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At least 847 records · Page 47Linked to original sources
PubMed1995

US asthma mortality: 1941 to 1989.

BACKGROUND: Asthma mortality in the United States has nearly doubled in the past 10 years. An examination of long-term trends in United States asthma mortality places the current mortality rates in a historical perspective, identifies high-risk groups for interventions, and may provide clues to the etiology of asthma mortality. METHODS: Asthma deaths for the population aged 5 to 34 years were abstracted from United States vital statistics reports for the period 1941 through 1989. Race-specific and sex-specific mortality rates were age-adjusted to the 1989 estimate of the US population. RESULTS: Among the population aged 5 to 34 years, three distinct periods of asthma mortality were observed: 1941 to 1964, 1965 to 1977, and 1978 to 1989. From 1941 through 1964, nonwhites exhibited a gradual increase in asthma mortality rates; in contrast, whites showed no change in mortality rates. From 1965 through 1977, a marked decline in mortality rates was observed among both nonwhites and whites. From 1978 through 1989, asthma mortality increased with a near doubling in the mortality rates in both nonwhites and whites. Overall, nonwhites had mortality rates 4 times those of whites, with nonwhite males aged 15 to 34 at the greatest risk of death due to asthma. Age and sex differences in asthma mortality are also apparent. The population aged 15 to 34 years generally had mortality rates greater than the population aged less than 15 years. For the population aged 5 to 14 years, regardless of calendar year, females had lower mortality rates than males. Among the population aged 15 to 34 years, females experienced twice the mortality rates of males prior to 1965; however, by the 1980s this relationship no longer existed. CONCLUSIONS: The asthma mortality rate for nonwhites was 4-fold higher than for whites, although the reported prevalence of asthma is less than 2-fold greater. The population aged 15 to 34 years had higher mortality rates than the population aged 5 to 14 years despite exhibiting a lower prevalence of asthma. There are also gender differences in asthma mortality. These differences may be attributable to differences in asthma severity, or differences in disease management or reflect actual differences in mortality. These findings suggest that the search for clues to understand the increase in asthma mortality from 1978 to 1989 should include an attempt to understand why asthma mortality declined in the preceding decade from 1967 to 1977 as these may not be completely unrelated trends.

Adolescent↗
PubMed2001

The impact of heat waves and cold spells on mortality rates in the Dutch population.

We conducted the study described in this paper to investigate the impact of ambient temperature on mortality in the Netherlands during 1979-1997, the impact of heat waves and cold spells on mortality in particular, and the possibility of any heat wave- or cold spell-induced forward displacement of mortality. We found a V-like relationship between mortality and temperature, with an optimum temperature value (e.g., average temperature with lowest mortality rate) of 16.5 degrees C for total mortality, cardiovascular mortality, respiratory mortality, and mortality among those [Greater and equal to] 65 year of age. For mortality due to malignant neoplasms and mortality in the youngest age group, the optimum temperatures were 15.5 degrees C and 14.5 degrees C, respectively. For temperatures above the optimum, mortality increased by 0.47, 1.86, 12.82, and 2.72% for malignant neoplasms, cardiovascular disease, respiratory diseases, and total mortality, respectively, for each degree Celsius increase above the optimum in the preceding month. For temperatures below the optimum, mortality increased 0.22, 1.69, 5.15, and 1.37%, respectively, for each degree Celsius decrease below the optimum in the preceding month. Mortality increased significantly during all of the heat waves studied, and the elderly were most effected by extreme heat. The heat waves led to increases in mortality due to all of the selected causes, especially respiratory mortality. Average total excess mortality during the heat waves studied was 12.1%, or 39.8 deaths/day. The average excess mortality during the cold spells was 12.8% or 46.6 deaths/day, which was mostly attributable to the increase in cardiovascular mortality and mortality among the elderly. The results concerning the forward displacement of deaths due to heat waves were not conclusive. We found no cold-induced forward displacement of deaths.

Adolescent↗
PubMed2001

Temporal trends and ethnic variations in amenable mortality in Singapore 1965-1994: the impact of health care in transition.

BACKGROUND: Amenable mortality is used to assess the effects of health care services on gains in mortality outcomes. Possibly differing patterns of trends in amenable mortality may be expected in economically less developed countries, which have undergone rapid epidemiological transition and recent reforms in health care systems, but such studies are scarce. This study was set up to examine the trends in amenable mortality in Singapore from 1965 to 1994; to estimate the relative impact of medical care and primary preventive policy measures in terms of gains in mortality outcomes; to examine ethnic differences in amenable mortality among Chinese, Malays and Indians. METHODS: Age-standardized mortality rates were calculated for 16 amenable causes of death in Singapore for six 5-year periods (1965-1969,..., 1990-1994), and for each of the three main ethnic groups for three periods (1989-1991, 1992-1994, 1995- 1997). Amenable mortality rates were divided into those which can be reduced by timely therapeutic care for 'treatable' conditions (e.g. asthma and appendicitis), or by primary preventive measures for 'preventable' conditions (e.g. lung cancer and motor vehicle injury). RESULTS: Amenable mortality was higher in males (age-standardized rate 109.7 per 100 000 population) than in females (age-standardized rate 60.7 per 100 000 population). Amenable mortality declined by 1.77% a year in males and 1.72% a year in females. By comparison, the average yearly decline in non-amenable mortality was 0.91% in males and 1.17% in females. The decline in amenable mortality was largely due to 'treatable' causes rather than a decline in mortality due to 'preventable' causes of death. Amenable mortality was lowest for Chinese and highest for Malays. Over the recent 9-year period from 1989 to 1997, amenable mortality declined more in Chinese than in Malays and Indians. However, Indian females showed by far the sharpest decline, whereas Indian males, by contrast, showed an increase in amenable mortality, due to both treatable and preventable causes. CONCLUSIONS: In line with findings from European countries, amenable mortality in Singapore declined more than non-amenable mortality. There were more significant gains in mortality outcomes from medical care interventions than from primary preventive policy measures. Gender and ethnic differences in amenable mortality were also observed, highlighting issues of socioeconomic equities to be addressed in the financing and delivery of health care.

Adolescent↗