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PubMed1990

Automation of mortality data coding and processing in the United States of America.

The development in the United States of America of an automated system for coding mortality data (Automated Classification of Medical Entities--ACME) was undertaken with two major objectives in mind: (i) to introduce consistent and rapid assignment of underlying cause-of-death coding with reduced needs for manpower training; and (ii) to allow better utilization of medical information on death certificates for multiple cause-of-death analyses. The ACME system meets both of these objectives; the National Center for Health Statistics (NCHS) produces all of its underlying cause-of-death statistics for the United States on the basis of this system, and multiple cause-of-death data are routinely available for additional epidemiological study beyond the traditional methods of vital statistics analyses. Enhancements of the automated system, primarily through the software known as MICAR, reduce even further the levels of training necessary for persons doing the basic data entry. MICAR additionally will ease transitions between ICD revisions by reducing the need for coder reorientation and by permitting rapid calculation of comparability ratios when new revisions are introduced.

Disease↗
PubMed1986

Mortality study of men employed at a large chemical plant, 1972 through 1982.

The mortality experience of a cohort of approximately 9,000 traced men employed at a Tennessee chemical plant was examined between 1972 and 1982. Statistically significant total mortality deficits of 41% to 46% and 14%, respectively, were observed compared with general population and occupational controls. Cancer deaths were 22% (significant) below expectation based on state and national vital statistics, whereas comparison with an employed group showed no difference. Significantly low mortality differentials were also reported for other major causes, including diseases of the circulatory, respiratory, and digestive systems. Analysis of the data by length of employment, payroll status, and chemical production division demonstrated no unusual patterns. The cohort's favorable mortality experience may be attributed to such factors as employee selectivity, health maintenance, accessibility to medical care, and less cigarette smoking.

Chemical Industry↗
PubMed2002

Mortality patterns in the Russian Federation: indirect technique using widowhood data.

OBJECTIVE: The Russian mortality crisis of the early 1990s attracted considerable attention, but information on possible covariates of mortality is lacking, and concerns have been raised about the validity of official mortality data. To help elucidate the determinants of mortality, we examined whether indirect demographic techniques could be used to study mortality in countries such as the Russian Federation, where mortality data are inadequate, using input data independent from official vital statistics. METHODS: A national sample of the population was interviewed (n = 1600, response rate = 67%). Participants who had ever been married (82% of the sample) were asked about the date of birth and vital status of their first spouse. Spousal mortality was then estimated indirectly for the 531 men and 710 women for whom valid data were available. FINDINGS: The estimated risk of death between the ages of 35-69 years was 57% for male spouses and 17% for female spouses. Corresponding figures derived from national data for 1990 were 52% and 25% for the Russian Federation, and 31% and 20% for the United Kingdom. According to spouses' reports, 38% of their husbands died from cardiovascular disease, 22% from cancer, and 14% from injuries and accidents. Mortality of male spouses was inversely related to the education level of their wives, and the age-adjusted hazard ratios for death from all causes, compared to primary education, were 0.77 for secondary education and 0.57 for university education (trend P = 0.03). Mortality was also inversely related to ownership of household items, but not to size of settlement, pride in Russia, membership in the Soviet Communist Party, nationality or self-assessed social status. CONCLUSIONS: Although the indirect estimates were imprecise (partly owing to the small population size of the study), and mortality in women was probably underestimated (owing to many factors, including poorer reporting by males and high male mortality), our results are nevertheless consistent with the mortality pattern observed in official mortality data. The indirect technique thus appears to be a useful tool to study the determinants of mortality in the Russian Federation and other populations, where reliable or sufficiently extensive data are not available.

Adult↗
PubMed1993

Surveillance for ectopic pregnancy--United States, 1970-1989.

PROBLEM/CONDITION: From 1970 through 1989, hospitalizations for ectopic pregnancy have increased in the United States; the number of cases has increased fivefold, from 17,800 to 88,400. REPORTING PERIOD COVERED: 1970-1989. DESCRIPTION OF SYSTEM: Reported ectopic pregnancies were estimated from data collected by CDC's National Center for Health Statistics (NCHS) as part of the ongoing National Hospital Discharge Survey. Data from responding hospitals were weighted to represent national estimates. The number of deaths resulting from ectopic pregnancy was based on U.S. vital statistics collected by NCHS. Denominators for calculating ectopic pregnancy rates were the total number of reported pregnancies, which includes live births, legal induced abortions, and ectopic pregnancies. Data for live births were obtained from NCHS natality statistics and data for legal induced abortions from CDC's Division of Reproductive Health. RESULTS: From 1970 through 1989, more than one million ectopic pregnancies were estimated to have occurred among women in the United States; the rate increased by almost fourfold, from 4.5 to 16.0 ectopic pregnancies per 1,000 reported pregnancies. Although ectopic pregnancies accounted for < 2% of all reported pregnancies during this period, complications of this condition were associated with approximately 13% of all pregnancy-related deaths. During this period, the risk of death associated with ectopic pregnancy decreased by 90%: the case-fatality rate declined from 35.5 deaths per 10,000 ectopic pregnancies in 1970 to 3.8 in 1989. The risks of ectopic pregnancy and death from its complications were consistently higher for blacks and other racial/ethnic minorities than for whites throughout the period. INTERPRETATION: Although the general trend has been for the numbers and rates of ectopic pregnancy to increase over the 20-year period, the variability of the data does not permit meaningful conclusions to be made about year-to-year changes in the estimates of ectopic pregnancies, especially for the years 1988 and 1989. ACTIONS TAKEN: These findings indicate the need to characterize behaviors and risk factors that may respond to preventive interventions. Until these risks factors are better characterized, early detection and appropriate management of ectopic pregnancies will remain the most effective means of reducing the morbidity and mortality associated with this condition.

Adolescent↗
PubMed2002

Occupational mortality from squamous cell carcinoma of the esophagus in the United States during 1991-1996.

The epidemiology of esophageal squamous cell cancer has remained poorly understood. The occupational distribution of this cancer may provide clues about its yet unknown etiology. Data files from the National Center for Health Statistics (NCHS) of the United States offer a unique source to study causes of death, broken down by occupation and industry. The number of deaths from esophageal cancer was retrieved from the computerized US vital statistics. Mortality by occupation or industry was expressed as standardized proportional mortality ratio (PMR), adjusted by age, gender, and ethnicity. Between 1991 and 1996, 63,717 subjects died from esophageal squamous cell carcinoma. Mortality was particularly high among nonwhites and men. The industrial and the occupational distributions shared a similar pattern. Mortality from esophageal squamous cell carcinoma occurred more frequently among subjects exposed to silica dust, such as brickmasons and stonemasons, concrete and terrazzo finishers, roofers, and construction laborers. It was also high in such industries as unspecified machinery or manufacturing and such occupations as unspecified material handlers, janitors, or cleaners. It was low in industries and occupations associated with agriculture, clergy, work in religious organizations, and textiles. In conclusion, mortality from esophageal squamous cell carcinoma appeared to be low in occupations associated with less consumption of alcohol and tobacco. It was high among occupations potentially associated with exposure to silica dust and chemical solvents or detergents.

Aged↗
PubMed1997

Time off work and the postpartum health of employed women.

OBJECTIVES: Parental and maternity leave policies are a popular fringe benefit among childbearing employed women and a benefit employers frequently are required to offer. However, few rigorous evaluations of the effect of maternal leave on maternal health exist. METHODS: Using a hybrid of the household and health production theories of Becker and Grossman and a sample of women identified from state vital statistics records, a nonlinear relationship between maternal postpartum health and time off work after childbirth was estimated. RESULTS: For women taking more than 12 weeks leave, time off work had a positive effect on vitality. With more than 15 weeks leave, time off work had a positive effect on maternal, mental health, and with more than 20 weeks leave, time off work had a positive effect on role function. Subjects' mental health scores were comparable and vitality scores slightly lower than age- and gender-specific norms; 70% of women studied reported role function limitations. CONCLUSIONS: Findings suggest employed women experience problems in well-being at approximately seven months postpartum. Variables associated with improved health include: longer maternity leaves, fewer prenatal mental health symptoms, fewer concurrent physical symptoms, more sleep, increased social support, increased job satisfaction, less physical exertion on the job, fewer infant symptoms, and less difficulty arranging child care.

Adult↗
PubMed1992

A statistical chronicle of tuberculosis in Canada: Part I. From the era of sanatorium treatment to the present.

This report marks over 50 years of publication by Statistics Canada of annual reports on tuberculosis statistics. These years have witnessed what has been described as a conquest of tuberculosis in Canada. To quote George Jasper Wherrett in The Miracle of the Empty Beds: One hundred years ago the word consumption (as tuberculosis was then called) struck horror in human hearts. Today, in the western world, it barely evokes any emotion save a too easy surprise that it still exists. This statistical chronicle of tuberculosis in Canada is divided into two parts. Part I: From the Era of Sanatorium Treatment to the Present pulls together data from yellowed-with-age reports on tuberculosis and vital statistics, historical accounts and modern computer files, to document the changes in tuberculosis incidence and mortality over past decades to the present. Part II: Risk Today and Control takes a closer look at those most vulnerable to contracting tuberculosis. It also looks at the future, the need for maintaining and, indeed, strengthening vigilance, and the work yet to be done to eradicate tuberculosis in Canada. The fight against tuberculosis is far from over.

Adolescent↗
PubMed1992

A statistical chronicle of tuberculosis in Canada: Part II. Risk today and control.

This report marks over 50 years of publication by Statistics Canada of annual reports on Tuberculosis Statistics. These years have witnessed what has been described as a conquest of tuberculosis in Canada. To quote George Jasper Wherrett in the Miracle of the Empty Beds: One hundred years ago the word consumption (as tuberculosis was then called) struck horror in human hearts. Today, in the western world, it barely evokes any emotion save a too easy surprise that it still exists. This statistical chronicle of tuberculosis in Canada is divided into two parts. Part I: From the Era of Sanatorium Treatment to the Present pulls together data from yellowed-with-age reports on tuberculosis and vital statistics, historical accounts, and modern computer files, to document the changes in tuberculosis incidence and mortality over past decades to the present. Part II: Risk Today and Control takes a closer look at those most vulnerable to contracting tuberculosis. It also looks at the future, the need for maintaining and, indeed, strengthening vigilance, and the work yet to be done to eradicate tuberculosis in Canada. The fight against tuberculosis is far from over.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Mapping of mortality data--ischemic heart disease among men in Norway 1966-87].

We have illustrated how cartography can be used in the study of regional mortality. We chose as an example ischaemic heart disease among males aged 30-69 in Norway during the period 1966-87. Choropleth maps (area shading) and circle maps were used to demonstrate regional differences both as regards level of mortality and mortality time trends. A probability map was produced to show the degree of statistical significance for deviation from the national mortality rate. The examples in this study revealed some regional mortality patterns not previously reported. We conclude that mapping is a valuable method in the study of vital statistics

Adult↗
PubMed1989

[Recent trends and prognosis of pulmonary diseases in Japan].

To determine trends of death rates for patients with chronic pulmonary diseases the author compiled the numbers of deaths per 100,000 Japanese population per annum based on the annual reports of the Japan Vital Statistics for the past 43 years. Death rates for the newborn population as well as for the younger population decreased while those for the aged population remained unchanged. Increasing numbers of deaths from lung cancer and decreasing numbers of death from pulmonary tuberculosis were noted. The death rate from the chronic obstructive lung diseases was maintained while the death rate for diffuse fibrotic lung diseases tended to be elevated. Baseline reference values for respiratory physiology parameters, established by the Special Commission for Respiration Physiology of the Japan Society of Chest Diseases, were presented by single linear regression equations represented in terms of age covering the subject's whole age span, including the aged population. The author carried out further analyses based on the data collected in a multi-center cross-sectional survey and concerning, some parameters found consistent differences the linear regression equation calculated for the aged population from those for the younger population. A longitudinal survey conducted by follow-up observations at Keio University Hospital to determine the annual decline of parameters on respiration physiology was designed to cover healthy subjects as well as subjects with chronic pulmonary diseases. Annual declines in vital capacity, forced vital capacity, forced expiratory volume in one second, arterial oxygen tension and arterial carbon dioxide tension showed linear changes throughout the entire age span. Some parameters, such as flow max at 25% vital capacity or alveolar-arterial oxygen tension difference (AaDO2), demonstrated statistically consistent differences in annual decline between younger and older age populations. The annual decline of parameters in patients with chronic pulmonary diseases demonstrated consistently larger values compared with those for healthy subjects. In a study on the pathophysiology and prognosis of patients with respiratory failure with/or without cor pulmonale extension of the survival period for the patients with cor pulmonale was demonstrated.

Adolescent↗
PubMed1987

Improving the validity and reliability of medical-legal certifications of suicide.

On a very basic level, those who study suicide are either explicitly or implicitly concerned with the certification of suicide deaths by coroners and medical examiners. Although many authors have questioned the reliability and validity of officially reported rates, these statistics continue to be quoted as fact--a potentially problematic practice for researchers who seek accurate and true causative factors for suicidal behavior. In relation to this topic, this article provides an overview of the existing vital statistics registry system and describes and proposes innovations that could ultimately improve the quality of officially reported suicide statistics.

Accidents↗
PubMed1976

[World health-related indicators].

Many of the statistics given in this report are estimates based on tentative data and on that extent are not reliable in a strict sense. But the picture they present of gross differences in demographic and social characteristics, in vital statistics, and in resources of medical manpower and hospital beds between major areas of the world is real. More than half of the people of the world live in South Asia and East Asia; population density is highest in Western Europe; and highest rates of population growth are in Middle America and Tropical South America. In Europe less than one-third of the population are aged under 20 years, whereas more than half the population are aged under 20 im Middle and Tropical South America and the Carribbean, in Africa and in South Asia. Urbanization is high in Temperate South America, Northern America, Northern and Western Europe, and Oceania. The daily dietary energy supply per person is 50% higher in Northern America, Europe, USSR, and Ocenia than in Africa (excluding Southern Africa, South and East Asia. The Gross National Product in Northern America is 10 times higher than in Tropical South America and 30 to 40 times higher than in Western Middle and Eastern Africa and in Middle South and South East Asia. Crude birth rates are close to three times higher in Africa, Middle America and South Asia than in Europe, North America and USSR. Differences in crude death rates are less--rates in Western, Middle and Eastern Africa are double these of America Europe, USSR and Oceania. The Expectation of Life is over 70 years for Northern America, Europe, USSR and Oceania. It is under 50 years for Western, Middle and Eastern Africa. In all areas the expectation of life at birth has increased--by up to 10 years--in the past quarter century. Infant mortality is less than 20 per 1 000 in Northern and Western Europe and Northern America. It is over 100 in Africa and South Asia. Number of physicians range from 25 per 10 000 population in USSR to less than 1 per 10 000 in Western, Middle and Eastern Africa. There are over 100 hospital beds per 10 000 population in USSR and in Northern and Western Europe, less than 10 per 10 000 in Western Africa, Middle South Asia and South East Asia.

Age Factors↗
PubMed1950

[Statistics].

Explore the source record for details and available documents.

Biometry↗
PubMed1994

Impact of HIV infection and AIDS on death rates in British Columbia and Canada.

OBJECTIVE: To assess the impact of HIV infection and AIDS on death rates in British Columbia and Canada. DESIGN: Descriptive, population-based study. SETTING: British Columbia and Canada. PATIENTS: All people for whom HIV infection or AIDS was listed as the underlying cause of death in Canada and all provinces from 1987 to 1991, as reported to Statistics Canada, and all people for whom HIV infection or AIDS was listed as the underlying or antecedent cause of death in British Columbia and Vancouver from 1987 to 1992, as reported to the Division of Vital Statistics, British Columbia Ministry of Health. MAIN OUTCOME MEASURES: Age- and cause-specific patterns of death, and potential years of life lost (PYLLs) for men. RESULTS: From 1987 to 1991 a total of 4189 deaths from HIV infection and AIDS (in 3941 males and 248 females) in Canada and 686 such deaths (in 671 males and 15 females) in British Columbia were reported to Statistics Canada. The rate of death from HIV infection and AIDS was 1.39 times higher (95% confidence interval [CI] 1.29 to 1.50) in British Columbia than in Canada as a whole and 1.95 times higher (95% CI 1.65 to 2.29) when HIV infection was associated with specified malignant neoplasms than with other related causes. The PYLLs from HIV infection and AIDS for men rose steadily in Canada, from 17,615 in 1987 to 38,735 in 1991; the latter is comparable to the PYLLs from stroke and colorectal cancer. In Vancouver the PYLLs from HIV infection and AIDS for men increased sharply from 1987 to 1992, surpassing the PYLLs from heart disease, malignant neoplasms and accidents. CONCLUSIONS: From 1987 to 1991 the rate of death from HIV infection and AIDS in British Columbia was higher than the national average. In Vancouver HIV infection and AIDS have become the leading causes of premature death in men, exceeding heart disease, malignant neoplasms and accidents.

Acquired Immunodeficiency Syndrome↗
PubMed1993

One-year outcome of elderly and young patients admitted to intensive care units.

OBJECTIVE: To compare the outcome of patients over and under age 65 admitted to two intensive care units (ICUs). DESIGN: Prospective, two-center study. Convenience sample of all admissions to two adult ICUs for a 1-yr period, with a 1-yr follow-up. SETTING: Adult multidisciplinary closed ICUs. PATIENTS: All patients (n = 1,040) admitted to two ICUs during a 1-yr period were entered into the study, except patients with self-induced poisoning. Of these patients, 145 patients were lost to follow-up. INTERVENTIONS: Admission statistics on all patients included demographic, case mix, and severity data. Variables associated with intensive care unit outcomes at discharge (length of stay, mortality) and at 1 yr from admission (mortality, functional capacity, health attitudes) were analyzed. Vital status was confirmed from both Alberta Vital Statistics and Alberta Health. Follow-up interviews were conducted with all available survivors. RESULTS: The elderly group (> 65 yrs) comprised 46% of patients studied. Both age groups (> 65 yrs and < 65 yrs) had comparable demographics and illness severity measures. Although ICU and 1-yr mortality rates differed between groups (16% of > 65 yrs vs. 12.9% of < 65 yrs ICU mortality and 49% of > 65 yrs vs. 31% of < 65 yrs 1-yr mortality), age was not a major contributor to the variance in outcome. At 1 yr, 65% of patients admitted to the study were alive. Follow-up interviews were conducted with 75% of survivors. Assessment of activities of daily living showed that the elderly patients were similar to younger patients. The elderly demonstrated more positive health attitudes than younger survivors. Functional capacity was significantly associated with health attitudes of younger patients, but not for older survivors. CONCLUSIONS: Age does not have an important impact on outcome from critical illness, which is most strongly predicted by severity of illness, length of stay, prior ICU admission and respiratory failure. Satisfaction with personal health should not be inferred from the functional status of elderly survivors of intensive care.

Activities of Daily Living↗
PubMed2004

Epidemiologic study of mortality during the Summer 2003 heat wave in Italy.

INTRODUCTION: It is widely recognized that extreme climatic conditions during summer months may constitute a major public health threat. Owing to what is called the "urban heat island effect," as well as to the consequences of heat waves on health, individuals living in cities have an elevated risk of death when temperature and humidity are high compared to those living in suburban and rural areas. Studies on heat wave-related mortality have further demonstrated that the greatest increases in mortality occur in the elderly. Following the unusually hot summer of 2003 and the dramatic news from neighboring countries such as France, the Italian Minister of Health requested the Istituto Superiore di Sanita-Bureau of Statistics to undertake an epidemiologic study of mortality in Italy during Summer 2003 to investigate whether there had been an excess of deaths, with a particular focus on the elderly population. MATERIALS AND METHODS: Communal offices, which maintain vital statistics, were asked for the individual records of death of residents registered daily during the period 1 June-31 August 2003 and during the same period of 2002 for each of the 21 capitals of the Italian regions. As it was necessary to obtain mortality data quickly from many municipalities and to make the analysis as soon as possible, the method adopted was comparison of mortality counts during the heat wave with figures observed during the same period of the previous year. RESULTS: Compared with 2002, between 1 June and 31 August 2003, there was an overall increase in mortality of 3134 (from 20,564 to 23,698). The greatest increase was among the elderly; 2876 deaths (92%) occurred among people aged 75 years and older, a more than one-fifth increase (21.3%, from 13.517 to 16.393%). The highest increases were observed in the northwestern cities, which are generally characterized by cold weather, and in individuals 75 years and older: Turin (44.9%), Trento (35.2%), Milan (30.6%), and Genoa (22.2%). Of note are also the increases observed in two southern cities, L'Aquila (24.7%) and Potenza (25.4%), which are located, respectively, at 700 and 800 m above see level. For Bari and Campobasso, both in the South, with a typically hot summer climate, the increase during the last 15 days of August was 186.2 and 450%, respectively. CONCLUSIONS: The relationship between mortality and discomfort due to climatic conditions as well as the short lag time give a clear public health message: preventive, social, and health care actions must be administered to the elderly and the frail to avoid excess deaths during heat waves.

Aged↗
PubMedDate not supplied

Death data as input to policy-making.

United States and international mortality statistics are analyzed for various applications because of their importance for identifying and monitoring health problems, developing programs for disease prevention and health promotion, and for portraying trends and patterns. Since public and corporate policy is significantly affected by vital statistics data, the quality of the information on the death certificate should be as accurate and complete as possible.

Cause of Death↗