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PubMed1994

Infant mortality in Nigeria: effects of place of birth, mother's education and region of residence.

This paper examines the effects of a child's place of birth, mother's education, region of residence and rural and urban residence on infant mortality in Nigeria between 1965 and 1979, using data from the 1981/82 Nigeria Fertility Survey. Infant mortality rates declined in all regions between 1965 and 1979. Children born in modern health facilities, irrespective of their mothers' place of residence, experienced significantly lower rates of infant mortality than those born elsewhere. Logistic regression analysis showed that all other variables tested were also significant, although some to a lesser degree. Efforts to reduce infant mortality in Nigeria should include policies that rectify rural and urban differentials in the distribution of health facilities and encourage their use.

Adolescent↗
PubMed1998

Ecological and geographic characteristics predict nutritional status of communities: rapid assessment for poor villages.

The quality of poverty alleviation programmes relies heavily on appropriate targeting and priority setting. Major problems in assessing poverty include identification of the indicators of poverty and the methods used for its assessment. Nutritional status, expressed by anthropometric indices, has been proposed as a poverty indicator because of its validity, objectivity, reliability and feasibility. This study was conducted to explore the application of remote sensing to poverty mapping based on nutritional status at the community level. Relationships between the nutritional status within a community and the ecological characteristics of the community were investigated. Multiple linear regression tests were executed, and the resultant equations were tested for their validity in predicting communities with poor nutritional status. Among geographical and ecological indicators used, distance to the nearest market, main soil type, rice field area, and perennial cultivation area were found to be most useful predictors for the ranking of the communities by nutritional status. Among non-ecological determinants, food consumption, health service status and living conditions were also found as predictors. The highest correlation was found if total population was also taken into account in the regression model (R2 = 0.69; p < 0.0001). In the assessment of the sensitivity and specificity of the eight models studied, 'undernutrition' was defined as a condition where a community belongs in the first quartile for nutritional status (highest prevalence of undernutrition), and the baseline nutritional survey was considered as a standard method for final diagnosis. Most models which included only ecological factors in the equations had lower sensitivity and specificity than models which included all determinant factors in the equations. All models which took into account the total population had higher sensitivity and specificity than those that did not take total population into account. The best model of those that took into account only the geographical and ecological characteristics of the community's living environment had similar sensitivity and specificity (80% and 94.1%, respectively) as the models that considered non-geographical and non-ecological variables in addition to geographical and ecological variables. In the case of West Sumatra, only four ecological and geographic characteristics were sufficient to predict poverty in village. Since these characteristics could be surveyed by remote sensing, it may well be possible to use remote sensing for a rapid method for poverty mapping.

Data Collection↗
PubMed1993

Death of choice in the subpopulation of people aged 60 and more in psycho-epidemiological studies in the years 1978-1991.

"The structure and dynamics of [suicide] in the subpopulation of elderly people [in Poland] is discussed on the basis of official [statistical] data. Routine epidemiological analyses allow us to state that sex, age and place of residence are decisive factors determining the number of suicides at postproductive [ages]. The suicidal death rate is higher for men in all age groups, both in urban and rural areas."

Adult↗
PubMed2000

The impact of co-resident spouses and sons on elderly mortality in rural Bangladesh.

This paper uses prospective data from the Matlab surveillance system in rural Bangladesh to demonstrate that initially co-resident spouses and sons have a major impact on the subsequent mortality of old people, with significant differences by the sex of the elderly person, and the age of the son. Spouses significantly reduce mortality by similar magnitudes for both elderly men and women. On the other hand, co-resident adult sons reduce mortality for elderly women much more than for elderly men, with younger sons being more beneficial than older sons. Furthermore, both married and unmarried females appear to benefit equally from co-resident adult sons. Finally, this analysis suggests that the impact of spouses and sons on mortality in old age is not substantially mediated through changes in elderly economic status.

Adult↗
PubMed1997

Small area variation in the incidence of childhood insulin-dependent diabetes mellitus in Yorkshire, UK: links with overcrowding and population density.

BACKGROUND: The incidence of insulin-dependent diabetes mellitus (IDDM) incidence varies between and within countries. The origins of this variation are disputed, but they involve both genetic and non-genetic influences. To explore the role of environmental factors in the aetiology of IDDM we have examined the incidence in small geographical areas and related it to variables derived from national censuses. METHODS: This is an ecological analysis of incidence data from a register of children with IDDM covering the counties of West Yorkshire, North Yorkshire and Humberside in the north of England. All children aged < or = 16, diagnosed with IDDM between 1978 and 1990 were eligible for inclusion. Spatial variation in incidence between electoral wards was investigated using Poisson regression, in relation to socioeconomic status, population density, urban-rural status and measures of geographical isolation. Ward child populations varied in size from 84 to 7197 (mean = 1545). RESULTS: Rates were significantly lower in wards of high population density and with many overcrowded houses. The rate ratio for areas in the upper half of the childhood density distribution was 0.88 (95% confidence interval (CI): 0.78-0.99) and for the two upper tertiles of household overcrowding the rate ratios were 0.84 (95% CI: 0.74-0.95) and 0.68 (95% CI: 0.58-0.79) respectively. CONCLUSIONS: The incidence of childhood IDDM was associated with environmental factors including population density and overcrowded homes. A possible inference from these data is that patterns of infection are involved in the occurrence of IDDM. Analytical epidemiological studies will be needed to investigate these ideas further.

Adolescent↗
PubMed1998

Abortion affiliation, urban size, and geographic bias of responses to lost letters.

A study using 1800 "lost letters" was designed to test the hypothesis that returned responses would be greater in smaller rural communities (population M = 964) than in a city (population = 60,591) or the suburbs (population = 195,847) unless the addressee was affiliated with a pro-abortion group. Returns to control, Committee For Free Abortion, and Committee Against Free Abortion affiliates were 37.2%, 24.0%, 29.3%, respectively. From the city, the number of returned letters was much larger than the number from the suburbs except for those letters with an affiliation to the pro-abortion condition. Returned letters from the city were fewer than those from smaller rural communities except those letters affiliated with the pro-abortion group. More letters affiliated with the pro-abortion condition were returned from the suburbs than from the smaller rural communities. The geographic condition influenced over-all rates of return. Rates were higher when letters were addressed to a city P.O. Box than to a rural one. Second, rates were also greater in smaller rural communities for letters bearing "in-town" (Molino) and "out-of-town" (Pensacola) addresses than those from the city bearing an "out-of-town" (Molino) address. These findings seem to indicate the possibility that there may be some geographic bias in the willingness of people to help a stranger in need by returning a lost letter.

Abortion, Legal↗