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Assessment of surveillance and vital statistics data for monitoring abortion mortality, United States, 1972-1975.

To assess the usefulness of vital statistics and surveillance for monitoring abortion mortality, the authors compared data from two systems of classification: 1) deaths classified according to the underlying cause by the National Center for Health Statistics (NCHS) under the International Classification of Disease, Adapted (ICDA) code numbers 640-645 (abortion) for 1972-1975; and 2) abortion-related deaths reported to the Center for Disease Control (CDC) through its epidemiologic surveillance of abortion mortality for the same years. Vital statistics classifications dealing with the underlying cause of death are based on criteria defined by ICDA guidelines applied to all available information listed on death certificates, and exclude some deaths classified as abortion-related by CDC. Surveillance classifications are based on broader criteria developed by CDC for expanded data gathered by individual case investigation. Results showed that the surveillance techniques had identified more deaths as abortion-related and had resolved more cases into the specific abortion categories of legal, illegal, and spontaneous than vital statistics tabulations based on death certificates. The authors estimate that the surveillance system alone reported 88% of all abortion-related deaths, the vital statistics system 52%, and the two systems combined a total of 94%. Inadequate physician documentation on the death certificate was the primary reason vital statistics data contained a smaller number of reported abortion deaths than surveillance data.

Abortion, Illegal

[Suicide deaths among psychiatric patients--a study based on vital statistics].

Utilizing data from the Vital Statistics in 1987 of the Ministry of Health and Welfare, a study was performed to estimate suicide mortality rates among psychiatric in and out-patients. Mental disorder was recorded as being present on 1,755 certifications of suicide deaths (984 men and 771 women). Suicide rate per 100,000 person-years in psychiatric in-patients was 167.3 for males, 116.0 for females. Compared with the general population, this represented an age-standardized mortality ratio (SMR) of 4.5 for males and 5.3 for females. For out-patients the suicide rate was 135.7 for males and 103.7 for females, and the SMR was 4.6 and 5.9 respectively. Considering that the possibility of omission of mental disorders in a death certificate is greater for an out-patient than that for an in-patient, it is concluded that the suicide rate of psychiatric out-patients is greater than that of in-patients.

Adolescent

Annual summary of vital statistics-1975.

Data for this article, as in previous reports, are drawn principally from the Monthly Vital Statistics Report, published by the National Center for Health Statistics. The international data come from the Demographic Yearbook and the quarterly Population and Vital Statistics, both published by the Statistical Office of the United Nations, and the World Health Statistics Report, published by the World Health Organization. All the United States data for 1975 are estimates based upon a 10% sample of material received in state offices between two dates, one month apart, regardless of when the event occurred. Experience has shown that for the country as a whole the estimate is very close to the subsequent final figures. There are, however, considerable variations in a few of the states; state information should be interpreted cautiously.

Birth Rate

Deaths from ischaemic heart disease in Helsinki in the years 1959-1968. Vital statistics and medico-legally autopsied sudden deaths.

According to the official vital statistics, altogether 10910 deaths from ischaemic heart disease (IHD) occurred in persons resident in Helsinki during the 10-year period 1959-68. A significant increase was found in the incidence of IHD deaths in both sexes even though changes in the structure of the population were taken into account. The increase in the age-dependent incidence of IHD deaths was most conspicuous at middle age in both sexes and in young males. Altogether 3044 IHD deaths occurring unwitnessed or within 24 hours of the onset of the fatal attack were autopsied medico-legally during the 10-year period of the study. The medico-legally autopsied cases obviously represented a high proportion of sudden IHD deaths occurring outside hospitals in Helsinki. A clear male preponderance was found in the autopsy material as compared with all IHD deaths. The prevalence of cases of acute myocardial infarction varied in different years from 27 to 49 percent at medico-legal autopsies. No significant change occurred during the 10-year period in the distribution of the medico-legally autopsied IHD deaths into social groups, in the suddenness or place of death. The home was the most common place of death. From 1963 onwards the patients dying from an ischaemic heart attack during transportation to hospital or in an outpatient department constituted 6-7 percent of all annual IHD deaths.

Acute Disease

On the estimation of relative risk from vital statistical data.

A method is described for the determination of a measure of relative risk from vital statistical data. If the frequency of disease in a population is linearly related to the level of exposure to a given factor, then a measure of the relative risk can be estimated from the slope and intercept of the regression line. For example, when the exposure is measured in terms of the proportion of the population exposed to the factor, then the relative risk is equal to (Formula: see text). This offers an indirect but simple and inexpensive method for estimating relative risk. It should be used with caution, particularly where confounding factors may be responsible for the apparent association between disease and factor. Applications of the method to estimate the relative risk of (a) circulatory diseases in women using oral contraceptives and (b) ovarian cancer in women with different average family sizes, both yielded relative risk estimates comparable with those obtained from case-control and prospective studies.

Cardiovascular Diseases

Annual fertility rates from Census data on own children: comparisons with vital statistics data for the United States.

This paper begins by describing the procedure and data requirements for calculating annual fertility rates from census data on own children. Then, using data from the United States Censuses of 1960 and 1970, fully adjusted estimates are presented and compared with recorded vital statistics rates. Total fertility estimates derived from own children data for whites average less than two percent lower than the recorded rates- a difference that can be attributed partially to the fact that the estimates are adjusted for net census undercount but the recorded rates are not. Even without adjustments for mortality, children not living with their mothers, and net census undercount, the own children data estimates accurately replicate recorded trends (even though the levels are misspecified). The utility of own children data for the study of differential fertility is discussed.

Adolescent