Geographical Distribution Of Deaths Research Articles

Mortality Among People Experiencing Homelessness in San Francisco During the COVID-19 Pandemic

There has been recent media attention on the risk of excess mortality among homeless individuals during the COVID-19 pandemic, yet data on these deaths are limited. To quantify and describe deaths among people experiencing homelessness in San Francisco during the COVID-19 pandemic and to compare the characteristics of these deaths with those in prior years. A cross-sectional study tracking mortality among people experiencing homelessness from 2016 to 2021 in San Francisco, California. All deceased individuals who were homeless in San Francisco at the time of death and whose deaths were processed by the San Francisco Office of the Chief Medical Examiner were included. Data analysis was performed from August to October 2021. Homelessness, based on homeless living status in an administrative database. Descriptive statistics were used to understand annual trends in demographic characteristics, cause and manner of death (based on autopsy), substances present in toxicology reports, geographic distribution of deaths, and use of health and social services prior to death. Total estimated numbers of people experiencing homelessness in San Francisco were assessed through semiannual point-in-time counts. The 2021 point-in-time count was postponed owing to the COVID-19 pandemic. In San Francisco, there were 331 deaths among people experiencing homelessness in the first year of the COVID-19 pandemic (from March 17, 2020, to March 16, 2021). This number was more than double any number in previous years (eg, 128 deaths in 2016, 128 deaths in 2017, 135 deaths in 2018, and 147 deaths in 2019). Most individuals who died were male (268 of 331 [81%]). Acute drug toxicity was the most common cause of death in each year, followed by traumatic injury. COVID-19 was not listed as the primary cause of any deaths. The proportion of deaths involving fentanyl increased each year (present in 52% of toxicology reports in 2019 and 68% during the pandemic). Fewer decedents had contacts with health services in the year prior to their death during the pandemic than in prior years (13% used substance use disorder services compared with 20% in 2019). In this cross-sectional study, the number of deaths among people experiencing homelessness in San Francisco increased markedly during the first year of the COVID-19 pandemic. These findings may guide future interventions to reduce mortality among individuals experiencing homelessness.

Atmospheric circulation and mortality by unintentional drowning in Spain: from 1999 to 2018.

Drowning deaths are a leading cause of unintentional deaths worldwide. Few studies have analysed the role of meteorology in drowning, and with inconclusive results. The aim of this work is to analyse the temporal and geographical distribution of deaths by accidental drowning and submersion in Spain over 20 years, and to assess the relationship between accidental drowning and main atmospheric circulation patterns. An ecological study was performed, in which drowning and submersion mortality data from 1999 to 2018, considering demographic variables, were analysed. To study the association with atmospheric circulation we used an ERA5 reanalysis product over the whole European continent and the Climatic Research Unit Time Series (CRU TS) data set. The annual average rate of deaths by accidental drownings was 11.86 deaths per million of habitants in Spain. The incidence in males was four times higher than in females, and when comparing age groups, the rate in the eldest group was the highest. Unintentional drowning deaths were not equally distributed around the country; the provinces with the highest registered standardized drowning death rates were touristic waterfront provinces either in Eastern Spain or in one of the archipelagos. There was a significant relationship between accidental drowning and meteorological variables during summer months, and drowning deaths were spatially correlated with sea-level pressure over the Mediterranean basin. Although the mortality rate registered a statistically significant decreasing tendency over the studied period, our results must be taken into consideration to improve the prevention strategies in the country since most of these deaths are avoidable.

Geographic distribution of deaths among elderly due to traffic accidents

OBJECTIVE: Analyze traffic accidents with fatalities involving elderly people according to the condition of the injured subjects, place of occurrence and cause of death, preparing maps of geographic distribution. Methods: A cross-sectional study was developed at the Police Station for Traffic Crimes Punishment in Teresina in 68 accident and police investigation records from 2010 to 2011. Local Moran Index and Kernel density were used for spatial analysis. Results: Regarding the condition of the elderly at the time of the accident, 57.3% of the deceased were pedestrians. In regard to the place of occurrence and the first cause listed, it was found that 49.6% of the deaths occurred at the scene, with multiple trauma being the major cause. Conclusion: The deaths were concentrated in urban areas, with agglomeration of neighborhoods with a high rate of traffic accidents, presenting positive correlation, also highlighting the existence of regions with higher density of occurrences. Keywords: Elderly; Traffic accidents; Death; Spatial analysis. Objetivo: Analisar os acidentes de trânsito envolvendo idosos em que ocorreu desfecho fatal, segundo condicao do acidentado, local de ocorrencia e causa do obito, elaborando mapas de distribuicao geografica. Metodos: Estudo transversal realizado na Delegacia de Repressao aos Crimes de Trânsito de Teresina, em uma populacao de 68 boletins de registro de acidente e inqueritos policiais de idosos nos anos de 2010 e 2011. Na analise espacial utilizaram-se o Indice Local de Moran e a densidade de Kernel. Resultados: Em relacao a condicao do idoso no momento do acidente, comprovou-se que 57,3% dos obitos foram de pedestres. Considerando o local de ocorrencia e a primeira causa registrada, constatou-se que 49,6% ocorreram no local do acidente, a maior causa o politraumatismo. Conclusao: Os obitos concentraram-se na area urbana, com aglomerado de bairros com alta ocorrencia de acidente, apresentando correlacao positiva, evidenciando tambem a existencia de regioes com maior densidade de ocorrencias. Palavras-Chave: Idoso; Acidentes de trânsito; Obito; Analise espacial Language: en

Spatial analysis of cerebrovascular mortality in Rio de Janeiro municipality from 2002 to 2007, demographic and socioeconomic correlations

Purpose: Despite moderate decline of Cerebrovascular Disease (CBVD) in the last several decades, it is still the leading cause of death in the municipality of Rio de Janeiro (RJ). The spatial distribution of mortality across regions is unknown. The aim of this study was to understand the geographical distribution of deaths from CBVD in Rio de Janeiro and the correlations with socioeconomic and demographic data methods. Methods: This ecological study examined all death certificates from 2002 to 2007 of RJ residents 20 years or older, with CBVD as the underlying cause of death. The geographical distribution of CBVD deaths were observed by geocoding addresses. The proportions of death from each Administrative Region (AR) were analyzed by gender, age, education and marital status and standardized by 2000-2010 population averages. The socioeconomic indicator used in this study was the Human Development Index (HDI) of each AR for the year of 2000. The magnitude of effect of individual variables and HDI were obtained by modeling hierarchical pattern of dots through log-Gaussian Cox model with Bayesian inference credibility intervals (CI) of 95% for each variable (Markov Chain Monte Carlo simulations method -MCMC). The Relative Risk (RR) for death for each AR was calculated and compared with AR 6 (highest HDI-RJ) for variable settings. Results were presented as maps. Results: The spatial distribution of deaths from CBVD in Rio de Janeiro was heterogeneous and showed a strong inverse linear correlation with HDI of the AR (CI: -10,2; -9,7). For each reduction of 0.05 HDI there was a 65% increase in the number of deaths (CI: 1,64; 1,66). Male gender, older age and poor education were risk factors for death from CBVD in almost every AR. For poorly educated people, living together represented a protective factor for death by CBVD in the majority of Administrative Regions (AR's). In all AR's the RR of death was high and occurred earlier compared with AR's of higher socioeconomic status, with regional difference correlating with the HDI of each region. No significant effect was observed for some of the study variables in some slums and Guaratiba AR. Conclusion: Increased risk of death from CBVD in the municipality of Rio de Janeiro was found in areas of lower socioeconomic development where death usually occurs earlier. It is recommended that the government address health issues in a more active manner not only to control individual risk factors, but, most of all, to use multidisciplinary interventions according to the geographical distribution of mortality.

Mortality from oral cancer in Aracaju/SE, Brazil: 2000-2009

INTRODUCTION: The incidence of oral cancer varies widely in the world, with two thirds of cases diagnosed in developing countries. OBJECTIVE: To investigate the epidemiology of deaths from oral cancer and the spatial distribution in the city of Aracaju in the state of Sergipe between 2000 and 2009. MATERIAL AND METHOD: Data were collected using the Mortality Information System (MIS) of Aracaju/SE at the DATASUS website and were tabulated using the software TABWIN 3.4. The geographic distribution of deaths by neighborhoods of that city was visualized. RESULT: Of the 78 deaths, 61 (78.2%) were male. The mean age was 64.23 years. Individuals of mixed ethnicity had a higher death frequency (34.6%). Regarding education, the majority of death certificates recorded the option ignored, followed by individuals with 1 to 3 years of study. The anatomical sites most affected were unspecified parts of the mouth (43.6%). The spatial distribution analysis indicated that neighborhoods such as Santos Dumont, Luzia, Atalaia, Santa Maria, Cidade Nova and Industrial had the highest death frequencies. CONCLUSION: Males between the fifth and sixth decades of life of mixed ethnicity, low education and in neighborhoods with low and very low standards of living constitute the epidemiological profile for deaths from oral cancer.

562 Geographical Distribution of Deaths from Asthma in Salvador, Brazil (2000–2009)

BackgroundSalvador is the 3rd largest city of Brazil with 3 million inhabitants, divided into neighborhoods with remarkable social inequalities, varied infrastructure and access to health services.ObjectiveTo evaluate the geographic distribution and identify areas of risk for asthma deaths in the city of Salvador, Bahia, Brazil (2000–2009).MethodsObservational descriptive study of deaths from asthma according to ICD-10 in the period between 2000 and 2009, with information obtained from the National Database of Mortality of the Ministry of Health of Brazil. The distribution of deaths was mapped with points and public primary care facilities including emergency care units were located in the geographical grid of the City by the software Arcview. The risk areas were identified by the method of Kernel. Correlation between the number of deaths and number of health care units was assessed using the Spearman test.ResultsWe geocoded the location of 395 of 409 deaths from asthma (96.58%) occurred during the study period. It was observed that 78% of deaths occurred in hospitals or health facilities. The highest density in areas of risk and the highest concentrations of death from asthma occurred in more populated and underprivileged areas. There was a direct correlation between the number of public primary health facilities and the number of deaths (rho = 0.667, P = 0.018).ConclusionsAsthma deaths in Salvador are concentrated in the poorest areas of the city where there are a great number of public primary health facilities. The geographic distribution of deaths indicates that current practices in primary care are insufficient to prevent deaths from asthma in Salvador, Brazil.

Global mesothelioma deaths reported to the World Health Organization between 1994 and 2008

To carry out a descriptive analysis of mesothelioma deaths reported worldwide between 1994 and 2008. We extracted data on mesothelioma deaths reported to the World Health Organization mortality database since 1994, when the disease was first recorded. We also sought information from other English-language sources. Crude and age-adjusted mortality rates were calculated and mortality trends were assessed from the annual percentage change in the age-adjusted mortality rate. In total, 92,253 mesothelioma deaths were reported by 83 countries. Crude and age-adjusted mortality rates were 6.2 and 4.9 per million population, respectively. The age-adjusted mortality rate increased by 5.37% per year and consequently more than doubled during the study period. The mean age at death was 70 years and the male-to-female ratio was 3.6:1. The disease distribution by anatomical site was: pleura, 41.3%; peritoneum, 4.5%; pericardium, 0.3%; and unspecified sites, 43.1%. The geographical distribution of deaths was skewed towards high-income countries: the United States of America reported the highest number, while over 50% of all deaths occurred in Europe. In contrast, less than 12% occurred in middle- and low-income countries. The overall trend in the age-adjusted mortality rate was increasing in Europe and Japan but decreasing in the United States. The number of mesothelioma deaths reported and the number of countries reporting deaths increased during the study period, probably due to better disease recognition and an increase in incidence. The different time trends observed between countries may be an early indication that the disease burden is slowly shifting towards those that have used asbestos more recently.

Geographic distribution of deaths due to sentinel health event (occupational) causes.

This report describes the Compressed Mortality File available from the National Center for Health Statistics that can be used to easily and efficiently generate annual mortality rates for geographic areas as small as counties for any period from 1968 to 1985. Several ways of presenting geographic variation in mortality rates due to potentially work-related deaths and changes in these rates over time are discussed for the 15-year period from 1969 through 1983. Causes of death that are potentially work-related were identified using the sentinel health events (occupational) [SHE(O)] concept. Data are given for nine diagnostic groups of occupationally related disorders, and maps are presented for bladder cancer, acute myeloid leukemia, and pneumoconioses. Significant changes in age-adjusted mortality rates were noted for pneumoconioses and acute myeloid leukemia that could not be due to changes in the disease coding of death certificates. Racial differences in mortality rates due to pneumoconioses may be due to differences in employment patterns. The use of SHE(O) codes to search the Compressed Mortality File may be helpful in identifying areas for public health concern, even if only as a monitoring signal for subsequent time periods. This file also provides an easy way to generate reference population mortality rates for epidemiologic studies.

Epidemiological study of tumors of the central nervous system in Ohio.

Historically, the first epidemiological lead of an excess risk of death due to malignancies of the brain and central nervous system among the former employees of the rubber industry was in 1949, in a study correlating causes of death with prior employment designated on the death certificates for the state of Ohio in 1947. The geographical distribution of deaths (1955) due to histologically confirmed tumors of the CNS identified one county, Summit, of the 88 counties of Ohio, as having significantly more deaths than expected for ages 25-64. Summit County represents the principal rubber manufacture center in the U.S. A series of analyses were carried out which identified a higher death risk among rubber workers compared to nonrubber worker residents of Summit County according to histologically confirmed diagnoses of tumors of the CNS in 1963. Longitudinal employee cohort studies of four different companies engaged in the manufacture of rubber products, in the same state, Ohio, indicated a higher death rate due to tumors of the central nervous system. Epidemiological leads were cited in a broad industry survey comparison in which higher death rates due to neoplasms of the central nervous system were observed among workers in electrical machinery and paper and allied products as well as the rubber industry. Potential chemical linkage of the excess of CNS neoplasm deaths among rubber workers and workers in the rayon industry was explored.

Geographical Distribution of Deaths from Cancer

THE General Register Office has initiated a series of occasional publications under the title of "Studies on Medical and Population Subjects". The purpose of the series is to present a more detailed treatment of certain important subjects than is possible in the Registrar General‘s Annual Statistical Review. The first publication is by Dr. Percy Stocks, and studies geographical variations in mortality from cancer of various sites (Regional and Local Differences in Cancer Death Rates. London: H.M. Stationery Office. Is. net). One of the underlying difficulties in such a study is the uncertainty as to the accuracy of the certified cause of death, particularly in relation to inaccessible sites. It is, however, impossible to dismiss all the local differences demonstrated by Dr. Stocks as due to such variations in certification practice, and this study investigates other possible explanations. Correlations with social indices show a marked relationship with stomach cancer, but none with lung cancer. However, lung cancer mortality is closely associated with annual hours of sunshine in twenty large towns, and this suggests that a beneficial effect of sunshine or a deleterious effect of smoke may operate. A grouping of London boroughs according to their water supply is reminiscent of Farr and cholera, but is not so revealing. Dr. Stocks has brought together a great deal of information and has put forward many suggestions for more intensive research.

Geographic Distribution of Deaths from Diphtheria

AN attempt has been made to study the geographic distribution of diphtheria deaths during the last two years (1926 and 1927) based primarily upon records of the industrial policy holders of the Metropolitan Life Insurance Company. During 1927 there was an increased prevalence of diphtheria which, except for limited areas, appeared to spread quite generally over the United States and Canada. The extent of this increase, so far as the Metropolitan experience is concerned, is indicated in Table I.