Thursday, May 28, 2009

Life expectancy around the world

Note that life expectancy is an actuarial projection, not a report of actual age at death. If the conditions relevant to mortality change, the current projection could be quite wrong. In the case of Japan, error seems likely. There are now many old peoiple in Japan but that is probably true because of limits on total calorie intake that prevailed in Japan up to about 1960. Many Japanese had insufficient food to eat all they wanted up to then. And calorie restriction leads to life extension. In more recent decades, however, Japan has become a rich country and involuntary calorie restrictions should have almost completely vanished. The Japanese of the future may therefore live noticeably shorter lives that their forbears. Japanese diets have changed a lot too but the evidence for dietary effects on lifespan is scant

A GIRL born in Japan today will likely live to celebrate her 86th birthday, the longest life expectancy anywhere in the world. Men fare best in the tiny, wealthy European nation of San Marino, where the average boy will live to 81.

The West African country of Sierra Leone has the shortest life expectancy for men - just 39 - while Afghanistan fares badly for both sexes, with men and women living to 41 and 42 years respectively.

Those figures come from the World Health Organisation, which announced its annual health statistics on Thursday on the year 2007, the latest figures available.

The data showed that some countries have made remarkable progress in increasing life expectancy since 1990 - partly by ending wars, partly through successful health initiatives....

In the United States, the life expectancy was on the rise for both sexes, but not so dramatically: up to 76 from 72 years for men, and to 81 from 79 for women. Other countries, meanwhile, showed a sharp decline since 1990, especially in Africa....

In Russia, the average life expectancy for men dropped to 60 from 64 years since the time of the Soviet Union. For women the drop was less marked, to 73 from 74 years.

The figures are only one of over 100 health indicators that WHO tracks in its 193 member states. Others include mother and child mortality; prevalence of diseases such as HIV, malaria and tuberculosis; access to doctors and medical facilities; and health expenditure per person.


Natural childbirth techniques 'make no difference' to women

Antenatal programmes focusing on 'natural' techniques did not cut rates of Caesarean births. Classes on birth techniques involving breathing, relaxation and massage make no difference to women's experience of labour, claim researchers. Pain-relieving epidural injections were needed for pregnant women who had attended these advanced classes just as often as for those given standard antenatal classes.

The findings will come as a blow to thousands of expectant mothers who, keen to increase their chances of a natural birth, learn yoga breathing exercises and self-hypnosis while their partners are taught how to massage them during labour.

Professor Philip Steer, editor-in-chief of BJOG: An International Journal of Obstetrics and Gynaecology, which is publishing the Swedish research, said: 'The findings of this study are contrary to what many of us would expect. 'The lack of benefit is disappointing, and suggests that parents' experience of childbirth is affected more by their personality and previous psychological orientation than by the relatively limited training that is possible during pregnancy. 'An alternative view is that standard antenatal classes are "good enough" and therefore represent an effective use of limited resources.'

The study, which involved 1,087 first-time mothers and 1,064 of their partners, was run by the Department for Woman and Child Health at the Karolinska Institute in Sweden between January 2006 and May 2007. Participants were randomised into two groups for antenatal classes. The standard care group were provided with information about childbirth and parenting, modelled on the standard Swedish antenatal education programme.

The researchers anticipated that those in the 'natural' group would have fewer Caesareans, epidurals, and instrumental deliveries (i.e., requiring forceps). But the epidural rate was 52 per cent and the spontaneous birth rate 66 per cent in both groups.

The Caesarean section rate was 20 per cent in the 'natural' group and 21.5 per cent in the standard group. The instrumental delivery rate was 14 per cent in the 'natural' group and 12 per cent in the standard group. There were also no statistically significant differences between the groups in the satisfaction of the childbirth experience or postnatal parental stress three months later.

British reaction to the study was muted, with the National Childbirth Trust saying it was impossible to tell how the Swedish experience compared with that in Britain. Belinda Phipps, the parenting charity's chief executive, said: 'This limited study in Sweden compares two slightly different types of antenatal education and does not look at the more common situation in the UK which is no or limited antenatal preparation.

'NCT antenatal classes are valued by parents and cover many topics including parenting, baby-feeding, physical skills for labour and information about the birth as well as relaxation and breathing.'


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