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PubMedDate not supplied

Gene diversity and estimation of genetic admixture among Mexican-Americans of Starr County, Texas.

The Mexican-Americans of Starr County, Texas, classified by sex and birthplace, were studied to determine the extent of genetic variation and contributions from ancestral populations such as Spanish, Amerindian and West African. Using 21 genetic marker systems, genetic distance and diversity analyses indicate that subpopulations of Mexican-Americans in Starr County are similar, and that more than 99% of the total gene diversity (HT) can be attributed to individual variation within the population. Genetic admixture analysis shows the predominant influence comes from the Spanish, a lesser contribution from Amerindians and a slight one from the West Africans. The contribution of the ancestral population to various subpopulations of the Mexican-Americans of Starr County is similar. The Mexican-Americans of Starr County are similar to the Mexican population from northeastern Mexico. The history of admixture is apparently old enough to have brought the entire Mexican-American gene pool to Hardy-Weinberg equilibrium. There is no non-random association of alleles among the genetic marker systems considered in the present study, in spite of the fact that this population is of admixed origin. These results, in aggregate, suggest genetic homogeneity of the Mexican-Americans of Starr County, Texas, and point towards the utility of this population for genetic and epidemiological studies.

Africa↗
PubMed1995

Population trends in resource-dependent counties.

"Resource-dependent communities in the United States have a history of economic instability and population decline. In this article, national county-level data were used to compare population trends during the 1980s of resource-dependent counties with counties economically dependent on other sustenance activities. It was found that resource-dependent counties were significantly more likely to experience population declines during the 1980s than other types of counties. This relationship remained significant even when the effects of several variables were statistically controlled."

Americas↗
PubMed2003

Rapid communication: sociodemographic differences between counties with high and low utilization of a regional poison control center.

A retrospective review of data from the New Jersey Poison Information and Education System (NJPIES) was conducted to determine whether differences exist in the sociodemographic characteristics between counties with high or low utilization of the regional poison control center (PCC). The goal was to generate hypotheses about the potential reasons for the variances in the utilization rates by different subpopulations, in order to develop culturally sensitive educational and preventive strategies in an effort to enhance the use of PCC services. Data from the NJPIES 2002 computerized medical records were analyzed to estimate the utilization rates (number of calls to NJPIES per 1000 of population) for each county in New Jersey. This information was then combined with county sociodemographic data from the 2000 U.S. Census. Sociodemographic characteristics were compared between the counties with high and low utilization rates and statistically significant differences were found. Counties with low utilization of PCC had significantly higher population density per square mile, smaller proportion of White residents, larger proportion of residents of "other race," and larger proportion of Black, Asian, and Hispanic and Latino residents. Further study is needed to examine the underlying reasons for the underutilization of PCC among such populations and to explore methods for improving their awareness and use of the services provided by PCC.

Adolescent↗
PubMed1979

Rural-urban differences in the structure of services for the elderly in upstate New York counties.

This research examines the impact of federal intervention and local community effort on the development of programs for the elderly. The study was designed, first, to gather longitudinal data on the structure of services for the elderly in 53 upstate New York counties for comparison with a study conducted in 1967 and, second, to measure the effectiveness of 43 counties with a County Office for the Aging (COFA) in mobilizing resources to increase services for the elderly. The findings reveal: (1) federal intervention has had the effect of an overall increase in services while at the same time decreasing rural-urban differences; (2) urban COFAs score consistently higher on the measures of community effectiveness; (3) the educational attainment of COFA directors is not a good predictor of success in mobilizing outside resources in both urban and rural counties; (4) in urban but not in rural counties, directors with administrator/planner experience have greater success in mobilizing outside resources.

Aged↗
PubMed1983

Diabetes among Mexican Americans in Starr County, Texas.

An increasing body of evidence suggests that diabetes mellitus constitutes a major health burden among the Mexican-American population. For example, county-wide death rates in Texas attributable to diabetes from 1970-1981 range from 2.5-52.0 diabetes deaths per 1000 total deaths with the highest rates generally occurring in counties whose populations are more than 75% Spanish ancestry. To assess the prevalence and morbidity of noninsulin-dependent diabetes mellitus among Mexican Americans, 14% of the Starr County, Texas, population (97% Mexican-American) was randomly sampled. The reference population, sampling strategy, and screening results are described. Age-specific prevalences of diabetes for males ranged from 0% in males aged 15-24 years to 17.6% in those above 75 years of age. Rates for females ranged from 0.4% in those aged 15-24 years to a high of 19.0% in the 55- to 64-year age group. In both sexes, the rates are relatively low for persons under age 45 with a sharp increase in those aged 45-54 years and high rates prevailing in the older age groups. Comparisons of the rates in Starr County to those of the general US population indicate a two- to fivefold greater risk in Starr County. In terms of impact on this community, these results imply that over 50% of individuals older than 35 years are directly affected by diabetes by virtue of their having the disease or by being a first-degree relative of a diabetic.

Adolescent↗
PubMed1996

The epidemiology of Down syndrome in four counties in Ireland 1981-1990.

BACKGROUND: We conducted a descriptive epidemiological study of Down syndrome (DS) in the four Irish counties (Dublin, Kildare, Wicklow and Galway) covered by EUROCAT registries of congenital malformations for the years 1981-1990. METHODS: EUROCAT registries, which cover defined populations, use multiple sources for case ascertainment. All DS cases born between 1 January 1981 and 31 December 1990 to mothers resident in the four counties were identified. Crude birth prevalence rates and maternal age-standardized rates (SPRs) were calculated for each county and for each year in the study period. The prevalence of DS by maternal age grouped in five-year periods and the risk for each five-year group were also estimated. RESULTS: The crude birth prevalence for the four counties was 18.5/10 000 for all births and 18.3 for live births. There was a fall in the total number of DS births over the decade, but less change in the crude birth prevalence owing to an increase in the proportion of mothers aged 35+. Galway had the highest crude birth prevalence of DS (23.5/10 000) but the SPR was within average for the four counties as a whole - 110.3, 95 per cent confidence interval (CI) 86.7-139. The risk of having a DS child increased 70-fold from 1:1841 at age 15-19 to 1:26 at 45 years or older. Nearly half of all DS cases (47.4 per cent) had at least one additional anomaly. CONCLUSIONS: The parts of Ireland covered by EUROCAT have a high birth prevalence of DS births as compared with some other countries, but the maternal age-specific rates are not substantially different from those in large international studies.

Adolescent↗
PubMedDate not supplied

Climatic variables and transmission of malaria: a 12-year data analysis in Shuchen County, China.

OBJECTIVE: The objective of this study was to explore the impact of climate variability on the transmission of malaria, a vector-borne disease, in a county of China and provide suggestions to similar regions for disease prevention. METHODS: A time-series analysis was conducted using data on monthly climatic variables and monthly incidence of malaria in Shuchen County, China, for the period 1980-1991. RESULTS: Spearman's correlation analysis showed that monthly mean maximum and minimum temperatures, two measures of monthly mean relative humidity, and monthly amount of precipitation were positively correlated with the monthly incidence of malaria in the county. Regression analysis suggested that monthly mean minimum temperature and total monthly rainfall, with a one-month lagged effect, were significant climatic variables in the transmission of malaria in Shuchen County. Seasonality was also significant in the regression model and there was a declining secular trend in the incidence of malaria. CONCLUSION: The results indicate that climatic variables should be considered as possible predictors for regions with similar geographic, climatic, and socioeconomic conditions to those of Shuchen County.

China↗
PubMed1999

The residential radon-lung cancer association in U.S. counties: a commentary.

There is little doubt that underground miners exposed to radon and its progeny have increased rates of lung cancer. Residential radon exposures should carry a possibly smaller risk of increased cancer. When it became possible to collect radon data in a large number of U.S. homes and the data were aggregated by counties, the apparent association with lung cancer was a negative one, even when many other variables were taken into account. Residential radon levels are higher in suburban residences leading to a negative association with population density. Population density is strongly positively associated with lung cancer. It follows that aggregate residential radon and lung cancer rates should be negatively associated for reasons having nothing to do with the possibility of radon being carcinogenic to the lung. A second problem presented by the data is the one of sampling bias since the county lung cancer data are from the whole county population, but only a few residences are tested. Examples of other inherent associations in environmental epidemiology are cited. One strategy is to study areas of the same population density but with radon exposure gradients. This is approximated by choice of rural high radon states. Counties in such states have weak and inconsistent associations between radon and lung cancer, some of which are positive. I conclude that counties are generally inappropriate units for study of radon and lung cancer associations.

Air Pollutants, Radioactive↗
PubMed2000

Changing the paradigm: planning for ambulatory care expansion in Los Angeles County using a community-based and evidence-based model.

In 1998, Los Angeles County's Department of Health Services (DHS) embarked on a planning process to expand ambulatory care services for the county's 2.7 million uninsured and otherwise medically indigent residents. This planning process was novel in two ways. First, it used a quantitative, needs-based approach for resource allocation to ensure an equitable distribution of safety-net ambulatory care services across the county. Second, it used a new community-based planning paradigm that took into consideration the specific needs of each of the county's eight geographic service planning areas. Together, the evidence-based approach to planning and the community-based decision-making will ensure that DHS can more equitably provide for the needs of Los Angeles County's medically indigent residents.

Ambulatory Care↗
PubMed1988

County mapping of injury mortality.

Death rates for injuries were mapped by county in order to identify high-risk geographic areas. Overall rates of unintentional injury death were high in rural areas, especially in the West, and in low-income southern counties. Homicides, primarily due to firearms, had high rates throughout the South; elsewhere, homicide rates were high in large cities but not in suburban counties. Southern counties also had high rates of housefire mortality. Drowning rates for young children were high on the West Coast and in Florida, and were high for the population as a whole in the Mississippi Delta. Mapping by county is a potentially powerful tool for identifying high-risk areas and developing preventive measures.

Adolescent↗
PubMed2001

Prevalence of thyroid diseases in Nevada counties with respect to perchlorate in drinking water.

Perchlorate is well-known to inhibit the uptake of iodine by the thyroid and has been shown to do so at doses in the milligrams-per-day range and higher. Perchlorate has been found in the water supply of Clark County (Las Vegas), Nevada, at 4 to 24 micrograms/L (parts per billion) and may provide exposure dosages in the tens of micrograms per day. An analysis of the Medicaid database from Nevada was undertaken to determine whether an increase in the prevalence of any thyroid disease was associated with that level of perchlorate content. The prevalence of persons being seen for thyroid disease or for specific thyroid diseases (goiter, nodule, thyrotoxicosis, congenital hypothyroidism, acquired hypothyroidism, thyroiditis, and other thyroid disorders) and for thyroid cancer among the Medicaid-eligible population of each county was calculated for the 2-year period 1997 to 1998. The prevalences in Clark County were compared with those in Washoe County (i.e., Reno), the second most populous county in the state, and with those for the rest of the state. There was no evidence of an increased rate of thyroid disease (or of any specific thyroid disease) associated with perchlorate exposure. Generally, the prevalences in the metropolitan parts of the state were lower than for the rest of the state, particularly for acquired hypothyroidism. This analysis found no evidence that perchlorate-containing drinking water at the given level increased the prevalence of acquired hypothyroidism or of any other thyroid condition.

Humans↗
PubMed2004

Breast cancer incidence and exposure to environmental chemicals in 82 counties in Mississippi.

OBJECTIVE: Breast cancer is a major public health problem in the United States and in most industrialized countries. Environmental exposure to several chemicals has been implicated in the cause of breast cancer. However, data are not consistent about the role of the environment in breast cancer incidence. To assess environmental risks for breast cancer, patterns of breast cancer incidence in relation to environmental chemicals in Mississippi counties were mapped. METHODS: This article presents an analysis of age-adjusted incidence rates of female breast cancer and environmental chemical emissions by county in the state of Mississippi. The incidence data were obtained from the State Department of Health, and emissions data sources included the U.S. Environmental Protection Agency's Air-Data and Toxics Release Inventory Program. RESULTS: Counties having a significantly higher incidence of breast cancer compared with the state's rate were identified. Also identified were counties with higher levels of chemical emissions. The incidence of breast cancer in 1998 was significantly associated with the amount of ammonia (r = 0.268, P = 0.015), minimum emissions (r = 0.233, P = 0.035), and maximum emissions (r = 0.237, P = 0.032) of the facilities in the county. A linear dose-response relationship was observed between increased amounts of chemical emissions and breast cancer incidence. CONCLUSIONS: This study found a significant link between breast cancer incidence and maximum emissions of environmental chemicals. However, further research using individual-level data is needed.

Adult↗
PubMed1999

Tracking the response to the Balanced Budget Act of 1997: impact on Medicare managed care enrollment in rural counties.

The impact of the Balanced Budget Act of 1997 on recent changes in enrollment of Medicare beneficiaries into managed care plans is examined. The Balanced Budget Act of 1997 created a new payment structure for Medicare risk contracts, which, in 1998, resulted in all counties receiving either a minimum payment or a payment with the increase restricted at 2 percent growth over the 1997 rate. Using a baseline of December 1997 and enrollment data through June 1998, differences in early enrollment trends between urban and rural counties and between counties at various rates of payment are examined. As expected, continued enrollment increases in all counties is observed but with some concerns about slow enrollment growth--and announcements of plan terminations--in counties with payment rates in the mid-range, above the floor payment but subject to the 2 percent growth. In addition, evidence of considerable changes in the benefits offered by plans and the premiums charged to beneficiaries also was observed during the first nine months of 1998. The implications for growth of managed care options in rural areas are still unclear. The floor on payments may be helpful, but constraints in payment increases and delays in implementing a blended rate can be expected to create a negative impact on decisions to market managed care plans.

Budgets↗
PubMed2000

Safe handling of agricultural pesticides in Minnesota: results of a county-wide educational intervention.

Safe pesticide handling in a group of Minnesota farmers, aged 40 years and older, was influenced through the use of a multifaceted, countywide educational intervention. Two intervention counties and two control counties were involved in this effort. The intervention consisted of mailed pesticide information to farm households, educational programs on pesticides for county physicians, elementary school training modules on pesticides and the use of safe pesticide handling displays in key business areas by agricultural extension agents. Five hundred eight farmers were identified as pesticide users (186 in the intervention counties and 322 in the control counties). The use of gloves and other protective clothing while handling pesticides increased in the intervention group. Improvement was greater in those who had used protective equipment the least before the intervention. From these results, it appears that a broad-based educational intervention might have a modest impact in how farmers protect themselves when using pesticides.

Adult↗
PubMed2005

The relationship of individual, family, and community characteristics with physical health: an adult study in 27 rural Minnesota counties.

CONTEXT AND PURPOSE: This study; investigates associations between the proportion of farm families in rural counties and the health of rural individuals, independent of county poverty rate and individual and family socioeconomic factors. This study also examines relationships of these socioeconomic factors and prevalence of specific diseases. METHODS: Multilevel analysis of 10,485 responses to a mailed health survey in 27 nonmetropolitan Minnesota counties. FINDINGS: Individual- and family-level variables such as age, gender, lower income, and unemployment were significantly associated with adverse physical health. The percentage of farm families in counties was significantly associated with adverse physical health of adults, independent of individual and family characteristics, county poverty rate, ethnic composition, and population density.

Adult↗
PubMed1998

County funding of mental health services in a rural state.

Relationships between funding for mental illness in Iowa counties and county wealth, political activism, need for public services, rural culture, and policy makers' attitudes were examined. Counties with fewer people, lower proportions of persons with college education, higher proportions of rural and elderly residents, higher rates of poverty, and a higher proportion of income from farms spent less money on mental health services. Regression analysis indicated that the size of the county population and the proportion of persons receiving Medicaid funds explained 96 percent of the variation between county budgets.

Community Mental Health Services↗
PubMed1994

Incidence of multiple myeloma in Olmsted County, Minnesota: 1978 through 1990, with a review of the trend since 1945.

PURPOSE: Incidence rates of multiple myeloma appear to have increased in recent decades, but it is difficult to compare the incidence rates over time because of changes in laboratory procedures, differences in diagnostic criteria, and variations in indexing of medical records. However, Olmsted County, Minnesota, provides a rare opportunity to minimize these limitations, because the medical care has been provided mainly by the Mayo Clinic. PATIENTS AND METHODS: Records of Olmsted County residents with a diagnosis of multiple myeloma from January 1, 1978 through December 31, 1990 were reviewed. Criteria for diagnosis and residency were the same as in previous Olmsted County studies. RESULTS: The incidence rate per 100,000 age-adjusted to the 1950 United States white population was 5.4 for males and 2.8 for females; the overall rate was 4.1. The rates were age-adjusted to the 1950 United States population for comparison with earlier data from this population. The rates increased with age for both sexes. There was no significant change in incidence rates from 1945 through 1990. A comparison of the median age for Olmsted County patients with the age of those referred to the Mayo Clinic from elsewhere indicated that the local patients were appreciably older (74 v. 62 years, respectively). Thirty-two of 55 patients (58%) with multiple myeloma from 1978 through 1990 had a monoclonal plasma-cell proliferative process before the diagnosis of multiple myeloma. CONCLUSION: The incidence rate of multiple myeloma in Olmsted County, Minnesota, has not changed significantly during the past 46 years. We believe that reports of increasing rates over time are mainly due to improved case ascertainment.

Adolescent↗
PubMed2000

Air pollution and daily mortality in three U.S. counties.

I used generalized additive models to analyze the time-series of daily total nonaccidental and cause-specific (cardiovascular, cerebrovascular, and chronic obstructive pulmonary disease) deaths over the period 1987-1995 in three major U.S. metropolitan areas: Cook County, Los Angeles County, and Maricopa County. In all three counties I had monitoring information on particulate matter [less than/equal to] 10 microm (PM(10)), carbon monoxide, sulfur dioxide, nitrogen dioxide, and ozone. In Los Angeles, monitoring information on particulate matter [less than/equal to] 2.5 microm (PM(2.5)) was available as well. I present the results of both single and multi-pollutant analyses. Air pollution was associated with each of the mortality end points. With respect to the individual components of the pollution mix, the results indicate considerable heterogeneity of air pollution effects in the different geographic locations. In general, the gases, particularly CO, but not ozone, were much more strongly associated with mortality than was particulate matter. This association was particularly striking in Los Angeles County.

Air Pollutants↗