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PubMed2003

Tobacco- and alcohol-attributable mortality and years of potential life lost in Germany.

AIM: To compare the ages of death caused by tobacco smoking and alcohol risk drinking. METHODS: Smoking rates from the largest population survey, alcohol drinking data from the National Health Survey and data from the vital statistics from Germany are used and attributable fractions computed. RESULTS: Alcohol-attributable deaths occurred at the youngest age, followed by tobacco- plus alcohol-attributable cases, whereas death cases attributable to tobacco smoking only occur latest. CONCLUSION: The overlap in the two substance-use behaviours has to be taken into account when considering attributable mortality data.

Adolescent↗
PubMed1978

[Epidemiological survey of cerebro-cardiovascular diseases at Iwamizawa in Hokkaido (author's transl)].

Since 1969, we have investigated epidemiological studies of cerebro-cardiovascular diseases in the suburbs of Iwamizawa city in Hokkaido, the northernmost island of Japan. Cross-sectional surveys of 1,092 persons, equivalent to 90.3% of inhabitants over 40 years of age, revealed that the prevalence of hypertension amounted to 34%, and that the prevalence of abnormal ECG, CTR, fundi, albuminuria, glucosuria and overweight in the hypertensive group were significantly higher than in the normotensive group. After a 5-year cohort follow-up study concerning the incidence of strokes and heart attacks, age was found to be the highest risk factor in both incidents and hypertension was the second highest in cerebrovascular accidents, but not so high in heart attacks. In addition, we measured plasma renin activity (PRA) as a risk factor. On the basis of our observations, it is evident that the casual PRA of the rural Japanese population in Hokkaido, who usually excrete sodium more than 200 mEq per day, is valuable for our study. PRA was inversely proportional to systolic blood pressure in the normotensives and total group, but no correlation was found in the hypertensives alone. Observing 13 renin-determined accidents (8 strokes & 5 heart attacks) prospectively, incidence of strokes and heart attacks occurred more frequently in the high- and low-renin subgroups than in the normal-renin subgroup. Based on multivariate analysis, the following conclusion was drawn: systolic pressure, high renin, diastolic pressure and low renin, in this sequence, contribute largely toward the discrimination of cerebro-cardiovascular accident from no cerebro-cardiovascular accident. Thus it was suggested that the casual PRA was useful to predict the occurrence of vascular complications, in addition to the existence of hypertension. It has been said that the mortality rate of CVA in Hokkaido is less than the average of the rest of northern parts in Japan. By the vital statistics and our survey, it was clear that seasonal variation of the death rate from CVA and heart attack, which increases in the winter season, is weaker in Hokkaido than in Honshu. It is of interest to speculate that it is due to better-equipped heating in houses in Hokkaido than in other northern parts of Honshu.

Adolescent↗
PubMed1980

National health data for policy and planning.

The role of the National Center for Health Statistics (NCHS) in providing data for health policy and planning at the national and local level is discussed. Four specific examples are considered. First, data from the Hospital Discharge Survey are used to identify surgical procedures with large increases between 1965 and 1976: 30 percent rise in the incidence of hysterectomy, 169 percent increase in cesarean section, 100 percent increase in lens extraction, and 35 percent increase in orthopedic surgery. The extent to which such increases represent unnecessary utilization and their impact on costs are discussed. Second, the combination of data from two sources (Health Interview Survey and Health and Nutrition Examination Survey) is illustrated by considering selected policy issues related to hypertension. Next, the problem of designating medically underserved areas is discussed in relation to the difficulties in implementing federal policies at the local level without local data. The potential for national data systems to provide guidance for these policies is also considered. The final example discusses the use of vital statistics to provide small area data for local health planning. In conclusion several areas are considered which need development in order to maximize the use of data for policy and planning: research on measurement of health status, with particular emphasis on how health policy can affect health status; research on appropriate levels of health resources and services; development of shared data systems to reduce cost and respondent burden; and training, especially at the undergraduate level and in interdisciplinary graduate programs.

Data Collection↗
PubMed1980

Starting from year one: the politics of health in Nicaragua.

The triumphant Sandinista revolution inherited a health situation characterized by high mortality, low life expectancy, widespread malnutrition, and a medical system limited in scope. The extent of these problems can only be estimated as a result of the somocista government's failure to develop an accurate system of vital statistics. While there are many options available for rapidly decreasing the high levels of mortality and morbidity in Nicaragua, the revolutionary government has chosen a strategy which fuses public health and politics. A health network based on popular participation and control is being formed which should not only decrease the high rates of malnutrition and infectious diseases in a cost-efficient manner, but should increase the strength of the revolution as well.

Community Health Services↗
PubMed1993

[Correction of the mean birth weight calculated from a frequency distribution (Japan, single births, 1969-88)].

Recently the mean birth weight (MBW) of Japan is on the decrease. This phenomenon started in 1976 and continues up to the present as of 1988. Various factors accounting for this phenomenon have been considered and discussed by several researchers. They were interested in social, cultural and economic factors as well as factors influencing community health status. Although the above factors seem to be important, one problem connected with calculation of MBW is worth discussing. The MBW was calculated from a frequency distribution because of a limitation of the source material. The accuracy of calculation of statistics from a frequency distribution depends on the assumption that few frequencies fall on boundaries, but birth weight measurements are apt to fall on figures having 0 at the end because of the properties of weighing scales. Suppose that the exact weight of an infant is 2996g. If his weight is read to the nearest figure having 0 at the end by rounding, it is recorded as 3000g on the birth certificate. Then, in a frequency distribution whose class interval is 500g, his weight is treated as 3250g in calculation of the mean. But some improvements of the methods of weighing, for example, utilization of a scale displaying a digital value of weight may result in a greater chance that his weight is recorded as 2996g. Then, in the same frequency distribution, his weight is treated as 2750g in calculation of the mean. Therefore, an improvement of the method of weighing produces the phenomenon that MBW decreases even if all the original birth weights did not change. Exact relative frequency, recorded as just 2500g, that is mentioned secondarily in the Vital Statistics of Japan has been decreasing consistently since 1969. This year is the oldest in the above source having frequency distributions of single birth infants. This fact shows that methods of weighing have been improved as the years pass. In this paper we tried to correct MBW by using the relative frequency recorded as exactly 2500g. Two kinds of widths where rounding would be executed were estimated from a frequency polygon. We obtained the following results. 1) The correction equation is represented as ld approximately; where l is a class interval (500g in this paper) and d is calculated by d = Q/(pa + pa+1 + Z) as a mean value in a certain sense and by d = 2Q/(pa + pa+1 + Z) as a maximum value.(ABSTRACT TRUNCATED AT 400 WORDS)

Birth Weight↗
PubMed1978

The magnitude of malnutrition in Latin America.

Malnutrition, an illness which can easily be prevented and cured with existing resources and technology, is perhaps the most widespread disease in Latin America. However, it is unrecognized as such, and those population groups that suffer most from it are most prone to have their sufferings unrecorded. Two factors contribute to this: (a) the inaccuracy and incomplete coverage of vital statistics, as reflected by underregistration of deaths, insufficient medical certification of registered deaths, and biases both among certifying physicians and in the International Classification of Diseases; and (b) low population coverage by the health care systems and thus by the statistics which they generate. These factors are related to the ideological bias of those statistical systems and to the concepts of causality which they use. Through a review and analysis of "ad hoc" studies on the frequency of malnutrition in Latin America and its incidence in relation to morbidity and mortality, an estimation is made of malnutrition-caused deaths, which would amount to almost one-fifth of deaths from all causes. As overall availability of food in Latin America is adequate, it is held that this continent ultimately has the level of malnutrition that it wishes to have.

Child, Preschool↗
PubMed2006

Back to the future? A critical commentary on the 2003 U.S. National standard certificate of live birth.

Vital statistics documents for the United States have been revised approximately decennially throughout the past century. In this commentary we review the contents of the 2003 revision of the national standard certificate of live birth, focusing on changes from the certificates in use nationally since 1989, and identifying strengths and weaknesses of key data elements. Additional federal-state partnership funding is imperative to support the transition to the new standard certificates, and to ensure a focus on data quality at the state and national levels.

Adult↗
PubMed1990

Infectious disease control in a long-term refugee camp: the role of epidemiologic surveillance and investigation.

This report demonstrates the role of epidemiologic surveillance and investigation in the control of infectious diseases in a long-term refugee camp. The applications of simple epidemiologic methods in a refugee camp on the Thai-Cambodian border are described for a one-year period. The development of a Health Information Office facilitated the collection of demographic and vital statistics data, administration of a disease surveillance system, regular monitoring of hospital and outpatient discharge diagnoses, and investigation of disease outbreaks. This office also organized community health education campaigns and disease control efforts. Examples of specific disease investigations are provided to demonstrate the utility of epidemiologic surveillance in the control of infectious disease. We conclude that simple epidemiologic methods play an important role in health planning in long-term refugee camps.

Adolescent↗
PubMed1988

[Descriptive epidemiology of cancers in children].

According to the Vital Statistics of Japan, the age-adjusted mortality rate for cancers in children has decreased almost 0.7 times between 1969 and 1986. The decrease was pronounced in cancers of the ovary, testis, stomach, nose & ear and leukemia, and in the age group under 5. Rises in the mean age at death were also observed. From international comparison, Japanese children had a relatively low mortality rate for cancers except leukemia. The international comparison of cancer of incidence suggested that some of risk factors for adult cancers were also involved in the etiology of cancers in children.

Child↗
PubMed1995

Suicide risk among people living with AIDS.

Using data from Louisiana vital statistics records, the authors found an increased suicide risk for people with AIDS. Between 1987 and 1991 the suicide rate of people with AIDS (175 per 10,000) was 134.6 times that of the general population (1.3 per 10,000). The suicide rate for people with AIDS in the metropolitan New Orleans area (126 per 10,000) was half that of the state's nonmetropolitan areas (249 per 10,000). This article explores the implications of this astounding suicide rate for social work practice.

Acquired Immunodeficiency Syndrome↗
PubMed2003

Underreporting of justifiable homicides committed by police officers in the United States, 1976-1998.

OBJECTIVES: This study assessed the consistency of estimates of the number of justifiable homicides committed by US police officers and identified sources of underreporting. METHODS: The number of justifiable homicides committed by police officers between 1976 and 1998 was estimated from supplementary homicide report (SHR) and National Vital Statistics System (NVSS) mortality data. RESULTS: Nationally, the SHR estimate was 29% larger than the NVSS estimate. However, in most states this pattern was reversed, with more deaths reported in the NVSS. CONCLUSIONS: Both systems underreport, but for different reasons. The NVSS misclassifies cases as homicides, rather than justifiable homicides committed by police officers, because certifiers fail to mention police involvement. The SHR misses cases because some jurisdictions fail to file reports or omit justifiable homicides committed by police officers.

Adolescent↗
PubMed2005

Trends and regional variations in infant mortality rates in Japan, 1973-1998.

OBJECTIVE: The purpose of the study was to investigate the trends and regional variations in infant mortality rates in Japan. METHOD: The data from 1973 to 1998 analysed in this paper were from the Vital Statistics Division, Ministry of Health, Labor and Welfare of Japan. RESULTS: Infant mortality rates declined significantly between 1973 and 1998 in all regions. Statistically significant differences in infant mortality rates among the regions were observed in 1973, 1974, 1976, 1977 and 1978. However, the regional differences in infant mortality rates were insignificant thereafter, indicating elimination of regional variations in infant mortality in Japan. CONCLUSION: The results of this study indicated declines in infant mortality rates in all regions, with elimination of regional variations in infant mortality in Japan in the last two decades. This may be attributable to both qualitative and quantitative improvements in health and medical services in Japan.

Cause of Death↗
PubMed1980

Suicide risk by birth cohort in the United States, 1949 to 1974.

Following the demonstration by Solomon and Hellon that in the past 30 years, successive birth cohorts in Alberta, Canada, carry successively higher suicide risks as they age, we examined data by birth cohort in the Vital Statistics of the United States by race and sex over a similar period. We found the same phenomenon, in reduced magnitude, in birth cohorts of much greater size. Not only does each successive birth cohort start with a higher suicide rate, at each successive five-year interval it has a higher rate than the preceding cohort had at that age. The regularity of this phenomenon over the past 25 years in the United States implies continually rising suicide rates in these birth cohorts. It suggests that whatever the cause of this effect, it is early and lasting. Birth cohort analysis appears to offer an important new tool for studying suicide. Its implications have only begun to be examined.

Adolescent↗
PubMed1992

[Seasonal variation of mean birth weight and births in Nagano Prefecture].

Seasonal variation of mean birth weight in Nagano Prefecture was examined by a traditional time series analysis, which decomposes the variation in a series into trend, seasonal variation, other cyclic changes, and remaining irregular fluctuations, based on the data in Vital Statistics from January 1974 to December 1983. The seasonal index of mean birth weight showed a unimodal pattern with a peak in June for males, and a bimodal pattern with peaks in spring and autumn in females with statistical significance. Previous reports have revealed that gestational period is the most important factor associated with birth weight. Therefore, we carried out time series analysis for the mean gestational period and observed an apparent seasonal periodicity, which showed a unimodal pattern with a bottom in winter for both sexes and parities. According to the results of statistical testing of the degree of coincidence between two time series, the time series of mean birth weight and that of mean gestational periods showed statistically significant coincidences in their monthly variations for multiparae. On the other hand, mean birth weight at 40 gestational weeks, which reflects the intrauterine growth, did not show seasonality. These results suggest that seasonality in gestational periods might play an important role in creating seasonal variations of mean birth weight in Nagano Prefecture. The average daily number of births by month also showed apparent seasonalities both for primiparae and multiparae. Primiparae showed a bimodal pattern with peaks in February and August, while multiparae showed a unimodal pattern with a peak in May and a bottom in November. It has been said that the seasonality in marriage is one of important factors associated with seasonal variation in births.(ABSTRACT TRUNCATED AT 250 WORDS)

Birth Rate↗
PubMed1985

The mortality of centenarians in England and Wales.

Vital statistics data previously published by the Registrar General of England and Wales have been separated into male and female deaths in 1960-69 aged 100, 1961-70 aged 101, 1962-71 aged 102 etc., to represent cohorts of 292 male and 1463 female centenarians born in 1859-1869. Mortality is fitted to age by the method of maximum likelihood. Estimated male mortality declines after age 103 and falls below that of females (who show no decline) at age 105. The cause of this non-Gompertzian tapering off in mortality is found to be selection due to variability in the males, which is more than sufficient to offset the biological effects of aging that nevertheless occur in each individual. Selection causes a reduction of 0.01 per year of age in mean male centenarian mortality rates in England and Wales.

Aged↗
PubMed1993

Increasing trends in mortality rate of aortic aneurysms in Japan, 1955-90.

To know the characteristics of mortality from aortic aneurysms in Japan, the age-adjusted and age-specific mortality rates of the diseases were calculated based on the Vital Statistics of Japan published from the Statistics and Information Department, Minister's Secretariat, Ministry of Health and Welfare. The overall age-adjusted mortality rate increased 24.8-fold from 0.43 to 10.98 per 100,000 for males, and 18.6-fold from 0.23 to 4.54 per 100,000 for females from 1955-90. The most common type was abdominal aortic aneurysms followed by dissecting and thoracic aortic aneurysms. The mortality rates of dissecting and thoracic aortic aneurysms increased greater than that of abdominal aortic aneurysms. The mortality rate of dissecting aneurysms was higher than that of abdominal and thoracic aortic aneurysms in age groups of 64 years or under. The mortality rate of abdominal aortic aneurysms was the most common in age groups of 65 years or over.

Adult↗
PubMed1994

Estimating African-American mortality from inaccurate data.

This paper evaluates the quality of vital statistics and census data for estimating African-American mortality over a period of six decades. The authors employ intercensal cohort comparisons and extinct generation estimates to demonstrate that conventionally constructed African-American death rates may be seriously flawed as early as age 50. Using the crude death rate at ages 50+ for 1978-1982 in conjunction with estimated growth rates and two model life table systems, the authors estimate black age-specific death rates in 1978-1982. These results suggest that if a racial crossover in death rates occurs, the age pattern of mortality among African-Americans must be far outside the range observed in populations with more accurate data.

Adolescent↗
PubMed1993

[Estimate of maternal mortality in a rural area of Niger: use of the indirect sisterhood method].

Maternal mortality remains one of the major public health problems nowadays. Each year, all over the world, half a million women die of pregnancy-related complications most of which could be avoided. In spite of enormous efforts at handling this problem, the results have been small. In many countries, the extent of the problem is virtually unknown for lack of reliable birth and mortality data. Where vital statistics are incomplete or non-existent, one should have recourse to other sources of information. In reaction to the classic, yet inadequate methods of collecting information, indirect techniques for estimating maternal mortality have been developed. One of these procedures is the sisterhood method: using this technique, researchers are able to deduce indicators of maternal mortality based on the proportion of sisters, who, once reached childbearing age, survived or died during pregnancy, childbirth or postpartum. The authors tested this method in Niger in a rural area with difficult access to primary health care. They noted a maternal mortality rate of 1,050 every 100,000 live births. This practical and simple method of estimating maternal mortality in a given area, at a relatively low cost, could readily be incorporated into routine medical activities.

Adolescent↗