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Unemployment rate as an updatable health needs indicator for small areas.

BACKGROUND: The objective of the study was to compare updatable unemployment rates with the unemployment rate and composite deprivation indices from the 1991 Census as health needs indicators for small areas. METHODS: Townsend, Carstairs and Jarman indices and male unemployment rates were calculated from the 1991 Census, for 275 wards of the former East Anglian health region with unchanged boundaries between 1981 and 1991. Male unemployment rates were also derived from April 1991 unemployment benefit claimant figures, using both Office of Population Censuses and Surveys mid-year estimates of population and estimates derived from Family Health Services Authority patient registers as the denominator. Ward values were compared using Pearson product moment correlation. RESULTS: All three unemployment measures were closely related to each other and all were broadly as effective in predicting ward variations in mortality and long-term illness in 1991 as the compound deprivation indices of Jarman. Townsend and Carstairs. CONCLUSION: Updatable unemployment rates were as suitable as the composite indices as an indicator of relative health needs for small areas in the year of the Census and might be expected to be superior in inter-censal years.

Adolescent↗

Retail tobacco outlet density and youth cigarette smoking: a propensity-modeling approach.

OBJECTIVES: We examined whether retail tobacco outlet density was related to youth cigarette smoking after control for a diverse range of neighborhood characteristics. METHODS: Data were gathered from 2116 respondents (aged 11 to 23 years) residing in 178 census tracts in Chicago, Ill. Propensity score stratification methods for continuous exposures were used to adjust for potentially confounding neighborhood characteristics, thus strengthening causal inferences. RESULTS: Retail tobacco outlets were disproportionately located in neighborhoods characterized by social and economic disadvantage. In a model that excluded neighborhood confounders, a marginally significant effect was found. Youths in areas at the highest 75th percentile in retail tobacco outlet density were 13% more likely (odds ratio [OR]=1.13; 95% confidence interval [CI]=0.99, 1.28) to have smoked in the past month compared with those living at the lowest 25th percentile. However, the relation became stronger and significant (OR=0.21; 95% CI=1.04, 1.41) after introduction of tract-level confounders and was statistically significant in the propensity score-adjusted model (OR = 1.20; 95% CI = 1.001, 1.44). Results did not differ significantly between minors and those legally permitted to smoke. CONCLUSIONS: Reductions in retail tobacco outlet density may reduce rates of youth smoking.

Adolescent↗

Prevalence of smoking in early pregnancy by census area: measured by anonymous cotinine testing of residual antenatal blood samples.

AIM: To accurately measure the prevalence of smoking in early pregnancy by census area units (CAU) in Christchurch. METHODS: Smoking status in pregnancy was determined by serum cotinine assay for all antenatal blood samples taken over a 6 month period. CAUs in Christchurch were grouped into quartiles according to the proportion of maternal smokers. Social factors from 1991 census data were used to describe the characteristics of each quartile. RESULTS: The overall rate of smoking in pregnancy was 33.0%. Rates ranged from 10.6% to 56.9% for the census area groups. CAUs in the upper quartile (39-57% of women smoking in pregnancy) were clustered together geographically and were associated with lower socioeconomic indices. The strongest correlation was between average income with smoking rates (Pearson correlation coefficient 0.76). CONCLUSION: Smoking rates in pregnancy have remained at around 30% for at least 20 years, with some areas of the city having rates nearly double this. It would seem logical to promote smoke-free pregnancy activities in localities with the highest rates of smoking. Future evaluation of the efficacy of such programmes should be done using objective measurements.

Confidence Intervals↗

[The 1986 Test of Adjustment Related Operations in Central Los Angeles County].

The author presents the methodology and results of a 1986 test census conducted in Central Los Angeles County, California, to examine the feasibility of adjusting the census for the estimated undercount using a post-enumeration survey. "The results of the dual-system estimates are presented for the test site by the three major race/ethnic groups (Hispanic, Asian, Other) by tenure, by age and by sex. Summaries of the small area adjustments of the census enumeration, by block, are presented and discussed."

Age Factors↗

Estimating the stability of census-based racial/ethnic classifications: the case of Brazil.

This study presents a method of estimating the degree to which people change their racial/ethnic identity from one census enumeration to another. The technique is applied to the classification of skin colour in Brazil (white, black, brown, yellow). For the period 1950-80, the findings show a deficit of 38 per cent in the black category and a gain of 34 per cent in the brown category, suggesting that a large proportion of individuals who declared themselves black in 1950 reclassified themselves as brown in 1980. Estimates for 1980-90, adjusted for the effects of international migration, reveal a similar pattern, although the magnitude of colour reclassification may have declined somewhat during the 1980s. Procedures to determine the stability of racial/ethnic identity produce data useful to recent policy initiatives that rely on demographic censuses to measure changes in the status of minority groups in less developed countries.

Brazil↗

Evaluation of the results of the register-based population and housing census 1990 in Finland.

"The 1990 population and housing census was the first one in Finland to be conducted entirely on the basis of registers, without any questionnaires. The Finnish population census system draws on the basic administrative registers of the society giving data on the population census target units and the links between them. These units comprise individuals, families, households, buildings, dwellings, enterprises and establishments. Transferring from one data collection method to another inevitably causes some kind of break in the time series. Because of these breaks it was decided in Statistics Finland to carry out an extensive evaluation study to analyse the differences between questionnaire-based and register-based census data."

Censuses↗

[Problems in the measurement of internal migration].

"The paper analyzes some problems related to the census measurement of internal migration according to the three following aspects: The lack of agreement between the proposed objectives and the type of question made; questionnaire design errors and enumeration errors; and inadequate data elaboration." The geographic focus is on Latin America. Problems concerning data on place of birth or place of previous residence and how these can affect the calculation of migration trends are considered. (SUMMARY IN ENG)

Americas↗

The Los Angeles Latino Eye Study: design, methods, and baseline data.

OBJECTIVE: To describe the study design, operational strategies, procedures, and baseline characteristics of the Los Angeles Latino Eye Study (LALES), a population-based assessment of the prevalence of visual impairment, ocular disease, and visual functioning in Latinos. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: Six thousand three hundred fifty-seven Latinos 40 years and older from 6 census tracts in Los Angeles, California. METHODS: A detailed interview and eye examination were performed on each eligible participant. The interview included an assessment of demographic, behavioral, and ocular risk factors and health-related and vision-related quality of life. The eye examination included a measurement of visual acuity, intraocular pressure, and visual fields; fundus and optic disc photography; a detailed anterior and posterior segment examination; and measurement of blood pressure, glycosylated hemoglobin levels, and blood glucose levels. MAIN OUTCOME MEASURES: Prevalence of visual impairment, blindness, cataract, glaucoma, diabetic retinopathy, and age-related macular degeneration constitute the study's primary outcome variables. Secondary outcomes include odds ratios for risk factors associated with eye disease, health-related quality of life, and vision-related quality of life. Response rates and baseline characteristics are presented. RESULTS: Of the 7789 individuals eligible for LALES, 6357 (82%) had a clinical examination; an additional 524 completed only an in-home interview. The majority of participants were female (58%), the average (+/- standard deviation) age was 54.9 (+/-10.8) years, and 80.0% were of Mexican origin and 0.4% self-identified as American Indian or Alaskan Native. The age distribution of LALES participants was similar to that of Latinos of Mexican origin in the rest of the United States. CONCLUSION: The LALES has recruited Latinos 40 and older for an ophthalmic epidemiologic study. The LALES cohort will provide information about the prevalence and risk factors of ocular disease in the largest and fastest growing minority in the United States.

Adult↗

United States Census 2000 population with bridged race categories.

OBJECTIVES: The objectives of this report are to document the methods developed at the National Center for Health Statistics (NCHS) to bridge the Census 2000 multiple-race resident population to single-race categories and to describe the resulting bridged race resident population estimates. METHOD: Data from the pooled 1997-2000 National Health Interview Surveys (NHIS) were used to develop models for bridging the Census 2000 multiple-race population to single-race categories. The bridging models included demographic and contextual covariates, some at the person-level and some at the county-level. Allocation probabilities were obtained from the regression models and applied to the Census Bureau's April 1, 2000, Modified Race Data Summary File population counts to assign multiple-race persons to single-race categories. RESULTS: Bridging has the most impact on the American Indian and Alaska Native (AIAN) and Asian or Pacific Islander (API) populations, a small impact on the Black population and a negligible impact on the White population. For the United States as a whole, the AIAN, API, Black, and White bridged population counts are 12.0, 5.0, 2.5, and 0.5 percent higher than the corresponding Census 2000 single-race counts. At the sub-national level, there is considerably more variation than observed at the national level. The bridged single-race population counts have been used to calculate birth and death rates produced by NCHS for 2000 and 2001 and to revise previously published rates for the 1990s, 2000, and 2001. The bridging methodology will be used to bridge postcensal population estimates for later years. The bridged population counts presented here and in subsequent years may be updated as additional data become available for use in the bridging process.

Censuses↗

Correlation bias in U.S. census adjustment.

One form of error that can affect census adjustments is correlation bias, reflecting people who are doubly missing--from the census and from the adjusted counts as well. This article presents a method for estimating the total national number of doubly-missing people and their distribution by race and sex. Application to the 1990 U.S. census adjustment leads to an estimate of 3 million doubly-missing people. Correlation bias is likely to be a serious problem for census adjustment in 2000. The methods of this article are well suited for measuring its magnitude.

Bias↗

A method for estimating the population at risk in primary care practices by applying correction factors to the active patient census.

Epidemiological research based in primary care practices has been hindered by the inability to estimate the number of persons served by individual practices. This study examines one method proposed as a means of estimating practice populations. The effectiveness of this "correction factor" method depends on uniformity in the proportion of persons visiting a physician in a two-year period across various sociodemographic subpopulations in the United States. The National Health Interview Survey data were examined for evidence of such uniformity. Within broad age-sex categories there was little variation by race, educational level, income, Spanish ancestry, or location of residence in the proportion reporting a physician visit within the previous two years. Although these results are encouraging, a number of problems remain before the "correction factor" method can be credibly used to estimate practice denominators.

Adolescent↗

Cement, cancers and clusters: an investigation of a claim of a local excess cancer risk related to a cement works.

BACKGROUND: We investigated claims by a campaigning group of a cancer cluster associated with a local cement works. METHODS: To investigate cancer rates in the town we defined the study area as the Census wards matching the geographical area code supplied to the campaigning group. Standard methods were applied to registered cases of cancer for the area for the years 1974-1989 to derive observed and expected numbers. The significance of the relative risk was assessed using the Poisson distribution. By selecting a different denominator population we attempted to reproduce the results of the campaign group. Cancer rates around the cement works were investigated for four cancer types plausibly associated with emissions, using cancer registrations for the years 1985-1994. Cases were mapped to 1981 Census ward boundaries, and the same statistical methods were used, but expected counts were also adjusted for deprivation. Rates were calculated for an inner 2 km zone and outer zone 2-5 km from the works. Relative risk was calculated and the ratio of risks was examined for evidence of increased risk closer to the works. RESULTS: Relative risks were not significantly elevated either in the town or around the cement works itself. We were able to reproduce the likely errors that resulted in the elevated relative risks for five cancer groups claimed by the campaigning group. CONCLUSIONS: We found no evidence of increased incidence of cancer around the cement works. Incorrect handling of cancer registration data can result in spurious cancer clusters and unnecessary public alarm.

Air Pollutants, Occupational↗

Department of Health's requirement for mandatory collection of data on ethnic group of inpatients.

On 1 April the Department of Health introduced the mandatory collection of data on the ethnic group of patients admitted to hospital. Its coding was based on a national minimum standard for classifying ethnic groups, ostensibly using the categories in the 1991 census. In the census, however, one in four people from ethnic groups other than white, including many of mixed parentage, provided non-standard responses to the question on ethnic group. The Department of Health's standard does not include provision for respondents to write in a description of their ethnic group, and this has produced a flawed system out of step with current practice on collection of data on ethnic group. Different methods of analysis preclude comparison with census statistics, and the difficulties in aggregating more detailed local categories to the standard raise concerns about consistency of reporting and quality of the data.

Data Collection↗

Cigarette smoking among U.S. adults by state and region: estimates from the current population survey.

BACKGROUND: Cigarette smoking is responsible for at least one third of all cancer deaths annually in the United States. Few sources exist in the peer-reviewed literature documenting state and regional differences in smoking behavior, despite the fact that cancer prevention and control efforts are increasingly being implemented below the national level. PURPOSE: Our goals were to determine smoking prevalence rates among men and women, by region, and for each of the 50 states and the District of Columbia from census survey data collected in 1992 and 1993 and to compare these rates with rates determined in 1985. METHODS: Every month, the U.S. Bureau of the Census collects labor force statistics on more than 100000 individuals on its Current Population Survey (CPS). For the September 1992, January 1993, and May 1993 CPS, the National Cancer Institute sponsored a 40-item Tobacco Use Supplement. The definition of a current smoker changed slightly between 1985 and 1992-1993. For the 1985 CPS, individuals were considered current smokers if they had smoked 100 cigarettes in their lifetime and were smoking at the time of interview; for the 1992-1993 CPS, current smokers included anyone who had smoked 100 cigarettes and was currently smoking every day or just on some days. We calculated current smoking rates (every day and some days combined) based on more than a quarter million adults (n = 266988) interviewed in 1992-1993. RESULTS: Substantial geographic variation exists in rates of current cigarette use among adults within the United States. In general, adults in the southern United States have higher rates of smoking and adults in the western states have lower rates of smoking and adults in the rest of the country, although differences in smoking behavior between men and women and among various racial and ethnic populations strongly influence these patterns. Only two states, Kentucky and West Virginia, exhibited adult smoking rates (men and women combined) of 30% or higher in 1992-1993; in contrast, in 1985, such rates were reported from 20 states. The only states in which the prevalence was below 20% in 1992-1993 were Utah (17.1%) and California (19.5%). Rates approaching 20% were reported from New Jersey (20.7%), Massachusetts (21.5%), and Nebraska, New York, and Hawaii (22.0% each) in 1992-1993. Rhode Island experienced the greatest relative decline in smoking prevalence from 1985 to 1992-1993, with a calculated relative change of -30.7% (based on a change in rate from 33.5% to 23.2%), followed by Delaware (-25.9%) the District of Columbia and New Jersey (-23.9% each), Connecticut (-23.2%), California (-22.9%), Alaska (-22.8%), Georgia (-22.6%), Massachusetts (-22.1%), and New York (-22.0%). CONCLUSIONS: Smoking rates are not uniform in the United States but vary considerably from state to state, even within the same region of the country. The CPS is the only mechanism currently capable of simultaneously monitoring smoking trends nationally, regionally, and on a state-by-state basis.

Age Distribution↗

Postcodes and the 1991 census of population: issues, problems and prospects.

"The decade between the 1981 and 1991 UK Censuses of Population has seen an enormous increase in the use of the postcode system for locational referencing. To date, no direct means have existed for linking postcoded data to census geography at the most detailed level, but the production of a new ED/postcode directory promises to offer a range of new opportunities for postcode applications following the release of the 1991 Census data. This paper reviews the characteristics of the postcode system, describes the new directory, and examines the methods which will be available for linking the Census and postcodes post-1991."

Censuses↗

[French neurosurgical practice in neurooncology (national survey--part II). Census of current research protocols on brain tumors in France].

OBJECTIVE: This second part of the inquiry of the NeuroOncolgy Group of the French Neurosurgical Society was undertaken to evaluate the involvement of French neurosurgeons in brain tumor research. METHODS: In December 2003, A questionnaire called "Census of current and future research studies about brain tumors in your center" has been mailed to every French neurosurgical department. For each protocol, responders were asked to mention: the title of the protocol, its mono- or multi-centric design, the name of the principal investigator, the name of the neurosurgeon(s) involved in the study, the topic of the study (epidemiology, imaging, biology, genetics, therapy), tumor histology, financial support, and partners. RESULTS: Twenty-three centers responded. Sixty-three studies were described. There were 6 epidemiological studies, 7 imaging studies, 27 biological or genetic studies and 15 clinical trials concerning glial tumors, and 8 biological studies concerning non glial tumors. Each study is described in the text with the data previously mentioned. CONCLUSION: Despite the fact that several centers did not answer, this inquiry confirmed the strong involvement of French neurosurgeons in brain tumor research.

Brain Neoplasms↗

Using information from demographic analysis in post-enumeration survey estimation.

"Population estimates from the 1990 Post-Enumeration Survey (PES), used to measure decennial census undercount, were obtained from dual system estimates (DSE's) that assumed independence within strata defined by age-race-sex-geography and other variables. We make this independence assumption for females, but develop methods to avoid the independence assumption for males within strata by using national level sex ratios from demographic analysis (DA).... We consider several...alternative DSE's, and use DA results for 1990 to apply them to data from the 1990 U.S. census and PES."

Americas↗

The 1990 U.S. census: how good is good enough?

The 1990 US census is likely to be the most accurate in the nation's history, but it may miss 2 or 3 million people, most of them poor and many of them black or Hispanic. Because the population census is the basis for political apportionment and determines the allocation of a growing share of federal funds to localities and public programs, undercoverage is of great concern to cities, states, and the groups most affected. The statistical methods developed to measure the extent of undercounting in the census have become increasingly reliable, but the official census count has never before been adjusted on the basis of these methods. This article describes plans for the 1990 census and examines a growing controversy over adjustment for an undercount.

Americas↗