we focus specifically on the relation downturns on population health. Specifically, austerity poli- between unemployment and suicide, and the possible mod- cies have a major detrimental effect on suicide, while public erating effect played by social protection, since suicide may spending in ALMPs can be an effective buffering mecha- be considered a gross indicator of mental health within a nism against negative health outcomes [5]. A case in point population. In fact, though suicide is a multifactorial phe- is Greece, where social and health indicators (all-cause mor- nomenon, severe mental illnesses account up to the 74% tality, cardiovascular mortality, homicides and crime, HIV of the population attributable risk of suicide [23], and in and tuberculosis infections, anxiety and mood disorders, psychological autopsy studies the median proportion of sui- suicide, alcohol abuse, attendance of public healthcare ser- cides attributable to mental disorders was 91% [24]. Also, vices) worsened after the implementation of severe austerity evidence concerning the moderating effect of social pro- measures [5]. tection are particularly sound with respect to the impact of Building on the existing literature, this study assesses the unemployment on suicide [4]. effect of ALMPs as moderator of the association between economic crises and suicide. No previous study we are aware of has yet investigated this relationship in Italy that, together with Greece, Portugal and Spain, was severely hit by the Methods crisis, and experienced one of the fastest reductions in gross domestic product (GDP) in Europe [6]. Notably, the GR hit Study design and data collection the Italian economy during a period of long-term difficul- ties coupled with a climate of political instability ultimately Health indicators were collected from the ‘Health for All’ resulting in the postponement of crucial structural reforms (HFA) database (version: December 2017) powered by the (e.g., concerning labor market and retirement system), that Italian National Institute of Statistics (ISTAT), that can be made the country particularly vulnerable to a sovereign debt freely downloaded at the following link: https ://www.istat crisis [7]. Some studies showed that in the first years of the .it/it/archi vio/14562 . Since available data referred to years economic crisis, Italy experienced increased suicides and 1990–2014, the latter was considered as observation period attempted suicides due to financial problems [8–11]. Also, of the study. Suicide rates obtained from HFA refer to the in the same period, the following were noticeable: increased actual rates that are observed in the Italian population. In ischemic heart diseases and cardiovascular mortality [10, other words, they are not derived from a representative sam- 12], increased nicotine consumption [13, 14], decreased pre- ple. Differently, unemployment rates (that were collected scription of expensive drugs, increased prescription of cheap from the online database https ://www.dati.istat .it, powered drugs [15]. As far as alcohol consumption in concerned, an by ISTAT) are derived from a survey carried on quarterly by increase in binge drinking may have occurred, accompanied the Italian National Institute of Statistics, based on a sample by an overall reduction in expenditure for alcoholics, pos- made up of 250,000 families living in about 1400 munici- sibly due to budget constraint [10, 14], and consistently with palities (corresponding to a sample size of about 600,000 international literature [16, 17]. people, representative of the Italian population). More infor- Although research has already shown that, as happened in mation concerning the survey may be found here: https :// the majority of EU-member states [18–20], the GR exerted a www.istat .it/it/archi vio/8263. negative health effect in Italy, particularly increased suicides Expenditure for ALMPs (per head, at current prices and and poor mental health outcomes [8–11, 21], little is known adjusted for purchasing power parity, in US Dollars) was about the role of welfare policies as buffering mechanisms. found on the Website of the Organization for Economic In a research letter published in the BMJ, De Vogli showed Co-operation and Development (https ://data.oecd.org). that the association between unemployment and suicides ALMPs include “spending on public employment services becomes weaker a higher levels of investment in social and administration, labor market training, special programs services across Italian regions [8]. The aim of the present for youth when in transition from school to work, labor mar- research is to assess the role of ALMPs as moderators for ket programs to provide or promote employment for unem- the adverse health effects of the crisis. Using longitudinal ployed and other people (excluding young and disabled peo- secondary data concerning both males and females, stratified ple), and special programs for disabled people” [4]. by age and region, we hypothesize that ALMPs are effec- The following Italian macro-regions were included in the tive social buffering mechanisms able to mitigate the conse- analysis: North-East (Emilia-Romagna, Trentino, Veneto, quences of financial hardship on suicidal behavior. Friuli Venezia-Giulia), North-West (Liguria, Lombardia, We are aware that other indicators may be influenced by Piemonte, Valle d’Aosta), Central Italy (Lazio, Marche, economic downturns, such as alcohol consumption, traffic Toscana e Umbria), South (Abruzzo, Basilicata, Calabria, fatalities, all-cause mortality and homicides [4, 22]; yet, Campania, Puglia, Molise),
Load more

Recommended publications
  • The Role of Well Water and Other Factors in the Aetiology of Parkinson’S Disease
    ^.,-wtM IC REGlSTRAh )0M 261 ^ER3!TY OF LONDON :«VATE HOUSE ‘LET STREET ' ’“IN WC1E7KU THE ROLE OF WELL WATER AND OTHER FACTORS IN THE AETIOLOGY OF PARKINSON’S DISEASE YOAV BEN-SHLOMO A thesis submitted for the degree of Doctor of Philosophy University College London, 2003 1 UMI Number: U602452 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. Dissertation Publishing UMI U602452 Published by ProQuest LLC 2014. Copyright in the Dissertation held by the Author. Microform Edition © ProQuest LLC. All rights reserved. This work is protected against unauthorized copying under Title 17, United States Code. ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 Abstract Objectives: To determine the risk of early onset Parkinson’s disease (PD) associated with well water consumption and other risk factors. Design: A case control study with strata matching by age group, gender and current urban or rural residence. Setting: Republic of Ireland, between 1993 to 1995. Participants: Cases with Parkinson’s disease, fulfilling at least two of the four cardinal features, with date of birth from 1st January 1926 and disease onset before 56 years. Controls were selected using stratified random sampling from the electoral register. Outcome measures: Odds ratio and 95% confidence interval for well water consumption and other risk factors.
    [Show full text]
  • Scarica N. 3/2018 (Full)
    Tabaccologia 3-2015 | xxxxxxxxxxxxxxxxx 1 3 | 2018 ANNO XVI Organo Ufficiale della Società Italiana di Tabaccologia-SITAB Official Journal of the Italian Society of Tobaccology www.tabaccologia.it Tabaccologia Poste italiane SPA Spedizione in Tobaccology Abbonamento Postale 70%-LO/BG Congresso Nazionale SITAB 2018: La tabaccologia italiana a Congresso Politici e tabacco Indipendenza delle Società e altre Istituzioni Scientifiche italiane dall’industria del tabacco Position paper sulla indipendenza delle Società Scientifiche italiane da Big Tobacco World No Tobacco Day 2018/Report ISS: tabagismo, un problema anche di cuore Report ISS/DOXA 2018 sul fumo in Italia Un modello integrato per la lotta all’uso adolescenziale di sostanze Fumo di tabacco in gravidanza e counseling ostetrico per attuare percorsi di disassuefazione Trimestrale a carattere scientifico per lo studio del tabacco, del tabagismo e delle patologie fumo-correlate Quarterly scientific journal for the study of tobacco, tobacco use and tobacco-related diseases [email protected] Morte improvvisa nell’atleta: “Eppur si muore!” A proposito Giornata Mondiale della una fatalità inevitabile? pag. 13 dei decessi per asma pag. 16 Tubercolosi pag. 19 ANNO XI N° 41 MARZO 2018 RE TRIMESTRALE DI INFORMAZIONE, PREVENZIONE E BENESSERE RESPIRONEWS.IT Trimestrale di ISSN 1970-4925 ISSN informazione, prevenzione e benessere, rivolto prevalentemente al Trimestrale per cittadino/paziente, professionisti dell’area quale strumento di Poste Italiane SpA - Sped. in A.P. - Stampe Periodiche in Regime Libero - Milano n. ... / .... (anno) - Milano n. ... / .... (anno) in Regime Libero - Stampe Periodiche Italiane SpA - Sped. in A.P. Poste pneumologica, educazione a un www.sintexservizi.it | www.sintexservizi.it strumento di formazione corretto stile di vita 7 Dalla comunicazione alla divulgazione Gli italiani sono E.
    [Show full text]
  • Mortality, Survival and Incidence Rates in the ITALUNG Randomised Lung
    Thorax Online First, published on April 4, 2017 as 10.1136/thoraxjnl-2016-209825 Lung cancer ORIGINAL ARTICLE Thorax: first published as 10.1136/thoraxjnl-2016-209825 on 4 April 2017. Downloaded from Mortality, survival and incidence rates in the ITALUNG randomised lung cancer screening trial Eugenio Paci,1 Donella Puliti,1 Andrea Lopes Pegna,2 Laura Carrozzi,3 Giulia Picozzi,4 Fabio Falaschi,5 Francesco Pistelli,3 Ferruccio Aquilini,3 Cristina Ocello,1 Marco Zappa,1 Francesca M Carozzi,6 Mario Mascalchi,7 and the ITALUNG Working Group ▸ Additional material is ABSTRACT published online only. To view Background ITALUNG is contributing to the European Key messages please visit the journal online (http://dx.doi.org/10.1136/ evaluation of low-dose CT (LDCT) screening for lung thoraxjnl-2016-209825). cancer (LC). Methods Eligible subjects aged 55–69 years, smokers For numbered affiliations see What is the key question? end of article. or ex-smokers (at least 20 pack-years in the last ▸ After the positive results of the National Lung 10 years), were randomised to receive an annual Screening Trial in the USA, the efficacy of lung Correspondence to invitation for LDCT screening for 4 years (active group) or cancer screening with low-dose CT (LDCT) is Dr Eugenio Paci, Clinical to usual care (control group). All participants were still debatable in Europe. Epidemiology Unit, ISPO— Cancer Research and followed up for vital status and cause of death (at the end of 2014) and LC incidence (at the end of 2013). What is the bottom line? Prevention Institute, Via delle ▸ fi Oblate, Florence 50144, Italy; Pathological and clinical information was collected from Despite the lack of statistical signi cance, the [email protected] the Tuscan Cancer Registry data.
    [Show full text]
  • Smoking Inequality Across Genders and Socio- Economic Classes
    ISSN: 2281-1346 Department of Economics and Management DEM Working Paper Series Smoking Inequality across Genders and Socio- economic Classes. Evidence from Longitudinal Italian Data Cinzia Di Novi (Università degli Studi di Pavia) Rowena Jacobs (University of York) Matteo Migheli (Università di Torino and Collegio Carlo Alberto) # 152 (02-18) Via San Felice, 5 I-27100 Pavia economiaweb.unipv.it February 2018 1 Smoking Inequality across Genders and Socio-economic Classes. Evidence from Longitudinal Italian Data Cinzia Di Novia, Rowena Jacobsb, Matteo Mighelic,d* Abstract There has been a dearth of literature on smoking inequalities, in spite of its contribution to health inequalities. We exploit longitudinal Italian individual-level data to identify the main socio- demographic characteristics that determine smoking inequalities. We use the Erreygers Concentration Index to identify in which groups smoking is relatively more prevalent. We find that, among men, pro-poor prevalence is driven by members of the lower socio-economic classes, while we observe the opposite for women. We encourage policymakers to address the issue of smoking inequalities, which the current policies have largely disregarded. Keywords: smoking inequality; Italy; gender; social classes JEL Codes: I14; I18; J16 a University of Pavia, Department of Economics and Management; Health, Econometrics and Data Group, University of York, Heslington, York ,UK; Laboratory for Comparative Social Research, National Research University Higher School of Economics, Moscow, Russia. b Centre for Health Economics, University of York, Heslington, York, UK. c University of Torino, Department of Economics and Statistics, lungo Dora Siena, 100 Torino, Italy. Email: [email protected] tel: +39 011 6709630 d CeRP – Collegio Carlo Alberto, piazza Arbarello, 8 Torino, Italy *Corresponding author.
    [Show full text]
  • Geographical and Socioeconomic Differences in Uptake of Pap Test and Mammography in Italy: Results from the National Health Interview Survey
    Open access Research BMJ Open: first published as 10.1136/bmjopen-2018-021653 on 19 September 2018. Downloaded from Geographical and socioeconomic differences in uptake of Pap test and mammography in Italy: results from the National Health Interview Survey Alessio Petrelli,1 Paolo Giorgi Rossi,2,3 Lisa Francovich,4 Barbara Giordani,5 Anteo Di Napoli,1 Marco Zappa,6 Concetta Mirisola,1 Lidia Gargiulo4 To cite: Petrelli A, Giorgi ABSTRACT Strengths and limitations of this study Rossi P, Francovich L, Objective The Italian National Health Service instituted et al. Geographical and cervical and breast cancer screening programmes in 1999; ► The large amount of information derived from Italian socioeconomic differences the local health authorities have a mandate to implement in uptake of Pap test and National Health Interview Survey allowed us to in- these screening programmes by inviting all women aged mammography in Italy: results vestigate inequities in screening uptake in Italy thor- 25–64 years for a Pap test every 3 years (or for an Human from the National Health oughly for the first time. Papilloma Virus (HPV) test every 5 years) and women aged Interview Survey. BMJ Open ► The joint use of two data sources enabled estimating 50–69 years for a mammography every 2 years. However, 2018;8:e021653. doi:10.1136/ the impact of screening programmes on uptake in the implementation of screening programmes throughout bmjopen-2018-021653 the country, evaluating also the differences between the country is still incomplete. This study aims to: (1) Prepublication history regions and in groups with different socioeconomic ► describe cervical and breast cancer screening uptake and for this paper is available and behavioural characteristics.
    [Show full text]
  • The Environmental Behaviour of Polonium
    technical reportS series no. 484 Technical Reports SeriEs No. 484 The Environmental Behaviour of Polonium F. Carvalho, S. Fernandes, S. Fesenko, E. Holm, B. Howard, The Environmental Behaviour of Polonium P. Martin, M. Phaneuf, D. Porcelli, G. Pröhl, J. Twining @ THE ENVIRONMENTAL BEHAVIOUR OF POLONIUM The following States are Members of the International Atomic Energy Agency: AFGHANISTAN GEORGIA OMAN ALBANIA GERMANY PAKISTAN ALGERIA GHANA PALAU ANGOLA GREECE PANAMA ANTIGUA AND BARBUDA GUATEMALA PAPUA NEW GUINEA ARGENTINA GUYANA PARAGUAY ARMENIA HAITI PERU AUSTRALIA HOLY SEE PHILIPPINES AUSTRIA HONDURAS POLAND AZERBAIJAN HUNGARY PORTUGAL BAHAMAS ICELAND QATAR BAHRAIN INDIA REPUBLIC OF MOLDOVA BANGLADESH INDONESIA ROMANIA BARBADOS IRAN, ISLAMIC REPUBLIC OF RUSSIAN FEDERATION BELARUS IRAQ RWANDA BELGIUM IRELAND SAN MARINO BELIZE ISRAEL SAUDI ARABIA BENIN ITALY SENEGAL BOLIVIA, PLURINATIONAL JAMAICA SERBIA STATE OF JAPAN SEYCHELLES BOSNIA AND HERZEGOVINA JORDAN SIERRA LEONE BOTSWANA KAZAKHSTAN SINGAPORE BRAZIL KENYA SLOVAKIA BRUNEI DARUSSALAM KOREA, REPUBLIC OF SLOVENIA BULGARIA KUWAIT SOUTH AFRICA BURKINA FASO KYRGYZSTAN SPAIN BURUNDI LAO PEOPLE’S DEMOCRATIC SRI LANKA CAMBODIA REPUBLIC SUDAN CAMEROON LATVIA SWAZILAND CANADA LEBANON SWEDEN CENTRAL AFRICAN LESOTHO SWITZERLAND REPUBLIC LIBERIA SYRIAN ARAB REPUBLIC CHAD LIBYA TAJIKISTAN CHILE LIECHTENSTEIN THAILAND CHINA LITHUANIA THE FORMER YUGOSLAV COLOMBIA LUXEMBOURG REPUBLIC OF MACEDONIA CONGO MADAGASCAR TOGO COSTA RICA MALAWI TRINIDAD AND TOBAGO CÔTE D’IVOIRE MALAYSIA TUNISIA CROATIA MALI
    [Show full text]
  • Parkinson's Disease?
    J7ournal ofNeurology, Neurosurgery, and Psychiatry 1996;61:4-16 NEUROEPIDEMIOLOGY J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.61.1.4 on 1 July 1996. Downloaded from How far are we in understanding the cause of Parkinson's disease? Y Ben-Shlomo generate suffi- ... the writer will repine at no censure which to have a large sample size to the precipitate publication of mere conjectural cient cases for analysis. The combined alumni suggestions may incur: but shall think himself cohorts of Harvard and Pennsylvania colleges fully rewarded by having excited the attention of consisted of 50 000 people and only generated those, who may point out the most appropriate Older cohorts will be more efficient means of relieving a tedious and most distress- 160 cases.6 ing malady. in terms of statistical power. Case- James Parkinson' control studies, although far more practical, are It is almost 180 years since James Parkinson more prone to bias. Particularly problematic is described his series of patients with what is the recruitment of control subjects and the now known as Parkinson's disease. His own measurement of putative exposures. Associa- astute clinical observations were unable to dis- tions must be treated with some caution and if cern any obvious aetiology. "On the subject possible verified using either historical data or a indeed of remote causes, no satisfactory cohort design. account has yet been obtained from any of the sufferers."' He noted an indulgence in alcohol, CASE DEFINITION lying on damp ground, and the possibility of The case definition for Parkinson's disease is trauma.
    [Show full text]
  • Smoking Habits in HIV-Infected People Compared with the General
    De Socio et al. BMC Public Health (2020) 20:734 https://doi.org/10.1186/s12889-020-08862-8 RESEARCH ARTICLE Open Access Smoking habits in HIV-infected people compared with the general population in Italy: a cross-sectional study Giuseppe Vittorio De Socio1,2* , Marta Pasqualini3, Elena Ricci4, Paolo Maggi5, Giancarlo Orofino6, Nicola Squillace7, Barbara Menzaghi8, Giordano Madeddu9, Lucia Taramasso10,11, Daniela Francisci1, Paolo Bonfanti12, Francesca Vichi13, Marco dell’Omo14, Luca Pieroni2 and On behalf of CISAI study group Abstract Background: Tobacco use is a leading cause of preventable diseases and death for all individuals, even more so for people living with HIV (PLWH), due to their status of chronic inflammation. To date, in Italy no study was performed to compare smoking habits in PLWH and the general population. We aimed to investigate smoking habits in PLWH, as compared to the general population. Methods: Multi-center cross-sectional study. Smoking habits were compared between PLWH and the general population. PLWH were enrolled in the STOPSHIV Study. The comparison group from the general population was derived from a survey performed by the National Statistics Institute (ISTAT), with a stratified random sampling procedure matching 2:1 general population subjects with PLWH by age class, sex, and macro-area of residence. Results: The total sample consisted of 1087 PLWH (age 47.9 ± 10.8 years, male 73.5%) and 2218 comparable subjects from the general population. Prevalence of current smokers was 51.6% vs 25.9% (p < 0.001); quitting smoking rate was 27.1% vs. 50.1% (p < 0.001) and the mean number of cigarettes smoked per day was 15.8 vs.
    [Show full text]
  • Italy Simsmoke: the Effect of Tobacco Control Policies on Smoking
    Levy et al. BMC Public Health 2012, 12:709 http://www.biomedcentral.com/1471-2458/12/709 RESEARCH ARTICLE Open Access Italy SimSmoke: the effect of tobacco control policies on smoking prevalence and smoking attributable deaths in Italy David Levy1, Silvano Gallus2*, Kenneth Blackman3, Giulia Carreras4, Carlo La Vecchia2,5 and Giuseppe Gorini4 Abstract Background: While Italy has implemented some tobacco control policies over the last few decades, which resulted in a decreased smoking prevalence, there is still considerable scope to strengthen tobacco control policies consistent with the World Health Organization (WHO) policy guidelines. The present study aims to evaluate the effect of past and project the effect of future tobacco control policies on smoking prevalence and associated premature mortality in Italy. Methods: To assess, individually and in combination, the effect of seven types of policies, we used the SimSmoke simulation model of tobacco control policy. The model uses population, smoking rates and tobacco control policy data for Italy. Results: Significant reductions of smoking prevalence and premature mortality can be achieved through tobacco price increases, high intensity media campaigns, comprehensive cessation treatment program, strong health warnings, stricter smoke-free air regulations and advertising bans, and youth access laws. With a comprehensive approach, the smoking prevalence can be decreased by as much as 12% soon after the policies are in place, increasing to a 30% reduction in the next twenty years and a 34% reduction by 30 years in 2040. Without effective tobacco control policies, a total of almost 300 thousand lives will be prematurely lost due to smoking by the year 2040.
    [Show full text]
  • Public Smoking Bans Are Good for the Heart* Steven A
    Journal of the American College of Cardiology Vol. 54, No. 14, 2009 © 2009 by the American College of Cardiology Foundation ISSN 0735-1097/09/$36.00 Published by Elsevier Inc. doi:10.1016/j.jacc.2009.08.006 QUARTERLY FOCUS ISSUE: PREVENTION/OUTCOMES Editorial Comment Public Smoking Bans Are Good for the Heart* Steven A. Schroeder, MD San Francisco, California In this time of health care reform debate in the U.S., it is media thickening, increases infarct size, causes oxidative stress fashionable to focus on what is wrong. Unmentioned is and mitochondrial damage, decreases heart rate variability arguably the most important health triumph in the past 50 (thus increasing the risk of malignant arrhythmias), and in- years: the steep decrease in deaths from cardiovascular disease creases insulin resistance (10). It is hard to imagine substances (1–3). Between 1950 and 2005, the age-adjusted, all-age death that would be more cardiotoxic. Furthermore, these adverse rate from heart disease decreased from 587 per 100,000 persons effects are observed at very low exposure doses (11). to 211 per 100,000, a spectacular improvement (4). As often So, what can cardiologists do to keep their patients from happens with such remarkable successes, the credit gets shared. being exposed to tobacco smoke? Obviously, they should One factor with a major claim to causality is the decrease in counsel patients who smoke to quit by serving as a resource smoking prevalence as the result of strong tobacco-control to help that happen; directing them to affiliated cessation programs (5,6). systems such as those of Kaiser Permanente, Group Health Cooperative, the Mayo Clinic, or the Veterans Administra- See page 1249 tion system; or referring them to toll-free telephone coun- seling available through 1-800-QUIT NOW (12,13).
    [Show full text]
  • Risk Factors for Classical Kaposi's Sarcoma
    Risk Factors for Classical Kaposi’s Sarcoma James J. Goedert, Francesco Vitale, Carmela Lauria, Diego Serraino, Mario Tamburini, Maurizio Montella, Angelo Messina, Elizabeth E. Brown, Giovanni Rezza, Lorenzo Gafa`, Nino Romano And the Classical Kaposi’s Sarcoma Working Group quently the lymph nodes draining those areas. It occurs predomi- Background: Classical Kaposi’s sarcoma (KS) is a malig- nantly among elderly people of Mediterranean or Jewish ances- nancy of lymphatic endothelial skin cells. Although all forms try, particularly men. Clinically distinctive and more aggressive of KS are associated with the KS-associated herpesvirus forms of KS were described between 1962 and 1981—endemic (KSHV), classical KS occurs in a small fraction of KSHV- KS [in central and eastern Africa (3)], iatrogenic KS [among Downloaded from https://academic.oup.com/jnci/article/94/22/1712/2519996 by guest on 29 September 2021 infected people. We sought to identify risk factors for clas- allograft recipients (4)], and epidemic KS [among persons with sical KS in KSHV-infected individuals. Methods: Lifestyle acquired immunodeficiency syndrome (AIDS) (5)]. In 1994, and medical history data from case patients with biopsy- Chang et al. (6) discovered a previously unknown KS-associated proven non-AIDS (non-acquired immunodeficiency syn- herpesvirus (KSHV, also known as human herpesvirus 8) in drome) KS in Italy were compared by logistic regression virtually every KS lesion examined. analysis with data from population-based KSHV- KSHV now is known to be the primary cause of all types of seropositive control subjects of comparable age and sex. Af- KS (7), but classical KS occurs in only a small fraction of ter KSHV immunofluorescence testing, randomly selected KSHV-infected people.
    [Show full text]
  • Changes in Active and Passive Smoking in the European Community Respiratory Health Survey
    Eur Respir J 2006; 27: 517–524 DOI: 10.1183/09031936.06.00106605 CopyrightßERS Journals Ltd 2006 Changes in active and passive smoking in the European Community Respiratory Health Survey C. Janson*, N. Ku¨nzli#, R. de Marco", S. Chinn+, D. Jarvis+, C. Svanes1, J. Heinriche, R. Jo˜gi**, T. Gislason##, J. Sunyer"", U. Ackermann-Liebrich++, J.M. Anto´"", I. Cerveri11, M. Kerhofee, B. Leynaert***, C. Luczynska+, F. Neukirch***, P. Vermeire###, M. Wjste and P. Burney+ ABSTRACT: The aim of the present investigation was to study changes and determinants for AFFILIATIONS *Respiratory Medicine and Allergology, changes in active and passive smoking. University of Uppsala, Uppsala, Sweden. # The present study included 9,053 adults from 14 countries that participated in the European Keck School of Medicine, University of Southern California, Los Angeles, CA, Community Respiratory Health Survey II. The mean follow-up period was 8.8 yrs. Change in the USA. "University of Verona, Dept of Medicine prevalence of active and passive smoking was expressed as absolute net change (95% and Public Health, Division of confidence interval) standardised to a 10-yr period. Determinants of change were analysed and Epidemiology and Statistics, Verona, Italy. the results expressed as adjusted hazard risk ratio (HRR) or odds ratio (OR). +Dept of Public Health Sciences, King’s The prevalence of active smoking declined by 5.9% (5.1–6.8) and exposure to passive smoking College London, London, UK. 1Dept Thoracic Medicine, Haukeland in nonsmokers declined by 18.4% (16.8–20.0). Subjects with a lower educational level (HRR: 0.73 Hospital, Bergen, Norway.
    [Show full text]