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Biomedical subjects

L A Fingerhut

Publications and source records attributed to L A Fingerhut.

33 records · Page 2Linked to original sources

Differences in infant mortality by race, nativity status, and other maternal characteristics.

The objective of this study was to examine the effects of nativity status (native vs foreign born) and other maternal characteristics (age, parity, education, and marital status) on infant, neonatal, and postneonatal mortality among white and black mothers. The design of this nonrandomized cohort study was based on birth and death certificates. The setting involved live births among US residents (excluding California, Texas, and Washington) in 1983 and 1984. The participants included white mothers with 4.4 million births and black mothers with 926,000 births in single deliveries. There were no interventions. With regard to measurements (the main results), after adjusting for other risk factors, neonatal mortality risk was 22% lower among the black foreign-born mothers than among the black native-born mothers, while among white infants, there was no risk difference by nativity. Relative risks were more similar for postneonatal mortality, ie, 24% lower among black foreign-born mothers and 20% lower among white foreign-born mothers. Combining the several categories of risk factors into three broad maternal risk groups, there was a near-doubling of black and near-tripling of white infant mortality rates between the low and high levels of maternal risk. We concluded that if the infant mortality rate in the low-risk groups could be achieved by the moderate- and high-risk groups, there would be a 30% reduction in infant deaths within each race. Since the black infant mortality rate is twice the white infant mortality rate and black foreign-born mothers have much lower rates than black native-born mothers, it is likely that further improvement is possible among black infants.

Educational Status↗

International and interstate comparisons of homicide among young males.

The homicide rate for males 15 through 24 years of age in the United States was compared with the rates in 21 other developed countries. The US homicide rate, 21.9 per 100,000, was more than four times higher than the next highest rate in Scotland (5.0). Most countries had rates that were between 1 and 3 per 100,000. The lowest rates were in Japan and Austria, each with rates below 0.6 per 100,000 males 15 through 24 years of age. Three quarters of the homicides in the United States resulted from the use of firearms contrasted with less than a quarter of all homicides in the comparison countries. The US homicide rate for black males 15 through 24 years of age (85.6) was more than seven times the rate for white males (11.2). In 1987 there were only four states that had homicide rates among white males that were as low as the rates among males in the comparison countries. The lowest state rate among young black males was still seven times the highest rate abroad. There are about 4000 homicides per year among young males in the United States. If the US homicide rate could be reduced to that in the country with the next highest rate, more than 3000 lives would be saved.

Adolescent↗

Smoking before, during, and after pregnancy.

We report the first national data on smoking before, during, and after pregnancy. Estimates are based on the 1986 Linked Telephone Survey that reinterviewed 1,550 White women 20-44 years of age who were respondents to the 1985 National Health Interview Survey. An estimated 39 percent of White women who had smoked before pregnancy quit smoking while pregnant (27 percent when they found out they were pregnant and 12 percent later during pregnancy). Women with less than 12 years of education were five times as likely to smoke and one-fourth as likely to quit as those with 16 or more years of education. Women who smoked more than one pack of cigarettes per day before pregnancy were one-fifth as likely to quit as those smoking less. Of the women who quit, 70 percent resumed smoking within one year of delivery. Of those who relapsed, 67 percent resumed smoking within three months of delivery and 93 percent within six months. There is little evidence of educational differentials in relapse rates. The fact that relapse remains high suggests that while health of the fetus is a strong influence on women's smoking habits, women may be less aware of the effect of passive smoke on the infant.

Adult↗

Injury fatalities among young children.

Injuries and violence are the primary causes of death among young children in the United States. In particular, in 1982-84 motor vehicle injuries, fires, drowning, and homicide were the leading external causes of death at ages 1-4 years and 5-9 years, accounting for nearly 80 percent of all deaths from external causes. The purpose of this article is to analyze race and sex differentials in injury fatalities among young children. Race and sex differentials in injury mortality were measured in terms of relative risks, that is, race (black to white) and sex (male to female) mortality ratios. Race ratios for external causes ranged from 1.7 to 1.9 for children 1-4 and 5-9, while sex ratios were somewhat lower, 1.4 to 1.8. Although race and sex ratios were relatively small for passenger-related motor vehicle fatalities (0.8 to 1.2) the ratios for pedestrian-related injuries were considerably greater (1.5 to 2.0). Race ratios for deaths caused by fires and homicide were particularly large (3.4 to 4.3). Mortality differences were also measured in terms of excess mortality. For each age-race group more than 65 percent of the overall excess deaths among males were due to external causes of death. Pedestrian-related motor vehicle injuries and drownings accounted for the largest proportion of excess deaths among males. At ages 1-4, 53 percent of the overall excess deaths among blacks were due to external causes. Deaths caused by fires and homicide accounted for more than two-fifths of the excess in this age group. At ages 5-9, 81 percent of excess mortality among black males and 69 percent among black females were accounted for by external causes. Fires, pedestrian-related motor vehicle fatalities, and homicides accounted for nearly 65 percent of excess mortality among black children.There has been a 30 percent decline in death rates from all external causes between 1972-74 and 1982-84. Pedestrian-related motor vehicle death rates declined the most in both age groups.Mortality also declined in each age-race-sex group for passenger-related motor vehicle injuries, for drownings, and for fires except among black males ages 5-9. Homicide, in contrast, increased in both age groups. There has been little change, however,in the incidence of injuries among children. Thus,it appears that declines in fatalities accounted for a major portion of the mortality reduction.

Accidents, Traffic↗

Medically attended nonfatal injuries among preschool-age children: national estimates.

We used data from the 1991 Longitudinal Follow-up to the National Maternal and Infant Health Survey to examine cumulative risk of injury among children from birth to three years old and to provide national-level cause-specific estimates of medically attended nonfatal injuries for this age group. Almost 25% of the 8,145 children reportedly received care for an injury between birth and three years old. Among the children with injuries, 25.4% reportedly had more than one medically attended injury. Risk of reported injury was higher for boys and upper level socioeconomic groups. Falls were the most frequently reported injury (51%), followed by burns (11.7%), striking or cutting injuries (9.8%), poisonings (9.8%), and injuries from devices not intended for the child's use (7.9%). Nonfatal injuries for preschool-age children present a pattern strikingly different from that of fatal injuries among this age group, and the need for this data is important in targeting prevention strategies.

Cause of Death↗

Poisoning mortality, 1985-1995.

Poisoning was reported as the underlying cause of death for 18,549 people in the United States in 1995 and was ranked as the third leading cause of injury mortality, following deaths from motor vehicle traffic injuries and firearm injuries. Poisoning was the leading cause of injury death for people ages 35 to 44 years. Poisoning death rates were higher in 1995 than in any previous year since at least 1979. From 1990 to 1995, the age-adjusted rate of death from poisoning increased 25%; all of the increase was associated with drugs. About three-fourths of poisoning deaths (77%) in 1995 were caused by drugs. The age-adjusted rate of drug-related poisoning deaths for males (7.2 per 100,000) in 1995 was more than twice that for females (3.0 per 100,000). From 1985 to 1995, poisoning death rates for males ages 35-54 years nearly doubled to 20.4 per 100,000, and the drug-related poisoning death rate for males ages 35-54 years nearly tripled, reaching 16.1 per 100,000. From 1990 to 1995, death rates associated with opiates and cocaine more than doubled among males ages 35-54 years. The numbers of opiate and cocaine poisoning deaths for 1995 more than doubled when all multiple cause of death codes were examined instead of only the underlying cause of death codes.

Adolescent↗