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Total error in PES estimates of population.

"We describe a methodology for estimating the accuracy of dual systems estimates (DSE's) of population, census estimates of population, and estimates of undercount in the census. The DSE's are based on the census and a post-enumeration survey (PES). We apply the methodology to the 1988 dress rehearsal census of St. Louis and east-central Missouri and we discuss its applicability to the 1990 [U.S.] census and PES. The methodology is based on decompositions of the total (or net) error into components, such as sampling error, matching error, and other nonsampling errors. Limited information about the accuracy of certain components of error, notably failure of assumptions in the 'capture-recapture' model, but others as well, lead us to offer tentative estimates of the errors of the census, DSE, and undercount estimates for 1988. Improved estimates are anticipated for 1990." Comments are included by Eugene P. Ericksen and Joseph B. Kadane (pp. 855-7) and Kenneth W. Wachter and Terence P. Speed (pp. 858-61), as well as a rejoinder by Mulry and Spencer (pp. 861-3).

Americas↗

Estimating ethnic change in London, 1981-91, using a variety of census data.

"This paper provides estimates of ethnic minority populations in 1981 in Greater London so that spatial population change can be measured. The estimation method involves the application of conditional probabilities of ethnicity given the country of birth. Several different data sources from the census of population have been used to compute the conditional probabilities. Each of these sources has deficiencies; the new method proposed here employs data on 1981-91 survivors in the ONS Longitudinal Study (LS). The estimated ethnic minority populations for 1981 are smaller than those generated using 1991 Census data, and hence the estimate of change is larger. Careful pairwise comparisons are made between alternative estimates. A set of very different maps of change, based on the LS method, are presented and interpreted for the ethnic groups of London at the borough scale."

Culture↗

Positional accuracy of two methods of geocoding.

BACKGROUND: Geocoding is often used in epidemiologic studies to map residences with geographic information systems (GIS). The accuracy of the method is usually not determined. METHODS: We collected global positioning system (GPS) measurements at homes in a case-control study of non-Hodgkin lymphoma in Iowa. We geocoded the addresses by 2 methods: (1) in-house, using ArcView 3.2 software and the U.S. Census Bureau TIGER 2000 street database; and (2) automated geocoding by a commercial firm. We calculated the distance between the geocoded and GPS location (positional error) overall and separately for homes within towns and outside (rural). We evaluated the error in classifying homes with respect to their proximity to crop fields. RESULTS: Overall, the majority of homes were geocoded with positional errors of less than 100 m by both methods (ArcView/TIGER 2000, median = 62 m [interquartile range = 39-103]; commercial firm, median = 61 m [interquartile range = 35-137]). For town residences, the percent geocoded with errors of </=100 m was 81% for ArcView/TIGER 2000 and 84% for the commercial firm. For rural residences, a smaller percent of addresses were geocoded with this level of accuracy, especially by the commercial firm (ArcView/TIGER 2000, 56%; commercial firm, 28%). Geocoding errors affected our classification of homes according to their proximity to agricultural fields at 100 m, but not at greater distances (250-500 m). CONCLUSIONS: Our results indicate greater positional errors for rural addresses compared with town addresses. Using a commercial firm did not improve accuracy compared with our in-house method. The effect of geocoding errors on exposure classification will depend on the spatial variation of the exposure being studied.

Adult↗

Reproduction rates for 1990-2002 and intrinsic rates for 2000-2001: United States.

OBJECTIVE: This report presents revised rates of reproduction for 1990-93, reproduction rates for 1994-2002, and intrinsic rates for 2000-2001. The revised rates for 1991-93 are based on populations consistent with the April 1, 2000, census, as are the rates for 1994-2002. METHODS: Tabular and graphic data on the reproduction and intrinsic rates by race and Hispanic origin of mother are presented and described. RESULTS: Rates of reproduction (total fertility, gross reproduction, and net reproduction rates), the intrinsic rate of natural increase, and the intrinsic birth rate were lower in 2001 (and 2002) than 1990. Among the race and Hispanic subgroups, the reproduction rates were lower for all groups except Cubans and whites (total). The overall intrinsic death rate increased between 1990 and 2001 with the rate declining for whites (total) but increasing for blacks (total).

Birth Rate↗

Burden and cost of inpatient care for HIV-positive paediatric patients--status in the Cape Town metropole during the second week of March 1999. Paediatric HIV Census Group.

OBJECTIVE: To determine the burden of the HIV epidemic on paediatric inpatient facilities in the teaching hospitals of the Cape metropole and tributaries to these hospitals. SETTING: Second- and third-level hospitals. METHOD: During the second week of March 1999 a multicentre collaborative census was performed of all paediatric beds in the teaching hospitals of Cape Town and all facilities draining to and from them. RESULTS: One hundred and six HIV-infected patients were identified from a total of 1,264 beds. Thirty-nine children were in second-level beds or in a long-term residential facility. Fifty-six children were in second-level beds designated for acute care, and occupied 12% of all such beds. Ten children were in beds designated for the care of tuberculosis. Thirty-two (56%) of the acute admissions were for gastro-enteritis, and 13 (23%) were for pneumonia. In 10 children (18% of all admissions) recognised complications of HIV infection were direct causes of admission. For 29 children (35% of all admissions) the current admission was the first; the remainder had had a mean of 2.4 previous admissions. Fourteen children (25%) had received oxygen, and 26 (46%) had received intravenous therapy. Mean lifetime hospitalisation cost per infected child was calculated to be R19,712. The projected cost of a local initiative to reduce mother-to-child transmission is between R8,326 and R10,806 per vertical infection prevented. CONCLUSION: The inpatient burden of HIV-infected children in Cape Town reflects an early stage of the epidemic. Compared with projected lifetime hospitalisation cost for infected children, an intervention to reduce vertical transmission cost would be cost effective.

Bed Occupancy↗

Assessing the relationship between marital status and cancer incidence: methodologic considerations.

In registry-based population studies on marital status in relation to cancer, incidence rates sometimes have been calculated using marital status-specific populations that have been estimated by interpolation and extrapolation from census data as a denominator. Alternatively, other cancers from the same registry have been used to estimate the proportion of the population in each marital-status category in the calculation of the relative risk (RR) of a given cancer. Using cancer registry data from four United States populations for the years 1979-87, we compared the relative incidence estimated using each of the two methods. For selected cancers diagnosed during 1979-81, the age-adjusted risks of never-married Black persons were 1.5 to 2.2 times those of married persons when the population size was estimated from census data. The corresponding RRs were 0.7 to 1.1 when the 'control' cancers were used. Among Whites, the differences between the two methods were about 20 to 30 percent. For both races, the difference between the methods was greater still for the years for which we relied on extrapolation to estimate the population (1981-87). The differences between the risk estimates from the two methods may be related to underenumeration in the census, inconsistent definitions of marital status between cancer registries and the census, errors in the extrapolation of the population, and/or the possible association of the incidence of 'control' cancers with marital status. In the US, while each method has some potential for bias, we believe that the likelihood of bias is relatively greater using the census-based method.

Black or African American↗

Survey design strategies for the study of disability.

This article examines international statistical guidelines and recommendations relevant to the collection and analysis of disability data in population census, household survey and civil registration programmes. It also gives examples of survey design methods and their influence on findings of disability surveys. These examples are taken from the results of population censuses, household surveys and registration systems of 55 countries, as compiled in the United Nations Disability Statistics Data Base (DISTAT, 1988). Comparisons of crude disability rates, defined as the percentage of the total population that is disabled, indicate considerable variation in the rates both within and across the major data-collection types. Cross-national variations in disability rates are not only due to actual differences in disability rates, but are also the result of differences in survey design, the statistical concepts and definitions and the survey screening devices used. This article provides the reader with specific examples of screening devices tried and topics covered in survey programmes, and reviews the potential for using the ICIDH as one way of standardizing survey results. Short lists of impairments and disabilities for survey research are proposed. Survey implementation of the study of handicap is also discussed, and a list of possible survey topics for the study of handicap is outlined.

Activities of Daily Living↗

Using remotely sensed data for census surveys and population estimation in developing countries: examples from Nigeria.

"Using examples from Nigeria, this paper demonstrates how remotely sensed data can be used to acquire some of the basic data requirements for census surveys and to estimate population. The result obtained shows that visual identification of settlements on Landsat MSS and TM is more accurate and economical than equivalent digital classification techniques. Black and white aerial photographs were used to estimate the population of a model town and to establish EAs [enumeration areas]. The population estimation method employed can be used to obtain intercensal population estimates for the rapidly growing central places, while the established EAs for the study area have created a permanent base for future census surveys and census cross-validation, population estimation and other social surveys."

Africa↗

Individuals living in areas with high background radon: a GIS method to identify populations at risk.

OBJECTIVE: to identify and link populations and individuals that live within high risk areas. DESIGN: census registers and disease registers which contain data on individuals can only give aggregate statistics relating to postal code districts, town, county or state boundaries. However environmental risk factors rarely, if ever, respect these man-made boundaries. What is needed is a method to rapidly identify individuals who may live within a described area or region and to further identify the disease(s) occurring among these individuals and/or in these areas. METHOD: this paper describes a method for linking the standard registers available in Sweden, notably the residence-property addresses they contain and the geographical coordinate setting of these, to map the population as a point coverage. Using standard GIS methods this coverage could be linked, merged or intersected with any other map to create new subsets of population. Representation of populations down to the individual level by automatised spatialisation of available census data is in its simplicity a new informatics method which in the designated GIS medium adds a new power of resolution. RESULTS: We demonstrate this using the radon maps provided by the local communes. The Swedish annual population registration records of 1991 for the county of Ostergötland and the property register available at the Central Statistical Bureau of Sweden formed the main data sources. By coupling the address in the population register to the property register each individual was mapped to the centroid of a property. By intersecting the population coverage with the radon maps, the population living in high, normal or low risk areas was identified and then analysed and stratified by commune, sex and age. The resulting tables can be linked to other database registers, to visualise and analyse geographical and related patterns. The methodology can be adapted for use with any other environmental map or small area. It can also be expanded to the fourth dimension by linking likewise available migration information to generate immediately coordinate-set, accumulated exposition and similar data.

Databases, Factual↗

Is there a healthy worker effect for cancer incidence among women in Sweden?

BACKGROUND: Our aim was to evaluate whether there is a healthy worker effect (HWE) for cancer incidence among women. HWE is a bias found in occupational studies that compare rates of disease among employed people to disease rates for the general population, which includes unemployed people (who may be less healthy than those who are employed). METHODS: Data from the 1960 and 1970 Swedish censuses were used to identify all 1,659,940 Swedish women who were employed in either year. They were followed during 1971-1989 through linkages to the national cancer and death registers. Standardized incidence ratios (SIRs) were computed comparing employed women to the 1,627,873 women who were not employed in either 1960 or 1970. RESULTS: For the 545,857 women employed in both 1960 and 1970, the SIR for all cancers combined was 1.05 (1.04-1.06). When specific cancer sites were analyzed separately, the highest cancer risks were for cancers of the lung and bladder (SIR = 1.2) and reproductive organs (breast, ovary, endometrium, and cervix SIR = 1.1). Overall cancer risks were highest among full-time workers, younger workers, urban workers, and workers with the highest socioeconomic status (based on the woman's job title). CONCLUSIONS: These results show no general HWE for cancer incidence among employed Swedish women.

Adult↗

Erectile dysfunction and coronary risk factors: prospective results from the Massachusetts male aging study.

BACKGROUND: Erectile dysfunction (ED), a wide spread and troublesome condition among middle-aged men, is partly vascular in origin. In the Massachusetts Male Aging Study, a random-sample cohort study, we investigated the relationship between baseline risk factors for coronary heart disease and subsequent ED, on the premise that subclinical arterial insufficiency might be manifested as ED. METHODS: Men ages 40-70, selected from state census lists, were interviewed in 1987-1989 and reinterviewed in 1995-1997. Data were collected and blood was drawn in participants' homes. ED was assessed from responses to a privately self-administered questionnaire. Analysis was restricted to 513 men with no ED at baseline and no diabetes, heart disease, or related medications at either time. RESULTS: Cigarette smoking at baseline almost doubled the likelihood of moderate or complete ED at followup (24% vs. 14%, adjusted for age and covariates, P = 0.01). Cigar smoking and passive exposure to cigarette smoke also significantly predicted incident ED, as did overweight (body-mass index > or =28 kg/m(2)) and a composite coronary risk score. Weaker prospective associations were seen for hypertension and dietary intake of cholesterol and unsaturated fat. CONCLUSIONS: Erectile dysfunction and coronary heart disease share some behaviorally modifiable determinants in men who, like our sample, are free of manifest ED or predisposing illness. Open questions include whether modification of coronary risk factors can prevent ED and whether ED may serve as a sentinel event for coronary disease.

Adult↗

Racial and ethnic differences in lung cancer incidence: how much is explained by differences in smoking patterns? (United States).

OBJECTIVES: Lung cancer rates vary considerably among U.S. racial/ethnic groups. We quantitatively analyzed the extent to which these differences can be attributed to differential patterns of smoking. METHODS: We utilized survey data from the U.S. Census to estimate smoking patterns in the following racial/ethnic groups: non-Hispanic whites, non-Hispanic blacks, Hispanics, Asian/Pacific Islanders and American Indians. We used several dose-response models of smoking and lung cancer to predict relative lung cancer rates in these groups based on reported smoking patterns, specifically, on smoking status (current, former, never), cigarettes per day, age started, and age quit (for former smokers). Predicted rates were compared to observed population rates for these groups. RESULTS: Black men had slightly lower predicted lung cancer rates than white men, but had 35-47% higher observed rates. Hispanic men had predicted rates about 25% lower than whites but observed rates 50% lower than whites; predicted rates for Hispanic women were 50% lower than whites compared to observed rates that were 60-70% lower. For Asian/Pacific Islanders, predicted and observed rates relative to whites were comparable. Predicted rates for American Indians were slightly higher than whites while observed rates were about 40% lower. CONCLUSION: Differences in smoking largely explain lower lung cancer rates in Asian/Pacific Islanders relative to whites and partially explain lower rates in Hispanics compared to whites. Increased rates in black men and decreased rates in American Indians are not explained by differences in smoking.

Ethnicity↗

Physician practice style variations.

This article studies the variation in physician practice style among geographic regions and across time. A physician practice profile is defined and a simple model for profile variation is developed. Ratios are calculated for the components of the profile--ambulatory visit rate, hospitalization rate and length of hospitalization--and studied in terms of adaptation to resource constraint and nonspecific style. The methods are applied to hospital use in the Census Metropolitan Areas of Canada.

Ambulatory Care↗

Risk factors for five-year incident age-related macular degeneration: the Reykjavik Eye Study.

PURPOSE: To establish risk factors for five-year incidence of age-related macular degeneration (AMD). DESIGN: Population-based, prospective cohort study, and risk analysis. METHODS: A random sample from the Reykjavik Population Census for individuals 50 years and older was selected. We took fundus stereo color photographs and used standard grading system to study the five-year incidence of drusen, pigmentary abnormalities, and AMD and to examine possible risk factors. A questionnaire including information on disease, medication, diet, and lifestyle from the Reykjavik Eye Study database provided additional information. RESULTS: Current alcohol consumption decreased the risk for drusen. Being married rather than divorced or widowed decreased the risk for soft drusen; being single decreased the risk of hypopigmentation as compared with being divorced or married. Both consuming dietary fiber-rich vegetables and meat and meat products once a week or less frequently was a risk factor for developing soft drusen and decreased the risk of pigmentary abnormalities. Those who had smoked 20 pack-years or more as compared with nonsmokers had decreased survival rate over the five years (odds ratio (OR) 0.46, 95% confidence interval (CI) 0.27 to 0.80; P = .006). CONCLUSIONS: Risk factors for drusen appear to differ from risk factors for pigmentary abnormalities. The effect of smoking on developing AMD is partly masked by selective mortality.

Aged↗

[Use of emergency medical service and sociodemographic factors].

OBJECTIVES: Health resources utilization is related to health conditions and to the population's sociodemographic characteristics. Low socioeconomic groups show increased utilization of certain resources. Emergency department utilization could also be affected by socioeconomic factors. The aim of this study was to identify differences in emergency department utilization among different socioeconomic groups. MATERIAL AND METHODS: A population-based study was performed. Census sections of the city of Santander in Spain were grouped according to sociodemographic variables (age, educational and professional attinment). Areas of the city with similar socioeconomic characteristics were established by cluster analysis. The place of residence of patients visiting the emergency department of th Hospital Marqués de Valdecilla was identified and the utilization rate was calculated for each cluster. RESULTS: Cluster analysis was able to identify four different groups, each with different socioeconomic characteristics, which were closely related to the districts of Santander. Comparison of clusters 1 and 4 showed that increased emergency department utilization was found amongst groups with lowest socioeconomic status and higher mean age, with an odds ratio of 1.91 (95% CI: 1.73-2.1). Patients from higher socioeconomic groups were more likely to be admitted to hospital while those from lower socioeconomic groups made more repeat visits to the emergency department. CONCLUSION: Emergency department utilization is affected by the sociodemographic characteristics of patients' area of residence. Patients with lower socioeconomic status show greater use of the emergency department.

Adult↗

Modeling community-level effects on preterm birth.

PURPOSE: We demonstrate modeling of community-level socioeconomic influences on risk of preterm birth (< 37 weeks gestation) in the Pregnancy, Infection, and Nutrition (PIN) Study. METHODS: Community-level information from the US Census was linked to 930 White and 817 African-American (Black) participants from a prospective cohort in central North Carolina through geocoded addresses, providing 123 census tracts with community-level and individual-level data for multi-level statistical analyses. RESULTS: Preterm delivery was experienced by 12.1% of Black and 10.4% of White participants. No appreciable aggregation of risk by community was discernable for White women. For Black women, random-coefficient logistic regression tract-specific preterm prevalence estimates ranged from 10.1% to 14.5%, "shrunk" from observed prevalences of 0% to 100%. Adding tract-level variables to the model representing median splits for household income and percent of single women heads of households with dependents, adjusting for individual-level maternal age and household income, accounted for much of the remaining between-tracts variation. CONCLUSIONS: Residing in a wealthier tract (> $30,000/year median income) was associated with reduced risk for Black women, adjusted OR = 0.59 (95% CI: 0.36, 0.96). The estimated conditional effect of lower community prevalence of female headed households was OR = 0.71 (95% CI: 0.43, 1.17).

Adolescent↗

A specialist leukaemia/lymphoma registry in the UK. Part 2: Clustering of Hodgkin's disease.

Part 1 describes the epidemiology of Hodgkin's disease occurring in those parts of the United Kingdom which are included in the Leukaemia Research Fund data collection survey. A total of 1,023 cases diagnosed between 1984 and 1986 were available for analysis. At county and district levels there was little heterogeneity in the distribution of cases. However, at the electoral ward level there were real differences for the younger age group (0-34). In this paper methods of investigation which are not dependent on census boundaries are applied and the presence of localised spatial clustering is confirmed. There is some evidence that the pattern of clustering relates to the nodular sclerosing subtype. These results are related to hypotheses of an infectious aetiology.

Adolescent↗