scholarly journals Widening Socioeconomic, Racial, and Geographic Disparities in HIV/AIDS Mortality in the United States, 1987–2011

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
Gopal K. Singh ◽  
Romuladus E. Azuine ◽  
Mohammad Siahpush
Keyword(s):  
United States ◽  
The United States ◽  
Mortality Data ◽  
Mortality Trends ◽  
Geographic Disparities ◽  
Socioeconomic Gradients ◽  
Relative Risks ◽  
Deprivation Group ◽  
Log Linear ◽  
Hiv Aids

This study examined the extent to which socioeconomic and racial and geographic disparities in HIV/AIDS mortality in the United States changed between 1987 and 2011. Census-based deprivation indices were linked to county-level mortality data from 1987 to 2009. Log-linear, least-squares, and Poisson regression were used to model mortality trends and differentials. HIV/AIDS mortality rose between 1987 and 1995 and then declined markedly for all groups between 1996 and 2011. Despite the steep mortality decline, socioeconomic gradients and racial and geographic disparities in HIV/AIDS mortality increased substantially during the study period. Compared to whites, blacks had 3 times higher HIV/AIDS mortality in 1987 and 8 times higher mortality in 2011. In 1987, those in the most-deprived group had 1.9 times higher HIV/AIDS mortality than those in the most-affluent group; the corresponding relative risks increased to 2.9 in 1998 and 3.6 in 2009. Socioeconomic gradients existed across all race-sex groups, with mortality risk being 8–16 times higher among blacks than whites within each deprivation group. Dramatic reductions in HIV/AIDS mortality represent a major public health success. However, slower mortality declines among more deprived groups and blacks contributed to the widening gap. Mortality disparities reflect inequalities in incidence, access to antiretroviral therapy, and patient survival.

scholarly journals Male Mortality Trends in the United States, 1900-2010: Progress, Challenges, and Opportunities

2019 ◽  
Vol 135 (1) ◽  
pp. 150-160
Author(s):  
Wanda K. Jones ◽  
Robert A. Hahn ◽  
R. Gibson Parrish ◽  
Steven M. Teutsch ◽  
Man-Huei Chang
Keyword(s):  
United States ◽  
Causes Of Death ◽  
The United States ◽  
Recent Analysis ◽  
Mortality Data ◽  
Female Mortality ◽  
Mortality Trends ◽  
Male Mortality ◽  
Death Rates ◽  
White Males

Objectives: Male mortality fell substantially during the past century, and major causes of death changed. Building on our recent analysis of female mortality trends in the United States, we examined all-cause and cause-specific mortality trends at each decade from 1900 to 2010 among US males. Methods: We conducted a descriptive study of age-adjusted death rates (AADRs) for 11 categories of disease and injury stratified by race (white, nonwhite, and, when available, black), the excess of male mortality over female mortality ([male AADR − female AADR]/female AADR), and potential causes of persistent excess of male mortality. We used national mortality data for each decade. Results: From 1900 to 2010, the all-cause AADR declined 66.4% among white males and 74.5% among nonwhite males. Five major causes of death in 1900 were pneumonia and influenza, heart disease, stroke, tuberculosis, and unintentional nonmotor vehicle injuries; in 2010, infectious conditions were replaced by cancers and chronic lower respiratory diseases. The all-cause excess of male mortality rose from 9.1% in 1900 to 65.5% in 1980 among white males and a peak of 63.7% in 1990 among nonwhite males, subsequently falling among all groups. Conclusion: During the last century, AADRs among males declined more slowly than among females. Although the gap diminished in recent decades, exploration of social and behavioral factors may inform interventions that could further reduce death rates among males.

Abstract 11: Geographic Inequalities in Cardiovascular Mortality: Impact of Public Health Initiatives

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Vibhu Parcha ◽  
Rajat Kalra ◽  
Nirav Patel ◽  
Thomas J Wang ◽  
Garima Arora ◽  
...  
Keyword(s):  
United States ◽  
Heart Failure ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Cardiovascular Mortality ◽  
The United States ◽  
Ischemic Heart ◽  
Mortality Trends ◽  
Geographic Disparities ◽  
Stroke Belt

Introduction: Improvements in therapy and prevention have led to declining cardiovascular mortality in the United States, but it is not clear whether these improvements have narrowed geographic disparities in cardiovascular outcomes. We sought to compare mortality due to cardiovascular disease, heart failure, stroke, and ischemic heart disease in the stroke belt cluster of 11 states versus the rest of the United States. Methods: A retrospective cross-sectional analysis of the CDC WONDER database was done to evaluate the nationwide mortality trends derived from the death certificates of all American residents from 1999 to 2017. Mortality trends for death due to heart failure, stroke, ischemic heart disease or any cardiovascular cause, were identified in the stroke belt and non-stroke belt populations using ICD-10 codes. Piecewise linear regression was used to assess the change in mortality trends. Results: Among 16,111,775 deaths due to cardiovascular causes during the study period, the age-adjusted mortality rates (AAMR) were highest among non-Hispanic Black, males from non-metropolitan areas, living in the stroke belt. In the stroke belt, AAMR due to all cardiovascular causes [Average Annual Percentage Change (AAPC): -2.5 (95% CI:-2.9 to -2.0); p<0.001], stroke [AAPC: -2.9 (95% CI: -3.7 to -2.1); p<0.001] and ischemic heart disease [AAPC: -3.9 (95% CI: -4.3 to -3.5); p<0.001] declined from 1999 to 2017. Similarly, a decrease in cardiovascular [AAPC: -2.6 (95% CI:-3.1 to -2.1); p<0.001], stroke [AAPC:-2.9 (95% CI: -3.2 to -2.2); p<0.001] and ischemic heart disease [AAPC: -4.1 (95% CI: -4.5 to -3.6); p<0.001] mortality was seen in the non-stroke belt region from 1999 to 2017. There was no overall change in heart failure mortality in either regions (p for AAPC >0.05). The gap in age-adjusted mortality estimates for cardiovascular cause of death was 11.8% in 1999 and was 16% in 2017 across the two regions ( Figure 1 ). The mortality gaps were persistent across sub-groups of age, sex, race, and level of urbanization. Conclusions: Despite the overall decline in cardiovascular mortality, significant geographic disparities in cardiovascular mortality persist. Preventive efforts targeting risk factors and improved disease management may attenuate the longstanding geographical heterogeneity in cardiovascular mortality.

Abstract 13795: Race and Gender Differences in Mortality From Atrial Fibrillation in the United States: 1999 to 2018

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Arshi Parvez ◽  
Justin Salciccioli ◽  
Augustin DeLago ◽  
Joseph Shalhoub ◽  
Adam Hartley ◽  
...  
Keyword(s):  
United States ◽  
Atrial Fibrillation ◽  
Black Women ◽  
The United States ◽  
Mortality Data ◽  
Mortality Trends ◽  
Race And Gender ◽  
The Us ◽  
And Gender ◽  
Observation Period

Objective: To assess differences in mortality trends from atrial fibrillation (AF) among different races and genders in the United States (US). Background: AF is the most common sustained cardiac arrythmia in the US. No up to date analysis has assessed AF mortality trends by race and gender across the US. Methods: For this observational analysis US AF mortality data from 1999 to 2018 for individuals >45 years of age were extracted from the CDC WONDER database. International Classification of Diseases code I48 was used to define AF. Mortality data were age-standardized to the US 2000 standard population, and stratified by gender and race (Caucasian, Black, Asian). Joinpoint regression analysis was used to assess for significant changes in trends over the observation period, and provide estimated annual percentage changes (EAPC)s with 95% confidence intervals (CIs). Results: From 1999 to 2018, the mortality rate per 100,000 population, increased significantly from 3.7 to 8.3 (+124%, the greatest increase observed) amongst Asian men (AM), from 5.4 to 10.8 (+100%) amongst Black men (BM), and from 9.2 to 19.2 (+108%) amongst Caucasian men (CM). Mortality increases, per 100,000 population, were seen from 4.0 to 7.4 (+85%, the smallest increase observed) in Asian women (AW), 5.3 to 12.8 (+121%) in Black women (BW), and 8.9 to 19.7 (+121%) in Caucasian women (CW) over the same time period. Joinpoint analysis demonstrated significant increasing AF mortality trends for both genders and all races studied. AW had the highest EAPC of 8.6 (95% CI 6.0-11.3) between 1999-2008, which slowed to 2.2 (95% CI 0.1-4.3) between 2009-2018. AM followed a similar EAPC pattern: 7.7 (95% CI 5.7-9.8) between 1999-2008, decreasing to 0.5 (95% CI -1.1-2.2) between 2009-2018. Between 1999-2018, EAPCs increased for BW (3.8, 95% CI 3.2-4.4), CW (4.4, 95% CI 4.0-4.8), BM (4.0, 95% CI 3.4-4.6) and CM (4.8, 95% CI 4.4-5.2). Conclusion: Between 1999 and 2018, there are increasing AF mortality trends amongst both genders and all races, with Caucasians having the greatest overall increases during the observation period. EAPCs demonstrate that the rates of increases in AF mortality are greatest in Caucasians, followed by Asian then Black Americans.

scholarly journals Outcomes for Children and Adolescents With Cancer: Challenges for the Twenty-First Century

2010 ◽  
Vol 28 (15) ◽  
pp. 2625-2634 ◽  
Author(s):  
Malcolm A. Smith ◽  
Nita L. Seibel ◽  
Sean F. Altekruse ◽  
Lynn A.G. Ries ◽  
Danielle L. Melbert ◽  
...  
Keyword(s):  
United States ◽  
Childhood Cancer ◽  
Cancer Mortality ◽  
Lymphoblastic Leukemia ◽  
The United States ◽  
Mortality Rates ◽  
Mortality Data ◽  
Childhood Cancers ◽  
Essential Information ◽  
The Impact

Purpose This report provides an overview of current childhood cancer statistics to facilitate analysis of the impact of past research discoveries on outcome and provide essential information for prioritizing future research directions. Methods Incidence and survival data for childhood cancers came from the Surveillance, Epidemiology, and End Results 9 (SEER 9) registries, and mortality data were based on deaths in the United States that were reported by states to the Centers for Disease Control and Prevention by underlying cause. Results Childhood cancer incidence rates increased significantly from 1975 through 2006, with increasing rates for acute lymphoblastic leukemia being most notable. Childhood cancer mortality rates declined by more than 50% between 1975 and 2006. For leukemias and lymphomas, significantly decreasing mortality rates were observed throughout the 32-year period, though the rate of decline slowed somewhat after 1998. For remaining childhood cancers, significantly decreasing mortality rates were observed from 1975 to 1996, with stable rates from 1996 through 2006. Increased survival rates were observed for all categories of childhood cancers studied, with the extent and temporal pace of the increases varying by diagnosis. Conclusion When 1975 age-specific death rates for children are used as a baseline, approximately 38,000 childhood malignant cancer deaths were averted in the United States from 1975 through 2006 as a result of more effective treatments identified and applied during this period. Continued success in reducing childhood cancer mortality will require new treatment paradigms building on an increased understanding of the molecular processes that promote growth and survival of specific childhood cancers.

scholarly journals Mortality due to Influenza in the United States—An Annualized Regression Approach Using Multiple-Cause Mortality Data

2005 ◽  
Vol 163 (2) ◽  
pp. 181-187 ◽  
Author(s):  
Jonathan Dushoff ◽  
Joshua B. Plotkin ◽  
Cecile Viboud ◽  
David J. D. Earn ◽  
Lone Simonsen
Keyword(s):  
United States ◽  
The United States ◽  
Mortality Data ◽  
Regression Approach
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