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PubMed1992

Establishing trends in ATSIC regional council populations using census data: a cautionary note.

"This paper points out that limitations in official census data for Aborigines and Torres Strait Islanders draw into question the validity of trend analysis based on time series data for Aboriginal and Torres Strait Islander Commission (ATSIC) regional council areas.... Following discussion of [the] problems, detailed figures showing changes in the size of the Aboriginal and Islander populations and labour force in each council area are presented using 1976 as the base year. As expected, geographic patterns of population and labour-force change are difficult to discern and exact reasons for comparative growth or decline are impossible to determine. The paper concludes that reverse projections for regional council areas using 1991 Census data would provide a more reliable basis for establishing demographic trends."

Australia↗
PubMed1987

Ethnic origin in the Australian census.

"This article discusses the Australian statistics of ethnic origin, collected under the headings of race and ancestry in the Australian census, with particular reference to conceptual precision and neutrality and to validity of results. It deals with European and non-European groups, but not with the special problems of counting the Australian aboriginal population."

Australia↗
PubMed1993

Census enumeration in remote Australia: issues for Aboriginal data analysis.

"Given the crucial role played by census data in informing economic and social policies directed at the Aboriginal population in remote areas, some assessment of the quality of remote area data is required as these are derived from enumeration procedures which differ fundamentally from the standard approach employed in the census. This paper discusses the remote area census enumeration strategy employed by the Australian Bureau of Statistics (ABS), with a particular focus on the Northern Territory, and highlights possible implications for the interpretation of census counts and census characteristics."

Australia↗
PubMed1984

Data dissemination for the population census.

"Recent developments in the data-dissemination system for census of population statistics are reviewed, with particular reference to Great Britain. Key issues discussed include: the expansion of census output and the need for summaries of census results; the significance of consultation with census users; the development and functions of guides for census users; the emergence of data-dissemination centres and archives offering new services; the functions of area typologies as a new type of census by-product; the demand for Public Use Samples and the problem of confidentiality; and the emergence of large-scale surveys as alternatives to the census."

Censuses↗
PubMed2004

Regional variations in racial differences in the treatment of elderly patients hospitalized with acute myocardial infarction.

PURPOSE: Racial differences in the treatment of patients with myocardial infarction are often presented as nationally consistent patterns of care, despite known regional variations in quality of care. We sought to determine whether racial differences in myocardial infarction treatment vary by U.S. census region. METHODS: We conducted a retrospective analysis of medical record data from 138,938 elderly fee-for-service Medicare beneficiaries hospitalized with myocardial infarction between 1994 and 1996. Patients were evaluated for the use (admission, discharge) of aspirin and beta-blockers, and cardiac procedures (cardiac catheterization, any coronary revascularization) within 60 days of admission. RESULTS: Nationally, black patients had lower crude rates of aspirin and beta-blocker use, cardiac catheterization, and coronary revascularization than did white patients. Racial differences in treatment, however, varied by region. Black patients in the Northeast had rates of aspirin use that were similar to those of white patients on admission (50.6% vs. 49.8%, P = 0.58) and at discharge (77.5% vs. 74.2%, P = 0.07), whereas racial differences were observed in the South (admission: 43.7% vs. 48.8%, P <0.001; discharge: 69.5% vs. 73.2%, P <0.001), Midwest (admission: 48.4% vs. 52.3%, P = 0.004), and West (admission: 49.2% vs. 56.2%, P <0.001; discharge: 70.7% vs. 76.2%, P = 0.02). Racial differences in beta-blocker use were comparable across regions (admission: P = 0.59, discharge: P = 0.89). There were no differences in cardiac catheterization use among black and white patients in the Northeast (38.9% vs. 40.5%, P = 0.24), as opposed to the Midwest (43.3% vs. 48.9%, P <0.001), South (39.2% vs. 48.5%, P <0.001), and West (38.3% vs. 48.6%, P <0.001). Similarly, racial differences in any coronary revascularization use were smallest in the Northeast (22.1% vs. 26.7%, P <0.001), greater in the Midwest (24.7% vs. 33.5%, P <0.001), and largest in the South (20.7% vs. 32.0%, P <0.001) and West (22.9% vs. 33.7%, P <0.001). Regional variations in racial differences persisted after multivariable adjustment for aspirin on admission (P = 0.09) and any coronary revascularization (P = 0.10). CONCLUSION: Racial differences in the use of some therapies for myocardial infarction in patients hospitalized between 1994 and 1996 varied by region, suggesting that national evaluations of racial differences in health care use may obscure potentially important regional variations.

Adrenergic beta-Antagonists↗
PubMed2006

The validity of the certification of manner of death by Ontario coroners.

PURPOSE: The aim of the study is to examine the validity of manner of death (MOD) certification of unnatural adult deaths by Ontario coroners. METHODS: A census of 306 active coroners practicing in Ontario was performed, with data collection occurring in 2002. Mailed self-administered questionnaires contained 14 fictitious clinicopathologic scenarios and questions regarding demographic information of the coroner. Crude and adjusted odds ratios of correct MOD certification were calculated by using responses of two deputy chief coroners as the gold standard. RESULTS: Nearly 74% of coroners responded to the survey. Deaths from hanging, drowning, and carbon monoxide had better odds of being certified correctly; whereas deaths from heroin, over-the-counter medication, and injuries from a descent had decreased odds of being certified correctly. Scenarios including a prior suicide attempt or a note had greater odds of correct MOD certification than those with only depression. Accidental deaths were underreported when injury resulted in a "natural" lethal complication and when there was a delay between injury and death. CONCLUSIONS: In detailing which deaths are likely to be misclassified and how they may be misclassified, this study will allow future research to more accurately assess suicidal and accidental deaths.

Cause of Death↗
PubMed2004

Do rates of hospital admission for falls and hip fracture in elderly people vary by socio-economic status?

OBJECTIVE: To determine the relationship between hospital admissions for falls and hip fracture in elderly people and area characteristics such as socio-economic deprivation. STUDY DESIGN: Ecological study of routinely collected hospital admissions data for falls and hip fracture in people aged 75 years or over for 1992-1997, linked at electoral ward level with characteristics from census data. METHODS: In total, 42,293 and 17,390 admissions were identified for falls and hip fracture, respectively, from 858 electoral wards in Trent. Rate ratios (RRs) for hospital admissions for falls and hip fracture were calculated by the electoral wards' Townsend score divided by quintiles. RRs were estimated by negative binomial regression and adjusted for the ward characteristics of age, gender, ethnicity, rurality, proportion of elderly people living alone and distance from hospital. RESULTS: There was a small but statistically significant association at electoral ward level between hospital admissions for falls and the Townsend score, with the most deprived wards having a 10% higher admission rate for falls compared with the most affluent wards (adjusted RR 1.10, 95% CI 1.01-1.19). No association was found between hospital admission for hip fracture and deprivation (adjusted RR 1.05, 95% CI 0.95-1.16). CONCLUSION: There is some evidence of an association at electoral ward level between hospital admissions for falls and socio-economic deprivation, with higher rates in deprived areas. No such association was found for hip fracture. Further work is required to assess the impact of interventions on reducing inequalities in hospital admission rates for falls in elderly people.

Accidental Falls↗
PubMed2005

Supplement use among men with prostate cancer.

OBJECTIVES: To characterize supplement use within a sample population of men diagnosed with prostate cancer. METHODS: A census of men diagnosed with prostate cancer at Duke University Medical Center from 1997 to 2002 (n = 1402) was mailed a survey that ascertained data on health status, education, diet, exercise, smoking status, and information on supplement use. Differences between demographic and treatment subgroups were described and tested, as was change in supplement use after diagnosis. RESULTS: Data from 805 respondents indicated that a majority (73%) used supplements, and 68% claimed that this information was shared with their cancer care provider. The most commonly reported supplements were multivitamins (56%), vitamin E (43%), vitamin C (33%), and calcium (26%). On average, 2.7 +/- 2.8 supplements per day were taken, and use increased significantly after diagnosis for most supplements. Use was significantly higher among men who were white (P = 0.043), were more highly educated (P = 0.002), exercise regularly (P = 0.020), and who consume five or more daily servings of fruits and vegetables (P = 0.040). CONCLUSIONS: A high percentage of men with prostate cancer take supplements, especially those who are white, more educated, and who pursue healthful behaviors. Systematic means of capturing these data are necessary to begin to understand the potential impact of supplements on disease outcome, especially because no data exist to suggest that supplements are of any benefit after diagnosis.

Aged↗
PubMed2006

Correlates of mammography in a national analysis compared to results in quintile- and regionally-defined samples.

BACKGROUND: National-level data are often used to identify groups of women at greater risk of not obtaining mammography, who might then receive targeted interventions. An important question, however, is how well results of national-level analyses match results from smaller samples of the same dataset. This study investigated the consistency of results about correlates of mammography from a single national-level analysis versus the results from analyses within each of five quintiles of mammography rates and nine Census subdivisions. METHODS: The sample for all analyses were women aged 42-79 from the Year 2002 United States' Behavioral Risk Factor Surveillance System (N = 80,283). Recent mammography was defined as self-report of a mammogram within the 2 years prior to the interview. Independent variables included sociodemographics, health practices, and a combined insurance status/usual source of care variable. RESULTS: Only smoking status, Pap testing, dental visit, and health insurance/source of care had consistent results with mammography status across all levels of analysis. Results for the other covariates, including standard sociodemographics, showed varying degrees of consistency. CONCLUSIONS: Caution is advised when using national data to inform regional or local intervention planning. Local and regional data are necessary to target programs to groups at greatest need for intervention.

Adult↗
PubMed2000

Stroke mortality in urban and rural Tanzania. Adult Morbidity and Mortality Project.

BACKGROUND: Most data for stroke mortality in sub-Saharan Africa are hospital based. We aimed to establish the contribution of cerebrovascular disease to all-cause mortality and cerebrovascular disease mortality rates in adults aged 15 years or more in one urban and two rural areas of Tanzania. METHODS: Regular censuses of the three surveillance populations consisting of 307,820 people (125,932 aged below 15 years and 181,888 aged 15 or more) were undertaken with prospective monitoring of all deaths arising in these populations between June 1, 1992 and May 31, 1995. Verbal autopsies were completed with relatives or carers of the deceased to assess, when possible, the cause of death. FINDINGS: During the 3-year observation period 11,975 deaths were recorded in the three surveillance areas, of which 7629 (64%) were in adults aged 15 years or more (4088 [54%] of these in men and 3541 [46%] in women). In the adults, 421 (5.5%) of the deaths were attributed to cerebrovascular disease, 225 (53%) of these in men and 196 (47%) in women. The yearly age-adjusted rates per 100,000 in the 15-64 year age group for the three project areas (urban, fairly prosperous rural, and poor rural, respectively) were 65 (95% CI 39-90), 44 (31-56), and 35 (22-48) for men, and 88 (48-128), 33 (22-43), and 27 (16-38) for women, as compared with the England and Wales (1993) rates of 10.8 (10.0-11.6) for men and 8.6 (7.9-9.3) for women. INTERPRETATION: We postulate that the high rates in Tanzania were due to untreated hypertension. Our study assessed mortality over a single time period and therefore it is not possible to comment on trends with time. However, ageing of the population is likely to lead to a very large increase in mortality from stroke in the future.

Adolescent↗
PubMed1998

Sectarian demography, territoriality and political development in Northern Ireland.

"Here we discuss, firstly, the limits of Census-based empiricism [in Northern Ireland] and the usually unacknowledged problems of data and interpretation which have resulted in a seriously misleading ¿conventional wisdom'. Secondly, we question its sectarian terms of reference, the over-identification of religion and politics, and misconceptions of ethnicity.... Thirdly, we focus on some of the flawed policy ¿solutions' associated with empiricism and sectarianism, including ¿internal' power-sharing and ¿consociational' strategies for political development."

Attitude↗
PubMed1997

Familial aggregation and covariation of diseases in a Japanese rural community: comparison of stomach cancer with other diseases.

PURPOSE: We investigated familial aggregation as well as familial covariation of diseases by means of a questionnaire survey dealing with family histories of stomach cancer, stroke, hypertension, diabetes and tuberculosis as well as life style among 2,769 inhabitants of a rural community (84% of census population). METHODS: The strength of familial aggregation was shown by an odds ratio (OR) that compared the number of families in which siblings suffered from one of the above diseases among families in which at least one parent suffered from it, and among families in which neither did. Probands were divided into two groups for analysis: an under-55 "young group," and a 55-and-older "old group." RESULTS: The OR for stomach cancer was lowest and insignificant in the young group, and significant (2.2, p < 0.05) only in the old group. The OR for stroke, hypertension, and tuberculosis was 4.5-5.1 (p < 0.05) in the young group but decreased to 2.3-3.2 in the old group. Diabetes increased from 3.9 to 5.7 (p < 0.05) with advancing age. Age-related OR trends were not affected by exposure to cigarette smoke in the past. Stomach cancer showed a borderline familial covariation with diabetes and a borderline inverse covariation with hypertension. Hypertension showed a familial covariation with stroke and diabetes. CONCLUSIONS: Among the investigated diseases, familial aggregation was weakest for stomach cancer. The results suggest that stomach cancer may share a common familial etiologic factor with diabetes and hypotension.

Adult↗
PubMed1984

Ecological fallacies and the analysis of areal census data.

The author examines problems related to the fact that in many countries, census data are only reported for areal units and not at the individual level. Attention is paid to the question of ecological fallacy problems that arise from this situation. Data from a 10 percent sample of the United Kingdom population and individual census data from Italy are used to illustrate the problem. "It is concluded that ecological fallacy effects are endemic to areal census data, although their magnitude is perhaps not as large as might have been expected. The principal difficulty is that there is at present no way of predicting in advance the degree of severity likely to be associated with particular variables and particular techniques. Finally, a suggestion is made concerning how the potentially serious practical consequences can be reduced."

Censuses↗