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PubMed2004

Seasonal changes in mortality rates from main causes of death in Japan (1970--1999).

BACKGROUND: It is well recognized that the season of the year exerts an influence on some diseases and causes of death such as coronary heart diseases, stroke, infectious diseases and so on. METHODS: We evaluated the influence of seasonal changes on diseases and causes of death in Japan using the Japan Vital Statistics from 1970 to 1999 and recorded weather data (mean temperature), by a Fourier decomposition in a log linear regression model. RESULTS: Major influences of seasonal change with the highest rates in winter were seen on the following: the overall causes of death; infectious and parasitic diseases including tuberculosis; respiratory disease, including pneumonia and influenza; heart and cerebrovascular diseases; diabetes; and digestive diseases and accidents. Two peaks were seen in suicides, a large peak in April and a small peak in autumn. Cancer and homicides were little or not at all influenced by seasonality. There was no major difference in changes between the years studied, except for respiratory disease and tuberculosis, which showed a clear reduction in the seasonality effect from 1970 to 1999. CONCLUSIONS: To reduce the overall mortality rate and to prolong life expectancy in Japan, measures must be taken to reduce those mortality rates associated with seasonal differences, especially those causes of death which show a strong correlation with seasonal change: respiratory, heart, cerebrovascular, diabetes and infectious diseases.

Accidents, Traffic↗
PubMed2005

Contributions of mortality changes by age group and selected causes of death to the increase in Japanese life expectancy at birth from 1950 to 2000.

The purpose of this study is to analyze contributions of mortality change by age group and selected causes of death to the increase in life expectancy at birth from 1950 to 2000 in Japan, which has the longest longevity in the world. Using mortality data from Japanese vital statistics from 1950 to 2000, we analyzed contributions of mortality change by age group and selected causes of death to the increase in life expectancy at birth by the method of decomposition of changes and calculated age-adjusted death rates for selected causes of death. Gastroenteritis, tuberculosis and pneumonia largely contributed to an increase in life expectancy in childhood and in the young in the 1950s and 1960s. The largest contributing disease changed from tuberculosis and pneumonia in earlier decades to cerebrovascular diseases in the 1970s. The largest contributing age group also shifted to older age groups. Age-adjusted death rate for cerebrovascular diseases in 2000 was one fifth of the 1965 level. Cerebrovascular diseases contributed to an increase in life expectancy at birth of 2.9 years in males and 3.1 years in females from 1970 to 2000. In the 1990s, the largest contributing age group, both among males and among females, was the 75-84 age group. Of the selected causes of death, heart diseases other than ischemic heart disease became the largest contributor to the increase in life expectancy at birth. Unlike cerebrovascular diseases, cancer and ischemic heart disease contributed little to change in life expectancy at birth over the past 50 years. In conclusion, although mortality from ischemic heart disease has not increased since 1970 and remained low compared with levels in western countries, mortality from cerebrovascular diseases has dramatically decreased since the mid-1960s in Japan. This gave Japan the longest life expectancy at birth in the world. It is necessary to study future trends in life expectancy at birth in Japan.

Adolescent↗
PubMed2006

Did the 1991-1995 wars in the former Yugoslavia affect sex ratio at birth?

Proportion of males at birth (commonly referred to as the sex ratio) has been investigated for countries of former Yugoslavia that were affected by the 1991-1995 wars. Number of live births for Slovenia, Croatia, Bosnia and Herzegovina with Serbian Republic, and Serbia and Montenegro were obtained from the official vital statistics data and analysed with the Chi-square test. Results yielded no difference in the sex ratio associated with the war for the entire data set. However, country level data analysis revealed a significant increase in Bosnia and Herzegovina with the Serbian Republic, where proportion of male births during the wartime reached as high as 0.523 (compared to 0.516 in the pre-war and 0.515 in the post-war period). Countries that were involved in either mild or intermediate level of warfare did not exhibit a significant increase in the sex ratio (e.g. Slovenia and Croatia). Although war in Croatia lasted a year longer than in Bosnia and Herzegovina, analysis of the most intensive wartime periods in Croatia did not yield significant change. It seems that a hypothetical threshold of the warfare intensity combined with duration has to be reached (e.g. as in case of Bosnia and Herzegovina), in order for war to influence the sex ratio.

Chi-Square Distribution↗
PubMed2005

Medicaid coverage and medical interventions during pregnancy.

This paper extends prior research on the effect of Medicaid coverage on medical interventions during pregnancy (prenatal ultrasound) and birth (ultrasound during delivery, cesarean delivery, inducement, and fetal monitor). The data are from two sources: the New York State Vital Statistics (VS) matched infant birth-death file and the Statewide Planning and Research Cooperative System (SPARCS) file for 1993--1996. Medicaid coverage increases the likelihood of teens and adults receiving prenatal care relative to being uninsured. Overall, the effect of insurance type varies depending on whether the procedure is part of standard care (ultrasound and fetal monitor) or more likely to be elective (inducement and cesarean delivery). Insurance type has a greater effect for elective procedures than for procedures that are part of standard care.

Adolescent↗
PubMed2006

Selective migration and infant mortality among Puerto Ricans.

OBJECTIVE: This study examines the implications of migration to the United States for infant mortality among Puerto Rican mothers born in Puerto Rico. The roles of selective migration and duration of US residence are assessed. METHOD: Using survey data collected from mothers of infants sampled from computerized birth and infant death records of six US vital statistics reporting areas and Puerto Rico, we estimate logistic regression models of infant mortality among the sampled infants. These models provide a baseline for comparison with fixed-effects models based on all births within each mother's history. RESULTS: Logistic regression models for sampled infants show that the risk of infant mortality is lower for migrant women than for nonmigrant women in Puerto Rico until the migrants have lived in the United States for a substantial period of time. Fixed-effects models indicate that once unmeasured stable characteristics of the mother are controlled, early migrants do not differ from nonmigrants with respect to the risk of infant death. Both sets of models demonstrate that as mothers' exposure to the US mainland increases, the risk of infant mortality rises. CONCLUSIONS: Selective migration plays a role in the relatively low risk of infant mortality among recent Puerto Rican migrants to the United States. Migrants appear to be selected on qualities that contribute to favorable health outcomes for their offspring, but those qualities are later lost with exposure to life in the United States.

Adult↗
PubMed2004

Coronary calcium screening and coronary risk stratification.

Current vital statistics clearly indicate a continuing epidemic of cardiovascular disease in the Western hemisphere and strongly suggest that the most desirable approach to this ailment is prevention rather than delayed treatment. Over 7 million people in the United States suffer from coronary artery disease and more than 500,000 die from its complications annually. In the majority of cases, the event announcing the presence of atherosclerosis is either sudden death or a disabling myocardial infarction or stroke. Though recent trials indicate a need for treatment of very large segments of the population, a review of current clinical practices indicates that the preventive attitude of the majority of physicians is not sufficiently developed and remains limited in most training programs. Additionally, although traditional risk factors are very helpful in predicting the development of cardiovascular disease, many individuals suffer events in the absence of established risk factors for atherosclerosis. To meet the challenge of coronary artery disease, several tools have been developed to identify atherosclerotic disease in its preclinical stages, with the hope of modifying its natural history. In this article, we review the current literature on utilization of electron beam tomography for detection of coronary artery calcification as a tool to conduct risk stratification for coronary artery disease events in the general population.

Animals↗
PubMed1990

Peripheral arterial occlusive disease of the extremities in the United States: hospitalization and mortality.

PAODE is an important cause of morbidity and health care expenditures among the elderly. Data from the NHDS and National Vital Statistics System were used to assess its impact in the U.S. In 1985 to 1987, an estimated 229 thousand men and 184 thousand women per year were discharged with any diagnosis of chronic PAODE. Discharge rates were much higher in men and increased sharply with age. Lower extremity arteriography was performed during 88 thousand hospitalizations and aorta-iliac-femoral bypass procedures were done during 31 thousand hospitalizations per year. Numbers of procedures increased markedly since 1979. An estimated 60 thousand men and 50 thousand women per year were discharged with any diagnosis of acute PAODE. Embolectomy or thrombectomy of lower limb arteries was listed for 28 thousand discharges per year. Few deaths were attributed to PAODE. Although these data are limited by likely incomplete reporting and by the nonspecificity of diagnostic codes, they provide an indication of the magnitude of the problem. An aging population and advances in surgical techniques suggest continued monitoring using multiple data sources. Vigorous primary prevention programs are needed to lessen the impact of all atherosclerotic diseases.

Acute Disease↗
PubMed1992

Causes of death in persons with human immunodeficiency virus infection.

PURPOSE: Pneumocystis carinii pneumonia (PCP) was reported to be the predominant cause of human immunodeficiency virus (HIV)-related deaths prior to 1988, the year that effective prophylaxis against PCP entered routine use. Our study was performed to study the causes of HIV-related death since January 1988 in a region where patient tracking is virtually complete. PATIENTS AND METHODS: We surveyed physicians associated with the Brown University Acquired Immunodeficiency Syndrome (AIDS) Program who cared for greater than 95% of known HIV-positive patients in Rhode Island. These physicians identified all those HIV-infected persons who had died under their care between January 1988 and July 1990, and determined these patients' causes of death by chart review. For comparison, death certificates of identified persons were also reviewed at the Rhode Island Department of Vital Statistics. RESULTS: Among 126 deaths since January 1988, bacterial infections were the most common cause of death (30%), whereas PCP was responsible for only 16% of deaths. Persons not receiving any form of PCP prophylaxis were more likely to die from PCP than were those who received prophylaxis (26% versus 11% [p = 0.04]). Cause of death as recorded on actual death certificates was imprecise, although bacterial infections were again the most common cause indicated. Only one death occurred in a patient with a CD4 count greater than 200/mL, and this was not HIV-related. CONCLUSION: PCP has not been the leading cause of death in our region since January 1988. Bacterial infections contribute substantially to mortality, and this may influence future prophylactic regimens. HIV-related deaths in patients with CD4 counts greater than 200/mL are unusual.

AIDS-Related Opportunistic Infections↗
PubMed1975

The effect of availability and utilization of prenatal care and hospital services on infant mortality rates. Summary of the findings of the Louisiana Infant Mortality Study. Part II.

A total of 69,556 birth and 1,541 death certificates from Louisiana, 1972, were reviewed. Infant, neonatal, and postneonatal mortality rates were computed for number of prenatal visits, type of hospital of delivery, hospital vs. nonhospital delivery, and geographical access to health care. The mortality rates were twice as great for infants born outside of hospitals. With no prenatal care, the infant mortality rates were between four- and tenfold greater than the rates of women receiving more than nine visits even when race, poverty, geography, and birth weight were considered. Infant mortality rates were twice as high in the neonatal period and three times greater in the postneonatal period among the poor who utilized charity hospitals. This study illustrates a method which could be incorporated into state vital statistics reports which would detect populations at risk of excess infant deaths and would provide a more refined analysis of birth and infant death data to monitor improvements in care of high-risk groups.

Black or African American↗
PubMed1976

Radical pelvic surgery versus radiation therapy for stage I carcinoma of the cervix (exclusive of microinvasion).

During the period from January 1, 1945, through December 31, 1975, 446 patients with Stage I infiltrative carcinoma of the cervix (exclusive of microinvasion) were evaluated at the University of Michigan Medical Center. Four different study groups with treatment comparisons between radical hysterectomy with pelvic lymph node dissection and full-course radiation therapy are analyzed. The over-all uncorrected five-year survival rate when each form of therapy is evaluated approximates 85 per cent; the corrected five-year survival rate is approximately 90 per cent. When the regional lymph nodes were negative, the five-year survival rate was 96 per cent; when they were positive, the five-year survival rate was 55 per cent. Pathologic variations are evaluated, and basic vital statistics are reported. Thirteen per cent of the patients developed a recurrence within five years, 70 per cent occurring within the first three years. The therapeutic morbidity experienced in both groups of patients is essentially comparable, and the advantages of each form of therapy are presented.

Adult↗
PubMed1986

Risk factors for the development of diethylstilbestrol-associated clear cell adenocarcinoma: a case-control study.

Factors related to the risk of developing clear cell adenocarcinoma in diethylstilbestrol-exposed women were investigated in 156 patients in the United States with clear cell adenocarcinoma and documented diethylstilbestrol exposure (Registry cases) and 1848 diethylstilbestrol-exposed women of similar age without cancer (National Cooperative Diethylstilbestrol Adenosis Project). Diethylstilbestrol dosage patterns, the use of other hormones, mother's age and pregnancy history, and daughter's birth month, birth weight, and age at menarche were compared. The relative risk was higher for those whose mothers began diethylstilbestrol before the twelfth week of pregnancy and for those who were born in the fall (winter conception). Maternal history of at least one prior spontaneous abortion elevated the risk. Supportive evidence for the difference in birth month distribution was also found by a comparison with United States vital statistics. Each factor was confirmed to be significant in a multivariate logistic model that examined all of them with region and year of birth adjusted.

Adenocarcinoma↗
PubMed1989

A comparison of low birth weight, perinatal mortality, and infant mortality between first and second births to women 17 years old and younger.

Several studies and vital statistics reports have indicated that second pregnancies in the young adolescent have worse outcomes than first pregnancies. This study compared the birth weights and mortality rates of first and second births to 407 teenagers who were less than or equal to 17 years old at the time of the second delivery. Contrary to previous studies, the mean birth weight was significantly lower for first births than for second births (p = 0.0001), even though patients registered for care earlier with their first pregnancy. The perinatal and infant mortality rates for first births were nearly double the rates for second births.

Adolescent↗
PubMed1992

Monthly variation of hospital admission and mortality of peptic ulcer disease: a reappraisal of ulcer periodicity.

The occurrence of peptic ulcer is characterized by a seasonal variation, the meaning of which is poorly understood. The present study examined the periodicity of hospital admissions and mortality resulting from gastric and duodenal ulcer to determine its etiologic relevance. Ulcer periodicity was studied in the nationwide data sets of the Department of Veterans Affairs, the Health Care Financing Administration, and the Vital Statistics. Both ulcer types were characterized by similar patterns of periodicity. Hospital admissions peaked during the first 3 months of the year, followed by a marked decline during summer and a second smaller peak around October. This pattern occurred independently of age, sex, race, and place of residence. It also pertained to ulcers complicated by hemorrhage or perforation. Although total admissions peaked earlier during the year and showed a less consistent peak in October, there was a close resemblance between the periodicity of all diseases and that of peptic ulcer. Mortality was highest in January and lowest in July for all disease and ulcer diseases alike. The similarity between the periodicity of peptic ulcer and other diseases suggests that the major factors responsible for the cyclic behavior of gastric and duodenal ulcer are not particular to these diseases but affect other unrelated diseases alike.

Hospitalization↗
PubMed1991

The costs of multiple pregnancy.

This paper reviews US vital statistics to describe the increase in multiple births in the United States between 1977 and 1987 and clarify the participation of differing maternal ethnic and age groups to this trend. The projected needs for NICU beds and costs of handicaps are estimated based on the distribution of low birthweights in multiple gestations. The potential methods of changing the distribution of low birthweight infants in multiple pregnancies are discussed.

Costs and Cost Analysis↗
PubMed1995

Current and historical mortality from cancer and cardiovascular disease in relation to age: U.S. and world values.

Data from the World Health Organization, U.S. Vital Statistics, the Historical Abstracts of the United States and the census of the United States were used to compare current world and states data on cancer death rate and age with historical data that shows the changing percentage of elderly. Current annual death rates from malignant neoplastic disease among the 73 countries for which data exist are highly correlated with the percent of the population > or = 60 yrs of age and a virtually identical relation exists presently among the 50 states of the U.S. The current world and states data provide a remarkably accurate snapshot of U.S. cancer death rates over the past century during which time the U.S. elderly population increased substantially. Data on U.S. lung cancer death rates since 1940 were similarly examined and these historical numbers also show good agreement with current values among countries that today span the same proportion of elderly that the U.S. had over this period. The agreement of current and historical CA death rate and age contrasts sharply with the picture that emerges when cardiovascular death rates and death rate from all causes are examined. The geographic and time invariance seen in the cancer data seems inconsistent with identical exposure to carcinogens and suggests that biological aging is an important intrinsic factor in cancer.

Aged↗
PubMed1994

Maternal mortality in Europe.

Maternal mortality rates (or ratios) are widely used as one indicator of the quality of medical care. There has been concern that conclusions may be drawn from unreliable data. A survey of practices in European countries confirms that there are differences in interpretation of definitions and evidence of significant under-reporting in official returns of vital statistics. Actual and potential sources of error are identified and a need for greater precision and uniformity of data collection is established.

Europe↗
PubMed1996

Excess males in preterm birth: interactions with gestational age, race, and multiple birth.

OBJECTIVE: To confirm an excess of males among preterm births and study its interaction with other risk factors to better understand its potential etiologic significance. METHODS: Fetal gender was analyzed in 1,781,960 white and 103,329 black singleton births, and in 37,429 white twin births using vital statistics data from the six New England states for 1977-1988. RESULTS: A 7.2% excess of males was found among white singleton preterm births. There was only a 2.8% excess among comparable blacks, a highly significant difference between the races (P < .001). The effect was roughly constant for 20-37 weeks' gestation. Being married increased the effect for white, but not black, women, and was also found among white fetal deaths. Among white twins, male excess in preterm births occurred only in 20-33 week's gestations. CONCLUSIONS: Male fetal gender is associated with singleton preterm birth, an effect most evident in white women, particularly if married. Among preterm white twins, there is also a male excess, limited to gestations under 34 weeks. The excess of males in selected groups suggests the existence of a mechanism of preterm birth influenced by fetal gender. Preterm births in blacks and in twin gestations greater than 33 weeks may be more often due to alternative mechanisms that are independent of fetal gender.

Female↗
PubMedDate not supplied

Some recent advances in non-communicable diseases in the tropics. 3. Coronary heart disease and associated characteristics in a tropical developing community.

Vital statistics indicate that cardiovascular disorders are now major causes of morbidity and mortality in many Caribbean communities. In Trinidad and Tobago, for example, the death rate from myocardial infarction is now similar to that in the UK and USA. In a 10-year prospective survey of 1386 men aged 35 to 69 years at entry, who belonged to a defined community in Port-of Spain, Trinidad, serum high-density (HDL) and low-density (LDL) lipoprotein cholesterol concentrations were very similar to those found by the same methods in Bristol, England. The age-adjusted incidence of first coronary heart disease (CHD) events in men clinically free of the disease at recruitment (per 1000 person-years) was 16.4 in men of Indian descent, 6.8 in those of African origin, 6.2 in those of European origin, and 2.4 in men of mixed descent (the contemporaneous figure for Bristol was about 12/1000 person-years). Serum HDL and LDL cholesterol concentrations were strong and independent predictors of CHD in Trinidad, as they are in temperate climes. With effective control of tropical infectious diseases, and adoption of western patterns of consumerism, tropical developing communities will rapidly acquire the CHD risk factor status once more or less exclusive to developed populations in more temperate climes.

Adult↗