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PubMed1987

New approaches to the estimation of migration flows from census and administrative data sources.

Census data represent an important source of information about migration flows. However, existing estimation procedures based on intercensal projection are often inconvenient to apply and are sensitive to even quite small changes in enumeration completeness. 2 new estimation procedures applicable to data from 2 censuses are developed and illustrated using US data. The 1st method is essentially a modification of traditional intercensal projection techniques, but as a result of working with age groups rather than cohorts, it is simpler to apply and allows mortality of the migrants to be incorporated over the intercensal period. The 2nd method also uses information from 2 censuses, but also uses independent information on the age pattern of migration from administrative sources or from other census questions. The method uses the fact that the age pattern of recent migration is likely to be different from the age distribution of the overall population to distinguish between intercensal change due to migration and apparent intercensal change due to changes in enumeration completeness. If the method's assumptions are met, it is possible to estimate the relative coverage of the 2 censuses as well as the scale of the independent age pattern of migration relative to the coverage of 1 or other of the censuses. The illustrative applications of the methods to US data suggest that both can work reasonably well.

Age Factors↗
PubMed2002

Trends of the risk of death due to circulatory, cerebrovascular, and ischemic heart diseases in 11 Brazilian capitals from 1980 to 1998.

OBJECTIVE: To assess the trends of the risk of death due to circulatory (CD), cerebrovascular (CVD), and ischemic heart diseases (IHD) in 11 Brazilian capitals from 1980 to 1998. METHODS: Data on mortality due to CD, CVD and IHD were obtained from the Brazilian Health Ministry, and the population estimates were calculated by interpolation with the Lagrange method based on census data from 1980 and 1991 and the population count of 1996. The trends were analyzed with the multiple linear regression method. RESULTS: CD showed a trend towards a decrease in most capitals, except for Brasília, where a mild increase was observed. The cities of Porto Alegre, Curitiba, Rio de Janeiro, Cuiabá, Goiânia, Belém, and Manaus showed a decrease in the risk of death due to CVD and IHD, while the city of Brasília showed an increase in CVD and IHD. The city of São Paulo showed a mild increase in IHD for individuals of both sexes aged 30 to 39 years and for females aged 40 to 59 years. In the cities of Recife and Salvador, a reduction in CD was observed for all ages and both sexes. In the city of Recife, however, an increase in IHD was observed at younger ages (30 to 49 years), and this trend decreased until a mild reduction (-4%) was observed in males >/= 70 years. CONCLUSION: In general, a reduction in the risk of death due to CD and an increase in IHD were observed, mainly in the cities of Recife and Brasília.

Adult↗
PubMed1994

An evaluation of vital registers as sources of data for infant mortality rates in Cameroon.

BACKGROUND: Infant mortality rates have been widely used as indicators of health status and the availability, utilization and effectiveness of health services. Two principal sources of data for infant mortality rates are vital registers and censuses. This study was designed to evaluate the accuracy of vital registers as sources of data for infant mortality rates in Cameroon. METHODS: A household census of births and infant deaths that occurred in Buea Subdivision between 1 November 1991 and 31 October 1992 was conducted to determine the proportion that were registered and the reasons why the remainder were not registered. RESULTS: The registration coverage was found to be 62% for births and 4% for infant deaths. The most frequently reported reasons for not registering births were lack of money, lack of time and a complicated registration procedure. For infant deaths the reasons were lack of knowledge and no perceived benefits. CONCLUSIONS: Vital registers of birth and death are not an accurate source of data for infant mortality rates in Cameroon. Motivation for birth and death registration appear to be dependent on the perceived benefits. A mechanism of registration that uses medical institutions may substantially increase registration coverage for births and infant deaths.

Birth Certificates↗
PubMed2000

A national census of ambulance response times to emergency calls in Ireland.

BACKGROUND: Equity of access to appropriate pre-hospital emergency care is a core principle underlying an effective ambulance service. Care must be provided within a timeframe in which it is likely to be effective. A national census of response times to emergency and urgent calls in statutory ambulance services in Ireland was undertaken to assess current service provision. METHODS: A prospective census of response times to all emergency and urgent calls was carried out in the nine ambulance services in the country over a period of one week. The times for call receipt, activation, arrival at and departure from scene and arrival at hospital were analysed. Crew type, location of call and distance from ambulance base were detailed. The type of incident leading to the call was recorded but no further clinical information was gathered. Results-2426 emergency calls were received by the services during the week. Fourteen per cent took five minutes or longer to activate (range 5-33%). Thirty eight per cent of emergencies received a response within nine minutes (range 10-47%). Only 4.5% of emergency calls originating greater than five miles from an ambulance station were responded to within nine minutes (range 0-10%). Median patient care times for "on call" crews were three times longer than "on duty" crews. CONCLUSION: Without prioritized use of available resources, inappropriately delayed responses to critical incidents will continue. Recommendations are made to improve the effectiveness of emergency medical service utilisation.

Ambulances↗
PubMed1991

Pregnancy outcomes in women potentially exposed to occupational solvents and women working in the electronics industry.

Associations of occupational solvent exposure and/or work in electronics production with adverse pregnancy outcomes were examined in a large cross-sectional community-based reproductive health study of 1038 California women pregnant between 1980 and 1985. Occupational solvent exposure was determined by two different methods: Bureau of Census codes judged by experts to probably include solvent exposure and self-reported exposure. First trimester solvent exposure classified by either method (n = 52) was significantly associated with spontaneous abortion, adjusted odds ratio 3.34 (95% confidence interval 1.42, 7.81). Among 29 women reporting regular and daily solvent exposure, the adjusted odds ratio increased to 4.44 (95% confidence interval 1.86, 10.58). Work in electronics assembly was significantly associated with delivering a low birth weight infant (adjusted odds ratio 5.38; 95% confidence interval 1.42, 20.46) but was not associated with spontaneous abortions. Further research using biologic monitoring and/or other objective measures of exposure is needed to validate these findings.

Abortion, Spontaneous↗
PubMedDate not supplied

Socioeconomic status, race, and death from coronary heart disease.

INTRODUCTION: Data to assess factors associated with differences in coronary heart disease mortality between Caucasians and African Americans are limited. We assessed risks for sudden, nonsudden, and other coronary death between Caucasians and African Americans in relation to known risk factors for coronary disease and socioeconomic status. METHODS: We analyzed data from the 1986 National Mortality Followback Survey, the 1985 National Health Interview Survey, and the U.S. Bureau of the Census. Logistic regression methods were used to create multivariate models to assess the relationship of socioeconomic status and other known modifiable risk factors to death from each of the three coronary diseases for Caucasians and African Americans separately. RESULTS: In an age- and gender-adjusted analysis of data on men 25-44 years old and women 25-54 years old, African Americans had about twice the risk for sudden, nonsudden, or other coronary death as did Caucasians. Adjusted risks for coronary death for Caucasians associated with modifiable risk factors (cigarette smoking, body weight, diabetes, and hypertension) either resembled or were slightly greater than those for African Americans. Half or more of all excess risks for African Americans in multivariate models could be explained by socioeconomic status. About 18% of excess sudden coronary death risk could be further explained by known modifiable coronary heart disease risk factors. CONCLUSIONS: Broad public health efforts are needed to address these causes of excess mortality.

Adult↗
PubMed2005

[Census population vs. registration population: which population denominator should be used to calculate geographical mortality].

OBJECTIVES: Studies on the geographical differences in mortality tend to use a census population, rather than a registration population, as the denominator of mortality rates in South Korea. However, an administratively determined registration population would be the logical denominator, as the geographical areas for death certificates (numerator) have been determined by the administratively registered residence of the deceased, rather than the actual residence at the time of death. The purpose of this study was to examine the differences in the total number of a district population, and the associated district-specific mortality indicators, when two different measures as a population denominator (census and registration) were used. METHODS: Population denominators were obtained from census and registration population data, and the numbers of deaths (numerators) were calculated from raw death certificate data. Sex- and 5-year age-specific numbers for the populations and deaths were used to compute sex- and age-standardized mortality rates (by direct standardization methods) and standardized mortality ratios (by indirect standardization methods). Bland-Altman tests were used to compare district populations and district-specific mortality indicators according to the two different population denominators. RESULTS: In 1995, 9 of 232 (3.9%) districts were not included in the 95% confidence interval (CI) of the population differences. A total of 8 (3.4%) among 234 districts had large differences between their census and registration populations in 2000, which exceeded the 95% CI of the population differences. Most districts (13 of 17) exceeding the 95% CI were rural. The results of the sex- and age-standardized mortality rates showed 15 (6.5%) and 16 (6.8%) districts in 1995 and 2000, respectively, were not included in the 95% CI of the differences in their rates. In addition, the differences in the standardized mortality ratios using the two different population denominators were significantly greater among 14 districts in 1995 and 11 districts in 2002 than the 95% CI. Geographical variations in the mortality indicators, using a registration population, were greater than when using a census population. CONCLUSION: The use of census population denominators may provide biased geographical mortality indicators. The geographical mortality rates when using registration population denominators are logical, but do not necessarily represent the exact mortality rate of a certain district. The removal of districts with large differences between their census and registration populations or associated mortality indicators should be considered to monitor geographical mortality rates in South Korea.

Censuses↗
PubMed1996

Neuro-epidemiological pilot survey of an urban population in a developing country. A study in Bangalore, south India.

A feasibility study was conducted in an urban population of 3,040 in Bangalore, South India, to understand the baseline characteristics, evaluate screening questionnaires, identify potential problems and determine the magnitude of the problems. The target population was selected by a random method, from four census enumeration blocks of a specific urban area. A two-phase study design was adopted consisting of screening by trained field investigators in the initial stage and clinical examination by a neurologist in the second stage. The information was collected by an interview method on a house-to-house basis. Evaluation of the screening instruments yielded high sensitivity and specificity rates, and it became clear that there is a need to reduce false-positive results in the screening questionnaire for individuals above 7 years of age. The prevalence of neurological disorders was 32.8 per 1,000 population (with a rate of 7.8/1,000 for epilepsy). It appears feasible to detect a wide range of neurological disorders using the methods described.

Adolescent↗
PubMed1998

[Mortality inequalities according to education in the city of Barcelona].

BACKGROUND: In Spain, individual-based studies on inequalities in mortality are scarce by the fact that death certificate often do not complete information on occupation. This study describes socio-economic inequalities in mortality using as social indicator the level of education, because in Barcelona the mortality registry is linked with the municipal census. MATERIAL AND METHODS: 28,046 residents in Barcelona, Spain, 24 years and older who died in 1992 and 1993 were studied. The level of education of the deceased people was obtained from the municipal census. Age standardized mortality rates were calculated by each educational level by sex. The most important causes of death were studied. Poisson regression models were adjusted to obtain the mortality ratio among the educational levels (being the more educated the reference group). RESULTS: The mortality ratio by all causes in illiterate was 2.05 times higher in males (p < 0.001) and 1.62 in females (p < 0.001). The higher was the education level, the lower were the rates. This mortality pattern was observed in the majority of causes of death studied and mainly in AIDS, cirrhosis and drug overdose, also in lung cancer in males and coronary disease in females. Breast and lung cancer in females were higher in the more educated. Educational inequalities by age group were more important in the youngest people and diminished with increasing age. CONCLUSION: This results show the existence in Barcelona, Spain, of inequalities in mortality by education level in the main causes of death in males and females and in the majority of age groups.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Outdoor exposure to airborne polycyclic organic matter and adverse reproductive outcomes: a pilot study.

BACKGROUND: To investigate the association between outdoor airborne polycyclic organic matter (POM) and adverse reproductive outcomes in New Jersey, we used a cross-sectional design combining air quality data from the USA EPA Cumulative Exposure Project and individual data on pregnancy outcomes from birth and fetal death certificates at the census tract level. METHODS: After excluding plural births and chromosomal anomalies, 221,406 live births and 1,591 fetal deaths registered in New Jersey during the years of 1990 and 1991 were included. The exposure estimates were derived from modeled average POM concentrations for each census tract in the state. RESULTS: After adjustment for potential confounders, the odds ratios (OR) for very low birth weight for the highest exposure compared to the lowest exposure group was 1.31 (95% CI 1.15-1.51); among term births, high POM exposure was associated with low birth weight OR = 1.31 (95% CI 1.21-1.43), with fetal death OR = 1.19 (95% CI 1.02-1.39) and with premature birth OR = 1.25 (95% CI 1.19-1.31). The univariate stratified analyses suggested effect modification of all observed associations by maternal alcohol consumption. CONCLUSIONS: This study found associations between outdoor exposure to modeled average airborne POM and several adverse pregnancy outcomes. The data and methods utilized in this pilot study may be useful for identifying hazardous air pollutants requiring in-depth investigation.

Air Pollutants↗
PubMed1993

Modelling in-patient bed usage behaviour in a department of geriatric medicine.

The flow of patients through geriatric hospitals has been previously described in terms of acute and long-stay states where the bed occupancy at a census point is modelled by a mixed exponential model. Using data for sixteen years the model was fitted to successive annual census points, in order to provide a description of temporal trends. While the number of acute patients has remained fairly stable during the period, the model shows that there has been a decrease in the number of long-stay patients. Mean lengths of stay in our geriatric hospital before death or discharge have decreased during the study period for both acute and long-stay patients. Using these fits of the mixed exponential model to census data, a method is provided for predicting future turnover of patients. These predictions are reasonably good, except when the turnover patterns go through a period of flux in which assumption of stability no longer holds. Overall, a methodology is presented which relates census analysis to the behaviour of admission cohorts, thus producing a means of predicting future behaviour of patients and identifying where there is a change in patterns.

Aged↗
PubMed1991

[Estimate of the population at risk between 2 census records for the calculation of incidence level or mortality of cancer: comparison of 4 methods].

The estimation of incidence (or mortality) rates for a given disease in a defined population needs precise knowledge of the population at risk of contracting the disease (or dying) during the study period. This article proposes and compares four methods for estimating population by age between two census surveys. The three methods which consist in aging the generations give results which are extremely close for age specific and standardized rates; on the contrary, the methods which do not take into account the generations at birth are inadequate due to the lack of births during the two world wars.

Adult↗
PubMed1993

Combining census, dual-system, and evaluation study data to estimate population shares.

"The 1990 [U.S.] census and Post-Enumeration Survey produced census and dual system estimates (DSE) of population by domain, together with an estimated sampling covariance matrix of the DSE. Estimates of the bias of the DSE were derived from various PES evaluation programs. Of the three sources, the unadjusted census is the least variable but is believed to be the most biased, the DSE is less biased but more variable, and the bias estimates may be regarded as unbiased but are the most variable. This article addresses methods for combining the census, the DSE, and bias estimates obtained from the evaluation programs to produce accurate estimates of population shares, as measured by weighted squared- or absolute-error loss functions applied to estimated population shares of domains."

Americas↗
PubMed1992

Overcoming the absence of socioeconomic data in medical records: validation and application of a census-based methodology.

BACKGROUND: Most US medical records lack socioeconomic data, hindering studies of social gradients in health and ascertainment of whether study samples are representative of the general population. This study assessed the validity of a census-based approach in addressing these problems. METHODS: Socioeconomic data from 1980 census tracts and block groups were matched to the 1985 membership records of a large prepaid health plan (n = 1.9 million), with the link provided by each individual's residential address. Among a subset of 14,420 Black and White members, comparisons were made of the association of individual, census tract, and census block-group socioeconomic measures with hypertension, height, smoking, and reproductive history. RESULTS: Census-level and individual-level socioeconomic measures were similarly associated with the selected health outcomes. Census data permitted assessing response bias due to missing individual-level socioeconomic data and also contextual effects involving the interaction of individual- and neighborhood-level socioeconomic traits. On the basis of block-group characteristics, health plan members generally were representative of the total population; persons in impoverished neighborhoods, however, were underrepresented. CONCLUSIONS: This census-based methodology offers a valid and useful approach to overcoming the absence of socioeconomic data in most US medical records.

Adult↗
PubMed1986

The USA's bicentennial census: new directions for methodology in 1990.

"Planning is under way for the U.S.A. bicentennial census in 1990. The U.S. Census Bureau sponsored a study panel under the U.S. Committee on National Statistics to consider key aspects of methodology for the census and to recommend priority areas for research and testing. The recommendations of the Panel on Decennial Census Methodology, which are summarized in this paper, cover four main topics: adjustment of the census counts for coverage errors, methods of coverage evaluation, uses of sampling in obtaining the count, and uses of administrative records in improving the quality of selected content items."

Americas↗
PubMed1998

Scales of geography, time, and population: the study of violence as a public health problem.

OBJECTIVES: In this study, data on violent deaths in the Bronx, New York City, from the 1970, 1980, and 1990 censuses were analyzed. METHODS: The incidence and areal density of intentional deaths were mapped by health area. Simple and stepwise regressions between violent death measures and other factors were performed. RESULTS: The incidence of deaths at levels of those in the highest 1970 quintile spread so that by 1990 only 2 areas saw incidences at levels of the lowest 1970 quintile. Overcrowding, socioeconomic status, population, population change, and drug deaths in simple regressions and overcrowding, socioeconomic status, and low-weight births in stepwise regressions correlated significantly with violent death incidence or density. CONCLUSIONS: Understanding the spatiotemporal development of violence can contribute to public policy on violence.

Censuses↗
PubMed2001

The prevalence of glaucoma in a population-based study of Hispanic subjects: Proyecto VER.

OBJECTIVE: To determine the prevalence of glaucoma in a population-based sample of Hispanic adults older than 40 years. METHODS: Using 1990 census data for Arizona, groups of persons living in sections of the city in Nogales and Tucson were randomly selected with a probability proportional to the Hispanic population older than 40 years. We tried to recruit all eligible adults in homes with 1 self-described Hispanic adult. Detailed ocular examinations at a local clinic included visual acuity testing, applanation tonometry, gonioscopy, an optic disc evaluation, and a threshold visual field test. Open-angle glaucoma (OAG) was defined using a proposed international system for prevalence surveys, including threshold visual field defect and optic disc damage. Angle-closure glaucoma was defined as bilateral appositional angle closure, combined with optic nerve damage (judged by field and disc as for OAG). RESULTS: Examinations were conducted in 72% (4774/6658) of eligible persons, with a 1.97% prevalence (95% confidence interval, 1.58%-2.36%) of OAG (94 persons). The age-specific OAG prevalence increased nonlinearly from 0.50% in those aged 41 to 49 years to 12.63% in those 80 years and older. Angle-closure glaucoma was detected in 5 persons (0.10%). Sex, blood pressure, and cigarette smoking were not significant OAG risk factors. Only 36 (38%) of the 94 persons with OAG were aware of their OAG before the study. Screening results with an intraocular pressure higher than 22 mm Hg (in the eye with a higher pressure) would miss 80% of the OAG cases. CONCLUSIONS: The prevalence of OAG in Hispanic persons was intermediate between reported values for white and black persons. The prevalence increased more quickly with increasing age than in other ethnic groups. Glaucoma was the leading cause of bilateral blindness.

Adult↗
PubMed1996

Prevalence of psychiatric disorders among incarcerated women. II. Convicted felons entering prison.

BACKGROUND: No unbiased estimates of the rates of psychiatric disorder among women prison inmates are available. Nonetheless, available data suggest that some psychiatric disorders are prevalent in this population. The objective of the study was to determine the rates, risk factors, and outcomes of specific psychiatric disorders among women prison inmates. METHODS: A virtual census of women felons (N = 805) entering prison in North Carolina was assessed using in-person interviews. Assessments were conducted for 8 disorders, using the Composite International Diagnostic Interview as the primary assessment measure. For validation purposes, one quarter of the inmates were reassessed for 2 of these disorders, using structured clinical interviews. RESULTS: Inmates were found to have high rates of substance abuse and dependence and antisocial and border-line personality disorders compared with women in community epidemiologic studies. Rates among inmates were also somewhat elevated for mood disorders but not for anxiety disorders. The rate of reports of lifetime exposure to traumatic events was also high. Rates of disorder tended to be higher among white than among African American women. CONCLUSION: High rates of substance abuse, psychiatric disorder, and psychological distress associated with exposure to traumatic events suggest that women in prison have a need for treatment for substance abuse and other mental health problems.

Adolescent↗