Birth-year Cohorts Research Articles

Cancer Incidence and Mortality Rates in Multiple Sclerosis: A Matched Cohort Study.

To determine whether cancer risk differs in people with and without multiple sclerosis (MS), we compared incidence rates and cancer-specific mortality rates in MS and matched cohorts using population-based data sources. We conducted a retrospective matched cohort study using population-based administrative data from Manitoba and Ontario, Canada. We applied a validated case definition to identify MS cases, then selected 5 controls without MS matched on birth year, sex, and region. We linked these cohorts to cancer registries, and estimated incidence of breast, colorectal, and 13 other cancers. For breast and colorectal cancers, we constructed Cox models adjusting for age at the index date, area-level socioeconomic status, region, birth cohort year, and comorbidity. We pooled findings across provinces using meta-analysis. We included 53,983 MS cases and 269,915 controls. Multivariable analyses showed no difference in breast cancer risk (pooled hazard ratio [HR] 0.92 [95% confidence interval (CI) 0.78-1.09]) or colorectal cancer risk (pooled HR 0.83 [95% CI 0.64-1.07]) between the cohorts. Mortality rates for breast and colorectal did not differ between cohorts. Bladder cancer incidence and mortality rates were higher among the MS cohort. Although the incidence of prostate, uterine, and CNS cancers differed between the MS and matched cohorts, mortality rates did not. The incidence of breast and colorectal cancers does not differ between persons with and without MS; however, the incidence of bladder cancer is increased. Reported differences in the incidence of some cancers in the MS population may reflect ascertainment differences rather than true differences.

Predictors of hospital readmission in infants less than 3 months old.

To examine rates and predictors of 7-day readmission in infants hospitalised before 3 months of age with infectious and non-infectious conditions. Retrospective population-based data-linkage study of 121 854 infants from a 5-year metropolitan birth cohort (2008-2012). Cox proportional hazard models were used to examine associations between infant and maternal factors with 7-day readmission. A total of 11 669 (9.6%) infants were hospitalised at least once by 3 months of age (median 23 days old, 56% male) with 12 602 total index hospitalisations. Infection-related conditions accounted for 29.4% (n = 3705). Readmission within 7 days occurred after 4.8% of all index hospitalisations and 5.4% of infection-related hospitalisations. Age ≤21 days was the strongest readmission risk factor (hazard ratio 7.7 (95% confidence interval 4.7-12.7) compared to infants 61-90 days old). Other risk factors included shorter index hospitalisations, younger maternal age and multi-gravidity. Hospitalisations and readmissions occur for many young infants. Risk factors for readmission should inform risk-based management guidelines.

Evaluation of an active population-based surveillance system for major birth defects in South Carolina.

Birth defects are common, costly, and contribute substantially to infant mortality. The South Carolina Birth Defects Program (SCBDP) employs active population-based surveillance to monitor major birth defects statewide. We evaluated SCBDP's system attributes using published CDC guidelines. To determine timeliness, completeness, and accuracy of birth defects information, we examined SCBDP's reports, program and education materials, advisory group meeting minutes, and strategic plan. We also met with program staff and stakeholders (n = 10) to discuss program goals and data utilization. We calculated the percentage of birth defects cases found 6 months after a birth cohort year for 2016-2018. SCBDP identifies 900-1,200 birth defects cases for a birth population of approximately 55,000 live births annually through active case reviews. SCBDP uses trained medical staff to abstract detailed information from maternal and infant medical records; SCBDP also has established auto-linkage with state vital statistics to capture demographic and birth data. SCBDP is timely and captures 97.1% (range 96.7-97.6%) of birth defects cases within 6 months after the birth cohort year closes. Active case identification using medical records as the primary data source improves quality assurance and completeness, while prepopulating demographic information improves timeliness. Given that birth defects significantly contribute to infant morbidity and mortality, monitoring these conditions is important to understand their impact on communities and to drive public health actions. SCBDP active surveillance and rigorous data quality practices provide the program with timely, complete, and accurate birth defects data.

Trends in prevalence and mortality burden attributable to smoking, Brazil and federated units, 1990 and 2017

BackgroundThe present study sought to analyze smoking prevalence and smoking-attributable mortality estimates produced by the 2017 Global Burden of Disease Study for Brazil, 26 states, and the Federal District.MethodsPrevalence of current smokers from 1990 to 2017 by sex and age was estimated using spatiotemporal Gaussian process regression. Population-attributable fractions were calculated for different risk-outcome pairs to generate estimates of smoking-attributable mortality. A cohort analysis of smoking prevalence by birth-year cohort was performed to better understand temporal age patterns in smoking. Smoking-attributable mortality rates were described and analyzed by development at state levels, using the Socio-Demographic Index (SDI). Finally, a decomposition analysis was conducted to evaluate the contribution of different factors to the changes in the number of deaths attributable to smoking between 1990 and 2017.ResultsBetween 1990 and 2017, prevalence of smoking in the population (≥ 20 years old) decreased from 35.3 to 11.3% in Brazil. This downward trend was seen for both sexes and in all states, with a marked reduction in exposure to this risk factor in younger cohorts. Smoking-attributable mortality rates decreased by 57.8% (95% UI − 61.2, − 54.1) between 1990 and 2017. Overall, larger reductions were observed in states with higher SDI (Pearson correlation 0.637; p < 0.01). In Brazil, smoking remains responsible for a considerable amount of deaths, especially due to cardiovascular diseases and neoplasms.ConclusionsBrazil has adopted a set of regulatory measures and implemented anti-tobacco policies that, along with improvements in socioeconomic conditions, have contributed to the results presented in the present study. Other regulatory measures need to be implemented to boost a reduction in smoking in order to reach the goals established in the scope of the 2030 United Nations Agenda for Sustainable Development.

Experience and Identity-driven Consumer Choice: Evidence from China

We study how shared experiences of political events can have a long-term effect on consumers' identity-driven brand choices, and how geopolitical conflicts can activate the effect. Our empirical strategy uses a generalized difference-in-differences design to exploit spatial variations in the intensity of China's Cultural Revolution (CR), a radical political movement during 1966-1976, and cohort variations in the number of impressionable years during CR. We observe over 11 million vehicle choices of individual Chinese consumers from 2012 to 2013. We find that the experience of CR increases the likelihood of choosing Chinese brands, controlling for location, birth-year cohort, and product attributes (e.g., price and class). Moreover, the effect is only significant after the China-Japan conflict in August-September 2012 activated Chinese national identity. The dynamics show the effect persisted throughout 2013 after the activation. Exploring heterogeneous effects, we find that the effects are stronger for more recognizable Chinese brands as well as more expensive models, and we rule out alternative mechanisms such as fear of violence.

Secular change in morphological cranial and mandibular trait frequencies in European Americans born 1824-1987.

Secular change in cranial and postcranial morphometrics and morphological traits has been documented in several studies. However, to date, few studies have addressed temporal changes occurring in the expression of cranial morphological traits commonly used in ancestry estimation. This study examines secular change in the expression of 23 cranial and mandibular morphological traits; accounting for age-at-death, sex, and year-of-birth. Data were collected on 23 morphological cranial and mandibular traits for European American individuals (19-97 years of age) from the Hamann-Todd Skeletal Collection (n = 518) and the William M. Bass Donated Skeletal Collection (n = 602). Individuals were divided into six birth-year cohorts: 1824-1849 (Cohort 1), 1850-1874 (Cohort 2), 1875-1899 (Cohort 3), 1900-1924 (Cohort 4), 1925-1949 (Cohort 5), and 1950-1987 (Cohort 6). Statistical analyses, including Pearson's chi-square, correspondence analysis, and ordinal regression, demonstrate that secular changes have occurred in 11 traits, including: anterior nasal spine (ANS); malar tubercle (MT); nasal bone contour (NBC); postbregmatic depression (PBD); supranasal suture (SPS); transverse palatine suture (TPS); zygomaticomaxillary suture (ZS); ascending ramus shape (ARS); gonial angle flare (GAF); mandibular tori (MDT); and posterior ramus edge inversion (PREI), with changes occurring in both sexes for ANS, MT, TPS, ZS, GAF, MDT, and PREI. Significant changes in trait expression were found predominately between Cohorts 3 and 4, and Cohorts 4 and 5. While the sex of an individual affected the expression of ANS, MT, NBC, PBD, SPS, ZS, ARS, GAF, and PREI, age-at-death only affected MT and PREI. This study demonstrates that secular change in morphological cranial and mandibular traits has occurred over the last two centuries in European Americans, with the most considerable change appearing at the turn of the twentieth century. Changes in morphological trait expression over a relatively short period of time correspond with changes seen in craniometric analyses and correlate with the industrialization of society and environmental and cultural changes, such as medical advancements, nutrition, and population health/stress.

Emerging cancer incidence trends in Canada: The growing burden of young adult cancers.

Recent studies have identified increases in cancer incidence among younger adults for some cancers. This study examined incidence trends for 28 cancers in Canada by age and birth cohort from 1983 to 2012. Canadian incidence data for 20 to 84 year-olds were obtained from the Cancer Incidence in Five Continents Plus database. Age-period-cohort modeling was used to estimate the average annual percentage changes (AAPCs) and incidence rate ratios (IRRs) for 10-year birth cohorts (reference cohort, 1943) for 28 cancer types. Incidence increased for 13 cancer sites among adults younger than 50years (1983-2012), with the largest increase occurring for rectal cancer (AAPC20-24 , 5.62; 95% confidence interval [CI], 3.77-7.51) and colon cancer (AAPC20-24 , 4.08; 95% CI, 2.89-5.29). Compared with the 1943 birth cohort, persons born circa 1988 had approximately 5- and 2-fold greater risks of rectal cancer (IRR, 4.98; 95% CI, 2.87-8.63) and colon cancer (IRR, 2.31; 95% CI, 1.62-3.30), respectively. Incidence decreased among younger adults for 9 sites (1983-2012), with the largest decreases observed for lung cancer (AAPC25-29 ,-2.29; 95% CI, -3.57 to -0.98), cervical cancer (AAPC25-29 , -1.29; 95% CI, -1.67 to -0.90), and melanoma (AAPC25-29 , -0.61; 95% CI, -0.97 to -0.24). Decreased risks in recent birth cohorts were observed for all sites with decreasing trends in younger adults. For example, the risk of lung cancer was 60% lower in the 1988 birth cohort than the 1943 birth cohort (IRR, 0.42; 95% CI, 0.23-0.78). Incidence among young adults is increasing for some cancers associated with obesity but decreasing for many cancers associated with infections or smoking. Although further studies are needed to replicate these findings and understand the etiology of early-onset cancers, measures to promote healthy behaviors in young adults warranted.

Impact of adolescent obesity on middle-age health of women given data MAR.

We analyze adolescent BMI and middle-age systolic blood pressure (SBP) repeatedly measured on women enrolled in the Fels Longitudinal Study (FLS) between 1929 and 2010 to address three questions: Do adolescent-specific growth rates in body mass index (BMI) and menarche affect middle-age SBP? Do they moderate the aging effect on middle-age SBP? Have the effects changed over historical time? To address the questions, we propose analyzing a growth curve model (GCM) that controls for age, birth-year cohort, and historical time. However, several complications in the data make the GCM analysis nonstandard. First, the person-specific adolescent BMI and middle-age SBP trajectories are unobservable. Second, missing data are substantial on BMI, SBP, and menarche. Finally, modeling the latent trajectories for BMI and SBP, repeatedly measured on two distinct sets of unbalanced time points, are computationally intensive. We adopt a bivariate GCM for BMI and SBP with correlated random coefficients. To efficiently handle missing values of BMI, SBP, and menarche assumed missing at random, we estimate their joint distribution by maximum likelihood via the EM algorithm where the correlated random coefficients and menarche are multivariate normal. The estimated distribution will be transformed to the desired GCM for SBP that includes the random coefficients of BMI and menarche as covariates. We demonstrate unbiased estimation by simulation. We find that adolescent growth rates in BMI and menarche are positively associated with, and moderate, the aging effect on SBP in middle age, controlling for age, cohort, and historical time, but the effect sizes are at most modest. The aging effect is significant on SBP, controlling for cohort and historical time, but not viceversa.

Changes in the depression gender gap from 1992 to 2014: Cohort effects and mediation by gendered social position.

The depression gap (i.e., higher rates of depression among women than men) represents an important mental health disparity in the US. Differences in gendered social position (i.e., the roles, responsibilities, and opportunities available to women and men), which have been changing since the mid-20th Century may contribute to this gender gap. The present study examined the evidence for a changing depression gap across birth cohorts and tested the extent to which any changes over time were mediated by changes in relative social position between women and men. Data were from the National Longitudinal Surveys. The depression gap was defined as differences in mean CESD scores for women vs. men. The analytic sample included 13,666 respondents interviewed from 1992 to 2014. Hierarchical mixed models estimated the magnitude of the gender depression gap over time, its association with 10-year birth cohort (range: 1957-1994), and whether any variation was mediated by ratios among women relative to men of obtaining a college degree, being employed full-time, and the average number of hours spent doing housework per week, three indicators of gendered social position. There was a linear decrease in the depression gap by 0.18 points across birth cohort (95% CI=-0.26, -0.10). The results of the mediation analysis estimated that an increasing ratio of college degree attainment mediated 39% of the gender depression gap across cohorts (95% CI=0.18, 0.78). There was no evidence of mediation due to changing employment or housework ratios. These findings partially support the hypothesis that the depression gap is changing over time and is meaningfully related to the social environment. Understanding the social causes of the depression gap can illuminate the fundamental processes through which depression disparities may be perpetuated or attenuated over time and may aid in the identification of strategies to reduce them.

Age and generational patterns of overdose death risk from opioids and other drugs.

The ongoing substance misuse epidemic in the United States is complex and dynamic and should be approached as such in the development and evaluation of policy1. Drug overdose deaths (largely attributable to opioid misuse) in the United States have grown exponentially for almost four decades, but the mechanisms of this growth are poorly understood2. From analysis of 661,565 overdose deaths from 1999 to 2017, we show that the age-specific drug overdose mortality curve for each birth-year cohort rises and falls according to a Gaussian-shaped curve. The ascending portion of each successive birth-year cohort mortality curve is accelerated compared with that of all preceding birth-year cohorts. This acceleration can be attributed to either of two distinct processes: a stable peak age, with an increasing amplitude of mortality rate curves from one birth-year cohort to the next; or a youthward shift in the peak age of the mortality rate curves. The overdose epidemic emerged and increased in amplitude among the 1945-1964 cohort (Baby Boomers), shifted youthward among the 1965-1980 cohort (Generation X), and then resumed the pattern of increasing amplitude in the 1981-1990 Millennials. These shifting age and generational patterns are likely to be driven by socioeconomic factors and drug availability, the understanding of which is important for the development of effective overdose prevention measures.

Congenital Chagas Disease in the United States: The Effect of Commercially Priced Benznidazole on Costs and Benefits of Maternal Screening.

.Chagas disease, caused by Trypanosoma cruzi, is transmitted by insect vectors, and through transfusions, transplants, insect feces in food, and mother to child during gestation. An estimated 30% of infected persons will develop lifelong, potentially fatal cardiac or digestive complications. Treatment of infants with benznidazole is highly efficacious in eliminating infection. This work evaluates the costs of maternal screening and infant testing and treatment for Chagas disease in the United States, including the cost of commercially available benznidazole. We compare costs of testing and treatment for mothers and infants with the lifetime societal costs without testing and consequent morbidity and mortality due to lack of treatment or late treatment. We constructed a decision-analytic model, using one tree that shows the combined costs for every possible mother–child pairing. Savings per birth in a targeted screening program are $1,314, and with universal screening, $105 per birth. At current screening costs, universal screening results in $420 million in lifetime savings per birth-year cohort. We found that a congenital Chagas screening program in the United States is cost saving for all rates of congenital transmission greater than 0.001% and all levels of maternal prevalence greater than 0.06% compared with no screening program.

Use of Antiasthmatic Drugs and the Risk of Type 1 Diabetes in Children: A Nationwide Case-Cohort Study.

Asthma has been reported to be associated with an increased risk of type 1 diabetes mellitus in childhood, but the reasons are unclear. We examined whether the use of antiasthmatic drugs was associated with the development of type 1 diabetes in childhood in a nationwide, register-based case-cohort study. We identified all children who were born January 1, 1995, through December 31, 2008, in Finland and diagnosed with type 1 diabetes by 2010 (n=3,342). A 10% random sample from each birth-year cohort was selected as a reference cohort (n=80,909). Information on all dispensed antiasthmatic drugs (Anatomical Therapeutic Chemical classification system code R03) during 1995-2009 was obtained, and associations between the use of antiasthmatic drugs and the development of type 1 diabetes were investigated using time-dependent and time-sequential Cox regression models. Dispensed inhaled corticosteroids and inhaled β-agonists were associated with an increased risk of type 1 diabetes after adjusting for other antiasthmatic drugs, asthma, sex, and birth decade (hazard ratio=1.29, 95% confidence interval: 1.09, 1.52, and hazard ratio=1.22, 95% confidence interval: 1.07, 1.41, respectively). These findings suggest that children using inhaled corticosteroids or inhaled β-agonists might be at increased risk of type 1 diabetes.

Recent Trends in Squamous Cell Carcinoma of the Anus Incidence and Mortality in the United States, 2001-2015.

Squamous cell carcinoma of the anus (SCCA) incidence is rising in the United States. Study of incidence trends by stage at diagnosis, age-specific and birth cohort patterns, and trends in mortality could provide evidence for a true increase and etiological clues for the increase in incidence. Using the US Cancer Statistics dataset, we examined trends in SCCA incidence (2001-2015) and mortality (2001-2016) rates. Join-point regression was used to compute annual and average annual percentage change (AAPC). Incidence patterns by 5-year age group and birth cohort were evaluated using incidence rate ratios (IRRs) and age-period-cohort modeling. SCCA incidence increased 2.7% per year (95% confidence interval [CI] = 2.1% to 3.3%), with pronounced increases in age groups 50 years and older. Distant-stage SCCA incidence tripled (AAPC = 8.6%, 95% CI = 5.4% to 12.0%, among men and AAPC = 7.5%, 95% CI = 4.8% to 10.2%, among women) and regional-stage SCCA incidence nearly doubled (AAPC = 4.7% for men and women) in both sexes; the AAPC for localized stage was 1.3% (95% CI = 0.6% to 2.0%) in men and 2.3% (95% CI = 1.8% to 2.8%) in women. Compared with adults born circa 1946, recently born black men (born circa 1986) had a nearly fivefold higher risk (IRR=4.7, 95% CI = 2.1 to 10.2) of SCCA, and the risk doubled among white men (IRR = 2.0, 95% CI = 1.7 to 2.2) and white women (IRR = 2.1, 95% CI = 1.9 to 2.3) born after circa 1960. Anal cancer mortality rates increased 3.1% per year (95% CI = 2.6% to 3.5%) with statistically significant increases in age groups 50 years and older. SCCA incidence-based mortality increased 1.9% annually(95% CI = 0.5% to 3.4%), with a notable (4.9%, 95% CI = 2.4% to 7.3%, per year) rise in adults ages 60-69 years. The increase in SCCA incidence, particularly advanced-stage disease, and a similar increase in mortality suggest a true increase in the occurrence of SCCA. Future research and improved prevention are urgently needed to mitigate the increasing disease burden.

The Ponseti Method Decreased the Surgical Incidence in Children with Congenital Clubfoot: A Population-Based, 8 Birth-Year Cohort Study.

With the introduction of the Ponseti method for congenital clubfoot, the relapse rate and the surgical rate have been remarkably reduced. However, data from population studies for patients up to 10 years of age are still lacking. This study aimed to survey the relapse and surgery rates in the first 10 years of life in children with congenital clubfoot before and after introduction of the Ponseti method in Taiwan using the National Health Insurance Research Database (NHIRD). We retrieved clubfoot cases and related surgical procedures determined by International Classification of Diseases, Ninth Revision (ICD-9) 754.51 from the 1999-2016 NHIRD. Foot and ankle surgical procedures coded as ICD-9 754.51 for patients who were older than 6 months of age were regarded as surgical procedures for relapsed or residual deformities. The rate of clubfoot release when the patients were 0.5 to 1 year of age and extensive surgical procedures in the first 10 years of life were assessed among 8 birth-year cohorts (1999 to 2006) with a 10-year follow-up. Among 622 children with idiopathic congenital clubfoot diagnosis, 301 underwent a total of 367 surgical procedures for clubfoot between 6 months and 10 years of age. Disease incidence of 0.32 per 1,000 live births remained stable in the 8 birth-year cohorts. After the Ponseti method was introduced in 2002, there was a decrease in the clubfoot release rate in the 0.5 to 1-year age group (25.8% in the 1999 to 2002 birth-year cohorts compared with 17.6% in the 2003 to 2006 birth-year cohorts) and the rate of extensive surgical procedures (41.5% in the 1999 to 2002 birth-year cohorts compared with 31.3% in the 2003 to 2006 birth-year cohorts), both determined to be significant at p < 0.05 using the chi-square test. A significant decreasing trend (p < 0.05) was revealed in the rate of clubfoot release in patients who were 0.5 to 1 year of age by polynomial correlation, with an increasing negative slope after a turning point around 2002. The Ponseti method increased the ratio of minor to extensive surgical procedures when a surgical procedure was required. The Ponseti method decreased subsequent extensive surgical procedures for clubfoot, especially in the group that was 0.5 to 1 year of age. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Population-based birth defects data in the United States, 2012-2016: A focus on abdominal wall defects.

In this report, the National Birth Defects Prevention Network (NBDPN) examines and compares gastroschisis and omphalocele for a recent 5-year birth cohort using data from 30 population-based birth defect surveillance programs in the United States. As a special call for data for the 2019 NBDPN Annual Report, state programs reported expanded data on gastroschisis and omphalocele for birth years 2012-2016. We estimated the overall prevalence (per 10,000 live births) and 95% confidence intervals (CI) for each defect as well as by maternal race/ethnicity, maternal age, infant sex, and case ascertainment methodology utilized by the program (active vs. passive). We also compared distribution of cases by maternal and infant factors and presence/absence of other birth defects. The overall prevalence estimates (per 10,000 live births) were 4.3 (95% CI: 4.1-4.4) for gastroschisis and 2.1 (95% CI: 2.0-2.2) for omphalocele. Gastroschisis was more frequent among young mothers (<25 years) and omphalocele more common among older mothers (>40 years). Mothers of infants with gastroschisis were more likely to be underweight/normal weight prior to pregnancy and mothers of infants with omphalocele more likely to be overweight/obese. Omphalocele was twice as likely as gastroschisis to co-occur with other birth defects. This report highlights important differences between gastroschisis and omphalocele. These differences indicate the importance of distinguishing between these defects in epidemiologic assessments. The report also provides additional data on co-occurrence of gastroschisis and omphalocele with other birth defects. This information can provide a basis for future research to better understand these defects.

Emerging Cancer Incidence Trends in Canada: A Population-Based Study of the Growing Burden of Young Adult Cancers

Background: Recent studies have identified significant increases in cancer incidence among younger adults for some cancers. We examined incidence trends of 27 cancer sites in Canada by age and birth cohort between 1983 and 2012. Methods: Canadian incidence data for 20-84 year-olds was obtained from the Cancer in Five Continents plus database. The average annual percentage change (AAPC) was calculated, and age-period-cohort modeling was used to estimate incidence rate ratios for 10-year birth cohorts. Results: Incidence significantly increased in 12 cancer sites among adults <50 years of age. The largest increases occurred for colon (AAPC20-24=4∙08, 95%CI: 2∙89 to 5∙29), gallbladder (AAPC25-29=3∙70, 95%CI=1∙27-6∙19) and anorectal (AAPC20-24=5∙25, 95%CI: 3∙50 to 7∙03) cancers. More recent birth cohorts had higher risk of these cancers compared to the 1943 reference cohort, with the risk of colon cancer more than double in the most recent cohort (IRR1988=2∙31, 95%CI=1∙62 to 3∙30) and risk of anorectal nearly five-times higher (IRR1988=4∙74, 95%CI=2∙82 to 7.97) in the most recent cohort. Incidence has decreased among younger adults for nine sites, with the largest decreases occurring for cervical (AAPC25-29 -1∙29, 95%CI: -1∙67 to -0∙90) and lung (AAPC25-29 -2∙29, 95%CI: -3∙57 to -0∙98) cancer, and melanoma (AAPC25-29 -0∙61, 95%CI: - 0∙97 to -0∙24). Decreased risks in recent birth cohorts were observed for all cancer sites with decreasing trends in younger adults. For example, the risk of lung cancer in the most recent birth cohort was less than half that of the reference cohort (IRR1988=0∙42, 95%CI=0∙23 to 0∙78). Interpretation: Incidence among young adults is increasing for cancers associated with obesity, while incidence is decreasing for cancers associated with primary prevention measures (e.g. HPV vaccination, smoking cessation campaigns). Although further studies are needed to determine other possible causes for these trends, campaigns seeking to prevent excess body weight in young adults seem warranted. Funding Statement: The authors state: No funding was associated with this manuscript. Declaration of Interests: All authors have completed the ICMJE uniform disclosure form at www.icje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. Ethics Approval Statement: Ethical approval was not required for this study.

Wage returns to education in Ethiopia

ABSTRACT In this paper, we aim to provide robust estimates of wage returns to education in Ethiopia. Previous estimates vary widely based on the scope and size of the study sample, variables employed, and estimation method. We use two recent rounds of national labour force survey data and a pseudo- (or synthetic) panel framework to address the well-known potential endogeneity of schooling in wage regressions. Birth-year cohort based pseudo-panel estimate of the return to an additional year of education is between 14 percent and 16 percent, 4 to 5 percentage points higher than that from ordinary least squares (OLS). The significant downward bias in OLS is further confirmed by two-year pseudo-panel estimates and remains robust, to a large extent, as we use an alternate model, change the estimation sample, and address selection bias concurrently with endogenous schooling using a novel approach. We discuss some possible explanations in the context of Ethiopia.

Early adulthood psychiatric diagnoses and the subsequent risk of life-time incarceration: a cohort study.

The association between incarceration and psychiatric disorders has been noted. Yet, existing studies are cross-sectional or examine the risk of recidivism, which has limited the predictive validity of psychiatric disorders as a risk factor for incarceration. To overcome this limitation, this study used a prospective cohort to examine whether psychiatric diagnoses in early adulthood predicted incarceration throughout a 30-year follow-up. It tested the association between psychiatric diagnoses with future incarcerations, their number and durations, controlling for education and ethnic status. This study merged data from three sources in Israel: a prospective 10-year birth cohort study of young adults aged 25-34, conducted in the 1980s (N = 4914) that included a psychiatric interview; data from the Prison Service, including the cause, number and duration of incarcerations; and from the Vital Statistics Registry on death records. Multivariate analysis showed that substance-use disorders, antisocial personality and lower levels of education predicted future incarceration, their number and maximum duration. The remainder diagnoses were not significantly associated with future incarceration. Results limited the prediction of future incarcerations to persons diagnosed with substance use and antisocial personality, and do not support an independent predictive association between additional psychiatric diagnoses and future incarceration.

Melanoma Incidence Among Non-Hispanic Whites in All 50 US States From 2001 Through 2015

The United States has large regional variation in primary prevention campaigns for skin cancer. We collected data from all 50 states to examine changes in melanoma incidence and performed age-period-cohort analyses to describe the simultaneous effects of age, period, and cohort on incidence rates. Annual melanoma incidence rates for non-Hispanic whites from 2001 to 2015 were extracted from the US Cancer Statistics registry. Secular trends were examined overall and by sex and state. We used joinpoint regression to compute annual percent change and average annual percent change and corresponding 95% confidence intervals (CIs). We also analyzed incidence trends by 5-year age group and birth cohort using incidence rate ratios and age-period-cohort modeling. Melanoma incidence increased from 20.7 per 100000 (95% CI = 20.5 to 20.9) in 2001 to 28.2 per 100000 (95% CI = 28.0 to 28.5) in 2015, increasing by 3.90% (95% CI = 2.36% to 5.48%) annually between 2001 and 2005 and 1.68% (95% CI = 1.37% to 1.99%) annually from 2005 through 2015. The average annual percent change in melanoma incidence rates were similar for men (2.34%, 95% CI = 1.91 to 2.78) and women (2.25%, 95% CI = 1.60 to 2.91). Age-specific relative risk by birth cohort increased from circa 1921 to 1981 before decreasing. Compared with adults born circa 1956, those born circa 1991 had lower melanoma risk (incidence rate ratio = 0.85; 95% CI = 0.77 to 0.94). Geographic variation was observed; some states still have melanoma rates trending upwards in all birth cohorts. The continued increase in melanoma incidence among non-Hispanic whites, particularly in states where rates continue to rise among recent and current birth cohorts, underscores the need for increased public health campaigns aimed at reducing sun exposure.

Expansion of disability across successive Mexican birth cohorts: a longitudinal modelling analysis of birth cohorts born 10 years apart

BackgroundLife expectancy (LE) in Mexico has risen rapidly since the 1950s. In high-income contexts, these increases have coincided with a compression of disability to later ages. However, little evidence on...