Trends for influenza and pneumonia hospitalization in the older population: age, period, and cohort effects

SUMMARYBirth cohort has been shown to be related to morbidity and mortality from other diseases and conditions, yet little is known about the potential for birth cohort in its relation to pneumonia and influenza (P&I) outcomes. This issue is particularly important in older adults, who experience the highest disease burden and most severe complications from these largely preventable diseases. The objective of this analysis is to assess P&I patterns in US seniors with respect to age, time, and birth cohort. All Medicare hospitalizations due to P&I (ICD-9CM codes 480-487) were abstracted and categorized by single-year of age and influenza year. These counts were then divided by intercensal estimates of age-specific population levels extracted from the US Census Bureau to obtain age- and season-specific rates. Rates were log-transformed and linear models were used to assess the relationships in P&I rates and age, influenza year, and cohort. The increase in disease rates with age accounted for most of the variability by age and influenza season. Consistent relationships between disease rates and birth cohorts remained, even after controlling for age. Seasonal associations were stronger for influenza than for pneumonia. These findings suggest that there may be a set of unmeasured characteristics or events people of certain ages experienced contemporaneously that may account for the observed differences in P&I rates in birth cohorts. Further understanding of these circumstances and those resulting age and cohort groups most vulnerable to P&I may help to target health services towards those most at risk of disease.

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Birth Cohort Differences in Multimorbidity Burden Among Aging U.S. Adults

Innovation in Aging ◽

10.1093/geroni/igab046.987 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 257-257

Author(s):

Nicholas Bishop ◽

Steven Haas ◽

Ana Quiñones

Keyword(s):

Cognitive Impairment ◽

Birth Cohort ◽

Repeated Measures ◽

Chronic Conditions ◽

Linear Models ◽

Birth Cohorts ◽

Older Americans ◽

Cohort Differences ◽

Increased Risk ◽

The Us

Abstract Multimorbidity is the co-occurrence of two or more chronic health conditions and affects more than half of the US population aged 65 and older. Recent trends suggest increased risk of poor self-reported health, physical disability, cognitive impairment, and mortality among later born birth cohorts, yet we are unaware of work examining cohort trends in multimorbidity among aging US adults. Observations were drawn from the Health and Retirement Study (2000–2018) and included adults aged 51 and older across 7 birth cohorts (1923 and earlier, 1924–1930, 1931–1941, 1942–1947, 1948–1953, 1954–1959, and 1960–1965). Multimorbidity was measured as a count of 9 chronic conditions including heart disease, hypertension, stroke, diabetes, arthritis, lung disease, cancer (excluding skin cancer), depression, and cognitive impairment. General linear models adjusting for repeated measures and covariates including age, sex, race/ethnicity, and education were used to identify whether trends in multimorbidity varied across birth cohort. 31,923 adults contributed 153,940 total observations, grand mean age was 68.0 (SD=10.09), and mean multimorbidity was 2.19 (SD=1.49). In analyses adjusted for age and other covariates, adults born 1948–1953 reported .34 more chronic conditions (SE=.03, p<.001), adults born 1954–1959 reported .42 more chronic conditions (SE=.03, p<.001), and adults born 1960–1965 reported .55 more chronic conditions (SE=.03, p<.001), than those born 1931–1941, respectively. Our preliminary results confirm increasing multimorbidity among later birth cohorts of older Americans and should help guide policy to manage impending health declines among older Americans.

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Why the Economics Profession Must Actively Participate in the Privacy Protection Debate

AEA Papers and Proceedings ◽

10.1257/pandp.20191106 ◽

2019 ◽

Vol 109 ◽

pp. 397-402 ◽

Cited By ~ 1

Author(s):

John M. Abowd ◽

Ian M. Schmutte ◽

William N. Sexton ◽

Lars Vilhuber

Keyword(s):

Privacy Protection ◽

Public Information ◽

Census Bureau ◽

Economic Research ◽

Technical Problems ◽

Public Data ◽

The Us ◽

Economics Profession ◽

Computer Scientists ◽

Us Census

When Google or the US Census Bureau publishes detailed statistics on browsing habits or neighborhood characteristics, some privacy is lost for everybody while supplying public information. To date, economists have not focused on the privacy loss inherent in data publication. In their stead, these issues have been advanced almost exclusively by computer scientists who are primarily interested in technical problems associated with protecting privacy. Economists should join the discussion, first to determine where to balance privacy protection against data quality--a social choice problem. Furthermore, economists must ensure new privacy models preserve the validity of public data for economic research.

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Choice and Conflict about Census Data Adjusting the American Census Count

Journal of Public Policy ◽

10.1017/s0143814x00006322 ◽

1991 ◽

Vol 11 (4) ◽

pp. 357-398 ◽

Cited By ~ 2

Author(s):

Michael L. Cohen

Keyword(s):

Census Data ◽

Political Representation ◽

The United States ◽

Political Conflict ◽

Census Bureau ◽

Census Count ◽

Social Fact ◽

The Us ◽

Census Adjustment ◽

Us Census

ABSTRACTThe census is a social fact, the outcome of a process that involves the interaction of public laws and institutions and citizens' responses to an official inquiry. However, it is not a ‘hard’ fact. Reasons for inevitable defects in the census count are listed in the first section; the second section reports efforts by the US Census Bureau to identify sources of error in census coverage, and make estimates of the size of the errors. The use of census data for policy purposes, such as political representation and allocating funds, makes these defects controversial. Errors may be removed by making adjustments to the initial census count. However, because adjustment reallocates resources between groups, it has become the subject of political conflict. The paper describes the conflict between statistical practices, laws and public policy about census adjustment in the United States, and concludes by considering the extent to which causes in America are likely to be found in other countries.

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From Statistics by Country of Birth to the System of National Origins

10.1093/acprof:oso/9780199917853.003.0018 ◽

2017 ◽

Author(s):

Paul Schor

Keyword(s):

Mother Tongue ◽

Census Bureau ◽

National Origin ◽

Immigration Restriction ◽

Birth Mother ◽

Immigrant Populations ◽

The Us ◽

History Of ◽

Us Census ◽

Immigration And Ethnicity

This chapter discusses changes in the categories of ethnicity and immigration in the US census. From the beginning of the twentieth century to the 1930s, statistics on immigration and ethnicity took first place in schedules, published reports, and public policy. Not only did census figures establish immigration quotas, but census statisticians, with their methods and their culture, constructed the mechanism for exclusion by national origin. However, after 1928 there was a retreat from measuring ethnicity, which became evident in the 1930 and 1940 censuses by a marked lack of interest in questions of place of birth, mother tongue, and degree of assimilation. The history of the categories that made it possible to measure ethnicity is a complex one, involving three main groups of actors: advocates of immigration restriction, representatives of immigrant populations, and Census Bureau statisticians, with each group attempting to respond to contradictory demands and to defend their own interests.

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Bladder cancer stage and mortality: urban vs. rural residency

Cancer Causes & Control ◽

10.1007/s10552-020-01366-1 ◽

2020 ◽

Author(s):

Marina Deuker ◽

L. Franziska Stolzenbach ◽

Claudia Collà Ruvolo ◽

Luigi Nocera ◽

Zhe Tian ◽

...

Keyword(s):

Bladder Cancer ◽

Rural Areas ◽

Tumor Stage ◽

Census Bureau ◽

Access To Treatment ◽

The Us ◽

Rural Residency ◽

Residency Status ◽

Cancer Specific Mortality ◽

Us Census

Abstract Objective Relative to urban populations, rural patients may have more limited access to care, which may undermine timely bladder cancer (BCa) diagnosis and even survival. Methods We tested the effect of residency status (rural areas [RA < 2500 inhabitants] vs. urban clusters [UC ≥ 2500 inhabitants] vs. urbanized areas [UA, ≥50,000 inhabitants]) on BCa stage at presentation, as well as on cancer-specific mortality (CSM) and other cause mortality (OCM), according to the US Census Bureau definition. Multivariate competing risks regression (CRR) models were fitted after matching of RA or UC with UA in stage-stratified analyses. Results Of 222,330 patients, 3496 (1.6%) resided in RA, 25,462 (11.5%) in UC and 193,372 (87%) in UA. Age, tumor stage, radical cystectomy rates or chemotherapy use were comparable between RA, UC and UA (all p > 0.05). At 10 years, RA was associated with highest OCM followed by UC and UA (30.9% vs. 27.7% vs. 25.6%, p < 0.01). Similarly, CSM was also marginally higher in RA or UC vs. UA (20.0% vs. 20.1% vs. 18.8%, p = 0.01). In stage-stratified, fully matched CRR analyses, increased OCM and CSM only applied to stage T1 BCa patients. Conclusion We did not observe meaningful differences in access to treatment or stage distribution, according to residency status. However, RA and to a lesser extent UC residency status, were associated with higher OCM and marginally higher CSM in T1N0M0 patients. This observation should be further validated or refuted in additional epidemiological investigations.

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Cigarettes smoked among daily and non-daily smokers following CVS Health’s tobacco-free pharmacy policy

Tobacco Control ◽

10.1136/tobaccocontrol-2020-055976 ◽

2020 ◽

pp. tobaccocontrol-2020-055976

Author(s):

Aryn Z Phillips ◽

Jennifer A Ahern ◽

William C Kerr ◽

Hector P Rodriguez

Keyword(s):

Market Share ◽

Rate Ratio ◽

Health Management ◽

Census Bureau ◽

Tobacco Sales ◽

Smoking Cues ◽

The Us ◽

Linear Effects ◽

Us Census ◽

The Impact

IntroductionIn September 2014, CVS Health ceased tobacco sales in all of its 7700 pharmacies nationwide. We investigate the impact of the CVS policy on the number of cigarettes smoked per day among metropolitan daily and non-daily smokers, who may respond to the availability of smoking cues in different manners.MethodsData are from the US Census Bureau Tobacco Use Supplement to the Current Population Survey 2014–2015 and the Blue Cross and Blue Shield Institute Community Health Management Hub. Adjusted difference-in-difference (DID) regressions assess changes in the number of cigarettes smoked per day among daily smokers (n=10 759) and non-daily smokers (n=3055), modelling core-based statistical area (CBSA) level CVS pharmacy market share continuously. To assess whether the policy had non-linear effects across the distribution of CVS market share, we also examine market share using tertiles.ResultsCVS’s tobacco-free pharmacy policy was associated with a significant reduction in the number of cigarettes smoked by non-daily smokers in the continuous DID (rate ratio=0.985, p=0.022), with a larger reduction observed among non-daily smokers in CBSAs in the highest third of CVS market share compared with those living in CBSAs with no CVS presence (rate ratio=0.706, p=0.027). The policy, however, was not significantly associated with differential changes in the number of cigarettes by daily smokers.ConclusionThe removal of tobacco products from CVS pharmacies was associated with a reduction in the number of cigarettes smoked per day among non-daily smokers in metropolitan CBSAs, particularly those in which CVS had a large pharmacy market share.

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From the US Census Bureau: Number of uninsured Americans on the rise

The Journal of the American Osteopathic Association ◽

10.7556/jaoa.1994.94.12.1031c ◽

1994 ◽

Vol 94 (12) ◽

pp. 1031C

Keyword(s):

Census Bureau ◽

The Us ◽

Us Census

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Examining social, physical, and environmental dimensions of tornado vulnerability in Texa

Journal of Emergency Management ◽

10.5055/jem.2016.0280 ◽

2016 ◽

Vol 14 (2) ◽

pp. 139

Author(s):

Laura Siebeneck, PhD

Keyword(s):

Vulnerability Index ◽

Census Bureau ◽

Source Information ◽

Principle Components Analysis ◽

Emergency Managers ◽

The Social ◽

Vulnerability Model ◽

The Us ◽

Components Analysis ◽

Us Census

Objective: To develop a vulnerability model that captures the social, physical, and environmental dimensions of tornado vulnerability of Texas counties. Design: Guided by previous research and methodologies proposed in the hazards and emergency management literature, a principle components analysis is used to create a tornado vulnerability index. Data were gathered from open source information available through the US Census Bureau, American Community Surveys, and the Texas Natural Resources Information System.Setting: Texas counties.Results: The results of the model yielded three indices that highlight geographic variability of social vulnerability, built environment vulnerability, and tornado hazard throughout Texas. Further analyses suggest that counties with the highest tornado vulnerability include those with high population densities and high tornado risk.Conclusions: This article demonstrates one method for assessing statewide tornado vulnerability and presents how the results of this type of analysis can be applied by emergency managers towards the reduction of tornado vulnerability in their communities.

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