Abstract WMP52: Age, Sex and Regional Differences in Recent Stroke Incidence Trends Among Young Adults

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Youngran Kim ◽  
Songmi Lee ◽  
Jennifer Meeks ◽  
Arvind B Bambhroliya ◽  
Trudy Karuse ◽  
...  
Keyword(s):  
Young Adults ◽  
Census Data ◽  
Primary Diagnosis ◽  
Incidence Rates ◽  
Younger Adults ◽  
Stroke Incidence ◽  
Incidence Trends ◽  
Southern Us ◽  
The Us ◽  
Us Census

Background: In the US, one third of strokes occur among younger adults (< 65 years). While stroke incidence among elderly has declined, trends in younger adults by age, sex and region are unknown. We report recent trends in stroke incidence among commercially-insured young adults aged 20 - 64. Methods: Stroke incidence was estimated using 2011 - 2017 IBM MarketScan® Commercial Database stratified by age (20 - 34, 35 - 44, 45 - 54, 55 - 64), sex, and US Census region and was extrapolated to the US population using census data. Stroke cases were identified based on a primary diagnosis of either ischemic stroke (IS) or intracerebral hemorrhage (ICH) or subarachnoid hemorrhage (SAH) using validated ICD-9 / 10 codes. We report incidence rates (IR) per 100,000 person-years, 95% confidence intervals and proportional change in IR between 2011 and 2017. Results: We identified 115,276 stroke admissions resulting in 172 million person-years. The overall stroke IR increased by 7% from 60.0 to 64.2 per 100,000 person-years between 2011 and 2017. The increase was greater among males as compared to females (9.8% vs 3.3%) and across both sexes the largest increase was observed for age category of 35 - 44 years (Table 1). Age-specific IR increased in all age categories except 20 - 34. Across US regions, the South showed the highest IR increase (10.0%) (Figure 1). IR for IS and ICH increased while a decrease in SAH IR was observed. The IR for IS was higher for males vs females (12.7% vs 5.4%), whereas it was higher for females vs males for ICH (14.5% vs 3.6%). Conclusions: Our analyses indicate an overall increase in stroke incidence for commercially-insured younger adults during a contemporary time period. Males between the ages of 35 - 44 have experienced the greatest increase in stroke incidence. Furthermore, the Southern US continues to experience highest increases in stroke incidence and there are gender differences in IR for stroke subtypes. Targeted strategies for stroke prevention may be warranted.

scholarly journals Injuries related to respiratory masks in the US are very rare

2021 ◽  
Author(s):  
Philip N. Cohen
Keyword(s):  
Census Data ◽  
Incidence Rates ◽  
Common Type ◽  
Respiratory Protection ◽  
Risk Of Falling ◽  
Injury Surveillance System ◽  
Household Products ◽  
The Us ◽  
Protection Devices ◽  
Almost All

Background. Protective facemasks are important for preventing the spread of COVID-19, and almost all Americans have worn them at least some of the time during the pandemic. There are reasonable concerns about some ill effects of mask-wearing, especially for people who wear masks for extended periods, and for the risk of falling as a result of visual obstruction. But there are also unsupported fears and objections stemming from misinformation and fueled by political disputes. Methods. The study analyzed the Consumer Product Safety Commission’s National Electronic Injury Surveillance System (NEISS) for 2020, using the product code for Respiratory Protection Devices, and calculated population incidence rates using Census data. Results. The NEISS included 128 cases, representing an estimated 5122 reported injuries in the population (95% CI 3322, 6922). The overall rate of injury reports was 1.54 per 100,000 U.S. residents (95% CI 1.00, 2.08). People over age 75 had higher rates than the population overall, with 5.27 injuries per 100,000 (95% CI 2.17, 8.37). The most common type of incidents involved facial injuries, rashes, falls, and those that might be considered anxiety-related. Conclusion. Wearing protective face masks is extremely safe, especially in comparison with other common household products, and in light of their protective benefits with regard to prevent the spread of COVID-19. This information may be useful for public health messaging, and for practitioners trying to increase compliance with mask-wearing guidance.

Choice and Conflict about Census Data Adjusting the American Census Count

1991 ◽  
Vol 11 (4) ◽  
pp. 357-398 ◽  
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.

scholarly journals The prevalence of MS in the United States

Neurology ◽  
2019 ◽  
Vol 92 (10) ◽  
pp. e1029-e1040 ◽  
Author(s):  
Mitchell T. Wallin ◽  
William J. Culpepper ◽  
Jonathan D. Campbell ◽  
Lorene M. Nelson ◽  
Annette Langer-Gould ◽  
...  
Keyword(s):  
United States ◽  
Census Data ◽  
Adult Population ◽  
The United States ◽  
Health Claims ◽  
The North ◽  
Time Period ◽  
The Us ◽  
Group A ◽  
Us Census

ObjectiveTo generate a national multiple sclerosis (MS) prevalence estimate for the United States by applying a validated algorithm to multiple administrative health claims (AHC) datasets.MethodsA validated algorithm was applied to private, military, and public AHC datasets to identify adult cases of MS between 2008 and 2010. In each dataset, we determined the 3-year cumulative prevalence overall and stratified by age, sex, and census region. We applied insurance-specific and stratum-specific estimates to the 2010 US Census data and pooled the findings to calculate the 2010 prevalence of MS in the United States cumulated over 3 years. We also estimated the 2010 prevalence cumulated over 10 years using 2 models and extrapolated our estimate to 2017.ResultsThe estimated 2010 prevalence of MS in the US adult population cumulated over 10 years was 309.2 per 100,000 (95% confidence interval [CI] 308.1–310.1), representing 727,344 cases. During the same time period, the MS prevalence was 450.1 per 100,000 (95% CI 448.1–451.6) for women and 159.7 (95% CI 158.7–160.6) for men (female:male ratio 2.8). The estimated 2010 prevalence of MS was highest in the 55- to 64-year age group. A US north-south decreasing prevalence gradient was identified. The estimated MS prevalence is also presented for 2017.ConclusionThe estimated US national MS prevalence for 2010 is the highest reported to date and provides evidence that the north-south gradient persists. Our rigorous algorithm-based approach to estimating prevalence is efficient and has the potential to be used for other chronic neurologic conditions.

scholarly journals Changes in the Incidence of Endstage Renal Disease Due to Lupus Nephritis in the United States, 1996–2004

2009 ◽  
Vol 36 (1) ◽  
pp. 63-67 ◽  
Author(s):  
MICHAEL M. WARD
Keyword(s):  
United States ◽  
Lupus Nephritis ◽  
Renal Disease ◽  
The United States ◽  
Population Based ◽  
Incidence Rates ◽  
Endstage Renal Disease ◽  
The Us ◽  
Population Based Registry ◽  
Us Census

ObjectiveTo determine if the incidence of endstage renal disease (ESRD) due to lupus nephritis has decreased from 1996 to 2004.MethodsPatients age 15 years or older with incident ESRD due to lupus nephritis in 1996–2004 and living in one of the 50 United States or the District of Columbia were identified using the US Renal Data System, a national population-based registry of all patients receiving renal replacement therapy for ESRD. Incidence rates were computed for each calendar year, using population estimates of the US census as denominators.ResultsOver the 9-year study period, 9199 new cases of ESRD due to lupus nephritis were observed. Incidence rates, adjusted to the age, sex, and race composition of the US population in 2000, were 4.4 per million in 1996 and 4.9 per million in 2004. Compared to the pooled incidence rate in 1996–1998, the relative risk of ESRD due to lupus nephritis in 1999–2000 was 0.99 (95% CI 0.93–1.06), in 2001–2002 was 0.99 (95% CI 0.92–1.06), and in 2003–2004 was 0.96 (95% CI 0.89–1.02). Findings were similar in analyses stratified by sex, age group, race, and socioeconomic status.ConclusionThere was no decrease in the incidence of ESRD due to lupus nephritis between 1996 and 2004. This may reflect the limits of effectiveness of current treatments, or limitations in access, use, or adherence to treatment.

Cost-Effectiveness of the Pneumococcal Vaccine in Healthy Younger Adults

2002 ◽  
Vol 22 (1_suppl) ◽  
pp. 45-57 ◽  
Author(s):  
Patricia Vold Pepper ◽  
Douglas K. Owens
Keyword(s):  
Young Adults ◽  
Cost Effectiveness ◽  
Pneumococcal Vaccine ◽  
Adult Population ◽  
Vaccination Strategy ◽  
Cost Effective ◽  
Incidence Rates ◽  
Younger Adults ◽  
Effective Measure ◽  
The Cost

Objectives Routine vaccination for Streptococcus pneumoniae has been recommended as a cost-effective measure for elderly and immunocompromised patients, yet no analysis has been performed for healthy younger adults in America. The authors evaluated the cost-effectiveness of the pneumococcal vaccine and determined the net health benefits conferred for the healthy young adult population. Methods The authors developed a decision model to compare the health and economic outcomes of vaccinate versus do not vaccinate for S. pneumoniae. Results Vaccinating patients for S. pneumoniae generates benefits that are dependent on incidence rates and the efficacy of the vaccine. In the 22-year-old patient with a pneumonia incidence of 0.3/1000, the vaccine would need to be >71 percent effective for the vaccination strategy to cost less than $50,000/QALY gained. At an incidence of 0.4/1000, the threshold efficacy is 53 percent, whereas at 0.5/1000 it is 43 percent. In the 35-year-old patient where the incidence of pneumococcal pneumonia is higher (0.85/1000), the vaccine would be cost-effective with an efficacy as low as 30 percent. Conclusions Use of the S. pneumoniae vaccine in young adults would provide modest reductions in pneumonia-associated morbidity and mortality. Vaccination of young adults is moderately expensive unless vaccine efficacy is above 50% to 60%. In 35-year-old adults, use of the vaccine is cost-effective even with moderate efficacy.

Demography and Social Epidemiology of Admissions to the Colorado Insane Asylum, 1879–1899

2014 ◽  
Vol 38 (1-2) ◽  
pp. 251-271 ◽  
Author(s):  
Ann L. Magennis ◽  
Michael G. Lacy
Keyword(s):  
Census Data ◽  
Social Epidemiology ◽  
Foreign Born ◽  
Personal Service ◽  
Admission Rates ◽  
Service Category ◽  
The Us ◽  
Males And Females ◽  
Urban Concentration ◽  
Us Census

This paper analyzes admissions to the Colorado Insane Asylum from 1879 to 1900. We estimate and compare admission rates across sex, age, marital, occupation, and immigration status using original admission records in combination with US census data from 1870 to1900. We show the extent to which persons in various status groups, who varied in power and social advantage, differed in their risk of being institutionalized in the context of nineteenth-century Colorado. Our analysis showed that admission or commitment to the Asylum did not entail permanent incarceration, as more than half of those admitted were discharged within six months. Men were admitted at higher rates than women, even after adjusting for age. Marital status also affected the risk of admission; single and divorced persons were admitted at about 1.5 times the rate of their married counterparts. Widows of either sex were even more likely to be admitted to the Asylum, and the risk increased with age. Persons in lower income/lower prestige occupations were more likely to be institutionalized. This included occupations in the domestic and personal service category in the US census, and this was evident for both males and females. Foreign-born men and women were admitted at, respectively, twice and three times the rate of their native counterparts, with particularly elevated rates observed among the Irish. In general, admission to the Colorado Insane Asylum appears to differ only in a slightly greater admission of males when compared to similar contemporaneous institutions in the East, despite the obvious differences in the Colorado population size and urban concentration.

FDA analysis: Demographic trends in bladder and renal cancer trials.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18144-e18144
Author(s):  
Laura L Fernandes ◽  
Zhantao Lin ◽  
Lola A. Fashoyin-Aje ◽  
Shenghui Tang ◽  
Rajeshwari Sridhara ◽  
...  
Keyword(s):  
Renal Cancer ◽  
Demographic Data ◽  
Census Bureau ◽  
Incidence Rates ◽  
Test Results ◽  
Enrollment Trends ◽  
Black Patients ◽  
The Us ◽  
Chi Squared ◽  
Us Census

e18144 Background: Many publications report under representation of minorities in certain subgroups, which may limit the generalizability of clinical trial (CT) results. This analysis, investigates and reports enrollment trends in CTs submitted between 2006-2017 in support of marketing applications for drugs indicated for the treatment of urothelial (UC) and renal cancer carcinoma (RCC), and compares them to incidence rates of these diseases by Surveillance, Epidemiology, and End Results (SEER) registry and the US census bureau. Methods: We identified all marketing applications for the treatment of UC and RCC that provided the primary evidence of safety and efficacy and aggregated the demographic data across trials and disease. Using these two pooled datasets, we compared the patient proportions enrolled in each of the race, sex and age categories to the corresponding rates in US cancer population estimated based on the corresponding incidence rates reported by SEER and the US census bureau using a Chi-squared test. Results: The pooled seven UC and 14 RCC CTs provided 2035 and 6757 patients respectively. The results are summarized below for the 939 (46%) UC and 1489 (22%) RCC patients enrolled in the US. Conclusions: Our findings indicate that majority of the patients were enrolled outside of the US. There were lower proportion of Black patients (4% vs 8%), older patients, age ≥ 75 years (30% vs 48%) and males (74% vs 80%) enrolled in UC population in the US. Higher proportions were observed in both White (89% vs 85%) and Asian (4% vs 2%) patients in UC and in White (90% vs 79%) patients in RCC.[Table: see text]

Abstract T P135: Geographic Microtargeting: Identifying High Risk Stroke Populations

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Jason Mackey ◽  
Heidi Sucharew ◽  
Monir Hossain ◽  
David E Jones ◽  
Kathleen Alwell ◽  
...  
Keyword(s):  
High Risk ◽  
Recurrent Events ◽  
Census Data ◽  
Incidence Rates ◽  
High Yield ◽  
Stroke Incidence ◽  
Census Tracts ◽  
Physician Review ◽  
Institutionalized Patients ◽  
The Impact

Introduction: Though the incidence of acute ischemic stroke is decreasing overall in the US, improvement is not occurring uniformly. A high-yield strategy might be to identify and target micropopulations of very high-risk patients. Methods: All acute ischemic strokes among residents in the Greater Cincinnati/Northern Kentucky (GCNK) region (estimated population: 1.3 million) at least 20 years of age were identified using ICD-9 codes of 430-436 and verified by physician review in the calendar years 1999 and 2005. Each patient residing at home was geocoded according to listed home address; institutionalized patients were excluded. We calculated crude incidence rates for the 346 census tracts and used stroke events for numerators and 2000 Census data for denominators. We produced incidence maps for 1999 and 2005 and a rate change map for comparison. Results: We identified 2330 acute ischemic strokes in the GCNK region in 1999 and 2165 in 2005. After excluding recurrent events, events in institutionalized patients, and events in patients without geocodable addresses, we identified 1942 patients in 1999 and 1766 patients in 2005 for this analysis. Overall incidence was 189/100,000 in 1999 and 167/100,000 in 2005. The interquartile range of incidences in the census tracts was 124 - 270/100,000 in 1999 and 112 - 243/100,000 in 2005. Rates by year and rate difference are shown in the Figure. There were 23 census tracts with rates >300/100,000 in both study years and 21 census tracts with a rate increase >200/100,000 from 1999 to 2005. Discussion: Stroke incidence varies widely in census tracts in the GCNK region. We identified several micropopulations in which targeted efforts might result in reductions of stroke burden on the population. Further investigation of the impact of socioeconomic status and risk factors in these micropopulations will help tailor stroke reduction efforts. Microtargeting deserves further study in stroke education and prevention endeavors.

scholarly journals Hurricane Katrina Deaths, Louisiana, 2005

2008 ◽  
Vol 2 (4) ◽  
pp. 215-223 ◽  
Author(s):  
Joan Brunkard ◽  
Gonza Namulanda ◽  
Raoult Ratard
Keyword(s):  
Hurricane Katrina ◽  
Disaster Preparedness ◽  
Census Data ◽  
Gulf Coast ◽  
Mortality Data ◽  
Chi Square ◽  
Term Care ◽  
The Us ◽  
State Death ◽  
Us Census

ABSTRACTObjective: Hurricane Katrina struck the US Gulf Coast on August 29, 2005, causing unprecedented damage to numerous communities in Louisiana and Mississippi. Our objectives were to verify, document, and characterize Katrina-related mortality in Louisiana and help identify strategies to reduce mortality in future disasters.Methods: We assessed Hurricane Katrina mortality data sources received in 2007, including Louisiana and out-of-state death certificates for deaths occurring from August 27 to October 31, 2005, and the Disaster Mortuary Operational Response Team's confirmed victims' database. We calculated age-, race-, and sex-specific mortality rates for Orleans, St Bernard, and Jefferson Parishes, where 95% of Katrina victims resided and conducted stratified analyses by parish of residence to compare differences between observed proportions of victim demographic characteristics and expected values based on 2000 US Census data, using Pearson chi square and Fisher exact tests.Results: We identified 971 Katrina-related deaths in Louisiana and 15 deaths among Katrina evacuees in other states. Drowning (40%), injury and trauma (25%), and heart conditions (11%) were the major causes of death among Louisiana victims. Forty-nine percent of victims were people 75 years old and older. Fifty-three percent of victims were men; 51% were black; and 42% were white. In Orleans Parish, the mortality rate among blacks was 1.7 to 4 times higher than that among whites for all people 18 years old and older. People 75 years old and older were significantly more likely to be storm victims (P < .0001).Conclusions: Hurricane Katrina was the deadliest hurricane to strike the US Gulf Coast since 1928. Drowning was the major cause of death and people 75 years old and older were the most affected population cohort. Future disaster preparedness efforts must focus on evacuating and caring for vulnerable populations, including those in hospitals, long-term care facilities, and personal residences. Improving mortality reporting timeliness will enable response teams to provide appropriate interventions to these populations and to prepare and implement preventive measures before the next disaster. (Disaster Med Public Health Preparedness. 2008;2:215–223)

scholarly journals Incidence of Silent Stroke in the United States

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 363-363
Author(s):  
Megan C Leary ◽  
Jeffrey L Saver
Keyword(s):  
United States ◽  
Stroke Prevention ◽  
The United States ◽  
Population Based ◽  
Incidence Rates ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Stroke Incidence ◽  
Age Cohorts ◽  
The Us

P134 Background: Recent estimates of stroke incidence in the US range from 715,000–750,000 annually. These estimates, however, do not reflect silent infarcts and hemorrhages. Since population-based studies have found that prevalence of silent stroke is 10–20 times that of symptomatic, estimates of stroke incidence based solely on symptomatic events may substantially underestimate the annual burden of stroke. Silent strokes contribute to vascular dementia, gait impairment, and other major adverse patient outcomes. Methods: Incidence of silent infarcts for different age strata were derived from two US population-based studies of the prevalence of silent infarct-like lesions on MRI, Atherosclerosis Risk In Communities and Cardiovascular Health Study. Prevalence observations in these studies and age-specific death rates from the US Census Bureau were inputted to calculate silent infarct incidence (method of Leske et al). Similarly, incidence rates of silent hemorrhage at differing ages were extrapolated from population-based prevalence observations employing MR GRE imaging in the Austrian Stroke Prevention Study. Age-specific incidence rates were projected onto age cohorts in the 1998 US population to calculate annual burden of silent stroke. Results: Derived incidence rates per 100,000 of silent infarct ranged from 6400 in the age 50–59 strata to 16400 at ages 75–79. Extrapolated incidence rates of silent hemorrhage ranged from 230 in the age 30–39 strata to 7360 at ages > 80. Incidence rates of both subclinical infarcts and hemorrhage increased exponentially with age. Overall estimated annual US occurrence of silent infarct was 9,039,000, and of silent hemorrhage 2,130,000. Conclusion: In 1998, nearly 12 million strokes occurred in the United States, of which ∼750,000 were symptomatic and over 11 million were subclinical. Among the silent strokes, ∼81% were infarcts and ∼19% hemorrhages. These findings demonstrate that the annual burden of stroke is substantially higher than suggested by estimates based solely on clinically manifest events, and suggest that greater research and clinical resources should be allocated to stroke prevention and treatment.

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