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PubMed2006

Racial disparity in hypertensive disorders of pregnancy in New York State: a 10-year longitudinal population-based study.

OBJECTIVES: We studied trends of hypertensive disorders of pregnancy by residential socioeconomic status (SES) and racial/ethnic subgroups in New York State over a 10-year period. METHODS: We merged New York State discharge data for 2.5 million women hospitalized with delivery from 1993 through 2002 with 2000 US Census data. RESULTS: Rates of diagnoses for all hypertensive disorders combined and for preeclampsia individually were highest among Black women across all regions and neighborhood poverty levels. Although hospitalization rates for preeclampsia decreased over time for most groups, differences in rates between White and Black women increased over the 10-year period. The proportion of women living in poor areas remained relatively constant over the same period. Black and Hispanic women were more likely than White women to have a form of diabetes and were at higher risk of preeclampsia; preeclampsia rates were higher in these groups both with and without diabetes than in corresponding groups of White women. CONCLUSIONS: An increasing trend of racial/ethnic disparity in maternal hypertension rates occurred in New York State during the past decade. This trend was persistent after stratification according to SES and other risk factors. Additional research is needed to understand the factors contributing to this growing disparity.

Adolescent↗
PubMed1993

Race and birthweight in biracial infants.

OBJECTIVES: The purpose of the study was to determine the role of infant race as a determinant of the Black-White disparity in low birthweight (< 2500 g). METHODS: Univariate analysis and multivariate logistic regression were performed on Illinois vital records from 1982 and 1983 and on 1980 United States census income data. RESULTS: Fourteen percent of the infants born to Black mothers and White fathers were of low birthweight, compared with 9% of infants born to White mothers and Black fathers and 6% of a random sample of White infants. Both groups of biracial infants were more likely to have been born to unmarried mothers and to reside in very low-income (< $10,000 per year) census tracts than were White infants. When all confounding variables were entered into a logistic model, the adjusted odds ratio of low birthweight for biracial infants born to Black mothers and White fathers equaled 1.4. When biracial infants born to White mothers and Black fathers were compared with White infants, the adjusted odds ratio of low birthweight equaled 1.0. CONCLUSIONS: Paternal and consequent infant race does not affect the birthweight distribution of those born to White mothers and Black fathers. Unidentified factors closely related to maternal race underlie the Black-White disparity in infant birthweight.

Adult↗
PubMed2001

Cigarette smoking behavior among US Latino men and women from different countries of origin.

OBJECTIVES: This study sought to compare smoking behavior among Latino men and women from different countries of origin. METHODS: A telephone-administered survey was conducted in 8 cities with Latino men and women of different national origin living in census tracts with at least 70% Latino individuals. RESULTS: A total of 8882 participants completed the survey; 53% were women. The average age of respondents was 44 years; 63% were foreign-born, and 59% preferred Spanish for the interview. Current smoking was more prevalent among men (25.0%, 95% confidence interval [CI] = 23.7, 26.3) than among women (12.1%, 95% CI = 11.1, 13.0). Smoking rates were not significantly different by national origin among men, but Puerto Rican women had higher rates of smoking than other women. Central American men and women had the lowest smoking rates. Foreign-born respondents were less likely to be smokers (odds ratio [OR] = 0.77, 95% CI = 0.66, 0.90) than US-born respondents, and respondents with 12 years or less of education had an increased odds of smoking (OR = 1.17, 95% CI = 1.01, 1.35). High ac culturation was associated with more smoking in women (OR = 1.12, 95% CI = 1.00-1.25) and less smoking in men (OR = 0.86, 95% CI = 0.78-0.95). Puerto Rican and Cuban respondents were more likely to be current smokers and to smoke more than 20 cigarettes per day. CONCLUSIONS: Older, US-born, and more-educated respondents were less likely to be current smokers. Respondents of Puerto Rican and Cuban origin were more likely to smoke. Acculturation has divergent effects on smoking behavior by sex.

Acculturation↗
PubMed2000

Income inequality and all-cause mortality in the 100 counties of North Carolina.

BACKGROUND: This study evaluated the relationship between income inequality and all-cause mortality in the 100 counties of North Carolina. METHODS: Mortality data for 1985 to 1994 came from the National Center for Health Statistics and household income data from the 1990 Census. Associations between county-level income inequality and age-adjusted, all-cause mortality rates were evaluated in stratified and regression analyses. RESULTS: Stratified analyses suggest that all-cause mortality was directly related to income inequality in all 100 counties and in non-metropolitan statistical area (MSA) counties. This relationship was statistically significant, controlling for per capita income in regression analyses for all age groups except > or =65 years among all 100 counties and for all ages combined and for ages 35 to 64 among non-MSA counties. CONCLUSIONS: A relationship between income inequality and all-cause mortality previously identified nationally among states and MSAs was also found among all counties and non-MSA counties of North Carolina in 1985 to 1994.

Adolescent↗
PubMedDate not supplied

[Relationship between obesity and educational level in Portuguese young males in 1990].

OBJECTIVE: To evaluate the relationship between the educational level, weight and obesity of young Portuguese males, aged 20 years. DESIGN: Cross-sectional study, based on the national military census files of 1990, provided by the military selection centres of Portugal (north, centre, south--including Azores and Madeira islands). SUBJECTS AND METHODS: In Portugal, all males aged 20 must present themselves to the military authorities to be submitted to a health exam in order to be screened for the armed forces. The data of 70,858 young Portuguese males aged 20 were gathered. Height and weight were measured by skilled teams. The educational level was confirmed by the presentation of educational attainment certificates. The population was divided into deciles of body mass index (BMI). The whole group was classified as obese or non-obese, according to a cut-off point of 27.8 Kg/sqm. The educational level was classified in four groups: group A--less than 5 years of schooling; group B--5 to 6 years; group C--7 to 9 years; group D--> or = 10 years. The level of education in each decile of BMI was determined and the percentage of obese subjects was calculated for each level of schooling. The odds of obesity associated with each group of schooling was determined as well as their 95% confidence intervals. Statistical significance was considered to exist when p < 0.05. RESULTS: The average BMI in the study population was 22.5 Kg/sqm. A slight increase in schooling was noticed from the lowest to the highest decile of BMI. The same result was obtained when we analysed the upper extreme of the BMI distribution in greater detail. According to our criteria for obesity, the percentages of obesity in each level of schooling were as follows: group A--4.2%; group B--5%; group C--5.1%; and group D--5.4%. The odds ratio (OR) of obesity according to each education level was higher in those with a higher level of education. In fact, those with 10 or more years of schooling presented an OR = 1.05(0.94;1.17) which was not statistically significant (ns) when compared to those with 7-9 years; while an OR = 1.08(0.97;1.21), was also ns when compared to those with 5-6 years, and, finally, an OR = 1.29(1.14;1.47) was statistically significant (p < 0.001) in comparison to those with only 0-4 years of schooling. CONCLUSIONS: As major conclusions one can say that the prevalence of obesity is low among young Portuguese males (4.9%), only 2.1% with a BMI > 30 Kg/sqm. Furthermore, our results show that, in Portugal, contrary to the results found mostly in western European countries, males aged 20 years with higher levels of education are slightly more prone to be obese than others with lower levels of schooling.

Adult↗
PubMed2000

[Anthropometry and the reference values of body composition by bioelectrical impedance in the adult population of L'Hospitalet de Llobregat].

BACKGROUND: The aim of the present study was to assess the anthropometric variables and the reference values of body composition in the adult population of L'Hospitalet de Llobregat, due to the lack of epidemiological studies on this matter in Spain. PATIENTS AND METHODS: We studied 234 normal subjects, 134 males, mean age 41.4 years, and 134 females, mean age 40.7 years, selected from the census of L'Hospitalet de Llobregat and representative of its population in sex and age. We determined anthropometric characteristics, body weight, height, body mass index, waist-hip ratio and body composition parameters: total body water, free fat mass, fat mass and body fat by bioelectrical impedance analyzer. RESULTS: Twenty-four males and 33 females were obese, and out of them 2 males and 4 women presented morbid obesity. The body mass index was higher either in males (p = 0.017) or in females (p = 0. 0001) in the last decades in relation to first decade, and in women was as consequence of higher fat mass (p = 0.0001). The waist-hip ratio was 0.93 (0.08) in male and 0.79 (0.07) in female, and it was high in males in the last decades. CONCLUSION: The present study points out the high prevalence of obesity in our city and the anthropometric characteristics and reference values of body composition in the normal population of L'Hospitalet de Llobregat, remarking the high body mass index in the last decades, especially in women due to an increase of fat mass. The waist-hip ratio was high in males in the last decades.

Adolescent↗
PubMedDate not supplied

Postterm delivery among African Americans, Mexican Americans and Whites in Chicago.

OBJECTIVES: The purpose of the present study was to examine the effect of individual-level and community-level risk factors on the postterm delivery rates of infants born to African-American, Mexican-American, and non-Latino White mothers; and to compare postterm delivery rates between these ethnic groups. DESIGN: This is a population-based study. METHODS: We performed stratified and multivariate logistic regression analyses on a linked dataset of 1992-1995 Illinois vital records, 1990 United States Census income data, and 1995 Chicago Department of Public Health information. Communities with one or more high-risk characteristics (low median family income or high rates of unemployment, homicide or lead poisoning) were classified as impoverished. RESULTS: In Chicago, African Americans (N = 85,978) had a postterm rate of 4.3/1,000 and Mexican Americans (N = 47,266) had a postterm rate of 3.6/1,000, compared to 2.3/1,000 for non-Latino Whites (N = 48,601); relative risk (ninety-five percent confidence interval) = 1.9 (1.5-2.3) and 1.6 (1.2-2.0), respectively. Maternal age, education, marital status, parity, and prenatal care usage were associated with ethnic group-specific postterm delivery rates. In a multivariate logistic regression model for non-impoverished mothers, the adjusted odds ratios of postterm delivery for African Americans and Mexican Americans were 1.0 (0.5-3.2) and 1.0 (0.6-1.7), respectively. CONCLUSIONS: We conclude that African Americans and Mexican Americans have greater postterm delivery rates than do Whites; however, commonly cited individual and community-level risk factors account for most of the disparity.

Adult↗
PubMed1988

[Analysis of the influence of social status on fertility of women in Bulgaria].

"The author studies the influence [of] the social status of women upon their fertility during first marriages [in Bulgaria]. The study has been made by means of the structural-factor analysis which is based on conventional one-dimensional and two-dimensional moment distributions. The degree of variations is determined by the integral coefficient of structural differences, the mean arithmetic value, the standard deviation, coefficients of asymmetry and excess. The author discusses: 1) the changes in the structure of various categories of women according to social groups, 2) the changes in the separate structures for each of the social groups of women according to the number of live-born children during the 1965-1985 period. The method of filtering variables is used to control the influence of the important demographic factor 'duration of marriage'." Data are from the censuses of 1965, 1975, and 1985. (SUMMARY IN ENG AND RUS)

Bulgaria↗
PubMed2004

Secondary prevention of stroke--results from the Southern Africa Stroke Prevention Initiative (SASPI) study.

OBJECTIVE: To describe the prevalence of risk factors and experience of preventive interventions in stroke survivors, and identilfy barriers to secondary prevention in rural South Africa. METHODS: A clinician visited individuals in the Agincourt field site (in South Africa's rural north east) who were identified in a census as possible stroke victims to confirm the diagnosis of stroke. We explored the impact of stroke on the individual's family, and health-seeking behaviour following stroke by conducting in-depth interviews in the households of 35 stroke survivors. We held two workshops to understand the knowledge, experience, and views of primary care nurses, who provide the bulk of professional health care. FINDINGS: We identified 103 stroke survivors (37 men), 73 (71%) of whom had hypertension, but only 8 (8%) were taking anti-hypertensive treatment. Smoking was uncommon; 8 men and 1 woman smoked a maximum of ten cigarettes daily. 94 (91%) stroke survivors had sought help, which involved allopathic health care for most of them (81; 79%). 42 had also sought help from traditional healers and churches, while another 13 people had sought help only from those sources. Of the 35 survivors who were interviewed, 29 reported having been prescribed anti-hypertensive pills after their stroke. Barriers to secondary prevention included cost of treatment, reluctance to use pills, difficulties with access to drugs, and lack of equipment to measure blood pressure. A negative attitude to allopathic care was not an important factor. CONCLUSION: In this rural area hypertension is the most important modifiable risk factor in stroke survivors. Effective secondary prevention may reduce the incidence of recurrent strokes, but there is no system to deliver such care. New strategies for care are needed involving both allopathic and non-allopathic-health care providers.

Community Health Centers↗
PubMedDate not supplied

Leukemia mortality and farming in the prairie provinces of Canada.

BACKGROUND: An increased risk of leukemia has been previously noted among farmers. PURPOSE: To examine the risk of fatal leukemia according to various farming practices in a large cohort of Canadian farm operators. METHODS: A cohort study of the mortality experience (1971-1987) of male farmers in Manitoba, Saskatchewan and Alberta has been conducted. The census records of 156,242 male farmers identified on the 1971 Census of Agriculture and the corresponding Census of Population were linked to mortality records through 1987. RESULTS: We observed a statistically significant test for trend (p = 0.03) between leukemia mortality and the number of chickens and/or turkeys owned (relative risk for > or = 130 chickens and/or turkeys = 1.32, 95% CI = 0.99, 1.77). No association was observed between leukemia mortality and either insecticide or herbicide use. CONCLUSIONS: Further research is necessary regarding why farmers exposed to chickens may be at an increased risk of leukemia.

Adult↗
PubMed1997

[Twelve-year trends of hip fracture rates in Chile. Is there a relationship between their increase and population aging?].

BACKGROUND: Epidemiology of osteoporosis is assessed measuring bone density or measuring the rates of bone frailty-related fracture rates. Of these, the most important are hip fractures, that markedly increase after 65 years of age. AIM: To measure the incidence of hip fractures in Chile from 1982 to 1993. MATERIAL AND METHODS: All hospital discharges that occurred in Chile from 1982 to 1993 were analyzed, looking for the diagnosis of hip fracture. National censuses in the same period were also analyzed searching for possible changes in the age structure of the population. Fracture rates were analyzed for three age groups, and changes along the years were calculated correlating the rates with the number of the year. RESULTS: In the twelve year period, women aged 55-64 years old had a correlation of 0.32 (NS), women aged 65-74 years old had a correlation of 0.58 (NS) and women aged over 75 years old had a correlation of 0.95 (p < 0.001). This age group corresponded to 2.01% of the whole population in 1982 and to 2.52% in 1993. The mean age of the group increased from 80.7 to 80.9 years in the same lapse. CONCLUSIONS: Fracture rates increased in the 12 years period studied, specially among women older than 75 years old. During the same period the proportion of people over 75 years old also increased, but there was only a slight increase in its mean age. Thus, the increase in fracture rates is disproportionate to population aging and could be related to changes in lifestyles.

Age Factors↗
PubMed2004

The 2002 Canadian Contraception Study: part 1.

OBJECTIVES: To investigate the contraception and sexual health-related awareness, attitudes, and practices of a representative sample of Canadian women of childbearing age. METHODS: A self-report survey was mailed to a national sample of 3345 women, aged 15 to 44 years, who were members of a pre-recruited market research panel. Survey questions and methodology were similar to 3 previous Canadian Contraception Studies, allowing for description of current patterns of behaviours and beliefs and comparison of trends over time. RESULTS: Of 3345 women contacted, 1582 returned completed surveys, for a response rate of 47.3%. Responses were weighted to represent Canadian women by region, age, and marital status on the basis of current census data. Eighty-six percent of women sampled had ever had sexual intercourse and 78% were currently sexually active. Women's familiarity with oral contraceptives and condoms as methods of contraception was high (96% and 93%, respectively), but familiarity with other methods was much lower (sterilization, 62%; withdrawal, 59%; the morning-after pill, 57%; intrauterine devices, 50%; depot [injectable] medroxyprogesterone acetate, 38%). A very favourable opinion was held by 63% of respondents concerning oral contraceptives, by 38% concerning condoms, and by 39% and 28% concerning male and female sterilization, respectively. Among respondents who have ever had sexual intercourse, the most frequently used current methods were oral contraceptives (32%), condoms (21%), male sterilization (15%), female sterilization (8%), and withdrawal (6%). Nine percent of these respondents reported using no method of contraception at all. The currently reported rate of female sterilization is the lowest ever recorded in Canada. Survey results show that adherence to contraceptive methods is a challenge for many women and their partners, and that risk of sexually transmitted disease is an ongoing concern. CONCLUSION: This study provides a wide-ranging examination of contraception awareness, beliefs, and use among Canadian women that may provide guidance for clinical and public health practice. Part 1 of this report describes the methodology of the 2002 Canadian Contraception Study and the overall results of this study; Part 2 considers results pertaining specifically to adolescent women and women in their later reproductive years, reports on indicators of women's sexual function and reproductive health history, describes approaches to addressing challenges in contraception counselling, and presents data concerning trends in Canadian women's awareness and use of contraception over the past 2 decades.

Adolescent↗
PubMed1997

Normative models and healthcare planning: network-based simulations within a geographic information system environment.

OBJECTIVES: Network analysis to integrate patient, transportation and hospital characteristics for healthcare planning in order to assess the role of geographic information systems (GIS). A normative model of base-level responses of patient flows to hospitals, based on estimated travel times, was developed for this purpose. DATA SOURCES/STUDY SETTING: A GIS database developed to include patient discharge data, locations of hospitals, US TIGER/Line files of the transportation network, enhanced address-range data, and U.S. Census variables. The study area included a 16-county region centered on the city of Charlotte and Mecklenburg County, North Carolina, and contained 25 hospitals serving nearly 2 million people over a geographic area of nearly 9,000 square miles. STUDY DESIGN: Normative models as a tool for healthcare planning were derived through a spatial Network analysis and a distance optimization model that was implemented within a GIS. Scenarios were developed and tested that involved patient discharge data geocoded to the five-digit zip code, hospital locations geocoded to their individual addresses, and a transportation network of varying road types and corresponding estimated travel speeds to examine both patient discharge levels and a doubling of discharge levels associated with total discharges and DRG 391 (Normal Newborns). The Network analysis used location/allocation modeling to optimize for travel time and integrated measures of supply, demand, and impedance. DATA COLLECTION/EXTRACTION METHODS: Patient discharge data from the North Carolina Medical Database Commission, address-ranges from the North Carolina Institute for Transportation Research and Education, and U.S. Census TIGER/Line files were entered-into the ARC/INFO GIS software system for analysis. A relational database structure was used to organize the information and to link spatial features to their attributes. PRINCIPAL FINDINGS: Advances in healthcare planning can be achieved by examining baseline responses of patient flows to distance optimization simulations and healthcare scenarios conducted within a spatial context that uses a normative model to integrate characteristics of population, patients, hospitals, and transportation networks. Model runs for the defined scenarios indicated that a doubling of the 1991 patient discharge levels resulted in an areal constriction of the service areas to those zip codes immediately adjacent to the hospitals, thereby leaving substantial areas unassigned to hospitals during the allocation process, but that doubling the demand for obstetrics care (DRG 391) resulted in little change in the pattern of accessibility to care as indicated by the size, orientation, and pattern of the service areas. CONCLUSIONS: The GIS-Network system supported "what if" simulations, portrayed service areas within a spatial context, integrated disparate data in the execution of the location/allocation model, and used estimated travel time along a transportation network instead of Euclidean distance for calculating accessibility. The results of the simulations suggest that the GIS-Network system is an effective approach for exploring a variety of healthcare scenarios where changes in the supply, demand, and impedance variables can be examined within a spatial context and where variations in system trajectories can be simulated and observed.

Computer Communication Networks↗
PubMed1998

Comparison of intramuscular triamcinolone and oral prednisone in the outpatient treatment of acute asthma: a randomized controlled trial.

STUDY OBJECTIVE: To determine whether a one-time dose of triamcinolone diacetate, 40 mg intramuscular (i.m.), given to adult patients treated in the emergency department for mild to moderate exacerbation of asthma would decrease the rate of relapse during the following week, compared with a nontapering course of oral prednisone, 40 mg/day over 5 days. METHODS: A randomized, double-blind, controlled clinical trial was conducted at two university-affiliated community teaching hospitals with a combined annual census of 97,000. Patients were eligible if they were between the ages of 18 and 50 years, had an initial peak expiratory flow rate of less than 350 L/minute, and were to be discharged from the ED taking steroids. Patients were randomly assigned to receive either triamcinolone (40 mg i.m.) and placebo tablets or a placebo injection and prednisone (40 mg/day orally for 5 days). Patients were instructed to use a beta-agonist metered-dose inhaler, to continue other routine medications, to complete symptom diary cards, and to return in 7 to 10 days for follow-up. The main outcome measure was relapse, which was defined as an unscheduled visit to a physician's office or ED for worsening or persistent symptoms within 7 days of the initial ED visit. RESULTS: A total of 168 patients were initially enrolled; 6 patients were withdrawn for protocol violations and 8 because they could not be contacted for follow-up. A total of 154 patients were available for outcome analysis, 78 in the triamcinolone group and 76 in the prednisone group. There were no differences between the two patient groups with regard to demographics, smoking history, weight, or symptom severity. Mean initial peak flows were 244+/-64 L/minute for the triamcinolone group and 245+/-83 L/minute for the prednisone group. Fifty percent of the study patients were current smokers. The relapse rates were 9.0% (7/78) in the triamcinolone group and 14.5% (11/76) in the prednisone group (P=.29). The absolute difference in relapse rates was 5.5% (95% confidence interval [CI], 4.6% to 15.6%). There was no difference in symptom frequency or severity between the two groups during the first 5 days of outpatient treatment. Analysis between the groups stratified for smoking showed no difference in relapse rate between smokers and nonsmokers. CONCLUSION: A single dose of triamcinolone diacetate, 40 mg i.m., produced a relapse rate similar to that of prednisone, 40 mg/day orally for 5 days, after ED treatment of mild to moderate exacerbations of asthma. Intramuscular triamcinolone would appear to be an attractive alternative when compliance with a daily oral regimen is of concern.

Acute Disease↗
PubMed2000

Quantitative methods for environmental justice assessment of transportation

Application of Executive Order 12898 to risk assessment of highway or rail transport of hazardous materials has proven difficult; in general, the location and conditions affecting the propagation of a plume of hazardous material released in a potential accident are unknown. Therefore, analyses have only been possible in a geographically broad or approximate manner. The advent of geographic information systems and development of software enhancements at Sandia National Laboratories have made kilometer-by-kilometer analysis of populations tallied by U.S. Census blocks along entire routes practicable. Tabulations of total or racially/ethnically distinct populations close to a route, its alternatives, or the broader surrounding area, can then be compared and differences evaluated statistically. This article presents methods of comparing populations and their racial/ethnic compositions using simple tabulations, histograms, and chi-square tests for statistical significance of differences found. Two examples of these methods are presented: comparison of two routes and comparison of a route with its surroundings.

Journal Article↗
PubMed2005

Home visits by family physicians during the end-of-life: Does patient income or residence play a role?

BACKGROUND: With a growing trend for those with advanced cancer to die at home, there is a corresponding increase in need for primary medical care in that setting. Yet those with lower incomes and in rural regions are often challenged to have their health care needs met. This study examined the association between patient income and residence and the receipt of Family Physician (FP) home visits during the end-of-life among patients with cancer. METHODS: Data Sources/Study Setting. Secondary analysis of linked population-based data. Information pertaining to all patients who died due to lung, colorectal, breast or prostate cancer between 1992 and 1997 (N = 7,212) in the Canadian province of Nova Scotia (NS) was extracted from three administrative health databases and from Statistics Canada census records. Study Design. An ecological measure of income ('neighbourhood' median household income) was developed using census information. Multivariate logistic regression was then used to assess the association of income with the receipt of at least one home visit from a FP among all subjects and by region of residency during the end-of-life. Covariates in the initial multivariate model included patient demographics and alternative health services information such as total days spent as a hospital inpatient. Data Extraction Methods. Encrypted patient health card numbers were used to link all administrative health databases whereas the postal code was the link to Statistics Canada census information. RESULTS: Over 45% of all subjects received at least one home visit (n = 3265). Compared to those from low income areas, the log odds of receiving at least one home visit was significantly greater among subjects who reside in middle to high income neighbourhoods (for the highest income quintile, adjusted odds ratio [OR] = 1.37, 95% confidence interval [CI] = 1.15, 1.64; for upper-middle income, adjusted OR = 1.19, 95%CI = 1.02, 1.39; for middle income, adjusted OR = 1.33, 95%CI = 1.15, 1.54). This association was found to be primarily associated with residency outside of the largest metropolitan region of the province. CONCLUSION: The likelihood of receiving a FP home visit during the end-of-life is associated with neighbourhood income particularly among patients living outside of a major metropolitan region.

Journal Article↗
PubMed1990

Untilting age distributions: a transformation for graphical analysis.

"This article presents a new approach to the plotting of age distribution data. 'Untilting' is a way of transforming data that vary systematically from very high to very low values so as to show local variation more clearly. The article derives an untilting transformation from the formal structure of age distributions. The transformation turns out to be closely related to two familiar demographic techniques, reverse-survival estimation of births and birth rates, and comparison of observed with stable age distributions. The ideas are illustrated by application to age distributions from the 1979 and 1989 censuses of Vietnam."

Age Distribution↗