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PubMed2005

Suicide risk in relation to level of urbanicity--a population-based linkage study.

BACKGROUND: The extent to which the high suicide rate in urban areas is influenced by exposures to risk factors for suicide other than urbanicity remains unknown. This population-based study aims to investigate suicide risk in relation to the level of urbanicity in the context of other factors, and to study the risk variation in a sex, age, and calendar year perspective. METHODS: The study is a nested case-control study comprising 21 169 suicides and 423 128 population controls matched for age and sex. Personal data on place of residence, socioeconomic status and psychiatric history were retrieved from various Danish longitudinal registers. Data were analysed with conditional logistic regression. RESULTS: This study confirms that people living in more urbanized areas are at a higher risk of suicide than their counterparts in less urbanized areas. However, this excess risk is largely eliminated when adjusted for personal marital, income, and ethnic differences; it is even reversed when further adjusted for psychiatric status. Moreover, the impact of urbanicity on suicide risk differs significantly by sex and across age. Urban living reduces suicide risk significantly among men, especially young men, but increases the risk among women, especially women aged 24-35 or >65 years. In addition, during 1981-1997, the suicide risk associated with urbanicity remained rather constant among women, whereas it dropped significantly among men, a trend that seemingly gained strength during the last part of this period. CONCLUSIONS: Suicide risk associated with urbanicity varies significantly by sex and age groups and recent years have seen a decline in the urban-rural disparities among men. The increased risk in urban areas can largely be explained by the effects of marital status, ethnics, income, and psychiatric status.

Adolescent↗
PubMed1998

Body mass index as indicator of standard of living in developing countries.

OBJECTIVE: To assess the suitability of the body mass index (BMI) as an indicator of standard of living in developing countries. DESIGN, SETTING AND SUBJECTS: The analysis is based on data collected in the first two rounds of the Ghana Living Standards Survey, held in 1987/88 (GLSS-I) and 1988/89 (GLSS-II). The dataset provides information on a wide range of socio-economic variables, at the individual, the household and the community level, including the height and weight data of approximately 9000 adults in the 20-65 y age bracket. METHOD: Bivariate analysis was used to assess, at the individual level and at the level of population groups, the relationships between adult Body Mass Index and selected household characteristics such as income and expenditure, years of schooling of head of household, access to services, quality of housing, and nutritional status of children. Through multiple regression, indicative estimates have been derived of the effects of these variables on adult BMI. For comparison, the same relationships were investigated for weight and height. RESULTS AND CONCLUSION: At the individual level, BMI shows a significantly positive relation with the various socio-economic indicators of living standard, though the correlation coefficients indicate a poor fit. However, at the level of population groups, The relationship between BMI and other characteristics of socio-economic development is strong with a correlation coefficient of 0.86 between mean BMI and mean per capita expenditures of 12 population groups in Ghana, presumed to be at different levels of standard of living. The relationships between weight and the various socioeconomic characteristics were comparable to those for BMI, while height was poorly correlated with the selected household variables. Result suggest that in low-income countries, information on adult BMI (mean and distribution) can be used for assessing differences in standards of living between population groups or for monitoring changes over time.

Adult↗
PubMed2003

[Alcohol consumption, income and education in Norway, 1993-2000].

BACKGROUND: We have studied the trend in alcohol consumption by socio-economic status in Norway over the 1993-2000 period. Have differences in consumption been stable over time, or have they levelled off? MATERIAL AND METHODS: Our analysis is based on self-reported data from 6894 persons, stratified by year, sex, age, level of education, level of income, and where in Norway they lived. Bivariate and multiple analyses were performed. RESULTS: Alcohol consumption increased in all socio-economic groups over this period. Men consumed more than women; consumption increased with level of education and level of income. Income and level of education predicted alcohol consumption about equally well. The Oslo area had the highest consumption. INTERPRETATION: Alcohol consumption has increased in all socio-economic groups. It increases with level of education and higher income; men consume more than women.

Adolescent↗
PubMed1995

Higher rates of SIDS persist in low income groups.

OBJECTIVE: To examine how changes in the rates of sudden infant death syndrome (SIDS) have varied in different income groups during a 25 year period. METHODOLOGY: Census data were obtained for five census periods (1971, 1976, 1981, 1986 and 1991) on the number of SIDS cases and inevitable deaths. Census area units (CAU) were ranked according to the average income earned by adults over the age of 15 years for each census year. The CAU were then divided into three equal income groups: low, middle and high. RESULTS: The rates of SIDS differed significantly between the three income groups for the 1991 census period with the low income SIDS rate being 4.6/1000 births compared to 1.2/1000 live births for the higher income groups (Chi-squared = 18.3, P < 0.0001). There was no association between rates of inevitable deaths and income groups. CONCLUSION: Currently, low income groups have three times the rate of SIDS compared to those in higher income groups. The reason for this is probably because the disadvantaged groups carry an overall higher burden of risk factors for SIDS. This must be kept in mind as further SIDS educational programmes are developed and implemented.

Adult↗
PubMed1994

A possible neural mechanism underlying consciousness based on the pattern processing capabilities of pyramidal neurons in the cerebral cortex.

This paper examines a possible neural mechanism underlying the phenomenon of consciousness by exploring the ability of cortical pyramidal cells to process patterns of information. A numerical model of a section of a neuron is described that enables the transient membrane potential distribution to be predicted following inputs to the cell. The neuron model incorporates learning by modelling the ability of dendritic spine receptors to undergo changes in their sensitivity if they receive inputs when their local membrane is depolarized. Simulations show the cell to be capable of recognizing patterns amongst its inputs, and to be able to extend its repertoire of learnt patterns by associating one pattern of inputs with another. These pattern processing capabilities can take place within the apical dendritic tree, whilst the soma sees a much attenuated and slower response that reflects the general level of pattern recognition taking place in the dendrites. It is argued here that the distribution of patterns stored in the apical dendrites of all the pyramidal cells represents the cortical knowledge base. Incoming patterns of information are compared with those stored in the cortical knowledge base to pick out components that have been experienced before. The resulting distribution of soma responses represents the way the incoming patterns of information are perceived. Most of the patterns learnt arise from other pyramidals and represent information about cortical behaviour itself. The distribution of soma responses therefore represents a perception of the self as well as a perception of the environment. It is argued here that this intimate perception of the self could underlie the phenomenon of consciousness.

Cerebral Cortex↗
PubMed2006

Resource exploitation and cross-region growth trajectories: nonparametric estimates for Chile.

As a sector of primary concern for national development strategies, mining keeps stimulating an intensive debate in Chile, regarding its role for long-term growth. Partly drawn on theoretical contributions to growth and mineral resource accounting, this analysis assesses patterns of economic growth across Chilean regions. The theoretical and methodological rationale for focusing on weak sustainability, by testing convergence across regions in a distribution dynamics perspective, is first discussed. This is followed by a brief review of policy issues and previous empirical findings of concern to Chile's mining and regional growth. Panel data over the period 1960-2001 are analysed, with growth measured in terms of both income per capita as such, and sustainable measures of this variable. Kernel density and quantile regression estimates indicate persistent bimodal (if not possibly trimodal) distribution of nationally standardised regional incomes per capita, whereby conditions for cross-region convergence are matched only within the inner range of this distribution.

Chile↗
PubMed2006

[Income differences in health and life expectancy--cross-sectional and longitudinal findings of the German Socio-Economic Panel (GSOEP)].

Income is an important determinant of individual standards of living and participation in social life. Data from the German Socio-Economic Panel shows that the level of income also affects a person's health and life expectancy. People's self-assessment of their health and health-related quality of life follow a distribution pattern which can be described as a gradient: the lower the income, the more frequent the impairments to subjective health. Life expectancy statistics also reflect income differences, primarily due to premature deaths among lower-income groups. Clues for explaining income-related differences in health and life expectancy can be found in the results on health-related behaviour and use of the medical system: people in the lower income groups smoke more frequently, are slaker in sports and are less likely to go to a doctor when their health is impaired. Furthermore, work environment and job-specific influences, stress burdens and reactions, social comparison processes and disease-induced processes of declining social mobility and social exclusion are discussed as possible explanations.

Adolescent↗
PubMed2003

Frequent failed early HIV detection in a high prevalence area: implications for prevention.

To identify the frequency of and factors associated with early detection of HIV infection in Los Angeles County, data were evaluated from interviews of a population-based sample of adult persons with AIDS. Early detection was defined as greater than 5 years between the first reported positive HIV test and an AIDS diagnosis. The associations between early detection and sociodemographic and behavioral factors were assessed for the period January 1997 through June 2002. Over the study period, only 20% (253/1268) of persons interviewed met the criterion for early detection. Early HIV detection was less likely for women (adjusted odds ratio [AOR] = 0.6, 95% confidence interval [CI]: 0.4, 0.9), blacks (AOR = 0.5, 95% CI: 0.4, 0.8), foreign-born Latinos (AOR = 0.2, 95% CI: 0.1, 0.3), U.S.-born Latinos (AOR = 0.3, 95% CI: 0.2, 0.6, and heterosexuals (AOR = 0.5, 95% CI: 0.3, 0.7). Trends of increasing early detection with older age groups (p < 0.001) and higher educational levels (p < 0.001) were also observed. Our findings indicate an overall low level of early HIV detection and suggest that major sociodemographic and risk group disparities exist in the likelihood of early detection among HIV-infected persons in Los Angeles. These differences have important implications for reducing the level of community HIV transmission and for improving individual health outcomes among people with HIV. Aggressive efforts are needed to expand HIV testing and early detection for women, minorities, heterosexuals, younger age groups, and persons of lower education. Links to treatment and behavioral intervention programs should accompany such expanded testing efforts.

Adult↗
PubMed2006

The impact of alcohol taxation on liver cirrhosis mortality.

OBJECTIVE: The objective of this study is to investigate the impact of distilled spirits, wine, and beer taxes on cirrhosis mortality using a large-panel data set and statistical models that control for various other factors that may affect that mortality. METHOD: The analyses were performed on a panel of 30 U.S. license states during the period 1971-1998 (N = 840 state-by-year observations). Exogenous measures included current and lagged versions of beverage taxes and income, as well as controls for states' age distribution, religion, race, health care availability, urbanity, tourism, and local bans on alcohol sales. Regression analyses were performed using random-effects models with corrections for serial autocorrelation and heteroscedasticity among states. RESULTS: Cirrhosis rates were found to be significantly related to taxes on distilled spirits but not to taxation of wine and beer. Consistent results were found using different statistical models and model specifications. CONCLUSIONS: Consistent with prior research, cirrhosis mortality in the United States appears more closely linked to consumption of distilled spirits than to that of other alcoholic beverages.

Alcoholic Beverages↗
PubMed1998

Reactions of adult and teenaged smokers to the Massachusetts tobacco tax.

OBJECTIVES: This study assessed smokers' reactions to a 25 cents cigarette tax imposed in Massachusetts. METHODS: A statewide telephone survey of 1783 adult smokers and 216 teenaged smokers was conducted. RESULTS: Among adult smokers, 3.5% reported that they had stopped smoking, owing in part to the price increase; 35% had considered quitting and 19% had attempted to cut the cost of smoking by switching to cheaper brands or cutting down. Among teenagers, 21% had considered quitting and 26% had cut costs. Low-income smokers were more responsive to the price increase than more affluent smokers. CONCLUSIONS: A modest and temporary price increase promoted quitting among adult smokers and reduced cigarette consumption among low-income teenagers.

Adolescent↗
PubMed2002

Accounting for the depth distribution of 137Cs in on-line mobile gamma spectrometry through primary and forward-scattered photons.

Stationary and mobile field gamma spectrometry is a useful tool for rapid estimation of environmental radioactivity inventories on and in the ground. A weak point however, is that the depth distribution of the activity in the ground must be known in order to calculate the true activity per unit area or unit mass from an observed photon fluence rate. A promising method for converting incoming spectral data into both true activity content and depth distribution in real time is the peak-to-valley method, which is based on an analysis of the ratio between count rates from primary and forward-scattered photons. In this study the peak-to-valley method was adapted to car-borne mobile gamma spectrometry, where the depth distribution of (137)Cs is fitted to a Lorenz function. Results from field experiments with a large HPGe detector, utilising point sources at different depths, are presented. It was found that the method can be useful for mobile measurements with a measuring time of 5-10 min for activity concentrations of about 100 kBq.m(-2) or higher, resulting in an uncertainty in the estimate of the true activity of about 50%.

Cesium Radioisotopes↗
PubMed2003

Docosahexaenoic acid level of the breast milk of some Filipino women.

This study was conducted to determine the docosahexaenoic acid (DHA) level of the breast milk of 100 Filipino women as affected by diet. The subject distribution was patterned after the 1997 Family and Income Expenditure Survey of the National Statistics Office regarding the total number of families, and the total and average family income and expenditures by income class in an urban area. The subjects were asked to complete a 3-day food record and food frequency questionnaire to ascertain the nutrient content of their food intake and approximate eating habits. Hind milk was drawn manually by means of a fabricated glass breast pump and collected in polypropylene vials. The milk samples were stored in a freezer maintained at -25+/-2 degrees C until they were transported to the University of Montreal for fatty acid composition. The milk was methylated using the Lepage and Roy method. The obtained fatty acid methyl esters were analyzed by gas chromatography. Results showed that the milk samples contain an average of 188.34 microg DHA/ml milk, while %DHA of the samples is 0.65%. Regression analysis revealed that mean protein intake of the subjects was a determinant of the DHA level in the milk samples.

Adult↗
PubMed2000

Prevalence of excessive gambling before and after introduction of a national lottery in the United Kingdom: another example of the single distribution theory.

BACKGROUND: According to the single distribution theory advocated by Rose, the prevalence of a deviant condition such as excessive alcohol consumption depends upon the average level of the corresponding characteristic in the population. The objective of this study was to establish whether the single distribution theory applies to gambling behaviour. METHODS: Household gambling expenditure in the United Kingdom was examined using Family Expenditure Survey data collected before and after the introduction of a national lottery in November 1994. RESULTS: In cross-sectional analyses, the mean (or median) household expenditure on gambling for each region predicted the prevalence of excessive gambling in that region: the slope of the relationship in 1995-96 was equivalent to an increase of 1.2 (95% CI 0.7-1.7) points in the percentage of households gambling more than 10% of income for every increase of 1 Pound in mean household gambling expenditure. The introduction of the national lottery was associated with an increase in mean household gambling expenditure from 1.45 Pounds to 3.81 Pounds per week, and an increase in the proportion of households gambling more than 10% of total income four-fold from 0.4% to 1.7%. Among households with income of less than 200 Pounds/week, the proportion gambling more than 10% of their income increased from 0.6% to 3.2%. INTERPRETATION: The single distribution theory applies to gambling behaviour. The increase in average gambling expenditure associated with the introduction of a national lottery in the United Kingdom has led to a pronounced increase in the prevalence of excessive gambling, especially in low-income households. This is likely to increase the prevalence of gambling disorders and to exacerbate social inequalities in health.

Cross-Sectional Studies↗
PubMed2006

Variation in chemotherapy utilization in ovarian cancer: the relative contribution of geography.

OBJECTIVE: This study investigates geographic variation in chemotherapy utilization for ovarian cancer in both absolute and relative terms and examines area characteristics associated with this variation. DATA SOURCES: Surveillance, Epidemiology, and End Results (SEER) Medicare data from 1990 to 2001 for Medicare patients over 65 with a diagnosis of ovarian cancer between 1990 and 1999. Chemotherapy within a year of diagnosis was identified by Medicare billing codes. The hospital referral region (HRR) represents the geographic unit of analysis. STUDY DESIGN: A logit model predicting the probability of receiving chemotherapy by each of the 39 HRRs. Control variables included medical characteristics (patient age, stage, year of diagnosis, and comorbidities) and socioeconomic characteristics (race, income, and education). The variation among HRRs was tested by the chi2 statistic, and the relative contribution was measured by the omega statistic. HHR market characteristic are then used to explain HRR-level variation. PRINCIPAL FINDINGS: The average chemotherapy rate was 56.6 percent, with a range by HRR from 33 percent to 67 percent. There were large and significant differences in chemotherapy use between HRRs, reflected by a chi2 for HRR of 146 (df = 38, p < .001). HRR-level variation in chemotherapy use can be partially explained by higher chemotherapy rates in HRRs with a higher percentage of hospitals with oncology services. However, an omega analysis indicates that, by about 15 to one, the variation between patients in use of chemotherapy reflects variations in patient characteristics rather than unexplained variation among HRRs. CONCLUSIONS: While absolute levels of chemotherapy variation between geographic areas are large and statistically significant, this analysis suggests that the role of geography in determining who gets chemotherapy is small relative to individual medical characteristics. Nevertheless, while variation by medical characteristics can be medically justified, the same cannot be said for geographic variation. Our finding that density of oncology hospitals predicts chemotherapy use suggests that provider supply is positively correlated with geographic variation.

Aged↗