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Biomedical subjects

J A Mercy

Publications and source records attributed to J A Mercy.

65 records · Page 4Linked to original sources

Comparison of suicides among Anglos and Hispanics in five southwestern states.

Little is known about deaths resulting from self-inflicted violent behavior for Hispanic Americans. To learn more about suicide for Hispanics of Mexican origin (Mexican Americans) we focused on the five southwestern states (Arizona, California, Colorado, New Mexico, and Texas) in which more than 60% of all Hispanics in the United States reside (86% of whom are Mexican American). We obtained data on the number of suicide deaths in the white population, with Hispanics and Anglos (white, non-Hispanic) identified separately. Suicides of Anglos were used as a comparison group. Results show that the suicide rate for whites in the five southwestern states (15.6) was almost one-fourth higher than the rate for whites nationally (12.7). Suicide rates for the two ethnic groups, however, showed the rate for Hispanics (9.0) to be less than the national rates for whites (12.7) and one-half that of Anglos residing in the same area (17.3). The lower suicide rate for Hispanics relative to Anglos is seen for both males and females. The ratio of male and female suicides for Hispanics was almost twice that for Anglos (4.0 to 1 for Hispanics and 2.3 to 1 for Anglos). More than 1 in 3 Hispanic men who committed suicide and more than 1 in 4 Hispanic women who committed suicide are under the age of 25.

Adolescent↗

Assigning time-linked exposure status to controls in unmatched case-control studies: alcohol use and nearly lethal suicide attempts.

In case-control studies, determination of alcohol consumption by cases immediately prior to the injury event is often conceptually straightforward. However, determination of consumption status by controls is difficult because they lack a reference point, especially when cases and controls are not individually matched. We describe a method of assigning alcohol consumption status to controls using a 24-hour drinking history, the distribution in time of case events, and the random assignment of a specific time period to each control subject. This methodology offers a practical approach for determining alcohol consumption status among control subjects immediately prior to a case event, when controls lack a reference point and have not been individually matched to cases. Published in 2001 by John Wiley & Sons, Ltd.

Adolescent↗

Public health: a successful paradigm applied to firearm injuries.

Firearm injuries are a major contributor to injury mortality and morbidity in the United States and account for substantial loss of productive years of life. A public health approach to injury reduction, and particularly firearm injury prevention, has promise because it emphasizes prevention rather than reaction, it utilizes a scientific approach to policies and programs, it brings an integrative, multi-disciplinary approach to the effort, and it emphasizes the role of communities in solving health problems. The new Firearm Injury Center at the Medical College of Wisconsin exemplifies the public health approach to this vexing problem.

Health Policy↗

Comparing death certificate data with FBI crime reporting statistics on U.S. homicides.

Both the National Center for Health Statistics (NCHS) Mortality System and the Federal Bureau of Investigation (FBI) Uniform Crime Reporting System measure the numbers and characteristics of homicide in the United States. There are important differences, however, in both the substance and the quality of the information that the two systems collect. The NCHS mortality system reported an average of 9 percent more homicides nationally than did the FBI crime reporting system during the 1976-82 period. Variations did occur in the average ratios of the frequencies of homicides reported by the two systems across age, race, and sex subgroups and geographic areas. The major source of the ascertainment difference between the NCHS and the FBI systems is thought to be incomplete voluntary reporting to the FBI by participating law enforcement agencies and lack of reporting by nonparticipating agencies. The proportions of homicides among corresponding demographic categories in the two systems is remarkably similar despite the difference in ascertainment. This congruence of the distributions of reported homicides supports the idea that inferences drawn from analysis of variables in one of these systems will be valid for the population reported on by the other system.

Adolescent↗

Suicide and homicide among Hispanics in the southwest.

A study of suicide and homicide among Hispanics of Mexican origin (Mexican Americans) focused on five southwestern States--Arizona, California, Colorado, New Mexico, and Texas--where more than 60 percent of all Hispanics in the United States reside. And 85 percent of them are Mexican Americans. Data were obtained on all suicides and homicides among Hispanics and Anglos (white non-Hispanics), using Anglos as a comparison group. Results for suicide showed the suicide rate for Hispanics (9.0 per 100,000) to be less than the national rate for whites (13.2) and half that of the Anglos residing in the same area (19.2). The lower suicide rate for Hispanics relative to Anglos is seen for both males and females. For homicide, the overall rate for Hispanics (20.5) was more than 2 1/2 times that of Anglos (7.9). The rate for Hispanic men (39.3) was more than three times the rate for Anglo men (11.4).

Adolescent↗

The emergency department in surveillance of attempted suicide: findings and methodologic considerations.

The authors conducted one of the first active, population-based public health surveillance systems for detecting suicide attempts in the United States. Surveillance was conducted in all four hospital emergency departments serving a county suburban to Atlanta, GA, with a population of 426,000. Emergency department staff gathered information from all patients who presented with an intentionally self-inflicted injury (suicide attempt) or with thoughts about self-injury (suicidal ideation). During an 18-month period in 1988 and 1989, 798 suicide attempt-related patients were reported, for a rate of 124.7 per 100,000 county residents per year. Females had a higher attempted suicide rate than males, but males had a higher completed suicide rate. Ingestion of drugs or poison was the most common method of attempted suicide (71.1 percent), and use of firearms was the most common method of completed suicide (69.8 percent). In comparing reported cases with those found by reviewing emergency department log books, the authors found that the case reports were 58 percent complete and that surveillance reporting was highly representative of all cases requiring emergency transport. The authors conclude that emergency department-based surveillance for attempted suicide is feasible. It can provide representative data that may be used to monitor trends in attempted suicide and to define high-risk groups. Such surveillance may also allow timely detection of suicide attempt clusters, facilitating prompt intervention.

Adolescent↗

Prevention of youth violence: rationale and characteristics of 15 evaluation projects.

Interpersonal violence is a major cause of injury, disability, and death, especially among youth. Evaluations of 15 youth violence-prevention projects are under way. Public health is concerned about health problems that need to be addressed via collective action. Public health involvement in addressing interpersonal violence among youths brings an emphasis on primary prevention, a systematic and scientific process, and integrative leadership. Few quantitative evaluations of violence-prevention projects have been done. The interventions are scientifically based and use a spectrum of strategies. Individually oriented strategies are more common than those directed toward peers, families, schools, or communities. Each project has a rigorous evaluation design. Twelve are randomized. Sample sizes range from 180 to 10,000. Participants range in age from 5 to 18 years, although most are in the middle-school years (11-14 years). At baseline, intervention and comparison groups are similar. Baseline data demonstrate high frequency of violent behavior, weapon carrying, and exposure to violence among the youthful participants. Field intervention and evaluation research is difficult and expensive. Difficulties encompass organizational programatic, and scientific issues; these difficulties reduce scientific interest and financial support for projects such as these. Public health has an important role to play in reducing violence. These projects will make important contributions to that task.

Adolescent↗

Trends in fatal firearm-related injuries, United States, 1962-1993.

OBJECTIVE: Our objective was to review historical trends in U.S. fatal firearm-related injuries for the years 1962-1993. METHODS: Using mortality data from the National Center for Health Statistics and population estimates projected from census data, we calculated national age-adjusted mortality rates and examined trends over the 32-year period. Data were also examined by type of firearm-related death (unintentional, suicide, homicide, legal intervention, and undetermined intention), race, gender, and age group. RESULTS: During the 32-year period, the total number of firearm-related deaths increased by 137%, from 16,720 in 1962 to 39,595 in 1993. Suicide and homicide were responsible for most firearm fatalities. Rates for both firearm suicides and firearm homicides increased over time, while rates for unintentional, legal intervention, and undetermined intention decreased. The highest rates and widest variation in total firearm-related mortality occurred among African-American men (35.2/100,000 to 84.5/100,000). Persons 15-19, 20-24, and > or = 75 years of age experienced the largest changes in rates during recent years; total firearm mortality was higher for the younger age groups (15-19, 20-24) during 1990 through 1993 than any other time during the 32-year period. CONCLUSIONS: These surveillance data help characterize trends over time and the magnitude of firearm-related mortality and identify groups at risk. However, further efforts to improve our understanding of firearm-related deaths and injuries, such as expansion of current surveillance to include information about morbidity associated with firearms and additional epidemiologic research to identify modifiable individual and societal risk factors, are necessary.

Accidents↗