A definition of "social environment".
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Humans↗
Biomedical subjects
M Casper
Publications and source records attributed to M Casper.
Community occupational structure, medical and economic resources, and coronary mortality among U.S. blacks and whites, 1980-1988.
PURPOSE: To examine the association between coronary heart disease (CHD) mortality, economic and medical resources, and county occupational structure. METHODS: U.S. counties were classified into five occupational structure categories based on the percentage of workers in white-collar occupations. Directly age-adjusted CHD mortality rates (from vital statistics and Census data) and economic and medical care data (from Census and Area Resource File data) were calculated for each occupational structure category. Participants were black and white, men and women, aged 35-64 years, in the U.S. during 1980-88. CHD mortality rates and economic and medical care data were compared across occupational structure categories. RESULTS: Among blacks, CDH rates were highest in counties with intermediate levels of occupational structure; rates among whites were inversely associated with occupational structure. Per capita levels of income and numbers of medical-care providers were positively associated with occupational structure. CONCLUSION: Strategies to improve the resources of disadvantaged communities and the access of black workers to local occupational opportunities may be important for CHD prevention in high risk populations.
Adult↗
The contribution of diabetes to early deaths from ischemic heart disease: US gender and racial comparisons.
We evaluated the contribution of diabetes mellitus to premature ischemic heart disease mortality among US race- and gender-specific groups in 1986. Among persons aged 45 to 64 years, we examined ischemic heart disease death rates (corrected for underreporting of diabetes on death certificates) by diabetes status and calculated the population attributable risk due to diabetes for each group. Diabetes increased the ischemic heart disease death rate by 9 to 10 times for women but by only 2 to 3 times for men. Racial differences in ischemic heart disease mortality attributable to diabetes were greater for women (Blacks = 39%; Whites = 27%) than for men (Blacks = 19%; Whites = 14%). These discrepancies in the contribution of diabetes to ischemic heart disease mortality warrant further study.
Aged↗
Blood pressure, diabetes, and body mass index among Chippewa and Menominee Indians: the Inter-Tribal Heart Project Preliminary Data.
THE HEART DISEASE MORTALITY RATES of the Chippewa and Menominee, who reside in the upper Midwest, are higher than the rates of most other tribes in the United States. Little is known, however, about the prevalence of hypertension, diabetes, and obesity among these communities. The Inter-Tribal Heart Project (ITHP) was designed to determine the prevalence of risk factors for heart disease and to implement community-based heart disease prevention programs. Age-stratified random samples of active users of the tribal-Indian Health Service (IHS) clinics, ages 25 and older, were drawn from three communities within the Bemidji Service Area. Between September 1992 and June 1994, 1396 people completed an extensive questionnaire and underwent a physical exam for heart disease risk factors. Preliminary data indicate mean blood pressure levels of 126 mmHg for systolic blood pressure (SBP) and 74.4 mmHg for diastolic blood pressure (DBP). Mean SBP and DBP were higher among men than women. Mean body mass index (BMI), which did not vary by gender, was 30.6 mmHg. The prevalence of hypertension was 33%; and diabetes, 33%. Men had a higher prevalence of hypertension than women, but there was little gender difference in the prevalence of diabetes. These preliminary data suggest that the prevalences of hypertension, diabetes, and obesity in these communities are higher than the recent estimates for the total United States. The next stage of the ITHP will focus on policies and programs to prevent and treat these conditions.
Adult↗
The maize mitochondrial genome: dynamic, yet functional.
The organization of the mitochondrial genome of higher plants is complex. It has two striking features: a large size that can vary among plant species; and the ability to undergo homologous recombination that results in variation within species. From cosmid clone mapping studies, the total genetic information of the plant mitochondrial genome can be arranged into a single circular molecule that is referred to as the master chromosome. This circular DNA molecule contains repeated sequences that can generate, via intramolecular recombination, either isomeric forms of the master chromosome or smaller subgenomic circular DNA molecules. The maize mitochondrial genome is the most complex and largest mitochondrial genome for which a physical map is presently available. Its organization varies considerably among the different maize cytotypes. In an attempt to understand the numerous different mitochondrial DNA rearrangements encountered among those cytotypes, we have proposed a general model of genome evolution that can explain a multitude of genomic rearrangements, not only for the maize mitochondrial DNA but also for other higher plant mitochondrial genomes as well.
Biological Evolution↗
A second type of normal maize mitochondrial genome: an evolutionary link.
A new type of maize mitochondrial genome has been identified in the male fertile (normal) inbred line A188. It has been named NA (N in the A188 nuclear background). In comparison to previously described maize mitochondrial genomes, it is classified as a new type since the genome contains unique DNA sequences and unique sets of repeated sequences, and has a unique organization. This brings the number of the maize mitochondrial genome types to five of which three are the cytoplasmic male steriles cmsT, cmsC and cmsS and of which two are the male fertile types NA (in this report) and NB (the previously characterized normal genome in the B37 nuclear background).
Biological Evolution↗
A non-traditional request-for-proposals.
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Colorado↗
Ins and outs of intrafacility transfers.
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Nursing Homes↗
Antihypertensive treatment and US trends in stroke mortality, 1962 to 1980.
OBJECTIVES: This study examines the association between increases in antihypertensive pharmacotherapy and declines in stroke mortality among 96 US groups stratified by race, sex, age, metropolitan status, and region from 1962 to 1980. METHODS: Data on the prevalence of controlled hypertension and socioeconomic profiles were obtained from three successive national health surveys. Stroke mortality rates were calculated using data from the National Center for Health Statistics and the Bureau of the Census. The association between controlled hypertension trends and stroke mortality declines was assessed with weighted regression. RESULTS: Prior to 1972, there was no association between trends in controlled hypertension and stroke mortality declines (beta = 0.04, P = .69). After 1972, groups with larger increases in controlled hypertension experienced slower rates of decline in stroke mortality (beta = 0.16, P = .003). Faster rates of decline were modestly but consistently related to improvements in socioeconomic indicators only for the post-1972 period. CONCLUSIONS: These results do not support the hypothesis that increased antihypertensive pharmacotherapy has been the primary determinant of recent declines in stroke mortality. Additional studies should address the association between declining stroke mortality and trends in socioeconomic resources, dietary patterns, and cigarette smoking.
Black or African American↗
Geographic and socioeconomic variation in the onset of decline of coronary heart disease mortality in white women.
BACKGROUND: Regional, metropolitan, and socioeconomic factors related to the onset of decline of coronary heart disease (CHD) mortality among White women are reported. Such studies are important for planning population-level interventions. METHODS: Mortality data for 1962 to 1978 were used, to estimate the year of onset of decline. Ecological analyses of socioeconomic data from the US census were used to emphasize structural and organizational aspects of changes in disease, rather than as a substitute for an individual-level design. RESULTS: Onset of decline of CHD mortality among White women was estimated to have occurred by 1962 in 53% of 507 state economic areas (SEAs), ranging from 79% in the Northeast to 39% in the South. Metropolitan areas experienced earlier onset of decline than did nonmetropolitan areas. Average income, education, and occupational levels were highest in early onset areas and declined across onset categories. CONCLUSIONS: The results provide additional evidence for previously observed geographic and social patterns of CHD decline. Emphasis on structural economic factors determining the shape of the CHD epidemic curve does not detract from the medical importance of risk factors, but underscores the importance of community development to public health improvements. The results are consistent with the idea that the course of the CHD epidemic in the United States has been strongly influenced by socioeconomic development.
Adult↗
Reaching out to hospitals and physicians.
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Economic Competition↗
Variation in the magnitude of black-white differences in stroke mortality by community occupational structure.
STUDY OBJECTIVE: The aim was to examine the patterns of black-white differences in stroke mortality across communities with varying levels of occupational structure in the southern region of the United States DESIGN: Annual age adjusted race-sex specific rates for stroke mortality were calculated for the years 1979-1981 and related to socioeconomic conditions. SETTING: The study involved 211 state economic areas comprising the southern region of the USA. STUDY POPULATION: Data on stroke mortality for black and white men and women between the ages of 35 and 74 years living in the study area were acquired from the National Center for Health Statistics. MEASUREMENTS AND MAIN RESULTS: Occupational structure was measured as the proportion of white collar workers in each state economic area, and is an indicator of the employment opportunities and related social and economic resources of a community. Stratified analyses and linear regression modelling indicate that communities of lower occupational structure have (a) higher levels of stroke mortality for all four race-sex groups (p less than 0.05) and (b) larger racial inequalities in stroke mortality (p less than 0.01). For men and women, the excess stroke mortality among blacks compared to whites is larger in communities of lower occupational structure. CONCLUSIONS: Consideration of occupational structure and related patterns of economic development is crucial for understanding the distribution of stroke mortality within and between racial groups, as well as for planning effective public health interventions. The larger racial inequalities in communities of lower occupational structure in the south suggest that aspects of the black experience which are conducive to high rates of stroke mortality are exacerbated in those communities. Public health interventions to reduce the racial and social inequalities in stroke mortality should recognise the social context within which nutritional, occupational, medical care, and environmental determinants of stroke are distributed.
Adult↗
Trends in the geographic inequality of cardiovascular disease mortality in the United States, 1962-1982.
Substantial geographic variation of cardiovascular disease (CVD) mortality within the U.S. has been recognized for decades. Analyses reported here address the question of whether relative geographic inequality has increased or decreased during the period of rapidly declining CVD mortality 1962-1982. Trends in geographic inequality, as measured by the weighted coefficient of variation of State Economic Area rates, are analyzed for whites and blacks by sex for 10-year age groups 35-44 to 85 and over. The average annual percent change in the coefficient of variation for each demographic group is presented for all cause mortality, all CVD, stroke and ischemic heart disease. In general, geographic inequalities declined in total mortality for all except the youngest age group. This is consistent with reports of a strong convergence of age-adjusted cancer mortality in U.S. counties. By contrast, increasing geographic inequality dominates in the CVD categories, especially for whites in heart disease and stroke. At younger ages, increases in the coefficient of variation for all race-sex groups exceeded 1% per year in stroke and 2% per year in heart disease. These results suggest that factors influencing the percent decline of CVD mortality are not reaching communities of the U.S. equally. Since increases in relative inequality are strongest in the younger age groups, the pattern of inequality may be accentuated as these cohorts move into ages of higher mortality.
Adult↗
Passive smoking and 20-year cardiovascular disease mortality among nonsmoking wives, Evans County, Georgia.
The association of passive smoking and cardiovascular disease (CVD) mortality was assessed in a cohort of 513 rural, married Black and White women who were disease-free and self-described as never-smokers at baseline in 1960. Over a 20-year period, 76 of 147 total deaths were attributed to CVD. Relative risk estimates adjusted for age, cholesterol, blood pressure, and body mass from proportional hazards models were 1.59 for CVD (95% CI = 0.99, 2.57) and 1.39 (CI = 0.99, 1.94) for all cause mortality among women with husbands who smoked cigarettes.
Adolescent↗
Stroke mortality maps. United States whites aged 35-74 years, 1962-1982.
We mapped average age-adjusted stroke mortality rates for white men and white women aged 35-74 years for state economic areas (counties or groups of counties) in the continental United States for three 7-year periods between 1962 and 1982. Despite the decline of national stroke mortality rates, rates in some areas failed to decline between 1962-1968 and 1969-1975. All areas experienced declines in 1976-1982, by which time some rates in the highest decile of the rate distribution were comparable to rates that had been in the lowest decile in 1962-1968. An east-west gradient of high-to-low stroke mortality rates was evident for both white men and white women in all three periods. Within the eastern part of the United States, high rates appeared more commonly in the South, and more so for white men than for white women. The "stroke belt" (area of very high stroke mortality rates in the coastal plain of the South) became less concentrated over the 2 decades, while a clustering of state economic areas with high rates along the Mississippi River and in the Ohio River valley became more pronounced.
Adult↗
Socioenvironmental characteristics associated with the onset of decline of ischemic heart disease mortality in the United States.
The relation of community socioenvironmental characteristics to timing of the onset of decline of ischemic heart disease (IHD) mortality was investigated among the 507 State Economic Areas of the continental United States. Onset of decline was measured using data for White men aged 35-74 and classified as early (1968 or before) vs late (after 1968). Ten socioenvironmental characteristics derived from US Census Bureau data were strongly related to onset of decline. Areas with the poorest socioenvironmental conditions were two to 10 times more likely to experience late onset than those areas with the highest levels. We found that income-related characteristics could account for most of the difference in onset of decline of IHD between metropolitan and non-metropolitan places. We conclude that community socioenvironmental characteristics provide the context for changes in risk factors and medical care.
Adult↗
Changing association between community occupational structure and ischaemic heart disease mortality in the United States.
The changing association between community occupational structure and ischaemic heart disease mortality in white men and women of the United States from 1968 to 1982 has been investigated. Occupational structure was represented by the proportion of workers in white-collar jobs. A negative association, with lower mortality in communities with higher levels of white-collar employment, emerged over the period in both men and women. The results for men may be interpreted as suggesting a recapitulation in the US of the changing association between social class and heart disease observed in Britain. Occupational structure, however, reflects resources and opportunities in a community derived from its contribution to the national and international economy. Thus the growing inequalities in heart disease mortality presented in this ecological study relate more appropriately to communities than to individual workers.
Adult↗
Medical screening of former asbestos cement workers in Israel: a pilot program.
A pilot screening program for the evaluation of former asbestos-cement workers was carried out in the Chest Disease Clinic of the Acco Public Health Office (Ministry of Health), Israel. A total of 184 subjects were evaluated using medical and occupational questionnaires, clinical examinations, and pulmonary function tests (forced expiratory volume, forced vital capacity). Thirty percent of individuals with more than 1 year of work experience had symptoms of breathlessness or cough. Individuals with 10 years or more of work experience showed a high prevalence of râles and reduced pulmonary function, as compared to those with shorter work histories. These findings indicate the urgent need for active follow-up of Israeli ex-asbestos workers. A proposed screening and surveillance program for this high-risk group is discussed with emphasis on follow-up, health education, and smoking cessation.
Adult↗