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PubMed1993

[Geography of mortality and birth in Pikine (Senegal): value and limitations of findings of the Civil State in African villages].

Research conducted in Third World towns show the heterogeneity of health population status. Among the indicators, mortality and birth are the most frequent, but the quantity of data and the classical methods in demography make the localisation of high-risk population difficult. Civil Registration Data Base are seldom studied, especially by geographers. The author analyses the interest and limits of these data in a spatial perspective, i.e. mortality and birth rates, mortality and birth volumes, seasonal variations of mortality, and relations between seasonal variations and health system activities. The author's conclusion is on the necessity to include these indicators in the health information system after complementary research on possible bias.

Adolescent↗
PubMed1996

Gender, geography and socio-economic status in the diffusion of malignant melanoma risk.

Malignant melanoma is the cancer that has shown the fastest increase in incidence in most white populations in recent decades. This paper studies the diffusion of the disease for males and females, geographical areas and socio-economic groups. Incidence data from the Norwegian Cancer Registry covering the period 1955-1989 make it possible to establish birth cohorts covering a time span from the late 1880s to the late 1950s. For Norway as a whole the increase in incidence was apparent between cohorts born in the 1880s and the 1890s for both sexes. The epidemic was first observable in the most central, south-eastern part of the country, with the onset reaching the most peripheral Northern Norway from the cohort born in the late 1910s. The onset also came later in rural than urban Norway. There are indications that the epidemic started in the more affluent part of the population, followed by an equalization. The increase in melanoma could be a result of more active outdoor recreation from the end of the last century. In cohorts born from the 1930s onwards a slowing down in the increase can be observed. International comparisons show that in most countries the incidence pattern in the first decades of the epidemic was dominated by males; later on the incidence became higher for females. Many cancer registries in the U.S.A. and Oceania now show a downward trend in melanoma incidence for males and females aged 15-29 years. A similar development has not been observed in Europe and Canada up to 1983-1987.

Adolescent↗
PubMed2005

The entangled geographies of social exclusion/inclusion for people with learning disabilities.

People with learning disabilities (PWLD) are one of the most marginalised groups in Western society. Social policies attempting to redress this situation focus on their 'reinclusion' into mainstream socio-spaces through engagement in 'normal' activities, primarily paid employment and independent living. Drawing on group interviews in Scotland, the paper develops a nuanced account of the lives of PWLD, exploring their experiences of exclusion and seeming 'inclusion', and also the alternative spaces and networks of inclusion developed by many PWLD. The paper argues that the situations and experiences of exclusion/inclusion are complex and 'entangled', shaped by the socio-spatial contexts within which PWLD live. The paper 'reimagines' social inclusion as a transformation of mainstream social spaces to incorporate PWLD, achieved through self-advocacy.

Deinstitutionalization↗
PubMed2006

An embodied geography of disablement: chronically ill women's struggles for enabling places in spaces of health care and daily life.

Using data gathered from 18 interviews with women who have developed arthritic illnesses we illustrate how becoming a chronically ill woman is a geographically uneven process. By examining changes in the spatial configuration of everyday life, performances of the ill female self in places, and relations with places of life important to these women, such as the health care clinic and workplace, we show how women's capacities to struggle effectively for enabling identities are challenged. Further, we argue that embodying illness involves women and others, including doctors, assigning meanings to their changing material, lived and represented places in the world.

Arthritis↗
PubMed2005

Trends in implantable cardioverter-defibrillator racial disparity: the importance of geography.

OBJECTIVES: The study was designed to determine whether racial disparity in utilization of the implantable cardioverter-defibrillator (ICD) has improved over time, and whether small-area geographic variation in ICD utilization contributed to national levels of racial disparity. BACKGROUND: Although racial disparities in cardiac procedures have been well-documented, it is unknown whether there has been improvement over time. Low ICD utilization rates in predominantly black geographic areas may have exacerbated national levels of disparity. METHODS: Discharge abstracts from elderly black and white Medicare beneficiaries hospitalized with ventricular arrhythmias from 1990 to 2000 were analyzed to determine if ICD implantation occurred within 90 days of initial hospitalization. Multivariate logistic regression models were constructed to assess the relationship between ICD implantation, year of admission, and the percentage of black inhabitants in each patient's county of hospitalization while controlling for clinical, hospital, and demographic characteristics. RESULTS: There was improvement in ICD implantation racial disparity: In the period 1990 to 1992, black patients had an odds ratio of 0.52 (95% confidence interval [CI] 0.42 to 0.64) for receiving an ICD compared with whites. However, by 1999 to 2000, the odds ratio for blacks had risen to 0.69 (95% CI 0.61 to 0.78) (test-for-trend p=0.01). Approximately 20% of this trend could be explained by reduction in geographic variation in ICD use between areas with larger black and predominantly white populations. CONCLUSIONS: Rates of ICD implants became more equal among whites and blacks during the 1990s, although persistent disparity remained at the decade's end. Geographic equalization in cardiovascular procedure rates may be an essential mechanism in rectifying disparities in health care.

Black or African American↗
PubMed2005

Geographies of inequality: child pedestrian injury and walking school buses in Auckland, New Zealand.

In the face of mounting concern at traffic congestion in the vicinity of schools and the associated risks of child pedestrian injury, the 'walking school bus' (WSB) idea has been rapidly adopted within metropolitan Auckland. WSBs involve volunteers guiding children to and from school in an orderly manner following established walking routes. This paper reports on a survey of the 34 Auckland primary schools which had adopted the scheme by November 2002. Despite rates of child pedestrian injury being highest in areas of socio-economic deprivation, our survey found WSB developments highly concentrated in low deprivation neighbourhoods. The inequitable socio-spatial distribution of WSBs in Auckland suggests that the ability to respond to road safety issues is closely correlated with socio-economic privilege. While our respondents identified a number of individual and community health benefits accruing from WSBs, we conclude that the initiative has a limited ability to address public health challenges originating within an inequitable and car-dominated urban political system.

Accidents, Traffic↗
PubMed2003

Is geography destiny for patients in New York with myocardial infarction?

PURPOSE: The use of coronary revascularization among patients with myocardial infarction varies by race/ethnicity and socioeconomic status. The objective of this study was to determine whether local availability of facilities might influence apparent racial disparities in revascularization and health outcomes. METHODS: Using Statewide Planning and Research Cooperative System data (1988-1999) from the New York State Department of Health, we determined revascularization rates among patients hospitalized with myocardial infarction in two socioeconomically disadvantaged communities in New York City (the South Bronx, which has no hospitals that have revascularization facilities, and Harlem, which has three revascularization facilities), as well as in its most advantaged community (mid-Manhattan, which has six such facilities). The rest of New York City served as reference. We measured demographic and clinical characteristics and revascularization rates in each community. RESULTS: Among patients hospitalized with myocardial infarction, the age-adjusted revascularization rates were 29.2% for whites, 12.5% for blacks, and 19.9% for Hispanics (P <0.01). Rates were 12.0% in the South Bronx, 24.0% in Harlem, 38.4% in mid-Manhattan, and 21.2% in the rest of New York City (P <0.05). Logistic regression analysis, adjusting for age, sex, race, insurance status, comorbidity, clinical complications, and year of admission, revealed that South Bronx patients were about 20% less likely to be revascularized than those in the rest of New York City, whereas patients living in Harlem were twice as likely to receive such treatment as residents in the rest of New York City. Among patients admitted to hospitals with cardiac revascularization facilities, lower use among South Bronx residents persisted, but after adjusting for patient characteristics, Harlem residents were significantly less likely to be revascularized than those from the rest of New York City. CONCLUSION: Race and socioeconomic factors influence the likelihood of revascularization after myocardial infarction among residents of New York City. In addition, lack of availability of revascularization further reduces its use by residents of disadvantaged neighborhoods.

Adult↗
PubMed1999

The geography of behaviour: an evolutionary perspective.

Traditional approaches to the study of behaviour have typically assumed that behavioural patterns, especially elements of reproductive behaviour, are invariant within species. Recent research on a diversity of behavioural traits in a wide array of taxa provides evidence that genetically based geographic variation in behaviour is common. Comparisons of populations that display geographic variation in behaviour can offer substantial insight into mechanisms of adaptive divergence and constraining or generative roles of gene flow, initial stages of speciation, and the roles of phenotypic plasticity and ontogeny in determining patterns of behavioural evolution.

Journal Article↗
PubMed2000

The mid-domain effect: geometric constraints on the geography of species richness.

Geographic patterns of species richness are influenced by many factors, but the role of shared physiographical and physiological boundaries in relation to range-size distributions has been surprisingly neglected, in spite of the fact that such geometric constraints lead to mid-domain richness peaks even without environmental gradients (the mid-domain effect). Relying on null models, several recent studies have begun to quantify this problem using simulated and empirical data. This approach promises to transform how we perceive geographic variation in diversity, including the long unresolved latitudinal gradient in species richness. The question is not whether geometry affects such patterns, but by how much.

Journal Article↗
PubMedDate not supplied

Geography of diabetes mellitus mortality in Mexico: an epidemiologic transition analysis.

BACKGROUND: The worldwide prevalence of diabetes mellitus (DM) will increase from 135 to 300 million cases by the year 2025. In Mexico, DM is the third cause of general mortality and the primary cause of mortality in the 55- to 64-year-old age group. The purpose of this study was to analyze the characteristics of DM mortality trends in Mexico from 1980 to 2000 in the context of this epidemiologic transition. METHODS: Age-adjusted mortality rates were estimated for DM as underlying cause of death using World Health Organization (WHO) reference population. To evaluate magnitude of risks, standardized mortality ratio (SMR) was calculated; prematurity of mortality was evaluated by means of potential lost life years index (PLLYI). Diabetes mortality trends in the U.S. were calculated with information from the Centers for Disease Control (CDC) public registry and were age-adjusted for comparison. RESULTS: Total number of deaths due to DM during the period was 582,826. Standardized mortality ratio by state showed higher mortality in the northern Mexican states; PLLYI was higher in the northern states. Mortality trends in Mexico showed a rapid increase during the 1980s followed by a less acute increment in the 1990s. Age-adjusted mortality rate trends in the U.S. were lower than those in Mexico. CONCLUSIONS: This study shows an increase in DM age-adjusted mortality trends during the years 1980-2000 in Mexico. The observed pattern of mortality varies widely throughout the country, probably due to differences in socioeconomic conditions and in access to healthcare.

Cause of Death↗