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Biomedical subjects

P Goldblatt

Publications and source records attributed to P Goldblatt.

At least 19 recordsLinked to original sources
PubMed2001

The sizes and characteristics of the minority ethnic populations of Great Britain--latest estimates.

This article presents estimates of the minority ethnic populations of Great Britain in 2000 and describes the regional distributions of the different groups. It also discusses changes in the sizes of the different minority ethnic populations during the 1990s. The paper provides information on some key demographic features of these populations at the end of the 1990s--age and sex structures, proportions born in the United Kingdom and whether children lived with their natural parents.

Adolescent↗
PubMed2000

Inequalities in health--development and change.

This article traces the changes that have taken place in the analysis and interpretation of health inequalities over the last 25 years. It sets these in their historic context, indicates how the debate on their validity and social context has shifted over the period and assesses the current evidence on the extent and importance of social variations.

Health Planning↗
PubMed1991

Mortality of employed men and women.

This paper presents mortality data for a 1% sample of men and women in England and Wales who were employed at the time of the 1971 Census of Population. It provides background information on the "healthy worker effect" by age, social class (as determined by occupation), cause of death, and length of follow-up. As expected, relative mortality of those employed at census rose with subsequent follow-up. This effect was strongly age-related, apparently as a consequence of the development (and increasing predominance) of chronic diseases with age. This suggests a unified explanation for some of the variation described in the literature. Statistical modelling of the relationship between mortality and length of follow-up confirmed that the healthy worker effect did not entirely disappear as follow-up progressed in this study. We examined social background as an explanation for this persistently low mortality, but found no evidence to suggest that it was an important factor.

Adult↗
PubMed1991

Women's lung cancer mortality, socio-economic status and changing smoking patterns.

Mortality data from the OPCS Longitudinal Study were used to determine whether the conventional classification of married women by their husband's occupation under-estimates the extent of social differences in lung cancer among this group. Differences existed for social class measures but alternatives based on housing tenure and car access defined socio-economic differences wider than any other previously recorded for England and Wales: married women living in rented housing and without a car were two and a half times as likely to die from lung cancer than those in owner occupied housing with access to a car. In 1957 and 1974 mothers of children included in the 1958 cohort study showed parallel socio-economic differences in smoking patterns as well as in uptake and cessation rates. Data from the General Household Survey for 1982 similarly suggest that cigarette smoking is more sharply differentiated using household rather than occupational measures of class. This suggests that wide differences in mortality are likely to persist through the eighties and beyond.

Adult↗
PubMed1990

Primary malignant peritoneal mesothelioma. A report of seven cases and a review of the literature.

Mesothelioma of the peritoneum is a rare malignant neoplasm easily mistaken by both surgeon and pathologist for one of the more common neoplasms of the abdomen. Review of our records from metropolitan-area hospitals for the past 15 years identified seven patients with primary peritoneal mesotheliomas. Their diagnosis, management, and survival is analyzed. We report a case of an extended survivor (7 years) and one of a long-term survivor (15 years), as well as what we believe to be the only case in the literature presenting with a coexistent malignant neoplasm. Prevention of this commonly fatal neoplasm is linked to avoiding occupational exposure to asbestos; long-term survival for a few patients may be achieved with correct identification of the neoplasm and aggressive management. This report includes a review of the literature.

Adult↗
PubMed1990

Survival among women with cancer of the uterine cervix: influence of marital status and social class.

STUDY OBJECTIVE: The aim was to investigate whether the survival of women with cancer of the uterine cervix is associated with their marital status and social class. DESIGN: The study was a survey of survival up to 5 years from diagnosis of women with cancer of the cervix registered in the South Thames Cancer Registry, using Cox regression to adjust for marital status, social class, age, and stage at registration. Because of deficiencies in social class data held by the Registry (social class was assigned in only 51% of cases, as opposed to 93% for marital status), the findings were compared with survival data from the OPCS Longitudinal Study. SETTING: During the period of study (1977-81) the South Thames Cancer Registry covered a female population of about 3.5 million in the south east of England. PATIENTS: Data on 1728 women were analysed. MEASUREMENTS AND AND MAIN RESULTS: Apparent differences in crude survival by marital status and social class were examined. These were found to be accounted for by adjustment for age and stage. The better survival of those whose social class was unknown was found to be an artefact of the way in which cancer registries assign social class, but this did not appear to bias registry based studies of social class survival seriously. CONCLUSIONS: (1) After adjusting for age, factors affecting survival in women with cancer of the cervix, such as stage at presentation or host resistance, appear to be similarly distributed in the different marital status and social class groups; (2) for cervical cancer, the marked social class gradient and unusual marital status distribution found in cross sectional mortality data reflect the incidence of the disease, not differences in survival; (3) explanations for these patterns in incidence and mortality data are to be found in the aetiology of the disease.

Adult↗
PubMed1989

Further results from a census based mortality study of fertiliser manufacturers.

The results of a further follow up of two cohorts of men identified as manufacturers of fertilisers in the 1961 and 1971 censuses of England and Wales are reported. Both cohorts have now been followed up until 1985 through the National Health Service Central Register. In the 1961 cohort the previous findings are replicated--low mortality from all causes, all cancers, and all circulatory diseases, and no evidence of dose response relation nor excess mortality from cancer at any site. In the 1971 cohort there remain more deaths from cancer than expected but none of the observed deaths from individual cancers differs significantly from expectation by comparison with national mortality rates or rates for other employed men. Evidence of an association between cancer mortality and frequency of exposure to nitrate containing dust is strengthened in the reanalysis of the 1971 cohort after longer follow up, but a negative trend, significant for digestive organ cancers, is observed in the analysis by product type in which manufacturers of straight nitrogen and compound fertilisers might have been expected to be most at risk. Failure to find specifically any excess mortality from gastric cancer and the contradictory dose response relations, weigh against the notion that the nonsignificant excesses of cancers in the 1971 cohort are related to nitrate exposure.

Air Pollutants, Occupational↗
PubMed1988

Tea consumption and cancer.

Following the report from Hawaii (Heilbrun et al., 1986) of relationships between tea consumption and respectively rectal cancer (positive) and prostate cancer (negative), these questions were examined using data from a prospective mortality study of London men initiated in 1967. The small numbers of men who did not usually drink any tea prevented a reliable study of this sub group. Nevertheless no evidence of a dose-response relationship was found for rectal, colon or prostate cancer. Significant relationships were found, however, between tea consumption and deaths from stomach, lung and kidney cancers. In the case of stomach and lung cancer, these were partly due to the effects of social class and smoking, and possible reasons are considered for the residual relations.

Adult↗
PubMed1986

Census based mortality study of pharmaceutical industry workers.

This study was designed to investigate whether the mortality of British pharmaceutical industry workers showed any evidence of occupationally related patterns associated with particular sections of the industry with special emphasis on cancers and respiratory diseases. The data were extracted from census schedules by the Office of Population Censuses and Surveys using occupational categories recorded by pharmaceutical workers at the 1961 and 1971 censuses of England and Wales. Subsequent mortality was ascertained through the National Health Service Central Registry. Both cohorts, followed up to the end of 1981, showed a "healthy worker effect," with overall SMRs ranging from 0.77 to 1.04, though comparison with the employed populations of the longitudinal study reduced this effect by 25%. Evidence of inconsistent excess mortality was noted in small numbers for suicide (SMR 0.91 to 2.79) and cancer of the large intestine (SMR 1.09 to 2.38). There was no clear association between the type of industry and the causes of death investigated. Although the census based study has several methodological shortcomings, there was no evidence, on the basis of this study, to suggest any excess mortality risk from employment in the pharmaceutical industry.

Adult↗
PubMed1983

Diabetes mortality: new light on an underestimated public health problem.

Mortality from diabetes is underestimated four- to fivefold by methods of analysis of death certification data which use only underlying cause of death. This problem is partially overcome by coding all conditions mentioned on death certificates. For a sample of deaths in England and Wales over the years 1972-1977, the observed proportion of certificates with specific underlying causes of death for certificates mentioning diabetes was compared with the expected proportion for all certificates. These observed/expected ratios were significantly increased in each sex for circulatory diseases and were significantly reduced for neoplasms. For 'nephritis' they were also increased, especially below 45 years of age. These results were confirmed by an analysis of underlying cause of death in a cohort of nearly 6,000 members of the British Diabetic Association. Of the 2,134 deaths in this cohort, diabetes was not mentioned on 33% of the death certificates. For the period 1972-1977, death rates for circulatory diseases associated with diabetes increased by 6% for males but remained constant for females.

Adolescent↗
PubMed1982

An investigation of the relationship between stomach cancer and cerebrovascular disease: evidence for and against the salt hypothesis.

Analysis of age-adjusted death rates in 21 countries during a 20-year period identified the presence of a strong positive association between recorded mortality from cerebrovascular disease, hypertension and stomach cancer. A study of multiple causes of death was undertaken to determine whether this association results from a unique relationship between these diseases or merely represents a secondary and fortuitous finding. The observed and expected concordances of stomach cancer, lung cancer, pancreatic cancer and cerebrovascular disease with several cardiovascular and non-cardiovascular diagnoses were calculated from tables of multiple causes of death for all persons who died in England and Wales during 1975 and 1976. Although several previously known disease associations were recognized, there was no evidence of a greater concordance between stomach cancer and hypertension or cerebrovascular disease than between lung cancer and hypertension or cerebrovascular disease. Likewise, with one exception, there was no evidence of a greater concordance between stomach cancer and hypertension or cerebrovascular disease than between pancreatic cancer and hypertension or cerebrovascular disease. These results suggest that the temporal and geographic relationships between mortality from cerebrovascular disease, hypertension and stomach cancer are not causally linked. Our findings fail to support the hypothesis that exposure to salt increases an individual's risk of both cerebrovascular disease and stomach cancer.

Adolescent↗
PubMed1982

Census-based mortality study of fertiliser manufactures.

This study was designed to investigate whether exposure to nitrate-containing dust during fertiliser manufacture was associated with an excess of deaths from cancer in general or specifically from cancers of the digestive tract, liver, lung, and bladder. It was based on data extracted from census schedules by the Office of Population Censuses and Surveys, occupational characteristics recorded by fertiliser workers at the 1961 and 1971 censuses of England and Wales being related to subsequent mortality ascertained through the National Health Service Central Register. The 1961 cohort, followed up until 1978, showed a "healthy worker effect" and no evidence of excess mortality from cancer at any site. The 1971 cohort also showed below average mortality during 1971-7 for all causes of death and for circulatory diseases, but there were more deaths from cancer than expected, due mainly to an excess of cancers of the lung and digestive tract. The excess of cancer was more pronounced, but not statistically significant, when compared with other employed men. Though the numbers for comparison were small, there was weak evidence of an association between cancer mortality and frequency of exposure to nitrate-containing dust in this cohort. It is difficult to reconcile the excess cancer mortality in the 1971 cohort with the more favorable level in the earlier cohort, since industrial hygiene has improved and the cohorts showed a similar distribution by region and social class. To examine further these conflicting results the 1971 cohort will be followed for a longer period and re-examined when more deaths have accrued.

Adult↗
PubMed1981

Hypertension, cerebrovascular disease and stomach cancer: is the salt hypothesis true?

1. Analysis of age-adjusted death rates from 21 countries over a 20-year period identified the presence of a strong positive association between recorded mortality from stroke, hypertension and stomach cancer. However, the slopes of regression lines for secular trends analyses varied considerably from country to country, suggesting an inconsistency in the pattern of the relationship. 2. A death certificate study of diagnostic concordance correctly identified previously known disease associations but failed to recognise any special relationship between stroke and stomach cancer or hypertension and stomach cancer. 3. Our results fail to confirm the presence of a unique relationship between stroke and stomach cancer. On the basis of these observations, the hypothesis that exposure to salt increases an individual's risk of developing both stroke and stomach cancer seems unlikely.

Aged↗