SSM - Population Health最新文献

{"title":"The paradox of declining fertility and declining contraceptive use in India: An artefact of survey design?","authors":"Sonalde Desai,&nbsp;Santanu Pramanik,&nbsp;Bijay Chouhan","doi":"10.1016/j.ssmph.2022.101256","DOIUrl":"https://doi.org/10.1016/j.ssmph.2022.101256","url":null,"abstract":"<p><p>•Ensuring data quality in large scale surveys is challenging.•The trend and pattern of declining fertility and declining contraceptive use in India is puzzling.•Interview privacy setting and interviewer effect can partially explain the anomaly.•Large scale surveys impose severe demands on survey supervision and ability to ensure privacy.•Innovative ways of data collection for sensitive issues can be explored for proper reporting.</p>","PeriodicalId":506314,"journal":{"name":"SSM - Population Health","volume":" ","pages":"101256"},"PeriodicalIF":4.7,"publicationDate":"2022-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/c1/64/main.PMC9547282.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33498166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using machine learning to understand determinants of IUD use in India: Analyses of the National Family Health Surveys (NFHS-4).","authors":"Arnab K Dey,&nbsp;Nabamallika Dehingia,&nbsp;Nandita Bhan,&nbsp;Edwin Elizabeth Thomas,&nbsp;Lotus McDougal,&nbsp;Sarah Averbach,&nbsp;Julian McAuley,&nbsp;Abhishek Singh,&nbsp;Anita Raj","doi":"10.1016/j.ssmph.2022.101234","DOIUrl":"https://doi.org/10.1016/j.ssmph.2022.101234","url":null,"abstract":"<p><p>Intra-uterine devices (IUDs) are a safe and effective method to delay or space pregnancies and are available for free or at low cost in the Indian public health system; yet, IUD uptake in India remains low. Limited quantitative research using national data has explored factors that may affect IUD use. Machine Learning (ML) techniques allow us to explore determinants of low prevalence behaviors in survey research, such as IUD use. We applied ML to explore the determinants of IUD use in India among married women in the 4th National Family Health Survey (NFHS-4; N = 499,627), which collects data on demographic and health indicators among women of childbearing age. We conducted ML logistic regression (lasso and ridge) and neural network approaches to assess significant determinants and used iterative thematic analysis (ITA) to offer insight into related variable constructs generated from a series of regularized models. We found that couples' shared family planning (FP) goals were the strongest determinants of IUD use, followed by receipt of FP services and desire for no more children, higher wealth and education, and receipt of maternal and child health services. Findings highlight the importance of male engagement and family planning services for IUD uptake and the need for more targeted efforts to support awareness of IUD as an option for spacing, especially for those of lower SES and with lower access to care.</p>","PeriodicalId":506314,"journal":{"name":"SSM - Population Health","volume":" ","pages":"101234"},"PeriodicalIF":4.7,"publicationDate":"2022-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9529578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33491296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Job loss, financial strain, and housing problems as suicide precipitants: Associations with other life stressors.","authors":"Namkee G Choi,&nbsp;C Nathan Marti,&nbsp;Bryan Y Choi","doi":"10.1016/j.ssmph.2022.101243","DOIUrl":"https://doi.org/10.1016/j.ssmph.2022.101243","url":null,"abstract":"<p><p>Previous research has shown that job loss, financial strain, and/or loss of housing (JFH) in midlife elevate suicide risk. In this study based on the 2017-2019 National Violent Death Reporting System, we examined other suicide precipitants and contributors of decedents whose suicide was in part precipitated by JFH and the circumstances under which they died. First, we examined all adult decedents (N = 94,454; 74,042 males [78.4%] and 20,412 females [21.6%]) and then focused on decedents age 45-64 (N = 34,208; 25,640 males [75%] and 8568 females [25.0%]). The 45-64 age group had the highest rate of JFH (22.0% for males and 15.1% for females) as a suicide precipitant. The results of generalized linear models for all adult suicide decedents of both sexes showed that the 45-64 age group (IRR = 2.02, 95% CI = 1.89-2.16), compared to 65+ age group, and relationship problems, mental disorders, and alcohol problems were associated with significantly higher risk of JFH-precipitated suicide. In male decedents age 45-64, JFH was positively associated with depressed mood (IRR = 1.95, 95% CI = 1.85-2.06), alcohol problems (IRR = 1.14, 95% CI = 1.07-1.21), and number of crises (IRR = 1.48, 95% CI = 1.43-1.53). In female decedents age 45-64, JFH was positively associated with relationship problems (IRR = 1.19, 95% CI = 1.05-1.35), legal problems (IRR = 1.27, 95% CI = 1.06-1.54), depressed mood (IRR = 1.78, 95% CI = 1.59-1.99), and number of crises (IRR = 1.58, 95% CI = 1.48-1.68). In both sexes, the risk of JFH was also positively associated with a college education. In female decedents, JFH risk was higher among divorced or never-married individuals. Coroner/medical examiner and law enforcement agency reports show that some experienced depression and started misusing alcohol and/or other substances following a job loss, but others had these problems throughout life, which caused/contributed to JFH. These findings show the significance of suicide prevention approaches at both systemic (generous unemployment insurance, housing subsidies) and individual (treatment of depression and alcohol/substance misuse problems and social support/connection) levels.</p>","PeriodicalId":506314,"journal":{"name":"SSM - Population Health","volume":" ","pages":"101243"},"PeriodicalIF":4.7,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/55/6f/main.PMC9530609.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33491295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-demographics, neighborhood characteristics, time use, and leisure-time physical activity engagement patterns over the life course.","authors":"Xiaoyue Chen,&nbsp;Astrid Kemperman,&nbsp;Harry Timmermans","doi":"10.1016/j.ssmph.2022.101244","DOIUrl":"https://doi.org/10.1016/j.ssmph.2022.101244","url":null,"abstract":"<p><p>Physical inactivity remains a major public health challenge today. Understanding the determinants of changes in habitual leisure-time physical activity patterns by type across the life course is important for developing targeted interventions. This study presents a multiple discrete-continuous extreme value model to examine the determinants of habitual participation in and time allocation to multiple leisure-time physical activities over the life course. A comprehensive set of socio-demographics, life transitions, neighborhood characteristics, and time-related factors are considered as determinants of each activity type, including sports, recreational walking, cycling, outdoor playing, and dog walking. Results estimated on retrospective survey data collected in the Netherlands show significant differences in the determinants of the different types of leisure-time physical activity. Social-demographic factors have a strong influence on sports participation, followed by recreational walking, cycling, outdoor playing, and then dog walking. Life transitions have different effects. A change in marital status appears to be the most important life event for sports participation while changing jobs is the most important event for the other two activities. Neighborhood characteristics primarily affect participation in recreational walking, cycling, outdoor playing, and dog walking. As for time-related factors, they mainly impact sports engagement. The findings of this study could help develop effective interventions to promote leisure-time physical activity participation during life transitions and encourage healthy living.</p>","PeriodicalId":506314,"journal":{"name":"SSM - Population Health","volume":" ","pages":"101244"},"PeriodicalIF":4.7,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9529596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33491290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifestyle factors as mediators of area-level socio-economic differentials in cardiovascular disease risk factors. The Tromsø Study.","authors":"Sweta Tiwari,&nbsp;Ester Cerin,&nbsp;Tom Wilsgaard,&nbsp;Ola Løvsletten,&nbsp;Inger Njølstad,&nbsp;Sameline Grimsgaard,&nbsp;Laila A Hopstock,&nbsp;Henrik Schirmer,&nbsp;Annika Rosengren,&nbsp;Kathrine Kristoffersen,&nbsp;Maja-Lisa Løchen","doi":"10.1016/j.ssmph.2022.101241","DOIUrl":"https://doi.org/10.1016/j.ssmph.2022.101241","url":null,"abstract":"<p><strong>Introduction: </strong>Cardiovascular disease (CVD) is a leading cause of death and disability and living in areas with low socio-economic status (SES) is associated with increased risk of CVD. Lifestyle factors such as smoking, physical inactivity, an unhealthy diet and harmful alcohol use are main risk factors that contribute to other modifiable risk factors, such as hypertension, raised blood cholesterol, obesity, and diabetes. The potential impact of area-level socio-economic status (ASES) on metabolic CVD risk factors via lifestyle behaviors independent of individual SES has not been investigated previously.</p><p><strong>Aims: </strong>To estimate associations of ASES with CVD risk factors and the mediating role of lifestyle behaviors independent of individual-level SES.</p><p><strong>Methods: </strong>In this cross-sectional study, we included 19,415 participants (52% women) from the seventh survey of the Tromsø Study (2015-2016) (Tromsø7). The exposure variable ASES was created by aggregating individual-level SES variables (education, income, housing ownership) at the geographical subdivision level. Individual-level SES data and geographical subdivision of Tromsø municipality (36 areas) were obtained from Statistics Norway. Variables from questionnaires and clinical examinations obtained from Tromsø7 were used as mediators (smoking, snuff, alcohol, and physical activity), while the outcome variables were body mass index (BMI), total/high-density lipoprotein (HDL) cholesterol ratio, waist circumference, hypertension, diabetes. Mediation and mediated moderation analysis were performed with age as a moderator, stratified by sex.</p><p><strong>Results: </strong>ASES was significantly associated with all outcome variables. CVD risk factor level declined with an increase in ASES. These associations were mediated by differences in smoking habits, alcohol use and physical activity. The associations of ASES with total/HDL cholesterol ratio and waist circumference (women) were moderated by age, and the moderating effects were mediated by smoking and physical activity in both sexes. The largest mediated effects were seen in the associations of ASES with total/HDL cholesterol ratio, with the mediators accounting for 43% of the observed effects.</p><p><strong>Conclusions: </strong>Living in lower SES areas is associated with increased CVD risk due to unhealthy lifestyle behaviors, such as smoking, alcohol use and physical inactivity. These associations were stronger in women and among older participants.</p>","PeriodicalId":506314,"journal":{"name":"SSM - Population Health","volume":" ","pages":"101241"},"PeriodicalIF":4.7,"publicationDate":"2022-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9530956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33491294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Participation in community-based healthcare interventions and non-communicable diseases early detection of general population in Indonesia.","authors":"Sujarwoto,&nbsp;Asri Maharani","doi":"10.1016/j.ssmph.2022.101236","DOIUrl":"https://doi.org/10.1016/j.ssmph.2022.101236","url":null,"abstract":"<p><strong>Background: </strong>Community-based Healthcare Interventions (CBHIs) are regarded as a critical component of healthcare task-sharing in LMICs and have the potential to address LMICs' health system weaknesses to improve NCDs prevention care. This study aims to investigate the relationship between participation in CBHIs and NCDs early detection at medical facilities among Indonesians.</p><p><strong>Methods: </strong>Data come from the fifth Indonesian Family Life Survey (2014-2015), a total of 27,692 individuals (14,820 female and 12,872 male individuals age 15 and older). Multiple ordered logistics and logistics regression was used to assess the association between individual participation in CBHI and early detection of NCDs at medical facilities.</p><p><strong>Findings: </strong>Participation in CBHIs are associated with higher odds of having regular blood pressure test (adjusted odds ratio [OR], 3.09; 95% confidence interval [CI], 2.67-3.58), cholesterol test (adjusted OR, 1.88; 95% CI, 1.60-2.22), blood glucose test (adjusted OR, 1.88; 95% CI, 1.58-2.23), electrocardiogram (adjusted OR, 1.37; 95% CI, 1.06-1.76) and basic dental examination (adjusted OR, 1.32; 95% CI, 1.09-1.60) at medical facilities. The odds of having pap smears (adjusted OR, 2.20; 95% CI, 1.62-2.98) and breast self-examination (adjusted OR, 1.73; 95% CI, 1.37-2.19) among females who participated in CBHIs are substantially larger than those who did not participate in CBHIs. No significant association is shown for the basic vision examination (adjusted OR, 1.14; 95% CI, 0.95-1.37), while the association of participation in CBHIs on prostate cancer checkup (adjusted OR, 0.18; 95% CI, 0.04-0.76) was negative and significant. The results were controlled with a wide range of predisposing, enabling and need factors for NCDs early detection.</p><p><strong>Conclusion: </strong>and recommendation: CBHIs may benefit NCDs early detection for the general population in Indonesia. Policymakers and health practitioners need to design CBHIs programs that are attractive to the population, especially men and younger people.</p>","PeriodicalId":506314,"journal":{"name":"SSM - Population Health","volume":" ","pages":"101236"},"PeriodicalIF":4.7,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9513697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40384887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What makes life purposeful? Identifying the antecedents of a sense of purpose in life using a lagged exposure-wide approach.","authors":"Julia S Nakamura,&nbsp;Ying Chen,&nbsp;Tyler J VanderWeele,&nbsp;Eric S Kim","doi":"10.1016/j.ssmph.2022.101235","DOIUrl":"https://doi.org/10.1016/j.ssmph.2022.101235","url":null,"abstract":"<p><strong>Aims: </strong>Prior research documents strong associations between an increased sense of <i>purpose</i> in life and improved health and well-being outcomes. However, less is known about candidate antecedents that lead to more purpose among older adults.</p><p><strong>Methods: </strong>We used data from 13,771 participants in the Health and Retirement Study (HRS) - a diverse, national panel study of adults aged >50 in the United States, to evaluate a large number of candidate predictors of purpose. Specifically, using linear regression with a <i>lagged exposure-wide approach</i>, we evaluated if <i>changes</i> in 61 predictors spanning physical health, health behaviors, and psychosocial well-being (between t₀;2006/2008 and t₁;2010/2012) were associated with purpose four years later (t₂;2014/2016) after adjustment for a rich set of baseline covariates.</p><p><strong>Results: </strong>Some health behaviors (e.g., physical activity ≥1x/week [β = 0.14, 95% <i>CI</i>: 0.09, 0.19]), physical health conditions (e.g., stroke [β = -0.25, 95% <i>CI</i>: -0.40, -0.10]), and psychosocial factors (e.g., depression [β = -0.21, 95% <i>CI</i>: -0.27, -0.15]) were associated with subsequent purpose four years later. However, there was little evidence that other health behaviors, physical health conditions, and psychosocial factors such as smoking, drinking, or financial strain, were associated with subsequent purpose.</p><p><strong>Conclusions: </strong>Several of our candidate predictors such as volunteering, time with friends, and physical activity may be important targets for interventions and policies aiming to increase purpose among older adults. However, some effect sizes were modest and contrast with prior work on younger populations, suggesting purpose may be more easily formed earlier in life.</p>","PeriodicalId":506314,"journal":{"name":"SSM - Population Health","volume":" ","pages":"101235"},"PeriodicalIF":4.7,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9a/cb/main.PMC9529595.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33491293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural-urban gradients and all-cause, cardiovascular and cancer mortality in Spain using individual data.","authors":"Ana Ayuso-Álvarez,&nbsp;Cristina Ortiz,&nbsp;Teresa López-Cuadrado,&nbsp;Carmen Rodríguez-Blázquez,&nbsp;Pablo Fernández-Navarro,&nbsp;Javier González-Palacios,&nbsp;Javier Damián,&nbsp;Iñaki Galán","doi":"10.1016/j.ssmph.2022.101232","DOIUrl":"https://doi.org/10.1016/j.ssmph.2022.101232","url":null,"abstract":"<p><p>•The literature reporting on rural-urban health status disparities remains inconclusive.•We analyzed data from a longitudinal population-based study using individual observations.•Our results show that the risks of all-cause and cancer mortality are greater in large cities than in other municipalities, with no clear urban-rural gradient.•Not differences were found among territories in cardiovascular mortality.</p>","PeriodicalId":506314,"journal":{"name":"SSM - Population Health","volume":" ","pages":"101232"},"PeriodicalIF":4.7,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6a/7f/main.PMC9516441.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40391450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning prediction of suicidal ideation, planning, and attempt among Korean adults: A population-based study.","authors":"Jeongyoon Lee,&nbsp;Tae-Young Pak","doi":"10.1016/j.ssmph.2022.101231","DOIUrl":"https://doi.org/10.1016/j.ssmph.2022.101231","url":null,"abstract":"<p><strong>Background: </strong>Suicide remains the leading cause of premature death in South Korea. This study aims to develop machine learning algorithms for screening Korean adults at risk for suicidal ideation and suicide planning or attempt.</p><p><strong>Methods: </strong>Two sets of balanced data for Korean adults aged 19-64 years were drawn from the 2012-2019 waves of the Korea Welfare Panel Study using the random down-sampling method (<i>N</i> = 3292 for the prediction of suicidal ideation, <i>N</i> = 488 for the prediction of suicide planning or attempt). Demographic, socioeconomic, and psychosocial characteristics were used to predict suicidal ideation and suicide planning or attempt. Four machine-learning classifiers (logistic regression, random forest, support vector machine, and extreme gradient boosting) were tuned and cross-validated.</p><p><strong>Results: </strong>All four algorithms demonstrated satisfactory classification performance in predicting suicidal ideation (sensitivity 0.808-0.853, accuracy 0.843-0.863) and suicide planning or attempt (sensitivity 0.814-0.861, accuracy 0.864-0.884). Extreme gradient boosting was the best-performing algorithm for predicting both suicidal outcomes. The most important predictors were depressive symptoms, self-esteem, income, consumption, and life satisfaction. The algorithms trained with the top two predictors, depressive symptoms and self-esteem, showed comparable classification performance in predicting suicidal ideation (sensitivity 0.801-0.839, accuracy 0.841-0.846) and suicide planning or attempt (sensitivity 0.814-0.837, accuracy 0.874-0.884).</p><p><strong>Limitations: </strong>Suicidal ideation and behaviors may be under-reported due to social desirability bias. Causality is not established.</p><p><strong>Discussion: </strong>More than 80% of individuals at risk for suicidal ideation and suicide planning or attempt could be predicted by a number of mental and socioeconomic characteristics of respondents. This finding suggests the potential of developing a quick screening tool based on the known risk factors and applying it to primary care or community settings for early intervention.</p>","PeriodicalId":506314,"journal":{"name":"SSM - Population Health","volume":" ","pages":"101231"},"PeriodicalIF":4.7,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9573904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40657163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does 'Data fudging' explain the autocratic advantage? Evidence from the gap between Official Covid-19 mortality and excess mortality.","authors":"Eric Neumayer,&nbsp;Thomas Plümper","doi":"10.1016/j.ssmph.2022.101247","DOIUrl":"https://doi.org/10.1016/j.ssmph.2022.101247","url":null,"abstract":"<p><p>Governments can underreport Covid-19 mortality to make their performance appear more successful than it is. Autocracies are more likely to 'fudge' these data since many autocratic regimes restrict media freedom and thus can prevent domestic media from reporting evidence of undercounting deaths. Autocracies also enjoy greater leverage over reporting health authorities to either fudge data or adopt restrictive definitions of what constitutes Covid-19 mortality. Controlling for other factors that explain official Covid-19 mortality, excess mortality and the difference between the two, our results suggest that any apparent 'autocratic advantage' in fighting the pandemic is likely to only exist in official Covid-19 mortality. Analyzing the gap between excess mortality and official Covid-19 mortality we find that autocracies on average have a larger gap between official Covid-19 mortality data and excess mortality data, which points towards 'autocratic data fudging' of their official Covid-19 mortality statistics.</p>","PeriodicalId":506314,"journal":{"name":"SSM - Population Health","volume":" ","pages":"101247"},"PeriodicalIF":4.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9523905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33490527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}