Survey Statistics Research Articles

Taxing tobacco as a strategy to reduce consumption and increase public health benefits in Pakistan

Background: Tobacco consumption poses a significant challenge to global health and contributes to the increase in noncommunicable diseases and premature deaths. Aim: To investigate the potential impact of a 70% tobacco tax on consumption and government revenue in Pakistan. Methods: We analysed secondary data from 2011 to 2022 (after imposition of a 70% excise tax) from the Pakistan Bureau of Statistics, Pakistan Social and Living Standard Survey, financial yearbooks and Federal Board of Revenue reports for tobacco consumption and government revenue. Variables included tobacco price inflation, per capita income, cigarette price, federal excise duty, and government revenue. Results: The higher taxes reduced tobacco production by PKR 3.72 billion (≈US$ 13.4 million). Price elasticity analysis indicated an inelastic demand for cigarettes, mostly among the rural populations. Imposition of excise duty of 70% of the retail price caused a decrease in government revenue by PKR 390 million (≈US$ 1.4 million). Conclusion: Implementing 70% taxation on tobacco products is beneficial, however, to fully realize its benefit, there is a need for strict regulation on brand shifting and illegal trade.

Novel applications of linked administrative data – adding longitudinal capability and additional variables to a nationally representative survey of an indigenous population.

Can linked administrative data be used to transform New Zealand's only sample survey on indigenous wellbeing into a longitudinal study? This project extends the usefulness of an important survey dataset by linkage to admin data, effectively adding longitudinal capability within a linked administrative data source. This created robust statistical processes to transform an official statistics survey into a nationally representative cohort study. NZ's Integrated Data Infrastructure (IDI) is a research database of administrative and survey datasets containing a range of variables linkable at the individual level. Te Kupenga is a large nationally representative post-censal survey of NZ's indigenous population (Māori) and is the only official survey with Māori culturally-informed variables. However, it is under-utilised in research. The Te Kupenga survey was used as a foundational cohort linking to outcomes and determinants in different datasets at different time periods. Outcomes included hospitalisations and COVID-19 vaccinations, while determinants included individual, household and geographic variables. Linking a representative survey to admin data created issues of loss to follow-up and missing data, so the original sample is not maintained after linkage. Loss to follow-up and missingness differed depending on variable selection and time periods. So, new universally applicable weights were not possible. However, we created a robust, generally applicable process for re-weighting survey data to account for missingness and loss to follow-up in admin data. This project demonstrates the approach for turning a sample survey into a longitudinal cohort using admin data and creates methods that can be used for other official statistics surveys.

Risk it for a biscuit: Food safety behaviours and food insecurity of older adults

Foodborne disease presents a significant public health issue, costing the UK economy £9 billion annually, with many incidences being due to food-related behaviours in the home. Adults aged 60 and over account for around a quarter of the population in England and Wales and are at a greater risk of foodborne disease and may suffer a much higher burden. Research into risky food behaviours has previously focused on larger cohorts and typically treats the over 60's as one homogenous group. The current paper aims to identify the characteristics associated with risky food-related practices related to cooking, cleaning, chilling, cross-contamination, and use-by date adherence. The current research analysed data from the Official Statistics survey, Food and You 2: Wave 6 (2022–23). A series of binary logistic regression models examined the characteristics associated with risky food-related practices. We demonstrate that the characteristics associated with risky behaviours are not uniform, with different factors being associated with specific behaviours. We suggest that risky behaviours cannot be targeted efficiently with a one size fits all approach. This research provides an evidence base for policy makers to target risky food behaviours in this understudied vulnerable group.

Burden and social distribution of occupational psychosocial exposures in the United States workforce, 2022.

To characterize the burden and social distribution of occupational psychosocial exposures in the United States (US). We merged 2022 US employment and demographic data from the Current Population Survey (CPS) with occupational characteristic data from the Occupational Information Network (O*NET), wage data from the Occupational Employment and Wage Statistics Survey, and hours worked from the CPS, to estimate the number and proportion of US workers at risk of exposure to 19 psychosocial hazards. We additionally estimated the number and proportion of US workers over- or underrepresented in exposure burden. Of the exposures examined, US workers were most commonly employed in occupations with high time pressure (67.5 million US workers exposed; 43.2% US workers exposed), high emotional labor (57.1 million; 36.6%), and low wages (47.8 million; 30.6%). The burden of exposures was uneven across sociodemographic strata, attributable to occupational segregation. The full data set is available online at https://deohs.washington.edu/us-exposure-burden. Work-related psychosocial exposures are ubiquitous and should be considered in occupational and public health research, policy, and interventions to reduce the burden of disease and health inequities in the United States.

„A bűntelen falu.”

Vál is a village in Fejér county, in the Martonvásár district. According to the latest Central Bureau for Statistics survey (2023), it has 2558 inhabitants. It is a special settlement with a rich history and traditions and an excellent location. What deserves special attention is the recent change in public security in the settlement. In the last three years, it could be rightly called a ‘crime-free village’. The spectacular improvement started in 2016, when the number of known crimes dropped to a fraction of the previous level. Mayor Tamás Bechtold, Member of Parliament Zoltán Tessely and Head of the Police Station Zsolt Kovács, who are responsible for different areas of the village, have created something special, and we asked them about it in this month’s interview. In our July monthly interview, Valér Dános, Editor-in-Chief, and Szandra Fazekas-Pátyodi, Editor-in-Chief, had the opportunity to ask Mayor Bechtold and Captain Kovács about the beginning of the cooperation, the joint achievements and the future tasks.

Differentials, barriers and enablers of death registration in Nepal: evidence from the Civil Registration and Vital Statistics (CRVS) survey

Death registration in Nepal is incomplete, which limits its utility as a routine source of mortality data to inform policy development. This study uses data from the Civil Registration and Vital Statistics (CRVS) Survey 2015/16 in Nepal conducted among households and CRVS service providers (local registrars) to assess the likelihood of death registration, using logistic regression with covariates of socio-economic, demographic and geographic characteristics. Respondents’ main reasons for registration and non-registration of deaths and ways to improve the CRVS system are also analysed. Death registration (70%) was more likely where the decedent was male (77%) versus female (60%), older aged (45 years and above 70%) versus young aged (0–14 years 26%) or died of injuries (more than 70%) compared with maternal causes (12%), where the household head’s education was higher and where the household haf more communication facilities. There were also large differences death registration by province and for certain ethnic groups. The main reasons for death registration were to transfer property entitlements, access social security or for other legal processes (a combined 85% of registered deaths). The major reason for non-registration of deaths according to most households (72%) and service providers (70%) was that it was not necessary. Both households and service providers stated that registration would be made more convenient by arranging mobile teams for registration, allowing registration at place of occurrence, and promoting online registration. The barriers and enablers identified in this study are valuable evidence to inform CRVS strengthening efforts in Nepal and other countries facing a similar challenge of incomplete death registration.

Gender Disparities Impact on Pre-Service Teachers' Attitudes in Mathematics and Statistics Education

The research investigates the impact of gender disparities on prospective teachers' attitudes towards statistics in mathematics education. The problem is a lack of understanding of how gender influences attitudes towards statistics. This research aims to explore differences in attitudes towards statistics based on gender and identify factors that influence these attitudes. The urgency lies in the importance of better understanding how gender can influence attitudes toward statistics among prospective teachers. This research method uses the Attitudes towards Statistics Survey (SATS-36) survey which was completed by 355 prospective teachers from 7 TTCs who were randomly selected. Data was collected through an online survey and analyzed using an independent T-test to compare the attitudes of prospective teachers based on gender. The results show that prospective teachers have a positive attitude towards statistics and gender has a significant influence on attitudes towards statistics. A significant difference was found in attitudes towards statistics between male and female teacher candidates, with men tending to have more positive attitudes. The conclusion is that gender plays an important role in shaping prospective teachers' attitudes towards statistics. The implication is that special attention is needed to pay attention to gender factors in developing mathematics education curricula to increase interest and understanding of statistics among prospective teachers.

Who smokes in Australia? Cross-sectional analysis of Australian Bureau of Statistics survey data, 2017-19.

To assess the socio-demographic and health-related characteristics of people who smoke daily, people who formerly smoked, and people who have never smoked in Australia. Cross-sectional analysis of Australian Bureau of Statistics (ABS) survey data. Adult participants (16 370 people aged 18 years or older) in the ABS 2017-18 National Health Survey (NHS); adult participants in the ABS 2018-19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) (6423 people aged 18 years or older). Socio-demographic and health-related characteristics of people who smoke daily, people who formerly smoked, and people who have never smoked, expressed as population-weighted proportions, overall and by Indigeneity. Among adult NHS respondents, an estimated 58.8% of people who smoked daily (95% confidence interval [CI], 56.2-61.4%) were men, 61.3% (95% CI, 58.7-63.9%) were 25-54 years old, 72.5% (95% CI, 70.0-74.8%) were born in Australia, and 65.4% (95% CI, 62.8-67.8%) lived in major cities and 54.3% (95% CI, 51.6-57.0%) in areas in the two socio-economically most disadvantaged quintiles; 75.9% (95% CI, 73.5-78.1%) reported good to excellent health, 73.0% (95% CI, 70.5-75.4%) reported low to moderate psychological distress, 69.0% of those aged 25-64 years (ie, of working age) had completed year 12 (high school), and 68.5% were currently employed. An estimated 2.57 million people smoke daily in Australia: 2.37 million non-Indigenous people (92%) and 195 700 Aboriginal or Torres Strait Islander people (8%). While smoking is more frequent among people living in socio-economically disadvantaged areas and in certain population sub-groups, this first quantitative national profile indicates that most people who smoke daily are in paid employment, are non-Indigenous, are in good physical and mental health, and have completed year 12. Improved comprehensive structural supply- and demand-based tobacco control, informed by the needs of priority groups and the overall profile of people who smoke, is needed to reduce daily smoking prevalence among adults to the 2030 targets of 5% or less for all Australians and 27% or less for Aboriginal and Torres Strait Islander people.

Health Conditions and Treatment Utilization Among Older Male Veterans Incarcerated in Prisons.

More than 50,000 older male veterans incarcerated in prisons are expected to return to their communities and utilize the Veterans Health Administration (VHA) and community healthcare systems. To support the continuity of healthcare and overall successful community reentry of older incarcerated veterans, an understanding of their health profiles and treatment utilization while in correctional care is needed. To assess the health status of older male veterans incarcerated in state prisons and explore demographic, military, and VHA-related factors associated with medical conditions, disabilities, behavioral conditions, and medical and behavioral treatment utilization. Cross-sectional observational study of 880 male veterans aged 50 + incarcerated in state prisons using data from the 2016 Bureau of Justice Statistics Survey of Prison Inmates. Veteran status, self-report health status, and treatment utilization since prison admission. Prevalence rates for conditions and treatment utilization were calculated. Logistic regression models were used to examine the association of characteristics with conditions and treatment utilization. Among the 880 older male veterans in state prisons, the majority reported having a current medical condition (79.3%) or disability (61.6%), almost half had history of a mental health condition (44.5%), and more than a quarter (29%) had a substance use disorder. Compared to White veterans, Black veterans were less likely to report a disability or mental health condition. Few demographic, military, and VA-related characteristics were associated with medical or behavioral conditions or treatment utilization. Our results suggest that the VHA and community healthcare systems need to be prepared to address medical and disability conditions among the majority of older male veterans who will be leaving prison and returning to their communities. Integrated medical and behavioral healthcare delivery models may be especially important for these veterans as many did not receive behavioral health treatment while in prison.

Water Statistical Survey and Data Application- Analysis and Practice Based on Zhejiang Province

Since the pilot water use statistics survey in Zhejiang Province in 2015, the list of water users in the province’s water use statistics survey has reached 7,899, with industrial and domestic direct reporting accounting for 94% of the total. By sorting out the problems and analyzing the causes in the implementation process of the water use statistics survey system, this paper proposes methods to improve the collection of water use data from public water supply enterprises, the backflow analysis of statistical direct reporting data, and the detailed rules for data review, as well as measures to solve problems. It also looks forward to the construction of a water index system that can predict economic changes and its application.

Achieving female supervisory representation in US law enforcement agencies: The roles of organizational structure, practice, and context

Abstract The current research explores relationships between law enforcement agencies’ organizational structures and practices and the representation of women in supervisory positions. Utilizing Law Enforcement Management and Administrative Statistics (2016) and American Community Survey (2011–15) survey data, we employed fractional response and binary logistic regression models to assess both the proportions of female officers in supervisory positions and differences between agencies that do and do not employ them. Results indicate organizational structures and practices play a limited role in shaping supervisory representation. The promotion of women, therefore, appears to be shaped to a greater extent by those managing the process rather than the framework it occurs within.

Board of Management Occupation and Professional Training: Predictors of Budgetary Processes in Public Secondary Schools in Kangundo Sub-County, Kenya

Budgetary processes are universal and essential tools for effective financial planning and management. Budgetary processes help in the establishment of predestined goals, giving progressive performance reports and evaluation of actual performance in terms of predetermined outputs. The study objective was to establish the influence of the Board of Management occupation and professional training on school budgetary processes. The study applied the Systems theory propounded by Ludwig Von Bertalanffy in 1940s and 1950s. The survey adopted descriptive and inferential statistics survey design and targeted Principals, Teachers, B.O.M members and (1) County Auditor. The sample size consisted of 12 Principals, 32 teachers,78 B.O.M members and (1) County Auditor. The process of collecting Data was run through interviews and questionnaires. Instruments’ validity was ascertained by seeking expert guidance from the university supervisors. The instruments’ reliability was ascertained through test-retest method. Both inferential and descriptive statistics were applied to determine correlation by the use of frequencies, mean and standard deviation. Pearson product moment correlation coefficient and inferential statistics were used to demonstrate the level of significance among the study variables. Statistical package for social sciences was applied in the data analysis process. The findings of the survey were that occupation influences budgetary processes moderately r (76) =0.425, p (0.000) <0.05). The research also found out that professional training influences the participation rate in the school budgetary processes to a great extent r (76) =0.595, p (0.000) <0.05). The research concluded that professional training and occupation influences budgetary processes. The survey suggest that further studies should be done on the influence of professional training of B.O.Ms on Budget controls and Principals technical skills on Budgetary process in public secondary schools.

APPLICATION OF CELL PHONE STATISTICS FOR ESTIMATING STRANDED PEOPLE BEHAVIOR AFTER SEVERE EARTHQUAKE IN TOKYO

Abstract. In this paper, we present a walking home simulation as anticipated after a large earthquake, and analyze people’s behaviors, walking and stopping, including the crowding of facilities by those unable to walk all the way home. For creating the necessary data for this simulation, we construct a method to estimate the spatiotemporal distribution of people with detailed individual information such as sex-age classification, and home location, by assembling population distribution data (Mobile Spatial Statistics and Person Trip survey data). The walking home simulation results verified significant variations in the crowding of facilities for stranded people due to differences in the day of the week and the time of the earthquake. Locations in Tokyo with insufficient numbers of facilities for stranded people were identified and some spatiotemporal characteristics of crowding, such as changes in crowding with time elapsed since the earthquake, were described.

Women Leaders in the Perspective of Indonesian Regulations and Progressive Fiqh

The population of Indonesian women is slightly less than men, according to the Indonesian Central Agency of Statistics survey in 2022. Unfortunately, they have not yet filled and occupied many public sectors, which have significant influence in determining decisions and important policies as their male counterpart have. This paper aims to elaborate on the potential of having Indonesian women as leaders - including political leaders and parliamentary representatives - by analyzing data about women's participation as parliamentary representatives and regency/city and provincial leaders in Indonesia. The study is descriptive qualitative research employing historical and both Indonesian regulations and progressive fiqh (Islamic jurisprudence) juridical approaches. The data were analyzed using fiqh al-siyāsah (Islamic jurisprudence on politics) and empowerment theories. The findings show that 1) historically, women, in general, have the same capability and competence to become public and political leaders as men, and 2) juridically, the right to become public and political leaders is properly guaranteed in both Indonesian regulations and progressive Islamic jurisprudence.

Stillbirths, miscarriages and early losses in armed conflict contexts. The modification effect of violence. The Colombian case

BackgroundColombia experienced a prolonged armed conflict that affected differently regions and periods. We explored how this regional violence influenced the well-being of newborns, using data from the National Centre of Historic Memory (NCHM) and the Vital Statistics Survey. The NCHM recorded the number of victims, while the Vital Statistics Survey reported data on births, stillbirths, and early losses. Aim: We aimed to assess the impact of regional violence on newborns' well-being and to examine whether mothers’ university education mitigated these effects. We focused on comparing two periods: 1998–2002 and 2003–2007, and two group of regions which differed in the intensity and distribution of violence. MethodsWe applied a difference-in-differences approach and logistic regression analysis to estimate the odds of stillbirths and miscarriages in regions exposed to violence during the treated regions. We also estimated the interaction effect between treated groups and mothers’ university education. FindingsWe found a significant association between living in the most violent regions and having a higher risk of stillbirths, miscarriages, or early losses (OR: 1.721). Women living in less affected regions had a higher probability of giving birth to live babies and preserving the dyad. However, we observed a negative modifier effect of violence on the likelihood of live births for mothers with university education (OR:1.273). DiscussionWe observed that the effect modification points to a higher impact of stress on mothers with university education in violent regions and periods compared to those without higher education. These findings unveil the concealed impact of regional violence, which diminishes the protective influence of maternal education, regardless of the level attained. ProblemThe scarcity of empirical evidence regarding the causa through which violence modify the shield effect of university education in most affected areas.What is Already Known: When women are able to complete their university education before giving birth, they are better able to have healthier pregnancies and therefore achieve higher levels of well-being for their newborns.What this Paper Adds: Pregnant women with university education are likely to be experiencing higher levels of stress compared to those mother with no university education within the most violent regions and periods embedded in armed conflict environments/contexts.

Acceptability and Feasibility of Text Message Interface to Assess Parents' Real-time PICU Experiences.

Parents of children in the pediatric intensive care unit (PICU) experience substantial stress; a parent's perception of their child's illness severity, more than objective measures, predicts psychological outcomes. No tools exist to assess parents' real-time experiences. This pilot study evaluated the feasibility and acceptability of a text-based tool to measure parental experience. Inclusion criteria included PICU stay >48 h, physician approval, smartphone access, and English-speaking caregiver. Eligible parents received a text-based baseline survey and surveys every other day while hospitalized regarding their mood/experiences and optional open-ended questions regarding stressors. They received post-discharge follow-up surveys at 1 week and 1, 3, and 6 months. Follow-up surveys assessed mood and symptoms of depression, anxiety, and post-traumatic stress. Interviews and surveys about the interface were conducted 1 week and 3 months following discharge. Feasibility was assessed by descriptive statistics (eg, response rates), and acceptability was assessed by descriptive statistics (survey results) and thematic analyses of interviews. Of 20 enrolled participants, the first 5 were excluded due to technical issues. Of the 15 included, results demonstrated feasibility and acceptability. Most participants (86%) completed all surveys during the PICU stay and continued to complete surveys at a high rate: 79%-94% 3 months post-discharge. All participants agreed that the system was easy to use and were satisfied with the system at discharge, and 91% remained satisfied 3 months post-discharge. Additionally, 76% reported comfort, and 69% reported benefit. From the interviews, participants lauded the system's convenience and applicability of content. Some proposed changes to improve ergonomics. Many suggested this interface could help teams better support families. A text-based interface for measuring experience in the PICU is feasible and acceptable to parents. Further research can explore how this could identify parents most at risk of adverse psychological sequelae and lead to earlier supportive interventions.

The challenges and experiences of providing end-of-life care in primary care: online survey and semi-structured interviews with UK primary care professionals.

Primary care professionals deliver the majority of end-of-life care to patients. However, extensive pressures and constraints can contribute to variable and substandard care quality. We will report on the preliminary results from an independent evaluation of the 'Daffodil Standards for Advanced Serious Illness and End-of-Life Care', created by the Royal College of General Practitioners and Marie Curie. To map activities to improve end-of-life care undertaken by GP practices, including the implementation of the Daffodil Standards. An online survey (Phase 1) has been made available to all GP practices in the UK to capture end-of-life care activities, experiences and challenges. Those who have signed up to receive guidance about the Daffodil Standards are also asked about their experiences of implementation and impact. Alongside this, a sub-sample of the survey responders are invited to take part in a semi-structured interview (n=20-26) to identify processes and mechanisms of implementation (Phase 2). This project is informed by the Normalisation Process Theory (NPT). Descriptive statistics (survey) and Framework Analysis (survey, interviews) are used to analyse the data. Sixty-eight surveys, of which 41% (n=28/68) had signed up to the Daffodil Standards, and five semi-structured interviews have been completed to date. Recruitment to both the survey and interviews is ongoing. The preliminary results of Phases 1 and 2 will be available for presentation in March 2023. The results will be used to inform and refine the design illustrative case studies to capture best available learning and identify exemplars of best practice for later phases of the study.

Energy Recovery and Economic Evaluation for Industrial Fuel from Plastic Waste.

Plasma gasification is considered an environmentally friendly process to convert plastic waste into fuel oil; a prototype system is described to test and validate the plasma treatment of plastic waste as a strategic vision. The proposed plasma treatment project will deal with a plasma reactor with a waste capacity of 200 t/day. The annual plastic waste production in tons in all regions of Makkah city during 27 years for all months in the years 1994 to 2022 is evaluated. A statistics survey of plastic waste displays the average rate generation ranging from 224 thousand tons in the year 1994 to 400 thousand tons in the year 2022, with an amount of recovered pyrolysis oil; 3.17 × 105 t with the equivalent energy; 12.55 × 109 MJ, and an amount of recovered diesel oil; 2.7 × 105 t with an amount of electricity for sale 2.96 × 106 MW.h. The economic vision will be estimated, using the results of energy generated from diesel oil as an industrial fuel extracted from plastic waste equivalent to 0.2 million barrels of diesel oil, with sales revenue and cash recovery of USD 5 million, considering the sale of each one barrel of diesel extracted from plastic waste in the range of USD 25. It is important to consider that the equivalent barrels of petroleum cost, according to the organization of the petroleum-exporting countries' basket prices, up to USD 20 million. The sales profit (2022) is as follows: for diesel with a sales revenue of diesel oil, USD 5 million, with a rate of return of 4.1%, and a payback period of 3.75 years. The generated electricity reached USD 32 million for households and USD 50 million for factories.

Racial/Ethnic Diversity in Positions of Power in U.S. Law Enforcement: An Examination of Active Representation and Disparities in Vehicle Stops

Increasing minority representation in law enforcement has long been viewed as a means of improving police-citizen relations. Yet, little scholarly attention has examined whether racial/ethnic diversity translates into desired outcomes. These studies largely measure the racial/ethnic composition of the agency in general—not in positions of power where they are most likely to make an impact on department policy/practice (i.e., ‘active representation’). Using data from the 2016 Law Enforcement Management and Administrative Statistics (LEMAS) survey, the current study 1) provides an overview of Black and Hispanic representation in chief executive, mid-level management, and supervisory roles and 2) explores the impact that diversity in these positions has on racial/ethnic disparities in vehicle stops in Illinois and Missouri. Minority officers are more underrepresented in these positions of power compared to their composition in agencies in general, and higher levels of representation are not significantly associated with reductions in disparities in stops.

Declining life expectancy in the Great Lakes region: contributors to Black and white longevity change across educational attainment

BackgroundThe East North Central Census division (aka the Great Lakes region) experienced a decrease in life expectancy of 0.3 years from 2014 to 2016 – one of the largest declines across the nine Census divisions. Disadvantaged groups that typically have below-average life expectancy, including Black individuals and those without a college education, may have been disproportionately affected by this longevity shift. This investigation examines life expectancy changes among different sex, race, and education groups in the Great Lakes region, and how specific causes of death contributed to within-group longevity changes over time and across age.MethodsWe used 2008 to 2017 death counts from the National Center for Health Statistics and American Community Survey population estimates to measure within-group change in life expectancy at age 25 among non-Hispanic Black and white males and females by educational attainment. We decomposed life expectancy change over time for each subgroup by 24 causes of death and measured their contribution to longevity change across 13 age groups.ResultsAmong persons with ≤ 12 years of education, white males and females experienced 1.3- and 1.7-year longevity declines respectively, compared to a 0.6-year decline among Black males and a 0.3-year decline among Black females. Life expectancy declined among all groups with 13–15 years of education, but especially Black females, who experienced a 2.2-year loss. With the exception of Black males, all groups with 16 + years of education experienced longevity gains. Homicide contributed 0.34 years to longevity decline among Black males with ≤ 12 years of education. Drug poisoning made large contributions to longevity losses among Black females with ≤ 12 years of education (0.31 years), white males and females with 13–15 years of education (0.35 and 0.21 years, respectively), and white males and females with ≤ 12 years of education (0.92 and 0.65 years, respectively).ConclusionsPublic health efforts to reduce the risks of homicide among Black males without a college education and drug poisoning among all groups could improve life expectancy and reduce racial and educational longevity disparities in the Great Lakes region.