Geographic Variation In Mortality Rates Research Articles

Temporal trends and geographic variations in mortality rates from tobacco and firearms in the United States

We explored temporal trends and geographic variations in United States of America (US) mortality rates from smoking and firearms from 1999 to 2019. To do so, we used the publicly available Centers for Disease Control and Prevention (CDC) Wide Ranging Online Data for Epidemiologic Research (WONDER) with Multiple Cause of Death files from 1999 to 2019. Using age-specific rates and ArcGIS Pro Advanced software for Optimized Hot Spot Analyses from Esri, we generated maps of statistically significant spatial clusters with 90–99% confidence intervals with the Getis-Ord Gi* statistic for mortality from smoking-related causes and firearms.These data show temporal trends and geographic variations in mortality from smoking and firearms in the US. Smoking and firearm-related mortality from assault and suicide increased throughout the US and clustered in the Southeast. Firearm-related suicide also clustered in the continental West and Alaska. These descriptive data generate many hypotheses which are testable in analytic epidemiologic studies designed a priori to do so. The trends suggest smoking and firearm-related causes pose particular challenges to the Southeast and firearms also to the West and Alaska. These data may aid clinicians and public health authorities to implement evidence-based smoking avoidance and cessation programs as well as address firearm mortality, with particular attention to the areas of highest risks. As has been the case with cigarettes, individual behavior changes as well as societal changes are likely to be needed to achieve decreases in premature mortality.

Geographic Patterns in U.S. Lung Cancer Mortality and Cigarette Smoking.

Despite the success of smoking cessation campaigns, lung cancer remains the leading cause of cancer death in the U.S. Variations in smoking behavior and lung cancer mortality are evident by sex and region. Applying geospatial methods to lung cancer mortality data from the National Vital Statistics System and county-level estimates of smoking prevalences from the NCI's Small Area Estimates of Cancer-Related Measures, we evaluated patterns in lung cancer mortality rates (2005-2018) in relation to patterns in ever cigarette smoking prevalences (1997-2003). Overall, ever smoking spatial patterns were generally associated with lung cancer mortality rates, which were elevated in the Appalachian region and lower in the West for both sexes. However, we also observed geographic variation in mortality rates that is not explained by smoking. Using Lee's L statistic for assessing bivariate spatial association, we identified counties where the ever smoking prevalence was low and lung cancer rates were high. We observed a significant cluster of counties (n = 25; P values ranging from 0.001 to 0.04) with low ever smoking prevalence and high mortality rates among females around the Mississippi River region south of St. Louis, Missouri and a similar and smaller cluster among males in Western Mississippi (n = 12; P values ranging from 0.002 to 0.03) that has not been previously described. Our analyses identified U.S. counties where factors other than smoking may be driving lung cancer mortality. These novel findings highlight areas where investigation of environmental and other risk factors for lung cancer is needed.

Geographic Variation in Racial Disparities in Mortality From Influenza and Pneumonia in the United States in the Pre-Coronavirus Disease 2019 Era

In 2018, influenza and pneumonia was the eighth leading cause of death in the United States. Since 1950, non-Hispanic blacks (NHBs) have experienced higher rates of mortality than non-Hispanic whites (NHWs). Previous studies have revealed geographic variation in mortality rates by race. The identification of areas with the greatest disparity in influenza and pneumonia mortality may assist policymakers in the allocation of resources, including for the coronavirus disease 2019 pandemic. Does geographic variation in racial disparity in influenza and pneumonia mortality exist? The Centers for Disease Control and Prevention database for Multiple Cause of Death between 1999 and 2018 for NHB and NHW decedents≥ 25 years of age with a Tenth Revision of the International Statistical Classification of Diseases and Related Health Problems code for influenza (J09-J11) and pneumonia (J12-J18) was used. Age-adjusted mortality rates (AAMRs) with 95%CIs were computed by race for Health & Human Services (HHS) regions and urbanization in NHBs and NHWs. In 1999 through 2018, there were 540,476 deaths among NHBs and NHWs 25 to 84 years of age. AAMRs were higher in NHBs than NHWs in each age group and in seven of 10 HHS regions. The greatest disparity was in HHS regions 2 (New York and New Jersey) and 9 (Arizona, California, Hawaii, and Nevada). In HHS region 2, NHBs (24.6; 95%CI, 24.1-25.1) were more likely to die than NHWs (15.7; 95%CI, 15.6-15.9). Similarly, in region 9, NHBs (23.2; 95%CI, 22.7-23.8) had higher mortality than NHWs (16.1; 95%CI, 15.9-16.2). Within these regions, disparities were greatest in the core of major metropolitan areas. A very high AAMR in NHBs was noted in large, central metropolitan areas of region 2: 28.2 (95%CI, 27.6-28.9). In 1999 through 2018, the NHB-NHW disparity in AAMRs from influenza and pneumonia was greatest in central metropolitan areas of HHS regions 2 and9.

Temporal Trends and Geographic Variations in Mortality Rates from Prescription Opioids: Lessons from Florida and West Virginia.

To explore temporal trends and geographic variations in mortality from prescription opioids from 1999 to 2016. Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death files were used to calculate age-adjusted rates and 95% confidence intervals (CIs) and create spatial cluster maps. From 1999 to 2016, counties in West Virginia experienced the highest overall mortality rates in the United States from prescription opioids. Specifically, from 1999 to 2004, the highest rate in West Virginia of 24.87/100,000 (95% CI 17.84-33.73) was the fourth highest in the United States. From 2005 to 2009, West Virginia experienced the highest rate in the United States, 60.72/100,000 (95% CI 47.33-76.71). From 2010 to 2016, West Virginia also experienced the highest rate in the United States, which was 90.24/100,000 (95% CI 73.11-107.36). As such, overall, West Virginia experienced the highest rates in the United States and the largest increases overall of ~3.6-fold between 1999 and 2004 and 2010 and 2016. From 1999 to 2004, Florida had no "hot spots," but from 2006 to 2010 they did appear, and from 2011 to 2016, they disappeared. These data show markedly divergent temporal trends and geographic variations in mortality rates from prescription opioids, especially in the southern United States. Specifically, although initial rates were high and continued to increase alarmingly in West Virginia, they increased but then decreased in Florida. These descriptive data generate hypotheses requiring testing in analytic epidemiological studies. Understanding the divergent patterns of prescription opioid-related deaths, especially in West Virginia and Florida, may have important clinical and policy implications.

Changing hepatocellular carcinoma incidence and liver cancer mortality rates in the United States.

The objectives were to describe Surveillance, Epidemiology and End Results (SEER) hepatocellular carcinoma (HCC) incidence trends and the US liver cancer mortality trends by geography, age, race/ethnicity, and gender. HCC incidence data from SEER 18 registries and liver cancer mortality data from the National Center for Health Statistics were analyzed. Rates and joinpoint trends were calculated by demographic subgroup. State-level liver cancer mortality rates and trends were mapped. HCC incidence rates in SEER registries did not significantly increase during 2007-2010; however, the US liver cancer mortality rates did increase. HCC incidence and liver cancer mortality rates increased among black, Hispanic, and white men aged 50+ years and decreased among 35-49-year-old men in all racial/ethnic groups including Asians/Pacific Islanders. Significantly increasing incidence and mortality rates among women were restricted to blacks, Hispanics, and whites aged 50+ years. Asian/Pacific Islander liver cancer mortality rates decreased during 2000-2010 with decreasing rates among women aged 50-64 years and men aged 35-49 years and stable rates in other groups. During 2006-2010, among individuals 50-64 years of age, blacks and Hispanics had higher incidence and mortality rates than Asians/Pacific Islanders. Liver cancer mortality rates were highest in Louisiana, Mississippi, Texas, and Washington, DC. Decreasing HCC incidence and liver cancer mortality rates among Asians/Pacific Islanders, men aged 35-49 years, and the nonsignificant increase in overall HCC incidence rates suggest that the peak of the epidemic may be near or have passed. Findings of geographic variation in mortality rates can inform control efforts.

Gastric cancer incidence and mortality is associated with altitude in the mountainous regions of Pacific Latin America

In Latin America, gastric cancer is a leading cancer, and countries in the region have some of the highest mortality rates worldwide, including Chile, Costa Rica, and Colombia. Geographic variation in mortality rates is observed both between neighboring countries and within nations. We discuss epidemiological observations suggesting an association between altitude and gastric cancer risk in Latin America. In the Americas, the burden of gastric cancer mortality is concentrated in the mountainous areas along the Pacific rim, following the geography of the Andes sierra, from Venezuela to Chile, and the Sierra Madre and Cordillera de Centroamérica, from southern Mexico to Costa Rica. Altitude is probably a surrogate for host genetic, bacterial, dietary, and environmental factors that may cluster in the mountainous regions. For example, H. pylori strains from patients of the Andean Nariño region of Colombia display European ancestral haplotypes, whereas strains from the Pacific coast are predominantly of African origin. The observation of higher gastric cancer rates in the mountainous areas is not universal: the association is absent in Chile, where risk is more strongly associated with the age of H. pylori acquisition and socio-economic determinants. The dramatic global and regional variations in gastric cancer incidence and mortality rates offer the opportunity for scientific discovery and focused prevention programs.

Sex-specific migration patterns of hawksbill turtles breeding at Mona Island, Puerto Rico

ESR Endangered Species Research Contact the journal Facebook Twitter RSS Mailing List Subscribe to our mailing list via Mailchimp HomeLatest VolumeAbout the JournalEditorsSpecials ESR 4:85-94 (2008) - DOI: https://doi.org/10.3354/esr00044 Sex-specific migration patterns of hawksbill turtles breeding at Mona Island, Puerto Rico Robert P. Van Dam1,*, Carlos E. Diez2, George H. Balazs3, Luis A. Colón Colón4, W. Owen McMillan5, Barbara Schroeder6 1Chelonia, PO Box 9020708, San Juan, Puerto Rico 00902 2Departamento de Recursos Naturales y Ambientales, PO Box 366147, San Juan, Puerto Rico 00936 3NOAA / National Marine Fisheries Service, Pacific Islands Fisheries Science Center, 2570 Dole Street, Honolulu, Hawaii 96822-2396, USA 4Departamento de Ciencias de Computadoras, Universidad de Puerto Rico en Arecibo, PO Box 4010 Arecibo, Puerto Rico 00613 5Department of Genetics, North Carolina State University, PO Box 7614, Raleigh, North Carolina 27695, USA 6 NOAA / National Marine Fisheries Service, Office of Protected Resources F/PR3, 1315 East West Highway, Silver Spring, Maryland 20910, USA *Email: rpvandam@yahoo.com ABSTRACT: Detailed post-breeding movement data is presented for hawksbill turtles tracked by satellite telemetry from Mona Island, Puerto Rico. Seven nesting females and 8 breeding males were tracked. Females traveled for 3 to 53 d to reach their foraging grounds, swimming distances of 84 to 2051 km (mean 867 km, n = 7) at average speeds of 23.5 to 38.7 km d–1 (n = 7). Males traveled for <1 to 22 d, covering distances of <2 to 476 km (mean 101 km, n = 8) at average speeds of 13.0 to 24.7 km d–1 (n = 5). One of the tracked males remained at the Mona Island breeding grounds for 11 mo before being recaptured there. The migration of 2 other male hawksbill turtles returning to Mona Island the following year from their foraging grounds was also documented. Descriptions of the foraging habitats used by these adult turtles are provided. The significant differences observed in migratory range between males and females are interpreted in an evolutionary context of food abundance predictability; an alternative hypothesis of geographic variation in mortality rates is also considered. KEY WORDS: Hawksbill turtle · Eretmochelys imbricata · Migration · Mona Island · Puerto Rico Full text in pdf format PreviousNextCite this article as: Van Dam RP, Diez CE, Balazs GH, Colón Colón LA, McMillan WO, Schroeder B (2008) Sex-specific migration patterns of hawksbill turtles breeding at Mona Island, Puerto Rico. Endang Species Res 4:85-94. https://doi.org/10.3354/esr00044 Export citation Mail this link - Contents Mailing Lists - RSS Facebook - Tweet - linkedIn Cited by Published in ESR Vol. 4, No. 1-2. Online publication date: January 18, 2008 Print ISSN: 1863-5407; Online ISSN: 1613-4796 Copyright © 2008 Inter-Research.

Geographic Patterns of Prostate Cancer Mortality and Variations in Access to Medical Care in the United States

Striking geographic variation in prostate cancer death rates have been observed in the United States since at least the 1950s; reasons for these variations are unknown. Here we examine the association between geographic variations in prostate cancer mortality and regional variations in access to medical care, as reflected by the incidence of late-stage disease, prostate-specific antigen (PSA) utilization, and residence in rural counties. We analyzed mortality data from the National Center for Health Statistics, 1996 to 2000, and incidence data from 30 population-based central cancer registries from the North American Association of Central Cancer Registries, 1995 to 2000. Ecological data on the rate of PSA screening by registry area were obtained from the 2001 Behavioral Risk Factor Surveillance System. Counties were grouped into metro and nonmetro areas according to Beale codes from the Department of Agriculture. Pearson correlation analyses were used to examine associations. Significant correlations were observed between the incidence of late-stage prostate cancer and death rates for Whites (r = 0.38, P = 0.04) and Blacks (r = 0.53, P = 0.03). The variation in late-stage disease corresponded to about 14% of the variation in prostate cancer death rates in White men and 28% in Black men. PSA screening rate was positively associated with total prostate cancer incidence (r = 0.42, P = 0.02) but inversely associated with the incidence of late-stage disease (r = -0.58, P = 0.009) among White men. Nonmetro counties generally had higher death rates and incidence of late-stage disease and lower prevalence of PSA screening (53%) than metro areas (58%), despite lower overall incidence rates. These ecological data suggest that 10% to 30% of the geographic variation in mortality rates may relate to variations in access to medical care.

Bayesian Analysis and Mapping of Mortality Rates for Chronic Obstructive Pulmonary Disease

This article summarizes our research on estimation of age-specific and age-adjusted mortality rates for chronic obstructive pulmonary disease (COPD) for white males. Our objectives are more precise and informative displays (than previously available) of geographic variation of the age-specific mortality rates for COPD, and investigation of the relationships between the geographic variation in mortality rates and the corresponding variation in selected covariates. For a given age class, our estimates are displayed in a choropleth map of mean rates. We develop a variation map that identifies the geographical areas where inferences are reliable. Here, the variation is measured by considering a set of maps produced using samples from the posterior distribution of the population mortality rates. Finally, we describe the spatial patterns in the age-specific maps and relate these to patterns in potential explanatory covariates such as smoking rate, annual rainfall, population density, elevation, and measures of air quality.

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.