Deaths Of Residents Research Articles

Relationships among death anxiety, attitudes toward aging, and experience with death in nursing home employees.

Measures of death anxiety, attitudes toward aging, and experience with death were obtained from 133 nursing home employees representing eight occupational subgroups. Increasing death anxiety was associated with greater anxiety toward aging. Greater exposure to deaths of residents was significantly related to more reported comfort in thinking about or discussing death and dying. The results indicate that a connection between old age and death may underlie the relationship between death anxiety and attitudes toward elderly adults.

The influence of alcohol abuse as a hidden contributor to mortality

Although only about 2–3 percent of annual deaths are attributed to one of the four underlying causes linked to chronic alcohol use, research results suggest that the impact of alcohol is much greater. The recent issue of mortality multiple cause of death tapes from National Center for Health Statistics permit exploration of associations of chronic alcohol abuse with conditions coded as underlying cause of death and provide leads for case-finding. Data analysis is reported from certificates of resident deaths in the United States in 1978. There are 12 groups of underlying causes for which the percentage of pairings with chronic alcohol abuse ranges from 4–16 percent of the number of deaths from the underlying cause. Age, sex, and metropolitan status of residence are associated with a listing of chronic alcohol abuse among decedents of liver cancer, varicose veins, symptomatic heart disease, septicemia, and respiratory system disease. Planners concerned with secondary prevention can use these clues provided by logistic regression modelling as an aid in case-finding.

SUDDEN UNEXPECTED CARDIAC DEATH IN A DEFINED COMMUNITY, AGES 1–21

A population-based study of sudden (demise less than 24 hours) and unexpected nontraumatic death (SUND) between ages 1-21 was done to delineate the descriptive epidemiology of these events. All deaths of residents of Allegheny County, Pennsylvania, ages 1-21, dying between 1972-1980 were evaluated by review of available records. Patients with previous open heart surgery were excluded. 196 cases of SUND were identified, with an autopsy rate of 87%. 47/196 were classified as cardiac, using conservative criteria. The most frequent diagnoses of these were myocarditis (14) and cardiomyopathy (8). Less common were myocardial fibrosis, coronary artery abnormalities, aortic aneurysm, Ebstein anomaly, endocarditis, prolonged Q-T syndrome, myocardial infarction and several other dysrhythmias and structural defects. Of the cardiac cases with complete information, 88% (30/34) were instantaneous and 81% (17/21) had prodromal symptoms. 31% (11/35) were associated with physical exertion, but only one case was related to formal school athletics. Of the non-myocarditis cases, 93% (27/29) had known cardiac disease prior to demise. Of all cases of SUND, the cardiac group comprised 53% of the instantaneous deaths and 65% of those related to exertion. Prevention of fatal events by identification of risk factors, better treatment of known disease or successful cardiopulmonary resuscitation may be possible.

Electoral ward mortality analysis in Newcastle upon Tyne

All deaths of residents of Newcastle upon Tyne aged from 15 to 64 years of age, occurring during 1978, 1979 or 1980 were analysed to calculate standardized mortality ratios for each electoral ward. This method of constructing a geographical profile of health within a district is economical, but limits on accuracy and reliability must be accepted.

Evidence for space-time clustering of lung cancer deaths.

One parish in Louisiana has the highest reported incidence of lung cancer in the United States. Statistically significant space-time clustering (P < 1.0) was present among lung cancer deaths (1960-1975) in residents of the urban portion of this parish. The spatial distribution of cancer deaths in the urban portion of the parish was compared to age, year of death, race, and sex matched control deaths to determine the risk of lung cancer associated with residential proximity to industry. For industries with independently increased risks, the combination of industries produced risks of 1.9 to 3.2 (P < .05) for residing within 1.2 km of one or more industries to three or more industries, respectively. The results suggest residential exposure to industrial effluents is a factor contributing to the rate of lung cancer.

Evidence for Space-Time Clustering of Lung Cancer Deaths

Abstract One parish in Louisiana has the highest reported incidence of lung cancer in the United States. Statistically significant space-time clustering (P < .01) was present among lung cancer deaths (1960–1975) in residents of the urban portion of this parish. The spatial distribution of cancer deaths in the urban portion of the parish was compared to age, year of death, race, and sex matched control deaths to determine the risk of lung cancer associated with residential proximity to industry. For industries with independently increased risks, the combination of industries produced risks of 1.9 to 3.2 (P < .05) for residing within 1.2 km of one or more industries to three or more industires, respectively. The results suggest residential exposure to industrial effluents is a factor contributing to the rate of lung cancer.

Studies on the reliability of vital and health records: I. Comparison of cause of death and hospital record diagnoses.

Based on computer linkage of death records and hospital discharge abstracts, underlying cause of death and discharge diagnoses are compared for 9,724 Vermont resident in-hospital deaths occurring between 1969 and 1975. The agreement between the diagnoses recorded in the two data systems provides a measure of the reproducibility of recording, abstracting, and coding practices. Using the first three digits of the International Classification of Diseases, the agreement between cause and closest medical record diagnosis was 72 per cent. Concordance declined by patient age and length of hospital stay and varied significantly by coded cause of death. A major source of variation was the hospital of death where agreement levels ranged between 45 and 84 per cent. The latter finding is regarded as a potential starting point for targeting investigation of sources of discrepancy and initiating efforts to improve diagnosis recording and coding in the two record systems. The value of both depends on continuing efforts to improve and maintain data quality.

A Linear Models Application of Competing Risks to Multiple Causes of Death

An analysis is performed to ascertain the joint incidence of two causes of death, acute myocardial infarct and stroke, for the deaths of residents of Massachusetts and North Carolina in 1969. To assay their association an explicit biological model of the nature of the relation is posited. It is shown that, under this model, Chiang's (1968) theory of competing risks may be extended to the case in which an individual's death may have multiple causes. Furthermore, techniques are developed which allow us to model the survival parameters derived under the model by categorical data procedures of the type introduced by Grizzle, Starmer and Koch (1969). The study shows that there is a greater incidence of the joint occurrence of stroke and myocardial infarct on death certificates in North Carolina than in Massachusetts, a pattern consistent with the generally higher stroke mortality in North Carolina. Furthermore, the incidence of the joint occurrence of the two diseases shows a clear age "gradient" increasing through the age range of the analysis. Males and females show somewhat different patterns of age variation in that state-by-age interaction terms are more prominent in the model fitted for females than for males.

Relation of place of birth and migration in cancer mortality in the U.S. — A study of Ohio residents (1959–1967)

The epidemiological method and findings have identified and emphasized the research potential of studying migrants within the U.S., for specific causes of death. The study has demonstrated the marked differences in cancer mortality which become manifest for the nonwhite and native-born white when resident male and female deaths of a state are subclassified by region of birth and state of residence, which would not otherwise be apparent in the comparisons by broad classifications as currently coded in vital records. The age adjusted rates for all cancers (ages 35–69) for the nonwhite males born in the South were 363.67 vs 180.43 for those born in Ohio. The same ratio among the white males born in the South was 225.73, and for those born in Ohio, 197.14. For cancer of the lung and other specific cancer sites, the nonwhite males showed a higher rate for those born in the South compared to those born in Ohio. The excess for the white males was most notable for cancer of the lung. Statistical evidence is presented for the conclusion that the observed differences in cancer mortality among the nonwhite are not due to race per se. The importance of endemic factors associated with place of birth in the U.S. and the influences of the early years of life, particularly in the South in the development of social and biological imprints, and following migration the subsequent exposure to industrial environments, has been considered.

The spectrum of coronary heart disease in a community of 30,000. A clinicopathologic study.

The high rate of necropsy in deaths among permanent residents of Rochester, Minnesota, provided a unique opportunity to study the prevalence of coronary heart disease and the frequency and mode of death resulting from this disease. In this community of approximately 30,000 population, necropsy was done in 73 per cent of all resident deaths during the years 1947 through 1952. Included in this group were 691 necropsies that represented 67 per cent of the 1,026 deaths of persons 20 years of age or older. Coronary heart disease caused death in 221 patients (23 per cent of all necropsies and 32 per cent of all necropsies on adults). These 221 coronary deaths in adults represented 41 per cent of the men and 22 per cent of the women. The coronary deaths were attributed to acute coronary failure (sudden death) in 94 patients (43 per cent), acute myocardial infarction in 87 patients (39 per cent), congestive heart failure in 32 patients (14 per cent) and thromboembolism in eight patients (4 per cent). The 87 patients dying during acute myocardial infarction died of congestive heart failure (30 per cent), myocardial rupture (24 per cent), acute coronary failure (23 per cent), and thromboembolism (14 per cent), with the remaining 9 per cent dying of a combination of acute myocardial infarction and additional serious systemic disease. The greatest number of deaths from coronary heart disease occurred during the seventh decade of life in men and the eighth decade in women. At least one coronary artery exhibited from 25 to 100 per cent obstruction from atherosclerosis in 513 hearts (74 per cent of the adult necropsies). These necropsies, representing two thirds of all deaths in adults in this community, disclosed that significant coronary-artery disease was present in three of four adults and was the cause of death in four of 10 men and two of 10 women.

Distribution of Cancer Mortality Among Ethnic Subgroups of the White Population of New York City, 1953–58&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;

Data on 84,341 deaths of white residents in New York City occurring in the years 1953–58 and attributed to malignant neoplasm were examined with respect to nativity status and religion. Comparison was with estimates of the religious distribution of the population of the city and with a 2 percent sample of deaths from all causes in 1955. After age adjustment, total mortality rates from all neoplastic disorders were similar in the native-born and foreign-born populations, and differences between religious groups were not remarkable. Rates for the foreign-born and native-born for specific sites of malignant neoplasm showed relatively small differences. Data were not available to enable examination of cancer-mortality rates according to specific country of birth of the foreign-born. Most striking were the differences in rates of mortality from individual sites of neoplasm between the Jewish group and the Catholic and Protestant groups. Among males, cancers of the buccal cavity and pharynx, esophagus, gall-bladder, larynx, lung, prostate, skin (other than melanoma), and other male genitalia were appreciably less common in the Jewish group than in either of the other religious groups. In females, cancer of the cervix uteri showed the same pattern. Certain sites exhibited higher rates in the Jewish group. These included cancers of the large intestine, kidney, brain, and thyroid, and melanoma, reticulum-cell sarcoma, lymphosarcoma, Hodgkin's disease, other lymphoma, and leukemia. Cancer of the male breast and, among females, cancers of the liver and pancreas, were also more common among the Jewish group. With some minor modifications, these patterns according to religion were seen in both the native-born and foreign-born populations.

Epidemiologic studies on cardiovascular-renal diseases: II. Analysis of mortality by age-race-sex-place of residence, including urban-rural comparisons

An epidemiologic analysis was accomplished of cardiovascular-renal (C-V-R) mortality rates by age-race-sex-place of residence for the city of Chicago (1953) and the state of Illinois (1951). The place of residence classification was based on income for the city of Chicago, and urban-rural differentiation for the state of Illinois. No significant differences were noted in C-V-R mortality rates—including rates for arteriosclerotic heart disease (ASHD)—in the Chicago population groups stratified by income. Residents of rural Illinois exhibited lower C-V-R and ASHD mortality rates than Chicagoans. However, these categories remained leading causes of death in middle-aged residents of rural Illinois.

Vital statistics available in health center

The author worked for 4 months, as a statistician, in the department of the the vital statistics of the Model Health Center of Kanagawa Prefecture The purpose of his work was to find some interesting problems in vital statistics available in the Health Center. The author could find following problems and studied them in detail during this period.1. How exactly the registration of V.D. and T.B. was?2. From where wives came to marry to husbands who were burn in Kanagawa prefecture? Comparing present and past materials the author could find the percentage of the wife born in -Kanagawa prefecture reduced to fifty-three per cent at present from eighty-seven per cent in the past.3. The percentages of birth and death of residents in Kanagawa Prefecture who have “Honseki” in other prefectures. He estimated them four to five per cent.

Challenge of Malaria in the South

A LL studies of the distribution, importance and trends of malaria with which I am familiar have involved consideration of methods for its measurement. No single method of measurement is ideal for use by the ordinary local health organization. Methods which can be employed by the malaria specialist are expensive, andunfortunately there are few real malariologists. As a consequence, accurate and full information is available only for limited areas and for brief periods. Where a systematic collection of all available data has been made, the malaria trends, as based upon personal histories, doctors' records, morbidity records, spleen examinations, blood examinations, and mortality records, are all in general corroborative. Mortality records of malaria afford the only reasonably complete index available for the entire area of malaria importance. It is known that these records contain inaccuracies and are often misleading. Deaths from malaria contracted elsewhere are recorded in localities in which no transmission of the disease occurs. Again, malaria transmission may be important in a community, impairing the health and working efficiency of the inhabitants without actually causing deaths from the disease. Cities, counties, and other communities, however, which show an appreciable number of deaths of residents from year to year due to malaria can, as a rule, be regarded as having a malaria problem. It should be observed that the total number of deaths occurring in a state where malaria is restricted to a small area may be so few as to suggest that the disease is unimportant, and yet in communities where malaria does occur, it may be the major health problem. Although malaria has rendered many places uninhabitable, it has rarely reached such a degree of severity in this country-certainly this applies to the past decade or two. In using mortality statistics as a basis for this discussion, it is believed that in spite of the inaccuracies and limitations of the statistics, they do give a true pictulJ nf trends over large areas. If a particular city or county were beir. cudied to determine whether malaria consti-