Recent international developments in vital and health statistics.
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Humans↗
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VITAL and health statistics in Norway.
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Humans↗
VITAL and health statistics in Indonesia.
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Humans↗
Injuries associated with snowmobiles, Alaska, 1993-1994.
OBJECTIVE: To characterize the nature and burden of snowmobile injuries in Alaska by examining injury deaths and hospitalizations associated with snowmobiles and comparing these with injury deaths and hospitalizations associated with on-road motor vehicles. METHODS: The authors used vital statistics, medical examiner, Department of Public Safety, and Department of Transportation records to identify snowmobile injury deaths, and used vital statistics mortality files to identify on-road motor vehicle injury deaths. The Alaska Trauma Registry provided data on hospitalizations. The number of vehicles in use in 1993-1994 was estimated from snowmobile sales and on-road motor vehicle registrations. RESULTS: For 1993-1994, injury death and hospitalization rates were greater for snowmobiles than for on-road motor vehicles. In northern Alaska, snowmobile injuries outnumbered on-road motor vehicle injuries. A total of 26 snowmobile injury deaths were reported; 7 decedents drowned after breaking through ice and 8 were ejected from vehicles. More than half (58%) of the snowmobile injury deaths involved a natural object such as a boulder, ravine, or river. Of the 17 decedents for whom blood alcohol concentrations were available, 11 (65%) had blood alcohol concentrations > or = 100 mg/dL. CONCLUSIONS: Natural obstacles and alcohol intoxication contribute to the high risk of injury death associated with snowmobile use. Injury control strategies, including trail development and improvement, should be evaluated.
Accidents, Traffic↗
Asthma in Hawaii: a tradition of excess mortality.
Hawaii has the highest asthma mortality in the nation and clinically has always had high rates. In contrast, international consensus has it that deaths have been rare over the past two centuries to 1950. The objective of this study was to document Hawaii's asthma mortality over the centuries to 1950. Asthma mortality was examined from pre- and early European times through kahunas, aphorisms, historical libraries, and materia medica. In 1879, vital statistics became available locally and from 1901 from the federal government. Asthma deaths were not rare in ancient Hawaii. Vital statistics in 1879 revealed an asthma mortality of 83/100,000 which declined to 4.0 by 1950. U.S. and international mortality, at least to 1930, was almost unknown. Compared to U.S. and international rates, Hawaii's asthma mortality has been excessive since ancient days.
Adolescent↗
Effects of very low birth weights on fetal and neonatal mortality rates in Alabama.
The relationship of births weighing less than 1,000 grams (g) to fetal and neonatal mortality rates, including changes over time, was studied. In Alabama during the period 1974-84, the percentage of reported births that weighed less than 500 g doubled, and the percentage of reported births weighing 500 to 999 g increased by about 10 percent. By the end of the study, while only 0.13 percent of reported births weighed less than 500 g, 24 percent of all stillbirths and 14 percent of all neonatal deaths were in this birth weight group. Similarly, in 1984, while only 0.62 percent of all births weighed 500 to 999 g, 23 percent of stillbirths and 42 percent of neonatal deaths were in this birth weight group. The data suggest that Alabama neonatal and fetal mortality rates declined more than was apparent in vital statistics data because of changes in reporting practices for very low birth weight newborns during the study period. Changes in vital statistics reporting are suggested to improve data reliability.
Alabama↗
Trends in breast cancer incidence and mortality.
Breast cancer is the leading form of cancer diagnosed in Canadian women (excluding non-melanoma skin cancer), accounting for about 30% of all new cases. After age 30, incidence rates begin to rise, and the highest rates are among women aged 60 and over. Canadian incidence rates have increased slowly and steadily since 1969, rising most rapidly among women aged 50 and over. Canada's rates are among the highest of any country in the world, ranking second only to those in the United States. After decades of little change, breast cancer mortality rates for all ages combined have declined slightly since 1990. While not dramatic, this decline is statistically significant and is consistent with similar decreases in the United Kingdom, the United States, and Australia. Breast cancer survival rates are relatively more favourable than those of other forms of cancer. Survival rates are better for younger women and for women whose cancer was detected at an early stage. This article presents breast cancer data from the Canadian Cancer Registry, the National Cancer Incidence Reporting System, and vital statistics mortality data, all of which are maintained by the Health Statistics Division of Statistics Canada. These data are provided to Statistics Canada by the provincial and territorial cancer and vital statistics registrars.
Adult↗
A surveillance system for assessing health effects from hazardous exposures.
A statistical procedure for monitoring the health status of a community potentially exposed to a hazardous environment is presented. It utilizes two levels of investigation. Level I studies monitor routinely collected vital statistics and routes of community exposure whereas level II studies require additional data collection and are further distinguished by their design and duration. In a level I study, routine vital statistics for specified end points over a specified period of time are monitored, and the observed number of events is compared with the expected number of events for a given population. The statistical model used with this procedure employs a two-step decision rule based on the standardized mortality ratio for the study community. An "alert status" is invoked when the number of events exceeds a prescribed excess. An "action status" is indicated if the excess noted in the initial period persists or if the observed number of events in the initial period greatly exceeds expectation. Should an "action status" be justified, level II studies to determine the likely explanation for the significant excess are initiated. This could include the conduct of a "case-control" study using the exposure data available from monitoring the community.
Cluster Analysis↗
Optimal estimate of population age structure with varying vital rates.
The author presents a method for estimating the age distribution of a population under varying vital statistics. "Some mathematical aspects of the method, as well as its applicability, will be discussed and numerical simulation will be run to illustrate the results and to compare the method with the traditional estimate of stable population theory...."
Age Distribution↗
Motorboat propeller injuries in Wisconsin: enumeration and prevention.
STUDY OBJECTIVE: To ascertain the nature and extent of motorboat propeller injuries in Wisconsin. DESIGN: Retrospective study of deaths and injuries from outboard motor propellers reported to the Wisconsin Division of Health, Vital Statistics, and reported by a statewide retrospective survey of emergency departments. RESULTS: For the study period 1987 through 1989, three fatalities were found in Vital Statistics and Emergency Department records and 14 nonfatal injuries reported by respondents to the Wisconsin emergency department survey. Thirty-six percent (5 of 14) of the nonfatal injuries occurred in water skiers. Injuries involved the lower extremities in 10 of 14 nonfatal cases (71%), frequently in association with other anatomic areas. At least three cases involved very severe injuries, with mean acute care medical charges of more than $100,000 per case. CONCLUSIONS: Where boating is common, fatal and severe injuries from propellers occur with regularity. These injuries are often severe, requiring complicated and expensive treatment. The authors urge improved documentation of the incidence of propeller injuries, and an active exploration of prevention strategies including fitting motorboat propellers with guards.
Accident Prevention↗
[Population forecast for Hungary, 1993-2020].
"The author discusses the results of [an] age-specific technical population forecast up to 2020, based on the latest available population and vital statistics [for Hungary]. The forecast starts from population figures as at 1 January 1993, that have been statistically updated from the 1990 census data, and it assumes that indicators of demographic trends (fertility, mortality) of 1992 will remain unchanged in the period between 1993 and 2020." (SUMMARY IN ENG AND RUS)
Age Factors↗
[Age of onset of rhegmatogenous retinal detachment analyzed by Weibull distribution function].
We reviewed a series of 426 case or rhegmatogenous retinal detachment due to idiopathic retinal break and characterized the age at onset using a vital statistics model, Weibull distribution. When cases were divided into groups based on the type of retinal break, the cumulative frequency of each group could be described by the model. The equatorial atrophic hole group showed a frequency distribution which starts at about 7.5 years, culminates at about 20 years and terminates at about 40 years. The tractional tear group revealed two distinct distributions depending upon refractive errors; the non-high myopic subgroup showed a distribution which starts at 30 years and peaks at 60 years, and the high myopic subgroup had a distribution which starts at about 15 years and peaks at about 40 years. The macular hole group showed a distribution which starts in the second half of the third decade and peaks at about 60 years. The findings are consistent with the view that pathomechanisms having differing time courses are responsible for the age distribution at onset of rhegmatogenous retinal detachment caused by various types of retinal break.
Adolescent↗
Estimation of mortality rates for disease simulation models using Bayesian evidence synthesis.
PURPOSE: The authors propose a Bayesian approach for estimating competing risks for inputs to disease simulation models. This approach is suggested when modeling a disease that causes a large proportion of all-cause mortality, particularly when mortality from the disease of interest and other-cause mortality are both affected by the same risk factor. METHODS: The authors demonstrate a Bayesian evidence synthesis by estimating other-cause mortality, stratified by smoking status, for use in a simulation model of lung cancer. National (US) survey data linked to death registries (National Health Interview Survey [NHIS]--Multiple Cause of Death files) were used to fit cause-specific hazard models for 3 causes of death (lung cancer, heart disease, and all other causes), controlling for age, sex, race, and smoking status. Synthesis of NHIS data with national vital statistics data on numbers and causes of deaths was performed in WinBUGS (version 1.4.1, MRC Biostatistics Unit, UK). Correction for inconsistencies between the NHIS and vital statistics data is described. A published cohort study was a source of prior information for smoking-related mortality. RESULTS: Marginal posterior densities of annual mortality rates for lung cancer and other-cause death (further divided into heart disease and all other causes), stratified by 5-year age interval, race (white and black), gender, and smoking status (current, former, never), were estimated, specific to a time period (1987-1995). Overall, black current smokers experienced the highest mortality rates. CONCLUSIONS: Bayesian evidence synthesis is an effective method for estimation of cause-specific mortality rates, stratified by demographic factors.
Adult↗
Relative risk of early and late death in infancy among offspring of non-native-born parents residing in Washington State.
It has been suggested that geographic variation in the early neonatal (0-6 days) and postperinatal (7-364 days) mortality rates for the United States derives from positive and negative associations, respectively, with the probability of an average couple sharing one or more HLA antigens. If this theory is correct, then the ratio of 0-6-day deaths to 7-364-day deaths among the offspring of migrant parents should be similar to that seen in the area from which the mother and the father originally migrated. Information on deaths among the offspring of migrant couples by the mother's region of birth was obtained from computerized vital statistics for Washington state for the period 1968-1977. Information on infant deaths occurring in the mother's region of birth was obtained from published vital statistics for the United States for 1980-1984. Ratios of 0-6-day deaths to 7-364-day deaths in 9 geographic regions for the period 1980-1984 were placed in 4 intervals. These intervals became the standard against which the 0-6/7-364-day ratios in the offspring of migrant parents were compared by means of a test for trend in proportions. As predicted, a significant positive trend was observed when the mother and the father were born in the same region but not when they were born in different regions.
Emigration and Immigration↗
Deaths resulting from animal attacks in the United States.
The objective of this study was to elucidate the etiology and frequency of deaths in the United States from encounters with animals. The number of deaths from venomous and nonvenomous animals is reported annually to the US Department of Health and Human Services and published in Vital Statistics of the United States. This study is a survey of all animal-related fatalities listed as E-codes 905-906 reported in the Vital Statistics of the United States from 1979 through 1990. Data were extracted uniformly from the annual reports and analyzed using descriptive statistics. From 1979 through 1990, there were 1882 animal-related deaths in the United States. Venomous animals caused 718 deaths; nonvenomous animals caused 1164 deaths. Most deaths occurred among white males. The home site was the location of injury for the majority of deaths. The majority of venomous animal-related deaths were from hymenoptera; "other specified animal" caused the majority of nonvenomous deaths. An annual average of 157 deaths from animal attacks occurred in the United States between 1979 and 1990. Both fatal and nonfatal animal-related injuries are under-recognized public health hazards. Health care providers should educate their patients on exercising caution around animals, seeking medical care after an animal injury, carrying epinephrine kits if they have a history of systemic reactions to insect stings, and wearing helmets and other protective equipment when riding or working around large animals.
Black or African American↗
[Surveillance of infant deaths in local health systems: assessment of verbal autopsy reports and of information gathered from health agents].
Knowing the vital statistics of a population is fundamental in controlling morbidity and mortality and improving living conditions. In Brazil, however, the available health information systems do not provide reliable vital statistics. This study was carried out in Quixadá, Icapuí, and Jucás, three municipalities in the state of Ceará that had good coverage by primary health care services. The study used an epidemiological instrument known as a "verbal autopsy" and investigated 215 (90%) of the 237 deaths of children younger than 1 year identified in 1993 and 1994 in the three communities. We investigated socioeconomic characteristics; sanitary conditions; nutritional status; the course of illness, health care, and death; the cause of death; and the operation of the national mortality information system and of the community health agents system. According to the verbal autopsies, diarrhea was the cause of death in 39% of the cases, followed by premature birth (17%), and acute respiratory infections (10%). Even though 79% of the families had sought formal health care services during the child's illness, 49% of the infants had died at home. This suggests limited effectiveness in the identification and treatment of sick infants. In 84% of the cases the family sought help from folk healers. Although community health agents reported 78% of the deaths, only 29% of the families had sought help from the agents during the children's illnesses. In terms of the statistical agreement between the information on the cause of death provided by community health agents and by the verbal autopsies, the agreement was good for diarrhea, intermediate for other causes, and low for acute respiratory infections. Making verbal autopsy a routine part of primary health care services in Ceará would provide invaluable information for local health care teams and would raise a critical consciousness fostering a reduction in infant mortality.
Autopsy↗
Kawasaki disease in parents and children.
AIM: To estimate the probability that the parents of patients with Kawasaki disease also had a history of the same disease. METHODS: Self-reported parents' histories of Kawasaki disease were collected from data of the 16th nationwide survey of the disease conducted in Japan from January 1999 to December 2000. The incidence of Kawasaki disease was calculated by using data reported in all 16 nationwide surveys and live births in the Japanese vital statistics. The expected number of parents with a history of Kawasaki disease in the general population, which was calculated by using the assumed number of parents in the vital statistics and the incidence of this disease, was compared with the observed number. RESULTS: Among 14,163 parent pairs of patients with Kawasaki disease, 33 parents (25 mothers and 8 fathers) had a history of the disease. The number of parents expected to have a history of Kawasaki disease was 16.1 (8.4 mothers and 7.7 fathers). From a Poisson distribution, the probability of the observed number was less than 0.001 among parents or mothers. The prevalence of a recurrence of Kawasaki disease and incidences involving siblings of patients whose parents had a history of the disease were five or six times higher than those of all patients who were reported in the 16th survey. CONCLUSION: When compared with parents in the general population, the probability of a history of Kawasaki disease was significantly higher in those parents whose children suffered from the same disease. This suggests that, epidemiologically, a genetic predisposition to Kawasaki disease may be implicated in its occurrence.
Adolescent↗
Does having cesarean section capability make a difference to a small rural maternity service?
OBJECTIVE: To determine whether having cesarean section capability in an isolated rural community makes a difference in adverse maternal or perinatal outcomes. DESIGN: Retrospective study comparing population-based obstetric outcomes of two rural remote hospitals in northwestern British Columbia. One hospital had cesarean section capability; one did not. SETTING: Bella Coola General Hospital (with cesarean section capability) in Bella Coola Valley (BCV) and Queen Charlotte Islands General Hospital (without cesarean section capability) in Queen Charlotte City (QCC). PARTICIPANTS: Women who carried pregnancies beyond 20 weeks' gestation and who gave birth between January 1, 1986, and December 31, 2000. INTERVENTIONS: British Columbia Vital Statistics Agency data was used to compare obstetric outcomes in the two communities. A chart audit of local births at BCV and QCC was done to validate the vital statistics data. MAIN OUTCOME MEASURES: Perinatal death, newborn transfer to a tertiary care facility, birth weight, gestational age at delivery, mode of delivery, and Apgar score. RESULTS: The rate of preterm deliveries in QCC was higher (relative risk 1.41, 95% confidence interval 1.00 to 1.99; P = .047) than the rate in BCV. Otherwise, there were no differences in adverse maternal or perinatal outcomes in the two populations. In BCV, 69.8% of women delivered locally compared with 50.2% of women in the southern Queen Charlotte Islands (P < .001). CONCLUSION: Having local cesarean section capability is associated with a greater proportion of local deliveries and a lower rate of preterm deliveries.
Adolescent↗