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Differential mortality and fertility in Sri Lanka by ethnic group.

"Using data from the publication by the Registrar-General [of Sri Lanka] of deaths by age, sex and ethnic group for the census year 1981, as well as births by maternal age and ethnic group for the same year, this study examines variation in mortality by ethnic group over the post-war period. It also examines differential fertility by ethnic group over the same period in the light of new data that have become available."

Age Factors↗

Population density and cancer mortality differentials in New York State, 1978-1982.

Patterns of cancer mortality within five population density quintiles in Upstate New York (New York State, exclusive of New York City), were investigated between 1978 and 1982. Sex-specific standardized mortality ratios (SMRs) were calculated within each population density quintile for all cancer deaths combined and for site-specific cancer deaths based on cancer mortality patterns exhibited by the general population of New York State, exclusive of New York City. Areas with the highest population density demonstrated a 12% excess of cancer deaths among males and a 6% excess among females. In contrast, areas with the lowest population density exhibited lower cancer mortality, among both males (9% less) and females (7% less). Males demonstrated a significant linear relationship between increasing population density and deaths for all cancer sites combined and for cancers of the oral cavity and pharynx, oesophagus, stomach, colon, gallbladder, pancreas, lung, prostate, and kidney. Among females, a significant linear relationship was observed between increasing population density and deaths for all cancer sites combined and for deaths due to cancers of the stomach, colon, liver and breast. Deaths due to cancers of the rectum, malignant melanomas of the skin, and cervix also exhibited unusual patterns of mortality across the population density quintiles. These data are most useful in generating hypotheses for further studies to define specific aetiological factors operating within population density groupings. Population density, as measured in this investigation, may represent a surrogate measure for other factors which are related to cancer morbidity and cancer mortality.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗

Alcohol-related deaths contribute to socioeconomic differentials in mortality in Sweden.

BACKGROUND: This study aims at estimating the contribution of alcohol to socioeconomic mortality differentials in Sweden. METHODS: Data were obtained from a Census-linked Deaths Registry. Participants in the 1980 and 1990 censuses were included with a follow-up of mortality 1990-1995. Socioeconomic status was assigned from occupation in 1990 or 1980. Alcohol-related deaths were defined from underlying or contributory causes. Poison regressions were applied to compute age-adjusted mortality rate ratios for all-causes, alcohol-related and other causes among 30-79-year-olds. The contribution of alcohol to mortality differentials was calculated from absolute differences. RESULTS: Around 5% (9,547) of all deaths were alcohol-related (30-79 years). For both sexes, manual workers, lower nonmanuals, entrepreneurs and unclassifiable groups had significantly higher alcohol-related mortality than did upper nonmanuals. Male farmers had significantly lower such mortality. The contribution of alcohol to excess mortality over that of upper nonmanuals was greatest among middle-aged (40-59 years) men who were manual workers or who belonged to a group of 'unclassifiable & others' (25-35%). It was of considerable size also for middle-aged lower nonmanuals (both sexes), male entrepreneurs, female manual workers and 'unclassifiable & others'. Among men, the total contribution of alcohol (30-79 years) was estimated at 16% for manual workers, 10% for lower nonmanuals and 7% for entrepreneurs; and among women, 6% (manual workers, lower nonmanuals) and 3% (entrepreneurs). CONCLUSION: Although deaths related to alcohol were probably underreported (e.g. accidents), alcohol clearly contributes to socioeconomic mortality differentials in Sweden. The size of this contribution depends strongly on age (peak among the middle-aged) and gender (greatest among men).

Adult↗

Urban-rural mortality differentials: controlling for material deprivation.

This paper investigates the relationship between premature mortality and material deprivation, and the differences in this relationship between urban and rural areas. We examine, given comparable measures of affluence or deprivation, whether residual differences exist between urban and rural areas for all-causes of death and, separately, for cancers, circulatory and respiratory diseases. Using 1990-92 mortality data for the 908 wards of Wales we apply statistical analyses based on tabular data and parametric Poisson regression models. Contrasts are sought between six urban and rural categories defined in terms of settlement sizes and the employment structure of rural areas. Inequalities in all-cause premature mortality are widest in the cities, narrowest in the deeper rural areas, and of intermediate and comparable value in other areas of Wales. This is largely a reflection of the different distributions of material deprivation in these areas. After controlling for differences in socio-economic characteristics, using deprivation measures, the tendency for lower mortality in deeper rural areas is substantially reduced. Residual mortality differences between urban and rural areas are shown to be dependent on the way deprivation is measured and the disease group under study. For cancers there are no residual mortality differences, while for respiratory and circulatory diseases some of the residual variation can be accounted for by employment variables, particularly previous employment in the coal mining industry.

Humans↗

[Mortality differential for cancer based on social class: the metropolitan region of Montreal, 1971].

Cancer mortality rates vary from area to area. Part of this variation is due to socio-economic characteristics of the area and part to other factors including the availability of health services. Three social indicators associated with cancer mortality are used to estimate variations between low and high census sectors within the metropolitan region of Montreal. The components of socio-economic status which have been used are revenue (median family income), education (college and university level) and occupation (higher status profession). For each of the three zones of the metropolitan area: the city of Montreal, the island of Montreal not included the city of Montreal, the north and south shores of the metropolitan area twenty five census sectors have been chosen which having higher or lower positions for each of the socio-economic components. For each group standardized death rates were evaluated for each type of cancer and the Poisson test was applied to judge whether the differences between the projected rate and the observed rate were significant. The results indicate a strong indirect relation between the standardized mortality rates and the socio-economic status in the central city. In the case of lung cancer, the spatial distribution showed district gradients of occurrence between the central-city and the suburbs.

Adult↗

[Differential mortality in women of reproductive age].

"This paper begins by reviewing some conceptual frameworks for the study of female mortality and indicates some of its application problems. Next it presents results of mortality of women in reproductive-age classified by age, causes of death, and socio-demographic traits (marital status, schooling, and occupation) for ten states [in Mexico] differentiated according to level of development and well-being. The data suggests differences according to age, marital status, and schooling. Finally, testing of the mutual independence and partial independence hypotheses indicates that age, marital status, and schooling correlate to the degree of development of each state." (SUMMARY IN ENG)

Age Factors↗

Socioeconomic status, particulate air pollution, and daily mortality: differential exposure or differential susceptibility.

BACKGROUND: Short-term increases in particulate air pollution are linked with increased daily mortality and morbidity. Socioeconomic status (SES) is a determinant of overall health. We investigated whether social class is an effect modifier of the PM(10) (particulate matter with diameter <10 micron)-daily mortality association, and possible mechanisms for this effect modification. METHODS: Area-based traffic emissions, income, and SES were available for each resident in Rome. All natural deaths (83,253 subjects) occurring in Rome among city residents (aged 35+ years) during the period 1998-2001 were identified. For each deceased individual, all the previous hospitalizations within 2 years before death were available via a record linkage procedure. PM(10) daily data were available from two urban monitoring sites. A case-crossover analysis was utilized in which control days were selected according to the time stratified approach (same day of the week during the same month). Conditional logistic regression was used. RESULTS: Due to the social class distribution in the city, exposure to traffic emissions was higher among those with higher area-based income and SES. Meanwhile, people of lower social class had suffered to a larger extent from chronic diseases before death than more affluent residents, especially diabetes mellitus, hypertension, heart failure, and chronic obstructive pulmonary diseases. Overall, PM(10) (lag 0-1) was strongly associated with mortality (1.1% increase, 95%CI = 0.7-1.6%, per 10 microg/m(3)). The effect was more pronounced among persons with lower income and SES (1.9% and 1.4% per 10 microg/m(3), respectively) compared to those in the upper income and SES levels (0.0% and 0.1%, respectively). CONCLUSIONS: The results confirm previous suggestions of a stronger effect of particulate air pollution among people in low social class. Given the uneven geographical distributions of social deprivation and traffic emissions in Rome, the most likely explanation is a differential burden of chronic health conditions conferring a greater susceptibility to less advantaged people.

Adult↗

Morbidity and mortality: differentials and their trends.

"To establish whether medical science has managed to ensure quality of life during the additional years of life now available in many populations requires a relatively complex interactive model of morbidity and mortality. The development of such a model has been the prime objective of this paper. For the model we describe, formulae were derived which allow a health scientist to explain the contributions, by age, of different diseases to changes in life expectancy in healthy or less than healthy states, and for a particular disease, the contribution of disease prevention, successful disease treatment (leading to recovery) and mortality prevention. Such an analysis can be very helpful for health policy purposes. Formulae were also developed for studying trends in life expectancy differentials in terms of changes in rates of disease prevention, disease treatment success and mortality prevention." (SUMMARY IN FRE)

Age Factors↗

Mortality differentials between three populations--residents of Scandinavia, Scandinavian immigrants to Canada and Canadian-born residents of Canada, 1979-1985.

The study compares the mortality of Canadian residents born in Canada and Scandinavia (Finland, Sweden, Norway, Denmark) to the mortality of the four Scandinavian countries. The study focuses on the mortality experience of anyone who was 35-74 years old during the period 1979-85. Swedish and Norwegian populations both in Scandinavia as well as immigrants to Canada had relatively low mortality from all causes of death. On the other hand, populations in Finland and Denmark had comparatively higher mortality from certain causes of death. Finnish excess mortality from cardiovascular diseases and from external causes of death was present in Finnish living in Scandinavia as well as in Finnish immigrants to Canada. This contrasted with the excess mortality from non-cardiovascular disease in the population of Denmark which was not reflected in the mortality of Danish immigrants to Canada. Finally, the cardiovascular mortality of all Scandinavian-born immigrants to Canada was found to be lower than in their respective countries of origin. The article includes a discussion of possible explanations for these results.

Adult↗