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PubMedDate not supplied

Life expectancy by employment status, income, and education in the National Longitudinal Mortality Study.

Based on data from the National Longitudinal Mortality Study for 1979-85, life expectancies are estimated for white men and white women by education, by family income, and by employment status. Life expectancy varies directly with amount of schooling and with family income. Differences in life expectancy at age 25 between the highest and the lowest levels of education completed were about 6 years for white men and about 5 years for white women. For family income, differences between the highest and the lowest income groups were about 10 years for white men and 4.3 years for white women. The largest differences in life expectancy were between employment categories. At age 25, white men in the labor force lived on average about 12 more years than those not in the labor force, and white women lived on average about 9 more years. For those who were unable to work compared with those in the labor force, the difference for white men was about 20 years; for white women, 29 years. Results in this study showed much the same differentials in life expectancy for education as the earlier Kitagawa-Hauser study.

Adult↗

PubMed2000

Observational study of home visits in Slovene general practice: patient characteristics, practice characteristics and health care utilization.

BACKGROUND: Home visits are an important way of delivering primary health care, but there is a long-term decrease in home visit rates in many countries. OBJECTIVE: The aim of this study was to evaluate patient characteristics, morbidity, functional status, quality of life, satisfaction with care, practice characteristics and health care utilization in general practice patients visited at home at least once in a study year. METHODS: The design of the study was a cross-sectional survey of the patients of a stratified sample of 36 GP offices in Slovenia using a self-administered questionnaire. Sixty consecutive patients in sampled practices contacting the doctor in the office in the study period in March 1998 were included in the analysis. The age, sex, educational status, residence, presence of chronic condition, measures of anxiety or depressive symptoms, rates of patients who expressed a need for emergency care in 1 year, rates of self-care, measures of functional status, quality of life, satisfaction with care, rates of using GP practice visits and out-of-hours services and rates of using specialist or hospital services were recorded in a home-visited group versus a non-visited group. RESULTS: A total of 277 patients (15.4%) were reported to have at least one visit in the study year. Patients visited in their homes were older, predominantly female, better educated, had lower perceptions of their functional status and well-being and they used primary health services more frequently than others. Their GPs were more likely to be males, and were more likely to practise in rural areas, in solo practices as private practitioners. CONCLUSION: Home visits remain an important part of GP work in countries in transition, such as Slovenia, especially for more seriously ill patients.

Activities of Daily Living↗

PubMed1992

Knowledge of HIV and condom use among heterosexual patients at a Glasgow genito-urinary medicine clinic.

Knowledge of HIV and knowledge of, attitudes to and use of the condom were assessed by a survey of a sample of 778 heterosexual patients attending the genito-urinary medicine clinic at the Glasgow Royal Infirmary. The mean age was 27.4 years for men and 24.5 years for women. Over two-thirds of the men and about half of the women reported more than one sexual partner during the previous year. More than 70% reported having intercourse at least three times each week. Knowledge about HIV transmission and the condom was generally good. Over three quarters of the respondents approved of the use of the condom. However, only 27% male and 24% female respondents reported using the condom, with 11% and 8% respectively using it always. Condom use was associated with a positive attitude to the condom, having received information from the media about the condom, educational status, a belief that condoms prevented sexually transmitted diseases, and having had sex education in school. It was unrelated to age, marital status, the number of sexual partners or the frequency of sexual intercourse. The most common reported reason for not using the condom was use of another form of contraceptive.

Adult↗

PubMed1999

Healthy dietary habits in relation to social determinants and lifestyle factors.

The aim of the present study was to evaluate the importance of social status and lifestyle for dietary habits, since these factors may influence life expectancy. We studied the association of four indicators for healthy dietary habits (fruits and vegetables, fibre, fat and Hegsted score) with sex, age, socio-economic status, education, physical leisure exercise, smoking and personal attention paid to keeping a healthy diet. Data were gathered with a self-administered quantitative food-frequency questionnaire distributed to a representative sample of Norwegian men and women aged 16-79 years in a national dietary survey, of whom 3144 subjects (63%) responded. Age and female sex were positively associated with indicators for healthy dietary habits. By separate evaluation length of education, regular physical leisure exercise and degree of attention paid to keeping a healthy diet were positively associated with all four indicators for healthy dietary habits in both sexes. Socio-economic status, location of residence and smoking habits were associated with from one to three indicators for healthy dietary habits. In a multiple regression model, age, education and location of residence together explained from 1 to 9% of the variation (R2) in the four dietary indicators. Length of education was significantly associated with three of four dietary indicators both among men and women. By including the variable 'attention paid to keeping a healthy diet' in the model, R2 increased to between 4 and 15% for the four dietary indicators. Length of education remained correlated to three dietary indicators among women, and one indicator among men, after adjusting for attention to healthy diet, age and location of residence. Residence in cities remained correlated to two indicators among men, but none among women, after adjusting for age, education and attention to healthy diet. In conclusion, education was associated with indicators of a healthy diet. Attention to healthy diet showed the strongest and most consistent association with all four indicators for healthy dietary habits in both sexes. This suggests that personal preferences may be just as important for having a healthy diet as social status determinants.

Adolescent↗

PubMed1996

Full-information models for multiple psychometric tests: annualized rates of change in normal aging and dementia.

The rates of change for five widely used psychometric tests were analyzed to compare how much more variance reduction can be achieved using full-information methods relative to the single-equation methods previously used in dementia research. Nondemented controls and subjects with Alzheimer disease (AD), probable/ possible vascular dementia (VD), or mixed dementia (MD) were evaluated. A cohort design was followed, with follow-up of three demented groups and one normal control group; data were analyzed in a multiple-equation regression model estimated with full-information methods. The study was conducted at Alzheimer's Disease Research Center sites at the University of California, Irvine, and at the University of Southern California. In all, 226 patients and controls who had completed initial assessment and at least one annual reassessment were included in the study. Dependent variables were annualized rates of change in the Mini-Mental State Examination (MMSE), the Short-Blessed Dementia Rating Scale (DRS), the Consortium to Establish a Registry for Alzheimer's Disease drawings test (CD), the WAIS-R Block Design test (WRB), and the Boston Naming Test (BNT). Independent variables were dementia severity, diagnosis (AD, VD, MD, or control), sex, age, marital status, education, and age at onset. Full-information methods reduced the variance in the change scores by > or = 25% compared with previous studies. The model's prediction of a test's rate of change was almost entirely due to dementia stage and diagnosis. The effects of other explanatory variables (sex, marital status, age, and education) were weak and statistically insignificant. When the effects of other independent variables were controlled, AD and MD patients were found to decline at significantly faster rates than VD patients. Full-information methods, relative to single-equation methods, substantially reduce the variance of rates of change for multiple psychometric tests. They do so by simultaneously considering the correlated error terms in the regression for each dependent psychometric change score variable. The robustness of these results to minor variations in follow-up time suggests that annualization is a reasonably valid procedure for making change scores comparable. This study's results suggest that change scores in psychometric tests provide information that can be used to aid differential diagnosis. However, the large variances of change scores preclude many other uses. Finally, since standardization of psychometric change scores translates all tests to the same scale (0-100%), standardized change scores are easier to interpret. The analysis of standardized change scores deserves further investigation.

Age of Onset↗

PubMed2004

Summary health statistics for the U.S. population: National Health Interview Survey, 2002.

OBJECTIVES: This report presents both age-adjusted and unadjusted health statistics from the 2002 National Health Interview Survey (NHIS) for the civilian noninstitutionalized population of the United States, classified by age, sex, race and Hispanic or Latino origin, family income, poverty status, education, place of residence, region of residence, and, where appropriate, health insurance coverage. The topics covered are health status and limitations in activities, special education or early intervention services, injuries and poisonings, health care access and utilization, and health insurance coverage. SOURCE OF DATA: The NHIS is a household, multistage probability sample survey conducted annually by interviewers of the U.S. Census Bureau for the Centers for Disease Control and Prevention's National Center for Health Statistics. In 2002, household interviews were completed for 93,386 persons living in 36,161 households, reflecting a household response rate of 89.6%. SELECTED HIGHLIGHTS: Nearly 7 in 10 persons were in excellent or very good health in 2002. About 34 million persons (12%) were limited in their usual activities due to one or more chronic health conditions, and about 4 million persons (2%) required the help of another person with activities of daily living. About 6% of children received special education or early intervention services. Among persons under age 65 years, about 40 million (17%) did not have any health insurance coverage. The most common reason for lacking health insurance was cost, followed by a change in employment.

Activities of Daily Living↗

PubMed2004

Gender differences in epidemiological factors associated with treatment completion status of leprosy patients in the most hyperendemic district of Nepal.

The introduction of multidrug therapy (MDT), recommended by WHO, has been a major advance in the treatment of leprosy because of its relatively short treatment course and low rate of relapse. Although leprosy treatment is provided to both sexes equally, in most parts of the world significant differences have been found in treatment status. The main objective of the study was to investigate gender differences in epidemiological factors associated with treatment status of leprosy patients. An analytic cross-sectional study was carried out in the most hyperendemic Dhanusa District, Nepal. Stratified random sampling was applied for selection of the patients. Statistical analysis of the differences in treatment status, between males and females, and among other epidemiological factors of interest was carried out using multiple logistic regression. Chi-square/Fisher's exact test were also used to assess significant differences in values between males and females. There were 580 leprosy patients (385 male and 195 female) aged >15 years registered for MDT between April 1, 2001 to March 31, 2002 in the 16 main health centers of the district. Of the 580 patients, a total of 273 (183 male and 90 female) were included in the study, to collect data on clinical type of leprosy, patterns of physical deformity/disability, site of skin lesions, and socio-demographic information. There were 183 male (68.3% on MB-MDT) and 90 female (61.1% MB-MDT) leprosy patients. We found that 79.2% of male patients completed treatment, while 34.4% female patients did not complete within the given time frame. Significant gender differences among leprosy patients were found in the distribution of disability grades and treatment completion status. However, there was no significant gender difference in the distribution of leprosy types and skin lesion sites. The study also found significant associations between treatment completion status and gender (adjusted OR 2.05, 95% CI: 1.07-3.94), educational status (adjusted OR 2.37, 95% CI: 1.12-4.99), disability grade I (adjusted OR 3.14, 95% CI: 1.23-8.04), and disability grade 0 (adjusted OR 2.92, 95% CI: 1.14-7.47) after adjustment for all other leprosy/demographic factors.

Adolescent↗

PubMed1996

Long-term health outcomes and medical effects of torture among US Navy prisoners of war in Vietnam.

OBJECTIVE: To characterize incidence of illnesses and injuries from 1979 to 1993 in former naval aviator prisoners of war (POWs) from the Vietnam War and a comparison group of naval aviators from the same war. DESIGN: Cohort analytic study. SETTING: A US Navy primary care clinic. PARTICIPANTS: Volunteer sample consisting of 70 former naval aviator POWs (white men, aged 47 to 69 years in 1993) and a comparison group of 55 naval aviators who served in Vietnam but were not POWs, matched on race, age, marital status, education, rank, year of entry into the navy, and pilot status. Subjects participated in an annual health screening program. This study reports data sampled on a biennial basis from subjects screening both in 1979 and 1993. MAIN OUTCOME MEASURE: Medically diagnosed incidence of illness and injury based on a standard protocol. RESULTS: POWs had higher incidence rates than the comparison group did of disorders of the peripheral nervous system (relative risk [RR], 8.4; 95% confidence interval [CI], 2.7-25.9; P<.001), joints (RR, 1.5; 95% CI, 1.2-2.0; P<.006), and back RR, 1.8; 5% CI, 1.0-3.0; P<.037). These findings also were statistically significant according to Kaplan-Meier survival analyses that included 131 (95%) of 138 POWs and 115 (83%) of the 138 members of the comparison group. Survival analyses revealed that, in addition to these disorders, POWs had higher hazard rates of peptic ulcer (P<.01). CONCLUSIONS: During captivity, ropes, ratchet handcuffs, leg irons, or stocks were used to put tightly constrictive pressure around the extremities of POWs as a means of torture, resulting in painful ischemia and subsequent neuropathies. Being a former POW was associated with increased cumulative incidence rates of chronic disorders of the peripheral nervous system, joints, and back and an increased hazard rate of peptic ulcer.

Aged↗

PubMed2005

Summary health statistics for the U.S. population: National Health Interview Survey, 2003.

OBJECTIVES: This report presents both age-adjusted and unadjusted health statistics from the 2003 National Health Interview Survey (NHIS) for the civilian noninstitutionalized population of the United States, classified by age, sex, race and Hispanic or Latino origin, family income, poverty status, education, place of residence, region of residence, and where appropriate, health insurance coverage. The topics covered are health status and limitations in activities, special education or early intervention services, injuries and poisonings, health care access and utilization, and health insurance coverage. SOURCE OF DATA: The NHIS is a household, multistage probability sample survey conducted annually by interviewers of the U.S. Census Bureau for the Centers for Disease Control and Prevention's National Center for Health Statistics. In 2003, household interviews were completed for 92,148 persons living in 35,921 households, reflecting a household response rate of 89.2%. SELECTED HIGHLIGHTS: Nearly 7 in 10 persons were in excellent or very good health in 2003. About 34 million persons (12%) were limited in their usual activities due to one or more chronic health conditions, and about 4 million persons (2%) required the help of another person with activities of daily living. About 6% of children received special education or early intervention services. Among persons under age 65 years, about 41 million (17%) did not have any health insurance coverage. The most common reason for lacking health insurance was cost, followed by a change in employment.

Activities of Daily Living↗

PubMed2003

Summary health statistics for the U.S. population: National Health Interview Survey, 2000.

OBJECTIVES: This report presents health statistics from the 2000 National Health Interview Survey for the civilian noninstitutionalized population of the United States, classified by age, sex, race and Hispanic or Latino origin, family income, poverty status, education, place of residence, region of residence, and, where appropriate, health insurance coverage. The topics covered are health status and limitations in activities, special education or early intervention services, injuries and poisonings, health care access and utilization, and health insurance coverage. SOURCE OF DATA: The NHIS is a household, multistage probability sample survey conducted annually by interviewers of the U.S. Census Bureau for the Centers for Disease Control and Prevention, National Center for Health Statistics. Household interviews were completed for 100,618 persons living in 38,633 households, reflecting a household response rate of 89%. SELECTED HIGHLIGHTS: Nearly 7 in 10 persons were in excellent or very good health in 2000, and fewer than 1 in 10 were in fair or poor health. About 31 million people (11%) were limited in their usual activities due to one or more chronic health conditions, and about 3 million people (2%) required the help of another person with activities of daily living such as bathing and dressing. Persons with the least education and the lowest incomes were the most likely to be limited in their ability to work. About 5% of children received special education or early intervention services. The three leading causes of medically attended injury and poisoning episodes were falls, being struck by a person or an object, and transportation. Among people under age 65 years, about 40 million (17%) did not have any health insurance coverage.

Adolescent↗

PubMed2003

Summary health statistics for the U.S. population: National Health Interview Survey, 2001.

OBJECTIVES: This report presents health statistics from the 2001 National Health Interview Survey for the civilian noninstitutionalized population of the United States, classified by age, sex, race and Hispanic or Latino origin, family income, poverty status, education, place of residence, region of residence, and, where appropriate, health insurance coverage. The topics covered are health status and limitations in activities, special education or early intervention services, injuries and poisonings, health care access and utilization, and health insurance coverage. SOURCE OF DATA: The NHIS is a household, multistage probability sample survey conducted annually by interviewers of the U.S. Census Bureau for the Centers for Disease Control's National Center for Health Statistics. Household interviews were completed for 100,760 persons living in 38,932 households, reflecting a household response rate of 89%. SELECTED HIGHLIGHTS: Nearly 7 in 10 persons were in excellent or very good health in 2001. About 33 million persons (12%) were limited in their usual activities due to one or more chronic health conditions, and about 4 million persons (2%) required the help of another person with activities of daily living. Persons with the least education and the lowest incomes were the most likely to be limited in their ability to work. About 6% of children received special education or early intervention services. The three leading causes of medically attended injury and poisoning episodes were falls, transportation, and overexertion. Among persons under age 65 years, about 39 million (16%) did not have any health insurance coverage. The most common reason for lacking health insurance was cost, followed by a change in employment.

Activities of Daily Living↗

PubMed1999

[Analysis of items missing in responses to a series of follow-up surveys in Japanese elderly].

PURPOSES: We examined whether the percentage of items missing and the factors related to item missing differ across follow-up surveys, Variables targeted to examine missing items included health indicators (activities of daily living, cognitive function, self-rated health, Center for Epidemiologic Studies--Depression, and PGC Morale Scale), health habits (cigarette smoking, alcohol consumption, physical exercise, and relative weight), and socioeconomic indicators (educational attainment, income, and social networks). METHODS: Longitudinal data were collected at intervals of three years since 1987 through a national survey of Japanese adults aged 60 and over, At the baseline survey, a total of 2,200 interviews were completed from the list of 3,288 names. At the following three follow-up surveys, 1,671, 1,369, and 1,068 persons were reinterviewed respectively. Possible factors related to appearance of a missing item consisted of five aspects; 1) demographic variables (age and sex), 2) social status (educational attainment, existence of a spouse, and job status), 3) health status (activities of daily living and cognitive function), 4) cooperative attitude toward a survey, and 5) whether an item had been missing at the previous survey (s). Those factors were analyzed for each variable respectively. If a group with scaled or collective items had one or more missing items, we classified that group as a missing item group. RESULTS: 1. The percentage of cases with items missing was 5 percent or more for four variables; CES-D, PGC Morale Scale, income, and health habits. Those percentages were almost constant over the four surveys. 2. Factors related to appearance of items missing differed by psychological variables such as, CES-D and PGC Morale Scale, income, or health habits. Those factors had constant impact on appearance of items missing over follow-up surveys. 3. Regarding CES-D, PGC Morale Scale, income, or health habits, persons with an item missing at a previous survey, or who did not have a cooperative attitude toward the survey had a significant impact on an increase in the percentage of missing items. CONCLUSION: Characteristics of persons with items missing differs among the variables, and those characteristics may contribute to the incidence of items missing in subsequent surveys.

Aged↗

PubMedDate not supplied

The effect of race on the incidence of low birth weight: persistence of effect after controlling for socioeconomic, educational, marital, and risk status.

The purpose of this study was to determine whether the elevated risk for low birth weight (LBW) infants among black mothers would persist when biologic, behavioral, and socioeconomic factors (as measured by socioeconomic status, level of education, and marital status) were controlled. It was found that the odds ratios for the risk of LBW for blacks/whites persisted above 1.5, regardless of what subgroups were used and what factors were controlled. The black/white odds ratios were, however, less than 2.0 when cigarette smoking was not a risk factor and higher than 2.0 when it was. In fact, the highest odds ratios, up to 2.65, occurred among the smoking group. These data suggest that smoking may have a more strongly negative effect among black than white pregnant mothers. In general, the effect of race on the LBW risk was much less strong than that of risk factors that can be influenced, such as adverse maternal practices.

Adolescent↗

PubMed1993

Helicobacter pylori prevalence in non-ulcer dyspepsia--ethnic and socio-economic differences.

Helicobacter pylori is an important cause of gastritis and a number of therapeutic trials suggest that it may be important in the genesis of duodenal ulcer recurrence. The reported prevalence of gastric colonisation by the organism varies considerably. The aim of this cross-sectional survey was to determine its prevalence in non-ulcer dyspeptics and to determine whether this is influenced by age, race, sex, socio-economic status, educational level and the number of persons sharing accommodation. One hundred and sixty-nine patients underwent endoscopy; biopsy specimens were taken from the antrum and H. pylori status was determined histologically. Gastric colonisation was found in 106 patients (63%). The prevalence showed a marked ethnic difference: 40% in whites and 71% in coloureds (P < 0.001). The ethnic groups were characterised by significant differences in socio-economic status (P < 10(-6)), educational level (P < 10(-6)), number of persons sharing accommodation (P < 10(-6)) and age (P < 0.001). These same differences were found when comparing the H. pylori-positive and negative groups, but were less marked and could be attributed to the marked differences between ethnic groups. We conclude that H. pylori prevalence differs between the ethnic groups studied. This may be because of varying degrees of exposure risk.

Adult↗

PubMed2004

Effects of education and other socioeconomic factors on middle age mortality in rural Bangladesh.

STUDY OBJECTIVE: To examine socioeconomic gradients in mortality in adult women and their husbands in Bangladesh, paying particular attention to the independent effects of the educational status of each spouse. DESIGN: Historical cohort study. SETTING: Matlab, a rural area 60 km south east of Dhaka, the capital of Bangladesh. PARTICIPANTS: 14803 married women aged 45 or over and their husbands who were resident in the Matlab Demographic Surveillance area between 30 June 1982 and 31 December 1998. MAIN RESULTS: Mortality was lower in women with formal or Koranic education compared with those with none (adjusted rate ratio for formal education = 0.68, 95% CI 0.53 to 0.86; adjusted rate ratio for Koranic schooling = 0.82, 95% CI 0.66 to 1.00). After adjusting for her own education, the husband's level of education or occupation did not have an independent effect on a woman's survival. Men who had attended formal education had lower mortality than those without any education (adjusted rate ratio = 0.84, 95% CI 0.75 to 0.93), but men whose wives had been educated had an additional survival advantage independent of their own education and occupation (adjusted rate ratio = 0.76, 95% CI 0.67 to 0.87). Mortality in both sexes was also significantly associated with marital status and the percentage of surviving children, and in men was associated with the man's occupation, religion, area of residence. CONCLUSIONS: The data suggest that socioeconomic status has a strong influence on mortality in adults in Bangladesh. They also illustrate how important the continued promotion of education, particularly for women, may be for the survival of both women and men in rural Bangladesh.

Bangladesh↗

PubMedDate not supplied

The status of geriatric education in dental hygiene curricula.

To assess the status of geriatric education in dental hygiene curricula, a pretested survey was sent to a 55% random sample of the 198 US dental hygiene programs. Of the 109 surveys mailed, a 90% response rate showed that geriatric didactic material is most frequently presented via occasional lectures, rather than in a formal course or an organized series of presentations. Seventy-five percent of the programs have a geriatric clinical component. Baccalaureate programs and programs longer than 2 years are more likely than associate programs and programs shorter than 2 years, respectively, to teach geriatrics in a more formalized setting. There is no significant difference in the way geriatric material is presented between hygiene programs that are and are not within dental schools.

Aged↗

PubMed1999

[School and vocational training, vocational status and myocardial infarct--a study with data of the mandatory health insurance].

We analysed whether indicators of social status (education and training, occupational grade) are associated with a first acute myocardial infarction (ICD-410) between 1987 and 1996. Analyses were based on data from a statutory health insurance (Allgemeine Ortskrankenkasse) in Northrhine-Westfalia, Germany. 132,255 men and women aged 30-69 years who were employed or were employed before retirement have been included in the investigation. The cumulated incidence of first myocardial infarction was 2.1% (n = 1938) among men and 0.8% (n = 327) among women. After adjustment for age and length of the observation period an increasing infarction risk with decreasing social status was observed in men. Respective odds ratios (OR) were 3.96 in the lowest educational and training group and 3.41 in the medium group as compared to men with the highest educational and training level. With regard to occupational grade respective odds ratios were 1.92 for the lowest (semi- and unskilled workers) and 1.73 for the medium group (skilled workers) compared to those with the highest grade level (skilled non-manuals, intermediate, professionals). Among women the risk was 1.47 in the lowest educational and training group and 1.03 in the medium group. In semi- and unskilled women the OR was 1.58 and 1.67 in skilled women as compared to the highest occupational group. Although associations were observed between indicators of social status and risk of first myocardial infarction it is concluded that further research is needed due to the selection of the population under study with regard to education and occupational grade. Future research activities should concentrate on health insurances for skilled non-manual employees.

Adult↗

PubMed1999

Impact of nativity and race on "Stroke Belt" mortality.

The southeastern region of the United States has been recognized for 6 decades as an area of excess cerebrovascular mortality rates. While the reasons for the disease variation remain an enigma, South Carolina has consistently been the forerunner of the "Stroke Belt." To determine the effects of nativity (birthplace) on stroke mortality rates in South Carolina, proportional mortality ratios (PMRs) were calculated for stroke deaths in South Carolina during 1980-1996 according to birthplace and stratified by gender, race, age, and educational status. The analyses revealed a graded risk of stroke by birthplace, with the highest PMRs (95% CI) among individuals born in South Carolina (104.8 [103.4 to 106.3]), intermediate PMRs in those born in the Southeast other than South Carolina (92.5 [90.2 to 94.9]), and lowest PMRs for those born outside the Southeast (77.4 [74.9 to 80.1]). The lower stroke PMRs for individuals born outside the Southeast were more striking in blacks (51.8 [45.2 to 59.3]) than in whites (84.9 [82.0 to 88.0]) and for men (73.3 [69.5 to 77.3]) than women (83.5 [79.9 to 87.3]). The findings, particularly in blacks, were not explainable by gender, differences in age, and/or markers of educational and socioeconomic status. These findings suggest that nativity is a significant risk marker for the geographic variation in stroke mortality. Moreover, the regional disparities for nativity and subsequent stroke mortality appear to be greater in blacks than in whites and for men than for women. An understanding of factors linking birthplace to risk for cerebrovascular mortality could facilitate efforts directed at stroke prevention.

Black or African American↗