A methodological note on the relationship between infant mortality and socioeconomic status with evidence from San Antonio, Texas.
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Much discussion has taken place over the recently published mortality statistics for infants and young children. These statistics are critically examined and conclusions reached. Suggestions with regard to the improving of Child Health Services are made.
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Burn injuries in GDR have a slight decreasing tendency concerning both morbidity and mortality. The distribution of injuries to the districts of GDR can be explained by the distribution of population, not by distribution of industry. The overwhelming share of injuries consists of children with small scalds. Therapeutical results are comparable with results from international literature. Owing to the fact that in last years no further decisive improvement could be achieved, more attention must be devoted to the problem of primary prevention especially to target groups, resulting from anamnestic and clinical data analysis.
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Mortality from kidney cancer in the United States declined dramatically over the period 1940-1969. This trend was nearly proportional to the increases in survival for 644 U.S. children reported to the End Results Group, National Cancer Institute. The improvements in survival occurred for all stages of disease and appeared to result from therapeutic advances rather than earlier detection. Total incidence trends showed no consistent change, but a shift toward female preponderance resembled that seen in the mortality statistics and suggests sex differences in etiology.
Gastrointestinal diseases accounted for about 10% of all natural deaths in Finland in 1955--1973. Total mortality for these diseases decreased slightly amongst young and middle-aged people in 1955--1973. This was mainly because mortality for ulcerative diseases of the stomach and the small intestine decreased continuously in practically all are groups, and also because the death rates of men and women from malignant neoplasms of the stomach decreased slightly but linearly at all ages. The autopsy rates increased highly significantly in all major categories of deaths between 1963 and 1973. In 1973 the autopsy rate for diseases of the digestive system (the ninth ICD main group) was 67%. This rate exceeded highly significantly the mean autopsy rate recorded for all (38%) and all natural deaths (33%). The autopsy rate for gastrointestinal malignancies was 26%, which in turn was highly significantly lower than the average rate for all and all natural deaths. The highest single autopsy rates in 1973 were recorded for ulcer of the duodenum (87%), diseases of the pancreas (78%), cholelithiasis (77%), and chronic enteritis and ulcerative colitis (76%). The present results suggest that the mortality statistics of Finland are obviously more reliable for the gastrointestinal diseases as a cause of death than in most other major categories of diseases.
Iowa birth and mortality statistics were reviewed to ascertain the outcome of perinatal care provided in hospitals with different-sized obstetric services. Although the data do not resolve the issue of the minimum number of deliveries necessary to ensure quality perinatal services, they do suggest that hospitals with small maternity services (fewer than 500 deliveries per year) can achieve acceptable perinatal outcomes when appropriate high-risk screening and prenatal referral occur.
The study of domestic accidents, which includes accidents in and around the home and in institutions, is of increasing importance. The mortality statistics are shown in Table 1. In 1974, 18,335 people died from accidents in the UK (RoSPA, 1974) equivalent to the population of a reasonably sized town. Accidents form one of the four main causes of death in this country and have become relatively more common in recent years. Analysis of the causes of home accidents make it possible to plan ways of preventing them. General practitioners and their colleagues in the primary health care team have the principal responsibility.
All causes of death related to the two risk factors, smoking and hazardous drinking, have been reviewed followed by a selection of those causes of death for which the causal role of the risk factor appears to be quasi-certain. For each cause, existing epidemiologic data were reviewed and used to determine the fraction of premature mortality which could be attributed to each factor (called the attributable fraction). This fraction was then multiplied by the corresponding Canadian premature mortality measured in terms of deaths between ages one and 70 and potential years of life lost (PYLL) between ages one and 70, which gives a higher weight to younger deaths. Of the 73,440 deaths between ages one and 70 in Canada in 1974, 12% (or 8718 deaths) were found to be attributable to current smoking and 6% (4716) to hazardous drinking. In terms of PYLL between ages one and 70, hazardous drinking ranks ahead of current smoking with 10% (or 132,044 PYLL) of the total PYLL, whereas current smoking represents 8% (105,085 PYLL) of the total . Regardless of whether premature mortality is expressed in terms of deaths or PYLL, about 18% of Canadian premature mortality is attributable to current smoking and/or drinking (with the range of possible values being 14-22%).