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Biomedical subjects

J Weinkam

Publications and source records attributed to J Weinkam.

5 recordsLinked to original sources
PubMed1993

Income, race, and mortality.

This study was undertaken to clarify the complex relationship between poverty and race with disease-specific mortality. Data from the 1987 National Health Interview Survey and the 1986 National Mortality Followback Survey were used to estimate standardized mortality ratios (SMRs) for various categories (all causes, all cancers, noncancerous medical causes, lung and breast cancers, ischemic heart disease, and cerebrovascular disease) associated with income below the poverty line and were compared with those with adequate or better than adequate income. All SMRs were substantially elevated. The SMRs were not appreciably affected by adjustments for confounding by alcohol consumption, occupation, or smoking. Sex-specific SMRs of blacks relative to whites with the exception of ischemic heart disease were significantly elevated for males but not for females with the exception of the SMR for all causes. However, when adjusted for per capita income within the family, black mortality never significantly exceeded that of whites. These results strongly support the conclusion that mortality differences between blacks and whites are due to differences in income and related factors. However, it is unclear why poverty should be associated with elevation in cancer relative risk.

Adult↗
PubMed1990

The confounding of occupation and smoking and its consequences.

A strong pattern in smoking behavior can be demonstrated, in which smoking is much more prevalent among those occupational groups (and social strata) that are also more exposed to hazards in the workplace and much less prevalent among those groups less exposed to such hazards. As a consequence, comparing individuals with greater to those with lesser exposure to tobacco also compares groups that differ with respect to occupational exposure to dust, fumes and toxic substances and with respect to occupationally related lifestyle factors. Analyses of the U.S. National Health Interview Survey show that smoking and occupation are substantially confounded among individuals differing by (1) amount of smoking; (2) smoking cessation; (3) types of cigarettes smoked; (4) age of starting to smoke; and (5) exposure to more or less environmental tobacco smoke at home. This confounding between types of work and proximity to tobacco smoke may have masked relationships between type of employment and disease. But it is difficult to disentangle the effects of occupation and of smoking from each other without well planned further studies because (1) of the difficulty of estimating occupational effects and simultaneously adjusting for healthy worker effects, (2) satisfactory techniques for estimating relative effects of intertwined variables make demands on the quality and quantity of data that are not met by presently available data, and (3) there may be deeply rooted social and psychological attitudes toward effects of work versus effects of lifestyles that tend to bias investigative work.

Age Factors↗