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"The study...[presents] data which are available at the national level about the population [of Hungary] between 0 and 14 years.... Due to the lack of specific data the author uses in her analysis mainly the data broken down by age groups [from the] population census, labour force statistics, health statistics and vital...statistics to delineate the living conditions of this age group." (SUMMARY IN ENG)
Cancer mapping is a rich resource for epidemiologic research. The Atlas of Cancer Mortality in the People's Republic of China has become a basis for the correct organization of anti-cancer campaigns, for the investigation of cancer etiology, and for the evaluation of the quality and impact of cancer prevention and control. A series of etiologic clues have been generated and tested from the geographic patterns of cancer mortality at the county level in China, and several prevention studies have been pursued to confirm the hypotheses and to discover reasonable preventive and control measures. This review describes the recent development of cancer epidemiologic research in China through a stepwise approach from cancer mapping to correlation studies to analytical studies (case control and cohort studies) as well as field intervention trials. A clear picture of the incidence and distribution of cancer in the population is useful in the organization of prevention programs, the investigation of cancer etiology, and the evaluation of cancer control activities. Developed countries have systematically collected cancer statistics through vital statistics, establishment of cancer registries, and the conduct of ad hoc surveys of cancer incidence for several decades. China, however, a country with a vast area and a large population, has a relatively short history of cancer control research, and of the accumulation of statistics on cancer mortality and morbidity. It was only in the 1970s that the National Cancer Control Office organized a nationwide retrospective death survey, and obtained relatively complete and reliable statistical data on cancer mortality (Marks 1981). These results have provided a clear picture of the cancer mortality patterns and distribution characteristics in China, as reported in the Atlas of Cancer Mortality in the People's Republic of China (Li Jun-yao et al. 1979). The Atlas, besides its general scientific value, has proved to be a useful guide for cancer research and control (Li Jun-yao et al. 1981). Its statistics on mortality are important for determining priorities in the cancer control program and for more rational allocation of human and material resources. Discovery of new high-mortality areas has guided the setting up of field stations for the early detection, diagnosis, and treatment of the disease (Li Jun-yao 1980). Knowledge of the distribution of high-cancer-risk areas and population characteristics provides valuable etiologic clues for the study of causative factors and is of help for the testing of hypotheses.(ABSTRACT TRUNCATED AT 400 WORDS)
The infant mortality rate for the United States for 1990-9.2 infant deaths per 1000 live births--was the lowest rate ever recorded and represented a decrease of 6% from the rate of 9.8 for 1989. This report summarizes 1990 infant mortality data based on information from birth and death certificates compiled by CDC's National Center for Health Statistics' (NCHS) Vital Statistics System and compares findings with those for 1989.
OBJECTIVES: This article examines trends in infant mortality and the incidence of low birthweight from 1975 to 1995. DATA SOURCES: The data are from the Canadian Vital Statistics Data Base, compiled from information provided to Statistics Canada by the Vital Statistics Registries in each province and territory. ANALYTICAL TECHNIQUES: Death rates, stillbirth rates, and the incidence of low birthweight were calculated for Canada, the provinces, and territories from 1975 to 1995. To examine the impact of changes in maternal characteristics during the period, the incidence of low birthweight was standardized by age and marital status of mothers, using the 1985 distributions. MAIN RESULTS: The pace of decline in infant and perinatal mortality has slowed in recent years. This slowdown may, at least in part, be attributed to the increase in the incidence of low birthweight. In turn, some of the increase in the incidence of low birthweight is explained by the rising proportions of births to women aged 35 and older and to unmarried women.
A population's age structure is widely used in the computation of many vital statistics. The importance of highly accurate vital statistics cannot be overemphasized--such statistics are used extensively by governments to determine the proper allocation of health resources and services, and by demographers, sociologists and epidemiologists to study secular trends. A computer program has been developed for use on an Apple II+ microcomputer for the analysis of population age profiles and determination of age reporting bias.
Vital statistics for coronary heart disease (CHD) were dramatically influenced by the tenth revision of the International Classification of Diseases (ICD-10) in 1995. To better understand the accuracy of death certificate diagnosis of CHD and heart failure, validation studies in Japan were reviewed. Positive predictive values and sensitivity, calculated as validation measures, varied widely between studies, differing with regard to autopsy rates, amount of information on medical records, and period investigated. However, heart failure, which has been frequently assigned on death certificates in Japan, was validated in some studies. Half of these were evaluated to be sudden deaths, including coronary deaths. Because autopsy-based studies on sudden deaths indicated that 30-50% of these were accounted for by CHD deaths, deaths assigned to heart failure should be taken into consideration in order to determine the actual number of CHD deaths in Japan. Focusing on changes in vital statistics after the 1995 ICD revision, the Oita Cardiac Death Surveys (OCDS) allowed interpretation of its effects on CHD and heart failure. Much of the increase in CHD deaths on vital statistics reflects more false positive cases, particularly for out-of-hospital deaths. Considering the Japanese features of vital statistics for CHD, further epidemiological validation studies are needed in order to confirm the accuracy of CHD death certificate diagnoses and to monitor actual CHD trends in Japan.
Recent studies in several states have found that the incidence of maternal mortality is higher than traditional vital statistics reports indicate. Since no comprehensive national study has been done to evaluate the completeness of maternal mortality ascertainment through the national vital statistics reporting system, the Centers for Disease Control (CDC) undertook such a study with the assistance of the National Center for Health Statistics and state health departments. The state health departments provided CDC with death certificates for all pregnancy-related deaths occurring during 1974-78. We reviewed and classified these certificates using both International Classification of Diseases, Adapted, Eighth Revision (ICDA-8) and International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) maternal death codes. We found that the actual incidence of maternal mortality for 1974-78 was approximately 20 per cent and 30 per cent greater than that published in national vital statistics reports using ICDA-8 and ICD-9-CM, respectively.
Information on Alaskan suicides has come primarily from studies based upon records obtained from the Alaska Bureau of Vital Statistics and the National Center for Health Statistics (NCHS). To evaluate the accuracy of these statistics, state and national (NCHS) vital statistics records were searched for suicide deaths in Alaska in 1983-1984. Of 195 deaths meeting our case definition of suicide, only 141 (72%) appeared in state records and 112 (57%) appeared in NCHS records. Native suicides were more likely to be underrecorded than non-Native suicides, even after differences in recording district personnel were adjusted for. Errors resulted primarily from delayed determinations of the cause of death and failure to update the records.
Increasing use of administrative records for research purposes has led to the need to develop methods for linking records. Linkage of the data from the Manitoba Health Services Commission (MHSC) with Canadian Vital Statistics records was done to verify Manitoba deaths, to measure degree of agreement between the two data sets, and to link "cause of death" information from Vital Statistics back to medical histories. A multi-stage approach to matching was adopted. Individual records matching perfectly across a number of relevant variables in the two files were selected first, reducing the number of records going through the probability matching to manageable proportions. Overall, almost 96% of the MHSC records were well matched with Vital Statistics records. Both uses of the matched data and various ways to confirm data quality are discussed.
OBJECTIVE: To evaluate the potential for and obstacles to routine monitoring of socioeconomic inequalities in health using U.S. vital statistics and disease registry data, the authors surveyed current data collection and reporting practices for specific socioeconomic variables. METHODS: In 1996 the authors mailed a self-administered survey to all of the 55 health department vital statistics offices reporting data to the National Center for Health Statistics (NCHS) to determine what kinds of socioeconomic data they collected on birth and death certificates and in cancer, AIDS, and tuberculosis (TB) registries and what kinds of socioeconomic data were routinely reported in health department publications. RESULTS: Health departments routinely obtained data on occupation on death certificates and in most cancer registries. They collected data on educational level for both birth and death certificates. None of the databases collected information on income, and few obtained data on employment status, health insurance carrier, or receipt of public assistance. When socioeconomic data were collected, they were usually not included in published reports (except for mothers educational level in birth certificate data). Obstacles cited to collecting and reporting socioeconomic data included lack of resources and concerns about the confidentiality and accuracy of data. All databases, however, included residential addresses, suggesting records could be geocoded and linked to Census-based socioeconomic data. CONCLUSIONS: U.S. state and Federal vital statistics and disease registries should routinely collect and publish socioeconomic data to improve efforts to monitor trends in and reduce social inequalities in health.
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The most comprehensive source of US data on fetal deaths of 20 gestational weeks or greater is available through the National Vital Statistics System (NVSS). The NVSS is a collaborative effort between the independent reporting areas (the individual States and the territories), and the federal government or its agent, the Centers for Disease Control, and Prevention's National Center for Health Statistics (NCHS). The federal government has no authority to register vital events. The registration of births, deaths, fetal deaths, marriages, and divorces is solely a state responsibility. However, NCHS is mandated by law to produce national data based on vital events. To promote the uniformity necessary to create a national file from this decentralized system, NCHS attempts to influence state systems via the development of certain standards, primarily, The Model State Vital Statistics Act and Regulations (The Model Law), and the Standard Certificates and Reports. The Model Law definitions for live birth, fetal death and induced termination of pregnancy are based on international standards set by The World Health Organization. All states have definitions of fetal death consistent with the Model Law. The Model Law also recommends reporting requirements for fetal death, but state requirements vary. This variation results in differences in reporting of fetal deaths among areas. Other limitations to the national fetal death file include: the under-reporting of fetal deaths incidence, higher than acceptable levels of missing data for some items, and the accuracy of the data reported. Also of concern is the potential misclassification of fetal deaths and short-lived live births. These limitations are amenable to improvement. The upcoming revision of the US Standard Report of Fetal Death addresses these issues and offers an opportunity to strengthen the quality of fetal death data. The development of worksheets, detailed specifications and instruction manuals, and a reformatted cause of death section should importantly enhance the quality of national fetal death file and ultimately reduce the incidence of these tragic events.
We examined the contribution of chromosomal abnormalities, mendelian disorders, and birth defects to mortality in a regional neonatal intensive care unit by medical record review of neonatal deaths in that unit. Of a total of 296 infant deaths during the 5-year period June 1986 to May 1991, 69 (23.3%) had a genetic disorder. By diagnostic category, 18.8% had a chromosomal abnormality, 10.1% had a mendelian condition, 42% had a single primary defect in development, and 29% had an unrecognized pattern of malformation. The rate of autopsy and genetic evaluation differed markedly between these diagnostic categories. A comparison was made of underlying cause of death determined from medical records with underlying cause as classified by vital statistics nosologic procedures. No death certificate was on file for two of the deaths; for the remaining 67, 27 (40.3%) had an erroneous or misleading underlying cause of death as determined from vital statistics. The important contribution of genetic disorders to neonatal mortality in this high-risk population and the relative underrecognition of these disorders by vital statistics sources indicate that efforts aimed at reducing neonatal mortality will require a full range of preventive health activities, including preconception, prenatal and perinatal assessment, and counseling. Improved data collection techniques need to be developed to understand the contribution of this group of conditions to total neonatal mortality.
BACKGROUND: Mortality and cancer deaths among young family members of patients with familial adenomatous polyposis (FAP) were investigated. METHODS: The subjects were 1764 members of 628 families with FAP registered at the authors' Polyposis Registry. They consisted of first-degree relatives of patients with FAP, excluding the propositus. These 1764 subjects were born between 1960 and 1978. Their survival times and causes of death were certified mainly by the National Family Registry and death certificates. Relative mortality rates were calculated based on the calendar year, age sex, and cause-specific death rate of Japanese people in the Vital Statistics, (Ministries of Health and Welfare, Japan. Vital statistics, Japan, Vol. 1960-1990. Tokyo: Statistics and Information Department, Minister's Secretariat, Ministry of Health and Welfare.) 1960-1990, Japan. RESULTS: There were 69 deaths before the age of 25 years. Deaths from malignant tumor were observed in 20 cases. Overall relative mortality rate in the subject group younger than age 20 years was 1.48. Relative cancer mortality in the age group between 1 and 4 years was significantly higher, because the relative mortality from hepatoblastoma in this age group was 176. Relative cancer mortality rate was significantly higher among males 15-19 years of age (15.4) and 20-24 years of age (male, 33.3; female, 150) due to colorectal cancer. CONCLUSIONS: Hepatoblastoma was a specific cancer in the 1- to 4-year-old age group in first-degree family members of patients with FAP. The incidence of colorectal cancer considerably increased, starting around the age of 20 years.
Official reports of death rates and other vital statistics provide useful, but sometimes incomplete, demographic information for specific research investigations concerned with mortality. Furthermore, methods for determining these statistics may be unclear and cumbersome to apply. The current paper describes formulas and logical procedures for computing proportions of deaths, death rates, and other vital statistics on combined groups. A simplified approach to finding age-adjusted death rates based on standard frequency distributions is also described. A computer program for facilitating these computations is available from the author.
OBJECTIVE: We reviewed recent evidence on the apparent Hispanic mortality paradox. METHODS: Recent studies using vital statistics, national community surveys linked to the National Death Index, Medicare data linked to application records for social security cards maintained in the Social Security Administration NUDIMENT file, and mortality follow-up by regional studies are reviewed critically. RESULTS: Data based on vital statistics show the greatest mortality advantage compared with non-Hispanic Whites for all Hispanics combined. The advantage is greatest among older people. National Community Surveys linked to the National Death Index show a narrowing of the advantage, and one study suggests that the Mexican Origin mortality advantage can be attributed to selective return migration of less healthy immigrants to Mexico. The Medicare-NUDIMENT data that avoid problems of other data sets also show an advantage in mortality among Hispanic elders, although the advantage is considerably lower than is found using the vital statistics method. DISCUSSION: Although some research has recently begun to question whether indeed all Hispanic groups enjoy a mortality advantage, the majority of the evidence continues to support a mortality advantage at a minimum among Mexican Americans and especially in old age, at least among men, which may provide partial, albeit indirect, support for a selective return migration or "salmon bias" effect. There is a need to further explore the existence of a selective return migration effect with expanded data bases that include more subjects from the various Hispanic origins. To date, the majority of the evidence continues to support the Hispanic paradox at least among people of Mexican origin and calls for additional attention to this interesting and highly important phenomenon.
BACKGROUND/AIM: According to the information about deaths from any causes, provided by the vital statistics based on the WHO Member Countries mortality and morbidity, suicide rate in Japan has been ranking high among the causes of death. The number of suicides goes on increasing every year in Japan. In fact, suicide rates per 100 000 population have already reached the sixth place among the leading causes of death. The aim of this study was to perform epidemiological surveys of suicide rates, obtained from the official vital statistics provided by the WHO on mortality and morbidity during several past decades in Japan. METHODS: Completed suicide data were collected via the vital statistics by the Health, Labor and Welfare Ministry (MHLW), Japan and the attempted suicide data were extracted from the Annual Report of the Ambulance and Rescue Activities by the Fire Prevention and Control Office (FPCO) in Kobe City. The data were examined on the basis of social factors including economic trends, gender differences, modus operandi of suicide, age group, and physical and mental disorders in suicidal behavior and compared to international data. RESULTS: Male suicide rates have gradually increased with the four temporal steep risings during the 20th century, while those of females have generally reached the stabilisation with no fluctuations. Suicides are not always under the influence of economic trends in Japan. Suicide rate was the highest in the Akita and Iwate prefectures, known for the low population density. Suicide rate increases with aging, reaching a peak in the age of 80 and over. The trends of completed suicide rates are elevating by males about twice the suicide rate of females which keeps on stable. On the other hand, female attempted suicide rates greatly increase from two to five times more than those in males which are generally close to the constant. The majority of suicides are caused by their physical and/or mental disorders including typical depressive states. Suffocations/hangings are the most common methods used to commit suicide by both sexes. Utilities and interactions among these several components were considered, as well as a perspective of suicidal behavior. CONCLUSION: In order to prevent suicide and avoid the worst tragedy for a family, it is an essential requirement to collect and analyze any information concerning suicide victims.