La mortalité des résidents d'Ehpad (Etablissement pour personnes âgées dépendantes) a augmenté de 43 % pendant la première vague de COVID-19. Nous avons estimé l'hétérogénéité inter-Ehpad de la mortalité et identifié les facteurs de risque de décès durant cette période, comparativement à 2019. Dans deux cohortes de résidents d'Ehpad gérés par le régime général en France métropolitaine (données de RESIDESMS du 01/03/2020 au 31/05/2020 et du 01/03/2019 au 31/05/2019), l'hétérogénéité inter-Ehpad de la mortalité était mesurée dans une régression logistique mixte par le coefficient de corrélation intraclasse (CCI). Les facteurs étudiés comprenaient les caractéristiques des résidents, notamment les pathologies repérées par la Cartographie des pathologies du Système national des données de santé (SNDS), et celles liées à l'Ehpad, notamment le département et le statut public/privé. Le CCI a également été estimé séparément dans les Ehpad avec aucun ou au moins un décès avec mention de COVID-19. Parmi 385 300 résidents (5339 Ehpad) inclus en 2020 (âge médian: 89 ans, 25 % d'hommes), 9,1 % sont décédés, contre 6,7 % des 379 926 résidents (5270 Ehpad) en 2019. Dans le modèle vide, le CCI était de 9,3 % en 2020 et de 1,5 % en 2019. Seul le département expliquait partiellement l'hétérogénéité observée en 2020 (CCI: 6,5 % après ajustement). Les associations étaient plus fortes en 2020 qu'en 2019 pour le sexe masculin et le diabète et plus faibles pour les cardiopathies, les maladies respiratoires chroniques et la résidence <6 mois. Dans les Ehpad avec au moins 1 décès avec mention de COVID-19, la mortalité était plus élevée en 2020 (15,1 %) qu'en 2019 (6,3 %) et plus hétérogène (CCI: 8,0 %) que dans les autres (mortalité: 6,7 % les deux années; CCI: 1,1 %). Nous avons observé une hétérogénéité inter-Ehpad de la mortalité lors de la première vague en 2020 qui n'existait pas en 2019, non expliquée par les caractéristiques des Ehpad, excepté le département. Ce résultat renvoie à la géographie de la diffusion du SARS-CoV-2. L'hétérogénéité inter-Ehpad semblait peu concerner les Ehpad non atteintes par la pandémie. Personnes âgées ; Mortalité ; COVID-19 ; Ehpad Les auteurs déclarent ne pas avoir de liens d'intérêts.

La recherche en sciences humaines et sociales (SHS), a qui l’on pose regulierement la question de son « utilite », a ete massivement mobilisee dans la premiere partie de l’annee 2020, tant par les medias et les institutions. Elle s’est montree d’une grande reactivite, en adaptant ses calendriers et ses objectifs, en modifiant ses formats d’interventions (webinaires, cours en distanciel). Chercheuses et chercheurs, enseignant(e)s-chercheurs ont ete presents, et ce malgre des inegalites generees par le confinement dans le travail de recherche, notamment en termes de genre. Le present travail a pour ambition de proposer a son lecteur une analyse mobilisant les travaux des SHS dans leur ensemble. Sans pretendre a l’exhaustivite, il tisse les fils, a travers les questions qu’il aborde, d’une discipline a une autre, composant un ensemble dans lequel les SHS entrent en resonance les unes avec les autres, deploient leur complementarite, et creent une analyse commune, qu’elles relevent plutot des sciences sociales ou des humanites. Il a pour objectif de rendre manifeste un capital scientifique des SHS en tant que telles, pour aborder les differents questionnements que suscite la pandemie de Covid-19. La recherche actuelle en SHS sur la pandemie, sa gestion politique, et ses enjeux, ne s’elabore pas ex nihilo. Tout en prenant la mesure de la specificite des temps presents, elle s’appuie sur un ensemble de cadres theoriques, de methodes, d’analyses elabores dans d’autres contextes, remobilises, reactualises, enrichis a la lumiere des problematiques associees a la pandemie de Covid 19. Par ailleurs, le parti-pris de ce travail a ete de tenir compte d’emblee de la dimension mondiale de la pandemie, et de ne pas s’en tenir a la situation francaise. Ainsi, plusieurs contextes nationaux, voire continentaux sont explores sur tel ou tel point et la dimension mondiale de la pandemie y est prise en compte en tant que telle. Enfin, ce document s’interesse aussi a la maniere meme dont les sciences humaines et sociales se sont mobilisees, en France, dans le contexte de la pandemie de Covid 19, aux formes collaboratives, aux pratiques pluridisciplinaires particulierement adoptees face a cette pandemie. Il se structure en cinq parties : la premiere porte sur la maniere dont les SHS font de la crise une question et un objet de connaissance (A – Du cadrage de la crise dans l’espace public a la crise comme objet de connaissance - l’exemple de la France). La seconde aborde un point saillant des analyses elaborees au cours des derniers mois, qui envisagent la pandemie comme un revelateur, voire un amplificateur d’enjeux pre-existants (B). Puis, la troisieme partie s’interesse aux societes et aux gouvernements confrontes a la pandemie (C), autrement dit aux formes de la gestion de la crise par le pouvoir politique, a la mobilisation des sciences et a l’exercice du pouvoir, ainsi qu’aux mesures prises et aux attitudes des populations au regard de ces mesures. La quatrieme partie presente la facon dont le temps de la pandemie a ete traverse de questionnements pour le futur, questionnements qui a leur tour impriment des orientations pour la recherche en SHS (D. Se reinventer en temps de pandemie). Enfin, la cinquieme et derniere partie invite le lecteur a decouvrir comment les SHS se sont mobilisees en temps de pandemie, comment elles ont collabore et entrepris de documenter a chaud la crise sanitaire tout en acceptant de voir se renouveler questions, objets, methodes sous l’effet de cette crise (E. Quand la crise invite aux collaborations et a une reflexion sur le « transfert » des connaissances).

Background Coronary heart disease (CHD) risk, and especially the risk of early onset myocardial infarction, shows a strong familial pattern. Associations with other circulatory conditions and overall survival are less well studied. We estimated the associations between age at death of the parents and the risk of 18 prevalent and incident conditions, and mortality, in a large middle-aged UK cohort. Methods Prospective data from the UK Biobank was available for 189,076 participants aged 55–73 years (including 696 offspring of centenarians). Participants were followed-up from baseline for hospital admissions and mortality (mean period of 6 years and 5.5 years respectively, maximum >8 years for both). We excluded premature parental deaths and parental survival was ranked into short, intermediate and long-lived categories. A combined ranked parental longevity score was created, with a higher score indicating a greater parental age at death. Cox proportional hazards regression models investigated the associations of parental longevity score and the risk of prevalent and incident disease and mortality. Results At baseline, increasing parents' age at death was associated with participants being more physically active and having more education and higher income, plus having less obesity and lower rates of smoking. Adjusting for age, sex, ethnicity, education, income, smoking status, alcohol intake, physical activity and body mass index, parental longevity was associated with lower prevalence and incidence of several common circulatory conditions, including peripheral vascular disease (per longevity category Hazard Ratio for incidence: 0.73; 95% CI: 0.64, 0.83), stroke (HR, 0.77; 95% CI: 0.70, 0.86), heart failure (HR, 0.78; 95% CI: 0.70, 0.87), coronary heart disease (HR, 0.86; 95% CI: 0.81, 0.91) and atrial fibrillation (HR, 0.88; 95% CI: 0.82, 0.94). Offspring of longer-lived parents also had a lower risk of all-cause mortality (HR, 0.87; 95% CI: 0.84, 0.91) and a markedly lower risk of CHD mortality (HR, 0.74; 95% CI: 0.65, 0.83). However, the associations with cancer mortality, incident cancers and other conditions were weaker. Conclusion Data from the UK Biobank provides evidence that the middle-aged offspring of longer-lived parents have markedly lower risks of several common cardiovascular conditions (in addition to coronary heart disease), and all-cause and cardiovascular mortality, and these associations remained after adjustment for several environmental risk factors. Family history of having longer lived parents could enhance risk assessment for a wide range of circulatory outcomes and all-cause mortality, but formal evaluations in representative samples are needed.

the control the (ii) analyses (interpreting trends and gaps, supple-mentary (iii) reporting (translation, the web and introduction and (IV) translation of the information to policy use.

Background Joint Action European Health and Life Expectancies Information System (JA EHLEIS) annually calculates healthy life expectancies (HLE) of EU member states. The aim is to calculate HLE in Japan for the same indicators and to compare with EU. Methods HLE in 2010 were calculated from the data of the Japanese national Comprehensive Survey of Living Conditions and the national Life Table using Sullivan method. Because the questionnaire of the Japanese and EU …

This work, based on a matched case-control design, tests the assumption that centenarians were conceived by parents younger than the parents of individuals who had lifespan close to mean life duration. The centenarians are paired with controls of the same sex, born at the same place and at the same time in order to avoid traditional biases related to mortality peaks or secular trend of increase in life expectancy. The parental age at the time of the birth registration of 320 centenarians born in France between 1875 and 1890 and deceased between 1990 and 1999 is collected, as well as the one of 603 controls of the same sex whose births were recorded immediately before or after those of the future centenarians on the birth registers of the cities concerned. No difference is found between the parental age of parents of centenarians and of controls. In particular, no difference is found for females. Recent studies showed--from genealogical data--that the life expectancy of a female would be much reduced if her father was old at the time of her conception. Our study does not indicate a negative effect of a higher paternal age on the longevity of daughters.

THE DEVELOPMENT OF STUDIES ON CENTENARIANS: In a spectacular context of increase in the number of centenarians and of emergence of super-centenarians (110 years old and over), large studies on the health of these very old populations were set up in France at the beginning of the 1990s. A HETEROGENIC POPULATION: The results of these studies make it possible to describe centenarians as a heterogenic population mainly composed of women. Their functional health, their sensory performance, their limitations in daily life activities, their social and family integration, their cognitive functioning, are very varied. They appear as robust individuals who have triumphed over the hardships they have lived. LONGEVITY AND DEMENTIA: The French study has revealed that 35% of the women and 58% of the men are free from any suspicion of dementia according to Pfeiffer's screening test, which is encouraging if we consider the disastrous scenarios which could have been forecasted.

In this issue of the journal Daniel Reidpath and Pascale Allotey provocatively wonder if disability adjusted life expectancy (DALE) brings more information than infant mortality rate (IMR) when comparing the overall health status of different populations.1 It is a relevant question because on the one hand IMR is easy to compute and to understand. It requires mortality and population data, which are not too difficult to collect. On the other hand DALE is quite difficult to compute and to precisely understand. It requires a lot of data that are much more difficult and expensive to collect thus raising additional data quality concerns. When the WHO published for the first time an estimation of DALE for the its 191 member states for the years 1997 and 1999,2 the results seemed surprising: a quasi perfect linear correlation between life expectancy at birth (LE) and DALE …

# 1. WHAT DO THE PUBLIC THINK ABOUT THE USE OF THEIR HEALTH INFORMATION? PATIENT ELECTRONIC RECORD: INFORMATION AND CONSENT—THE PERIC PROJECT {#article-title-2} 3921 adults randomly selected from across Great Britain were interviewed. Subjects were asked to assess a selection of 10 out of 200

Objectives of welfare and the welfare state conflict and people disagree upon the importance of different objectives. Disagreement and dispute arise with regard to definition, compatibility, or ranking of major objectives such as efficiency, freedom, and equity. The distinction between liberal, corporatist and universal welfare states or between social assistance, social insurance, and universal social protection models is at the core of comparative welfare state research. Institutional arrangements are another prominent approach in comparative welfare state research. Because of demographic and socio-economic changes and challenges, cost-containment and efficiency-improving approaches have recently been dominating welfare state policies. Alongside cost-containment concerns, and partly as a consequence, objectives such as choice, quality and autonomy have received increasing recognition in recent policy …

There is a double belief that causes health authorities to hold back from vigorously promoting healthy behaviours. The first is linked to the idea that there is a trade off between the quantity and the quality of life. Why increase the individual length of life if it is at the price of the quality of the years lived. But what do we mean by the quality of the years lived? Happiness or well being? This approach is considered too wide by the important literature devoted to this question in the field of health and social science. Experts in this field prefer to limit quality of life to what is conventionally called Health related Quality of Life (HRQoL). The key elements are, then, pain and self perceived symptoms, functional status and disability and perceived …

Disability-free life expectancies were calculated for socio-proiessional groups to gauge for magnitude and trends in health differentials during the 1980-91 period. These indicators allowed to assess the consequences of longer life on health and the uniformity of these effects across the social hierarchy A prevalence-based life table model was used to calculate disability-free life expectancy, combining cross-sectional data on disability prevalence from the 1980 and 1991 French health surveys, with incidence data on mortality. The study focused on the French male population, aged 35 and over, and divided into three socio-professional groups. Differentials in disability-free life expectancy remained stable between 1980 and 1991: at age 35, the "managers" group could expect an additional 5,4 years of life and an additional 7 years or life without disability compared to the manual workers group. At age 60, the gaps reached 3 expected years of life and 4 expected years of life without disability. The simultaneous increase in life expectancy and disability-free life expectancy between 1980 and 1991 led to a compression of the period lived with disability within lire expectancy, for all groups. This work raised some methodological issues related to the study of social inequalities in health and problems related to data limitations.

The purpose of this study was to analyse survivorship data from a French centenarian study. Medical predictors on survival duration after 100 years were assessed for 800 centenarians. Results indicate that it took more than eight years for 99 percent of the sample to die. The average survivorship time was almost two years. Several significant predictors of survivorship emerged: residence, global health status, cognitive impairment, both activities of daily living and instrumental activities of daily living, the body-mass index and diastolic blood pressure. Sex, systolic blood pressure and cholesterol level were not significant predictors of survivorship among community-dwelling centenarians. The results suggest that in order to survive beyond age 100 one should continue to live in the community, remain in good functional and physical health, without cognitive impairment. It may also help to be somewhat overweight, have a cholesterol level above the normal level and have regular diastolic blood pressure.

An estimate of the number of persons in France presently suffering from senile dementia has been made using a meta-analysis derived from recent epidemiological studies in conjunction with population statistics from the 1990 INSEE census. The results suggest that the number is less than has previously been estimated, but that significant increases can be expected in coming years if no efficient treatment is found for these disorders and the life expectancy of persons with dementia is not reduced. The importance of these observations in terms of public health planning extends beyond the help required for the elderly dementing person, to the implications of such an epidemic for family care-givers.