Biomedical subjects

Elizabeth Arias

Publications and source records attributed to Elizabeth Arias.

14 recordsLinked to original sources

PubMed2006

Multifactor cardiovascular disease risk reduction in medically underserved, high-risk patients.

Few data exist on the effectiveness of cardiovascular disease (CVD) risk-reduction programs in patients with limited access to health care. The objective of this project was to evaluate a disease management approach to multifactor CVD risk reduction in patients with limited or no health insurance and low family income. Patients (n = 148) were recruited from not-for-profit or free clinics and hospitals and randomized to usual care or usual care plus team case management. Mean age was 59.3 years, 57% were women, 50% had less than a high school education, 57% were Hispanic, and 64% had no health insurance. All had > or =1 increased risk factor for CVD, and 24.5% had documented coronary artery disease. Follow-up measurements were obtained at 6 and 12 months. Primary outcomes were low-density lipoprotein cholesterol and systolic blood pressure. The disease management program was supervised by a physician, delivered by nurses and dietitians, and included comprehensive lifestyle changes and medications. Data were collected on 91% of patients at 12 months. Disease management produced clinically important decreases in selected risk factors compared with usual care, including systolic blood pressure (p <0.01) and low-density lipoprotein cholesterol (p <0.03). More patients with disease management than those with usual care moved from "high" and "very-high" risk to lower risk categories for selected risk factors. In conclusion, the disease management program had excellent retention and lower CVD risk factors and demonstrated the potential of such approaches for decreasing long-term disease burden in selected medically underserved populations.

Adult↗

PubMed2006

United States life tables, 2003.

This report presents period life tables for the United States based on age-specific death rates in 2003. Data used to prepare these life tables are 2003 final mortality statistics; July 1, 2003, population estimates based on the 2000 decennial census; and data from the Medicare program. Presented are complete life tables by age, race, and sex. In 2003, the overall expectation of life at birth was 77.5 years, representing an increase of 0.2 years from life expectancy in 2002. Between 2002 and 2003, life expectancy increased for males and females and for both the white and black populations. Life expectancy increased by 0.3 years (from 77.7 to 78.0) for the white population and by 0.4 years (from 72.3 to 72.7) for the black population. Both males and females in each race group experienced increases in life expectancy between 2002 and 2003. The greatest increase was experienced by black females with an increase of 0.5 years (from 75.6 to 76.1). Life expectancy increased by 0.2 years for black males (from 68.8 to 69.0), white males (from 75.1 to 75.3), and for white females (from 80.3 to 80.5).

Adolescent↗

PubMed2004

United States life tables, 2002.

This report presents period life tables for the United States based on age-specific death rates in 2002. Data used to prepare these life tables are 2002 final mortality statistics; July 1, 2002, population estimates based on the 2000 decennial census and data from the Medicare program. Presented are complete life tables by age, race, and sex. In 2002 the overall expectation of life at birth was 77.3 years, representing an increase of 0.1 years from life expectancy in 2001. Between 2001 and 2002, life expectancy increased for both males and females. Life expectancy increased by 0.2 years for black males (from 68.6 to 68.8). It increased by 0.1 year for white males (from 75.0 to 75.1), for white females (from 80.2 to 80.3), and for black females (from 75.5 to 75.6).

Adolescent↗

PubMed2004

United States Life Tables, 2001.

This report presents period life tables for the United States based on age-specific death rates in 2001. Data used to prepare these life tables are 2001 final mortality statistics; July 1, 2001, population estimates based on the 2000 decennial census; and data from the Medicare program. Presented are complete life tables by age, race, and sex. In 2001 the overall expectation of life at birth was 77.2 years, representing an increase of 0.2 years from life expectancy in 2000. Between 2000 and 2001, life expectancy increased for both males and females and for both the white and black populations. Life expectancy increased by 0.3 years for black males (from 68.3 to 68.6) and black females (from 75.2 to 75.5). It increased by 0.1 year for white males (from 74.9 to 75.0) and white females (from 80.1 to 80.2).

Adolescent↗

PubMed2004

Factors associated with out-of-hospital coronary heart disease death: the national longitudinal mortality study.

PURPOSE: A significant portion of coronary heart disease deaths occur out of the hospital, prior to access to life saving medical care. Improving the immediacy of care could have important impact on coronary mortality. METHODS: The objective of this research is to identify factors associated with the occurrence of out-of-hospital coronary heart disease death as compared with in-hospital. Identification of these factors could lead to additional strategies for rapid treatment of coronary attack symptoms. A large national cohort study with individually identified characteristics was matched to the National Death Index to identify deaths by cause occurring in up to 11 years of follow-up. Approximately 60,000 deaths occurred in the cohort of approximately 700,000 participants aged 25 years or more. Location of death was defined as either in- or out-of-hospital. RESULTS: Among deaths classified as coronary heart disease (CHD), multivariate logistic models of the association between selected demographic and socioeconomic characteristics of individuals prior to death and place of death show that black persons are more likely to die out of hospital, as are persons who live alone or are unmarried, persons at the lowest end of the income distribution, and persons who live in rural areas vs. urban areas. CONCLUSIONS: The factors most strongly associated with a CHD death occurring out-of-hospital as compared with in-hospital are race (black persons are 1.23 times more likely to die out of hospital than white persons, net of demographic and socioeconomic differentials) and living status (persons who are not married are 1.60 times more likely to die out of hospital than persons who are married, net of demographic and socioeconomic characteristics). Attention should be paid to these groups to emphasize the need for rapid attention to the signs of a coronary attack so that rapid and potentially life saving intervention can be implemented.

Adult↗

PubMed2004

Paradox lost: explaining the Hispanic adult mortality advantage.

We tested three competing hypotheses regarding the adult "Hispanic mortality paradox": data artifact, migration, and cultural or social buffering effects. On the basis of a series of parametric hazard models estimated on nine years of mortality follow-up data, our results suggest that the "Hispanic" mortality advantage is a feature found only among foreign-born Mexicans and foreign-born Hispanics other than Cubans or Puerto Ricans. Our analysis suggests that the foreign-born Mexican advantage can be attributed to return migration, or the "salmon-bias" effect. However, we were unable to account for the mortality advantage observed among other foreign-born Hispanics.

Adult↗

PubMed2003

Deaths: final data for 2001.

OBJECTIVES: This report presents final 2001 data on U.S. deaths and death rates according to demographic and medical characteristics such as age, sex, Hispanic origin, race, marital status, educational attainment, injury at work, State of residence, and cause of death. Trends and patterns in general mortality, life expectancy, and infant and maternal mortality are also described. A previous report presented preliminary mortality data for 2001. METHODS: In 2001 a total of 2,416,425 deaths were reported in the United States. This report presents descriptive tabulations of information reported on the death certificates. Funeral directors, attending physicians, medical examiners, and coroners complete death certificates. Original records are filed in the State registration offices. Statistical information is compiled into a national database through the Vital Statistics Cooperative Program of the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention. Causes of death are processed in accordance with the International Classification of Diseases Tenth Revision (ICD-10). RESULTS: The age-adjusted death rate for the United States in 2001 was 854.5 deaths per 100,000 standard population, representing a decrease of 1.7 percent from the 2000 rate and a record low historical figure. Life expectancy at birth rose by 0.2 years to a record high of 77.2 years. Considering all deaths, age-specific death rates rose only for those 25-44 years, and declined for a number of age groups including those under 1 year, 5-14 years, 55-64 years, 65-74 years, 75-84 years, and 85 years and over. The 15 leading causes of death in 2001 remained the same as in 2000. Heart disease and cancer continued to be the leading and second leading causes of death, together accounting for over half of all deaths. Homicide became the 13th leading cause in 2001, rising from the 14th leading cause in 2000 as a result of the September 11, 2001, terrorist attacks. The infant mortality rate remained at a record low level, declining slightly but insignificantly from 6.9 in 2000 to 6.8 in 2001. CONCLUSIONS: Generally, mortality patterns in 2001 were consistent with long-term trends. Life expectancy in 2001 increased again to a new record level. The age-adjusted death rate declined to a record low historical figure. Although statistically unchanged from 2000, the trend in infant mortality has shown a steady, although slowing, decline. The declining trend in the homicide death rate was reversed primarily as a result of the September 11, 2001, terrorist attacks.

Adolescent↗

PubMed2003

The effect of revised populations on mortality statistics for the United States, 2000.

OBJECTIVES: This report presents revised mortality statistics for the year 2000 based on April 1, 2000, population figures from the 2000 census. Death rates are presented by race, Hispanic origin, sex, age, and cause of death. Life expectancies are presented by race (white and black), sex, and age. The revised statistics are compared with previously published statistics that used July 1, 2000, postcensal population estimates based on the 1990 census. METHODS: Data in this report are based on information from all death certificates filed in the 50 States and the District of Columbia. The statistics presented in this report are computed on the basis of two sets of population figures provided by the U.S. Census Bureau. The first set includes July 1, 2000, postcensal population estimates based on the 1990 decennial census. The second set includes April 1, 2000, populations from the 2000 decennial census bridged to single race categories. RESULTS: Crude death rates were lower for all groups using the April 1, 2000, populations. Age-specific death rates were generally lower for most age groups, except for infants and the very old for which death rates were higher. Age-specific death rates for males were lower for most age groups, except infants and those 75 years and over. For females, with the exception of infants, age-specific death rates were lower. Race-specific pattems by age for the white and black populations were similar to all races combined. For the American Indian population, age-specific death rates were substantially lower for ages under 75 years. For ages 75 years and over, American Indian death rates were dramatically higher. Age-specific death rates for the Asian or Pacific Islander (API) population were higher for ages under 15 years; lower for ages 15-84 years, especially for the 15-34 year age group; and higher for those 85 years and over. For the Hispanic population, age-specific death rates were substantially lower for those age 15-34 years and higher for those age 55 years and over, especially for those age 85 years and over. For the total white and total black populations, the age-adjusted death rate was somewhat higher for males and lower for females. For API the pattern was reversed. For the American Indian and Hispanic populations, age-adjusted death rates were higher for both males and females. For the 15 leading causes of death, age-adjusted death rates based on the April 1, 2000, population figures were lower for heart disease, cancer, chronic liver disease, septicemia, diabetes, chronic lower respiratory diseases, unintentional injuries, homicide, suicide, and hypertension. Age-adjusted death rates were higher for pneumonitis, Alzheimer's disease, and stroke. Rates were unchanged for influenza and pneumonia and nephritis, nephrotic syndrome and nephrosis. Life expectancy at birth was higher for the entire population and both the white and black populations using the April 1, 2000, population figures. It was 0.1 year higher for the whole population as well as for the total white and total black populations. For the total male population, life expectancy at birth was 0.1 year higher while it was 0.2 years higher for the female population. The increase in life expectancy at birth was 0.1 year for both sexes within the white and black populations. This observed gain in life expectancy at birth based on the revised population figures is reversed for life expectancy at the oldest age groups for the whole population and for males. A similar pattern is observed for both white and black males; however, the magnitude of the decline in life expectancy at older ages is much greater among black males. Among females of both race groups and the total population, there is either no change or an increase in life expectancy in the oldest age groups. CONCLUSIONS: Revised death rates and life expectancies are, in many cases, significantly different from previously published mortality statistics calculated using 1990-based postcensal estimates for 2000. Thus, previously published mortality statistics for 2000 using the 1990-based populations will not be comparable to the corresponding statistics that will be published for 2001. The data in this report will provide comparable 2000 data. Efforts are also underway to revise previously published mortality tables for 2000 as well as previously published data for 1991-99.

Adolescent↗

PubMed2003

Deaths: preliminary data for 2001.

OBJECTIVES: This report presents preliminary data on deaths for the year 2001 in the United States. U.S. data on deaths are shown by age, sex, race, and Hispanic origin. Death rates for 2001 are based on population estimates consistent with the April 1, 2000, census. Data on life expectancy, leading causes of death, infant mortality, and deaths resulting from September 11, 2001, terrorist attacks are also presented. For comparison, this report also presents revised final death rates for 2000, based on populations consistent with the April 1, 2000, census. METHODS: Data in this report are based on a large number of deaths comprising approximately 98 percent of the demographic file and 92 percent of the medical file for all deaths in the United States in 2001. The records are weighted to independent control counts of infant deaths and deaths 1 year and over received in State vital statistics offices for 2001. Unless otherwise indicated, comparisons are made with final data for 2000. For certain causes of death, preliminary data differ from final data because of the truncated nature of the preliminary file. These are, in particular, accidents, homicides, suicides, and respiratory diseases. Populations were produced for the Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS) under a collaborative arrangement with the U.S. Census Bureau. The populations reflect the results of the 2000 census. This census allowed people to report more than one race for themselves and their household members and also separated the category for Asian or Pacific Islander persons into two groups (Asian and Native Hawaiian or Other Pacific Islander). These changes reflect the Office of Management and Budget's (OMB) 1997 revisions to the standards for the classification of Federal data on race and ethnicity. Because only one race is currently reported in death certificate data, the 2000 census populations were "bridged" to the single race categories specified in OMB's 1977 guidelines for race and ethnic statistics in Federal reporting, which are still in use in the collection of vital statistics data. RESULTS: The age-adjusted death rate in 2001 for the United States decreased slightly from 869.0 deaths per 100,000 population in 2000 to 855.0 in 2001. For causes of death, declines in age-adjusted death rates occurred for Diseases of heart, Malignant neoplasms, Cerebrovascular diseases, Accidents (unintentional injuries), and Influenza and pneumonia. Age-adjusted death rates also declined for drug-induced deaths between 2000 and 2001. Age-adjusted death rates increased between 2000 and 2001 for the following causes: Alzheimer's disease, Nephritis, nephrotic syndrome and nephrosis, Essential (primary) hypertension and hypertensive renal disease, and Assault (homicide). The increase in homicide was a direct result of the terrorist attacks of September 11, 2001. The infant mortality rate did not change between 2000 and 2001. Life expectancy at birth rose by 0.2 years to a record high of 77.2 years.

Cause of Death↗

PubMed2003

Annual summary of vital statistics--2002.

The crude birth rate in 2002 was 13.9 births per 1000 population, the lowest ever reported for the United States. The number of births, the crude birth rate, and the fertility rate (64.8) all declined slightly (by 1% or less) from 2001 to 2002. Fertility rates were highest for Hispanic women (94.0), followed by black (65.4), Asian or Pacific Islander (63.9), Native American (58.0), and non-Hispanic white women (57.5). Fertility rates declined slightly for all race/ethnic groups from 2001 to 2002. The birth rate for teen mothers continued to fall, dropping 5% from 2001 to 2002 to 42.9 births per 1000 women aged 15 to 19 years, another record low. The teen birth rate has fallen 31% since 1991; declines were more rapid for younger teens aged 15 to 17 (40%) than for older teens aged 18 to 19 (23%). The proportion of all births to unmarried women remained approximately the same at one third. Smoking during pregnancy continued to decline; smoking rates were highest among teen mothers. In 2002, 26.1% of births were delivered by cesarean section, up 7% since 2001 and 26% since 1996. The primary cesarean rate has risen 23% since 1996, whereas the rate of vaginal birth after a previous cesarean delivery has fallen 55%. The use of timely prenatal care increased slightly to 83.8% in 2002. From 1990 to 2002, the use of timely prenatal care increased by 6% (to 88.7%) for non-Hispanic white women, by 24% (to 75.2%) for black women, and by 28% (to 76.8%) for Hispanic women, thus narrowing racial disparities. The percentage of preterm births rose to 12.0% in 2002, from 10.6% in 1990 and 9.4% in 1981. Increases were largest for non-Hispanic white women. The percentage of low birth weight (LBW) births also increased to 7.8% in 2002, up from 6.7% in 1984. Twin and triplet/+ birth rates both increased by 3% from 2000 to 2001. Multiple births accounted for 3.2% of all births in 2001. The infant mortality rate (IMR) was 6.9 per 1000 live births (provisional data) in 2002 compared with 6.8 in 2001 (final data). The ratio of the IMR among black infants to that for white infants was 2.5 in 2001, the same as in 2000. Racial differences in infant mortality remain a major public health concern. The role of LBW in infant mortality remains a major issue. New Hampshire, Utah, and Massachusetts had the lowest IMRs. State-by-state differences in IMR reflect racial composition, the percentage of LBW, and birth weight-specific neonatal mortality rates for each state. The United States continues to rank poorly in international comparisons of infant mortality. Expectation of life at birth reached a record high of 77.2 years for all sex and race groups combined in 2001. Death rates in the United States continue to decline. Between 2000 and 2001, death rates declined for the 3 leading causes of death: diseases of the heart, malignant neoplasms, and cerebrovascular diseases. Death rates for children ages 1 to 19 years decreased for unintentional injuries by 3.3% in 2001; the death rate for chronic lower respiratory diseases decreased by 25% in 2001. Cancer and suicide levels did not change for children ages 1 to 19. A large proportion of childhood deaths continue to occur as a result of preventable injuries.

Adolescent↗

PubMed2003

A further study of life expectancy by socioeconomic factors in the National Longitudinal Mortality Study.

OBJECTIVES: The objective of this article is to provide estimates of life expectancy for White, Black, and Hispanic populations by socioeconomic factors. Effects of educational, income, employment, and marital status on life expectancy are presented and interpreted. DESIGN: The National Longitudinal Mortality Study, consisting of a number of Current Population Surveys (CPS) linked to mortality information obtained from the National Death Index, provides data to construct life tables for various socioeconomic and demographic groups. Probabilities of death are estimated using a person-year approach to accommodate the aging of the population over 11 years of follow up. RESULTS: Across various ethnicity-race-sex groups, longer life expectancy was observed for individuals with higher levels of education and income, and for those who were married and employed. The differences in life expectancy between levels of the socioeconomic characteristics tended to be larger for men than for women. Also, differences were found to be larger for the non-Hispanic Black population compared to the non-Hispanic White population. Hispanic White men exhibited patterns similar to those of non-Hispanic White and Black men. CONCLUSIONS: For selected ethnicity-race-sex groups, the impact of socioeconomic variables on life expectancy is dramatic. The shorter life expectancy observed among the poor, the less educated, the unmarried, and those not in the labor force, highlights the impact of socioeconomic disadvantage on survival. Further, the substantial 14-year differential favoring the employed over those not in the labor force may be partially explained by unemployment due to poor health. Another reason may be that employed individuals have greater access to health care than do those not in the labor force.

Adult↗

PubMed2003

United States Census 2000 population with bridged race categories.

OBJECTIVES: The objectives of this report are to document the methods developed at the National Center for Health Statistics (NCHS) to bridge the Census 2000 multiple-race resident population to single-race categories and to describe the resulting bridged race resident population estimates. METHOD: Data from the pooled 1997-2000 National Health Interview Surveys (NHIS) were used to develop models for bridging the Census 2000 multiple-race population to single-race categories. The bridging models included demographic and contextual covariates, some at the person-level and some at the county-level. Allocation probabilities were obtained from the regression models and applied to the Census Bureau's April 1, 2000, Modified Race Data Summary File population counts to assign multiple-race persons to single-race categories. RESULTS: Bridging has the most impact on the American Indian and Alaska Native (AIAN) and Asian or Pacific Islander (API) populations, a small impact on the Black population and a negligible impact on the White population. For the United States as a whole, the AIAN, API, Black, and White bridged population counts are 12.0, 5.0, 2.5, and 0.5 percent higher than the corresponding Census 2000 single-race counts. At the sub-national level, there is considerably more variation than observed at the national level. The bridged single-race population counts have been used to calculate birth and death rates produced by NCHS for 2000 and 2001 and to revise previously published rates for the 1990s, 2000, and 2001. The bridging methodology will be used to bridge postcensal population estimates for later years. The bridged population counts presented here and in subsequent years may be updated as additional data become available for use in the bridging process.

Censuses↗

PubMed2002

United States life tables, 2000.

This report presents period life tables for the United States based on age-specific death rates in 2000. Data used to prepare these life tables are 2000 final mortality statistics; July 1, 2000, population estimates based on the 1990 decennial census; and data from the Medicare program. Presented are complete life tables by age, race, and sex. In 2000 the overall expectation of life at birth was 76.9 years, representing an increase of 0.2 years from life expectancy in 1999. Between 1999 and 2000, life expectancy increased for both males and females and for both the white and black populations. Life expectancy increased by 0.4 years for black males (from 67.8 to 68.2) and by 0.2 years for white males (from 74.6 to 74.8). It increased by 0.2 years for black females (from 74.7 to 74.9) and by 0.1 year for white females (from 79.9 to 80.0).

Adolescent↗

PubMed2002

Deaths: final data for 2000.

OBJECTIVES: This report presents final 2000 data on U.S. deaths and death rates according to demographic and medical characteristics such as age, sex, Hispanic origin, race, marital status, educational attainment, injury at work, State of residence, and cause of death. Trends and patterns in general mortality, life expectancy, and infant and maternal mortality are also described. A previous report presented preliminary mortality data for 2000. METHODS: In 2000 a total of 2,403,351 deaths were reported in the United States. This report presents descriptive tabulations of information reported on the death certificates. Funeral directors, attending physicians, medical examiners, and coroners complete death certificates. Original records are filed in the State registration offices. Statistical information is compiled into a national database through the Vital Statistics Cooperative Program of the National Center for Health Statistics (NCHS), Centers for Disease Control and Prevention. Causes of death are processed in accordance with the Tenth Revision of the International Classification of Diseases (ICD-10). RESULTS: The age-adjusted death rate for the United States in 2000 was 872.0 deaths per 100,000 standard population, a decrease of 1.1 percent from the 1999 rate and a record-low historical figure. Life expectancy at birth rose by 0.2 year to a record high of 76.9 years. Considering all deaths, age-specific death rates rose only for those 45-54 years and declined for a number of age groups including those 1-4 years, 55-64 years, 65-74 years, 75-84 years, and 85 years and over. Fourteen of the 15 leading causes of death are the same for 1999 and 2000. Heart disease and cancer continued to be the leading and second leading causes of death, accounting for over one-half of all deaths when combined. Aortic aneurysm, which was the 15th leading cause of death in 1999, dropped from the list in 2000 and, in its place, Pneumonitis due to solids and liquids is the 15th leading cause of death. The infant mortality rate reached a record low value of 6.9 infant deaths per 1,000 live births, declining 2.8 percent from the infant mortality rate in 1999 (7.1 deaths per 1,000 live births). CONCLUSIONS: Generally, mortality continued long-term trends. The slight increase in the age-adjusted death rate that was experienced in 1999 reversed itself in accordance to a longer standing decreasing pattern. Life expectancy increased 0.2 years, and the infant mortality rate decreased statistically to a record low 6.9 deaths per 1,000 live births, thus maintaining the steady decline that has characterized it for the past four decades.

Adolescent↗