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PubMed1995

[Decay of villages--population censuses at the end of the seventeenth century].

"The study raises an interesting methodological problem of population history research: the authenticity of bygone population censuses (in this case at the end of the 17th century [in Hungary]), their scientific applicability, and the interpretation of data...in these documents. The final conclusion of the study is that checking the data of population censuses from several aspects and accurate critics of the sources are extremely important...." (SUMMARY IN ENG)

Censuses↗
PubMed2005

[Immunization coverage survey: empirical assessment of the cluster sampling method proposed by the World Health Organization].

OBJECTIVE: To assess sample representativeness and the precision of estimates of immunization coverage obtained with the 30 by 7 cluster sampling method proposed by the World Health Organization, by applying the method to determine immunization coverage in two municipalities (Diadema and São Caetano do Sul) in the state of São Paulo, Brazil, in 2000. METHOD: The representativeness of the samples was determined by comparing the census sectors picked by lot for the surveyed sectors and for the nonsurveyed sectors in both municipalities, in terms of socioeconomic and demographic characteristics (age distribution of the population, schooling, proportion of households headed by a women, monthly income of household head, and sanitary conditions of the home (piped-in water, connected to the sewer system)). The precision of the coverage estimates for the vaccines in the basic immunization schedule-BCG; diphtheria, pertussis, and tetanus (DPT); poliomyelitis; hepatitis B; measles; and measles, mumps, and rubella (MMR)-was determined by calculating the design effect and the width of the confidence intervals. Precision was considered to be satisfactory if the design effect was below 2.0 and the confidence interval width was below 10%. RESULTS: In both municipalities the comparison between the surveyed and nonsurveyed sectors showed a similar distribution in terms of socioeconomic and demographic variables. Concerning the precision of the estimates, the design effect was below 2.0 for all the vaccines, both in São Caetano do Sul and Diadema. In Diadema, the confidence interval width was below 10% for all the vaccines, except for MMR (10.1%). In São Caetano do Sul, only 89% of the expected sample were included, so the width of the confidence interval was slightly above 10% for the poliomyelitis vaccine (10.3%), the hepatitis B vaccine (11.8%), the mumps vaccine (10.4%), the MMR (12.9%), and the complete schedule (11.2%). CONCLUSION: The cluster sampling method proposed by the World Health Organization produces representative data as long as the methodological procedures for selecting the sample are rigorously followed in the field.

Adolescent↗
PubMed2003

Sex in Australia: the rationale and methods of the Australian Study of Health and Relationships.

OBJECTIVE: To describe the methods and process of the Australian Study of Health and Relationships. METHODS: A computer-assisted telephone interview was developed and applied to a stratified sample of the Australian population. After initially weighting to reflect the study design, the sample was further weighted to reflect the location, age and sex distribution of the 2001 Census. RESULTS: Interviews were completed with 10,173 men and 9,134 women aged 16-59 years from all states and Territories. The overall response rate was 73.1% (69.4% among men and 77.6% among women). After accounting for the survey design and weighting to the 2001 Census, the sample appears broadly representative of the Australian population. CONCLUSION: The combination of methods and design in the Australian Study of Health and Relationships, coupled with the high response rate, strongly suggests that the results of the study are robust and broadly representative of the Australian population.

Adolescent↗
PubMed1997

Classifying ethnicity utilizing the Canadian Mortality Data Base.

UNLABELLED: The study of ethnic differences in disease is a methodological challenge as ethnicity is often not identified in existing datasets and surrogate measures need to be used. We have developed a novel methodology combining last name and country of birth to study mortality patterns of Canadians of South Asian (SA) and Chinese (CH) ethnic origin and have compared death rates among SA, CH, and White (WH) Canadians. METHODS: SA and CH were identified in the Canadian Mortality Data Base (CMDB) using the last name and country of birth of the deceased. Records of people who had been born in countries with large South Asian and Chinese populations (e.g. India, Pakistan, China, Hong Kong) were selected and manually screened by last name. A name directory was then created of distinct South Asian and Chinese names and this directory was used to search all other records in the CMDB for SA and CH deaths. Where necessary, other identifying characteristics such as first name and parents' last name were also used. Population counts were obtained from the Census self-reported question on ethnicity for SA and CH. WH were identified as non-immigrant Canadians who were neither SA nor CH. The method of assigning ethnicity in the CMDB and Census were assessed for comparability and issues of validity and reliability were addressed. RESULTS: Using this method, 10,989 SA and 21,548 CH deaths were identified. There was marked heterogeneity in birthplace, with only 56% of SA born in South Asia and only 74% of CH born in Greater China. Last names had high validity for self-reported ethnicity in a population sample of SA and were highly reproducible. Mortality rates varied dramatically between groups studied. SA and WH had high rates of ischemic heart disease while stroke mortality was similar among all three groups. Cancer death rates were high in CH and WH and much lower in SA. CONCLUSION: Last names and country of birth can be used to determined ethnicity of SA and CH with validity and reliability, and leads to a more accurate classification than country of birth alone. The contrasting patterns observed in mortality from major causes of death suggest many interesting hypotheses for further study.

Adult↗
PubMed1971

On the risk of multiple sclerosis according to age at immigration to South Africa.

In a national prevalence study of multiple sclerosis (M.S.) in the Republic of South Africa based on census day 1960 there were 118 individuals with M.S. who were born in Northern Europe (United Kingdom and other parts of North and Central Europe) and who had emigrated to the Republic by 1960. Their prevalence rate was 49 per 100,000 immigrants in comparison with a prevalence of 11 per 100,000 among native-born English-speaking white South Africans.To study the possible effect of age at immigration it was necessary to relate the M.S. immigrants to the appropriate denominator-the population at risk according to age at immigration. The population at risk by age at immigration has been estimated by two methods in an indirect fashion with the assistance of the Bureau of Census (1960) and by surveys of the population at risk 1968-9. Both studies suggest that the risk of developing M.S. was reduced to less than a third of the expected risk among those who immigrated under the age of 15 or 16.This study is further evidence that M.S. is an acquired exogenous disease, the precise nature of which is still not certain but, according to present knowledge, has as its leading contender the class of slow, latent, or temperate viruses.

Adolescent↗
PubMed2003

On the importance of age-adjustment methods in ecological studies of social determinants of mortality.

OBJECTIVE: To illustrate the potential sensitivity of ecological associations between mortality and certain socioeconomic factors to different methods of age-adjustment. DATA SOURCES: Secondary analysis employing state-level data from several publicly available sources. Crude and age-adjusted mortality rates for 1990 are obtained from the U.S. Centers for Disease Control. The Gini coefficient for family income and percent of persons below the federal poverty line are from the U.S. Bureau of Labor Statistics. Putnam's (2000) Social Capital Index was downloaded from http://www.bowlingalone.com; the Social Mistrust Index was calculated from responses to the General Social Survey, following the method described in Kawachi et al. (1997). All other covariates are obtained from the U.S. Census Bureau. STUDY DESIGN: We use least squares regression to estimate the effect of several state-level socioeconomic factors on mortality rates. We examine whether these statistical associations are sensitive to the use of alternative methods of accounting for the different age composition of state populations. Following several previous studies, we present results for the case when only mortality rates are age-adjusted. We contrast these results with those obtained from regressions of crude mortality on age variables. PRINCIPAL FINDINGS: Different age-adjustment methods can cause a change in the sign or statistical significance of the association between mortality and various socioeconomic factors. When age variables are included as regressors, we find no significant association between mortality and either income inequality, minority racial concentration, or social capital. CONCLUSIONS: Ecological associations between certain socioeconomic factors and mortality may be extremely sensitive to different age-adjustment methods.

Adolescent↗
PubMed2001

Ecological and socioeconomic correlates of fruit, juice, and vegetable consumption among African-American boys.

BACKGROUND: Investigators have reported that the availability of foods in local grocery stores correlated with consumption when using large geopolitical units of analysis, e.g., zip codes. Associations across smaller geopolitical units, e.g., census tracts, have not been tested, nor has this work focused on restaurant availability, child consumption, or specific ethnic groups. METHODS: This study examined whether median family income and fruit, juice, and vegetable (FJV) availability in grocery stores, restaurants, and homes in 11 census tracts correlated with FJV consumption among 11- to 14-year-old African-American Boy Scouts. FJV consumption was measured in 90 scouts using two 24-h food recalls. Instruments were developed to measure the availability of FJV at area grocery stores, restaurants, and homes where troop members resided. RESULTS: Median household income (from 1990 census) was significantly correlated with restaurant fruit availability. Significant correlations were found between restaurant juice and vegetable availability and Boy Scout reported consumption of juice and vegetables. CONCLUSION: Census tract may be a useful unit when studying restaurant, but not grocery store, FJV availability. Within a census tract, restaurant FJV availability may be a significant target for community intervention and process evaluation.

Adolescent↗
PubMed2003

Effects of communities, neighborhoods and stores on retail pricing and promotion of beer.

OBJECTIVE: This study examines how communities, neighborhoods and stores influence retail pricing and promotion of beer. METHOD: In the year 2000, trained field staff conducted observations in 2,024 retail alcohol stores in 160 communities throughout the contiguous United States. Based on a nationally representative sample of schools, we selected communities defined by the school's catchment area, or the vicinity from which the majority of students are drawn. We randomly selected off-sale alcohol retail establishments from a complete list of stores likely to sell tobacco or alcohol in the selected communities. Beer price and promotions are based on observations of Miller and Budweiser beer brands in the stores. Neighborhoods are defined by the store's census block. We used cross-sectional, hierarchical regression models and mixed methods procedures to analyze data. RESULTS: Community, neighborhood and store characteristics were related to beer price; however, only community and store characteristics were predictive of beer promotions. CONCLUSIONS: Overall, the pricing and promotion of beer vary systematically by some characteristics of communities, neighborhoods and stores, but not significantly by the number of young people populating a neighborhood. In addition, pricing and promotion of Budweiser and Miller beers, in particular, do not appear to target racial minority populations. Because of the significant effect of store characteristics, public health agencies and advocates might focus prevention efforts on collaborations with liquor control agencies to reduce variations in pricing and promotion of beer, which ultimately encourage risky drinking behaviors. Further studies are needed to examine the effects of pricing and promotion on alcohol-related social problems.

Adolescent↗
PubMed1988

On estimating census undercount in small areas.

"Net undercount rates in the U.S. decennial census have been steadily declining over the last several censuses. Differential undercounts among race groups and geographic areas, however, appear to persist. In the following, we examine and compare several methodologies for providing small area estimates of census coverage by constructing artificial populations. Measures of performance are also introduced to assess the various small area estimates. Synthetic estimation in combination with regression modelling provide the best results over the methods considered. Sampling error effects are also simulated. The results form the basis for determining coverage evaluation survey small area estimates of the 1900 decennial census."

Americas↗
PubMed1991

Evaluation of procedures for improving population estimates for small areas.

"We provide and illustrate methods for evaluating across-the-board ratio estimation and synthetic estimation, two techniques that might be used for improving population estimates for small areas. The methods emphasize determination of a break-even accuracy of knowledge concerning externally obtained population totals, which marks the point at which improvement occurs." The techniques are illustrated using 1980 U.S. census data.

Americas↗
PubMed1999

Associations between community income and cancer survival in Ontario, Canada, and the United States.

PURPOSE: The objectives of this study were as follows: (1) to compare the magnitude of the association between socioeconomic status (SES) and cancer survival in the Canadian province of Ontario with that in the United States (U.S.), and (2) to compare cancer survival in communities with similar SES in Ontario and in the U.S. METHODS: The Ontario Cancer Registry provided information about all cases of invasive cancer diagnosed in Ontario from 1987 to 1992, and the Surveillance, Epidemiology and End Results Registry (SEER) provided information about all cases diagnosed in the SEER regions of the U.S. during the same time period. Census data provided information about SES at the community level. The product-limit method was used to describe cause-specific survival. Cox proportional hazards models were used to describe the association between SES and the risk of death from cancer. RESULTS: There were significant associations between SES and survival for most cancer sites in both the U.S. and Ontario, but the magnitude of the association was usually larger in the U.S. In the poorest communities, there were significant survival advantages in favor of cancer patients in Ontario for many disease groups, including cancers of the lung, head and neck region, cervix, and uterus. However, in upper- and middle-income communities, there were significant survival advantages in favor of the U.S. for all cases combined and for several individual diseases, including cancers of the breast, colon and rectum, prostate, and bladder. CONCLUSION: The association between SES and cancer survival is weaker in Ontario than it is in the U.S. This is due to a combination of better survival among patients in the poorest communities and worse survival among patients in the wealthier communities of Ontario relative to those in the U.S.

Adult↗
PubMed2006

Associations between socioeconomic status and cancer survival: choice of SES indicator may affect results.

PURPOSE: Two previous studies, by Gorey et al. and Boyd et al., compared associations between socioeconomic status (SES) and cancer survival in Canada and the United States. Both studies used SES information from population censuses linked to cancer registries. This study investigates why two similar studies led to apparently conflicting results. METHODS: We conducted analyses following analytic details provided by the previously published studies to describe cancer survival in Toronto, Canada, and Detroit, MI. We examined the effects of choice of census indicators and census levels on the observed SES-related gradients in cancer survival. RESULTS: Significant associations between SES and cancer survival were observed in Toronto for several major disease sites when median household income was used as an SES indicator. Associations were weaker when a poverty indicator was used. In Detroit, similar SES gradients were observed by using both income and poverty as SES indicators. When SES quintiles were represented by income ranks, SES-associated survival gradients were much steeper in Detroit than Toronto. When SES was described by the median income in each quintile, gradients were similar in the two cities. CONCLUSIONS: The apparent contradiction in results of two previous studies is related to the choice of SES indicators. Poverty may not be an indicator of choice for such an intercountry comparison.

Data Interpretation, Statistical↗
PubMed2005

Utilization of screening mammography in New Hampshire: a population-based assessment.

BACKGROUND: The objective of screening mammography is to identify breast carcinoma early, which requires routine screening. Although self-report data indicate that screening utilization is high, the results of this population-based assessment indicated that utilization is lower than reported previously. METHODS: The authors compared New Hampshire population data from the 2000 Census with clinical encounter data for the corresponding time obtained from the New Hampshire Mammography Network, a mammography registry that captures approximately 90% of the mammograms performed in participating New Hampshire facilities. RESULTS: The results showed that approximately 36% of New Hampshire women either never had a mammogram or had not had a mammogram in > 27 months (irregular screenees), and older women (80 yrs and older) were less likely to be screened (79% unscreened/underscreened) compared with younger women (ages 40-69 yrs; 28-32% unscreened/underscreened). Of the screened women, 44% were adhering to an interval of 14 months, and 21% were adhering within 15 months and 26 months. The remaining 35% of the women had 1 or 2 mammograms and did not return within 27 months. CONCLUSIONS: Routine mammography screening may be occurring less often than believed when survey data alone are used. An important, compelling concern is the reason women had one or two mammograms only and then did not return for additional screening. This area deserves additional research.

Adult↗
PubMed2003

Children, family and cancer survival in Norway.

Models for all-cause mortality among 45,000 men and women with cancer in 12 different sites were estimated, using register and census data for complete Norwegian birth cohorts. This observed-survival method appeared to be an adequate approach. The results support the idea that women who were pregnant shortly before a breast cancer diagnosis may have a poorer prognosis than others. In principle, such an effect may also reflect that these women have a young child during the follow-up period and are burdened by that. However, this social explanation can hardly be very important, given the absence of a corresponding significant effect in men and for other cancer sites in women. Breast cancer is different from other malignancies also with respect to the effect of parenthood more generally, regardless of the timing of the pregnancies. On the whole, male and female cancer patients with children experience lower mortality than the childless, though without a special advantage associated with adult children. This suggests a social effect, perhaps operating through a link between parenthood, lifestyle and general health. No parity effect was seen for breast cancer, however, which may signal that the social effect is set off against an adverse physiologic effect of motherhood for this particular cancer. Among men, both marriage and parenthood were associated with a good prognosis. Married male cancer patients with children had mortality one-third lower than that among the childless and never-married. Women who had never married did not have the same disadvantage.

Adult↗
PubMed1999

International and US medical graduates in US cities.

OBJECTIVES: This study examines the comparative distributions of postresident international medical graduates (IMGs) and US medical graduates (USMGs) in high and low poverty areas of US cities. Existing research has established that IMGs are more likely than USMGs to practice in urban areas, yet there is the question whether IMGs locate more frequently than USMGs in urban poverty areas. METHODS: Data from the 1997 AMA Physician Masterfile and 1990 US Census were merged to classify physicians' practices into low- and high-poverty areas in selected cities. RESULTS: In 14 cities with populations of 2.5 million or more, IMGs were located in a statistically significant disproportion in poverty areas of 7 cities. Of 36 cities with populations of 1,000,000 to 2,499,999, there were 5 cities that had significant IMG disproportions in poverty areas. Of a random sample of 27 cities with populations of 250,000 to 999,999, there were 2 cities that had significant IMG disproportions. Many cities in all three size categories had a large proportionate IMG complement of the total physician workforce located within high-poverty areas. CONCLUSIONS: IMGs were found in disproportionate numbers in poverty areas in a number of US cities, especially the very largest ones. These findings are discussed in light of the current debate about a physician surplus and initiatives to reduce the number of IMGs in residency training.

Data Collection↗
PubMed2005

Differential inequity in health expectancy by region in Belgium.

OBJECTIVES: To evaluate the size of social inequities in health between regions in Belgium using a composite health measure, the disability free life expectancy (DFLE). METHODS: Mortality data (5-years follow-up of the 1991 census) are combined with the 1997 Health Interview Survey to estimate the DFLE by education. Differences in partial life expectancy25-74 (LE25-74) and in DFLE25-74 between those at the bottom and those at the top of a relative social scale are used to compare the regional inequities. RESULTS: The higher educated person has a longer LE, with more years free of disability and less years with disability (in years: Flemish males: LE = 46.48; DFLE = 42.08; Walloon males: LE = 44.92; DFLE = 39.80; Flemish females: LE = 47.90; DFLE = 41.93; Walloon females: LE = 46.90; DFLE = 39.84) compared to the population at the bottom of the education hierarchy (in years: Flemish males: LE = 44.86; DFLE = 30.16; Walloon males: LE = 42.77; DFLE = 27.00; Flemish females: LE = 46.86; DFLE = 28.30; Walloon females: LE = 45.44; DFLE = 25.30). The inequity in LE and in DFLE is larger in the Walloon Region than in the Flemish Region. Only the regional difference in inequity in LE is statistically significant. CONCLUSION: The DFLE can be used to monitor the size of health inequities.

Adult↗
PubMed2007

Hospital-based healthcare provider (nurse and physician) integration into an emergency medical services-managed mass-gathering event.

INTRODUCTION: This report describes not only the implementation of a coordinated emergency medical services-hospital-based healthcare team but also investigates the integration of nurse-physician teams at a mass gathering medical care event. METHODS: A review of resource utilization, patient encounters, and local ED census was performed during this period at a college football stadium. RESULTS: During this 4-year period, 1681 patients presented for medical care during 26 events with a total attendance of 1,544,244 (1.09 patients per thousand attendees [PT]). The majority of patient contacts were for minor complaints (1451, 87.6%), whereas 205 (12.4%) received full evaluations (focused history and physical examination most often with pulse oximetric and electrocardiographic monitoring). A total of 109 patients were transported (4.19 PT), representing 6.48% of all patients. Patient census for the event medical deployment increased from 0.44 PT in 2001 to 1.75 PT in 2004. The number and percent of patients transported also increased between 2001 (0.02 PT, 4.48%) and 2004 (0.12 PT, 6.67%). However, 118 (57.6%) patients who received full evaluations were able to be discharged by a physician, avoiding transport. Chief complaints and management of patients receiving full evaluations were consistent across this period, with altered mental status (52.7%) and chest pain (12.7%) as the most common complaints. Average ED census during this period was found to be significantly higher on event days (176.2) than nonevent days (161.2) (t = 8.04, P < .001), although this produced only a minor impact on the emergent care system. CONCLUSION: This study describes one potential deployment plan for a mass gathering medical event and suggests that the incorporation of physicians into a mass gathering setting may be associated with an absolute increase in patient census and transports, while decreasing the percent of patients transported. The impact on local emergency medical services and ED resources, although not specifically investigated in this study, was likely minimal.

Adult↗