Variation in the Geographic Distribution of the Otolaryngology Workforce: A National Geospatial Analysis

2020 ◽  
Vol 162 (5) ◽  
pp. 649-657 ◽  
Author(s):  
Shekhar K. Gadkaree ◽  
Justin C. McCarty ◽  
Jennifer Siu ◽  
David A. Shaye ◽  
Daniel G. Deschler ◽  
...  
Keyword(s):  
United States ◽  
Geographic Distribution ◽  
Demographic Data ◽  
Cohort Analysis ◽  
College Education ◽  
The United States ◽  
United States Census ◽  
United States Census Bureau ◽  
Cross Sectional ◽  
Hospital Referral

Objective To examine the current geographic distribution of otolaryngologists in the United States and the disparities in socioeconomic demographics at the county and hospital referral region (HRR) level. Study Design Cross-sectional study. Setting National cohort analysis including all otolaryngologists in the United States. Subjects and Methods All otolaryngologists board certified by the American Board of Otolaryngology–Head and Neck Surgery in the United States in 2018 were compared with overlaid demographic data from the 2010 United States Census Bureau by county and HRR. Associations between the density of otolaryngologists per population and socioeconomic characteristics were assessed and stratified by region. Results The average number of otolaryngologists was 3.6 (SD 9.6) per 100,000. On multivariable regression analysis, the density of otolaryngologists was positively associated with counties with the highest quartile of college education (1.8 providers per 100,000 [95% confidence interval [CI] 0.89, 2.90], P < .001) and income (2.1 providers per 100,000 [95% CI 1.03, 3.07], P = .01). Significant regional variation existed in access to otolaryngology care. Conclusion There are significant areas with disparate densities of otolaryngologists in the United States. Lower socioeconomic status, more severe poverty, and a lower number of college graduates in a county correlated with reduced density of otolaryngologists.

scholarly journals Complications Leading to Keratoplasty among Contact Lens Users and LASIK Patients: A 10-Year Cross-Sectional Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Sloan W. Rush ◽  
Blaze Bulla ◽  
Ryan B. Rush
Keyword(s):  
United States ◽  
Contact Lens ◽  
Geographic Area ◽  
The United States ◽  
Laser In Situ Keratomileusis ◽  
Secondary Outcome ◽  
United States Census ◽  
United States Census Bureau ◽  
Cross Sectional ◽  
Study Interval

Purpose. To determine the incidence and outcomes in patients who underwent penetrating keratoplasty (PK) resulting from complications related to contact lens (CL) use and laser in situ keratomileusis (LASIK) in a metropolitan area of the United States. Methods. Population data was obtained from the United States Census Bureau and the Centers for Disease Control. A retrospective, cross-sectional chart review was performed on all patients who underwent keratoplasty in a specific metropolitan geographic area over a ten-year period. The main outcome was best-corrected visual acuity (BCVA) at 2 years in patients who underwent PK secondary to complications related to CL use and LASIK. The secondary outcome was the relative risk of undergoing PK secondary to a complication related to CL use versus LASIK. Results. The study’s geographic area had 46,545 CL users in one or both eyes during any given year and 10,285 patients who underwent LASIK in one or both eyes during the study interval. There were 24 CL users (0.52 per 1,000) and 3 post-LASIK patients (0.29 per 1,000) who underwent PK secondary to complications during the study interval (OR 1.77 [0.53–5.87, 95% CI]; p = 0.35 ). BCVA at 2 years was 1.45 [1.0–1.90] logMAR (20/564 Snellen) in the CL using cohort and 0.07 [−1.19–1.33] logMAR (20/23 Snellen) in post-LASIK cohort following PK ( p = 0.04 ). Conclusions. Patients who underwent PK secondary to complications related to CL use had worse visual outcomes at 2 years compared to those related to LASIK. Complications leading to PK were rare in both cohorts, but the incidence of undergoing PK secondary to CL use trended higher than LASIK.

Automated Mapping at the United States Census Bureau: 1980-1994

1995 ◽  
Vol 22 (2) ◽  
pp. 128-134
Author(s):  
Frederick R. Broome ◽  
Carl S. Hantman ◽  
Robert W. Marx ◽  
Timothy F. Trainor
Keyword(s):  
United States ◽  
The United States ◽  
Census Bureau ◽  
United States Census ◽  
United States Census Bureau ◽  
Automated Mapping

Decomposing the Moral Community: Religious Contexts and Teen Childbearing

2010 ◽  
Vol 9 (3) ◽  
pp. 320-334 ◽  
Author(s):  
Seth Ovadia ◽  
Laura M. Moore
Keyword(s):  
United States ◽  
Birth Rate ◽  
The United States ◽  
Census Bureau ◽  
United States Census ◽  
United States Census Bureau ◽  
Birth Rates ◽  
Teen Birth ◽  
Teen Birth Rates ◽  
Teen Childbearing

Teen birth rates vary widely across counties in the United States. in this study, we examine whether the religious composition of a county is correlated with the rate of teen childbearing using both a traditional moral communities approach and a “decomposed” version of that framework. Utilizing 2000 data from the Centers for Disease Control and Prevention, the United States Census Bureau, and the Religious Congregation and Membership Survey, we find that the total percentage of religious adherents in a county is not significantly correlated with the teen birth rate. However, when we decompose the Christian population into major denominational groupings, we find the percentage of evangelical Protestants in a county is positively associated with the teen birth rate while the percentage of Catholics is negatively associated with teen childbearing. Possible explanations for the association between religious context and teen birth rates are discussed, as well as their policy and research implications.

scholarly journals Supply and Distribution of Vascular Access Physicians in the United States: A Cross-Sectional Study

Kidney360 ◽  
2020 ◽  
Vol 1 (8) ◽  
pp. 763-771
Author(s):  
Shoou-Yih D. Lee ◽  
Jie Xiang ◽  
Abhijit V. Kshirsagar ◽  
Diane Steffick ◽  
Rajiv Saran ◽  
...  
Keyword(s):  
United States ◽  
Vascular Access ◽  
Primary Care Physicians ◽  
The United States ◽  
Cross Sectional Study ◽  
Bivariate Analysis ◽  
Health Resource ◽  
Surgical Specialty ◽  
Cross Sectional ◽  
Hospital Referral

BackgroundBecause functioning permanent vascular access (arteriovenous fistula [AVF] or arteriovenous graft [AVG]) is crucial for optimizing patient outcomes for those on hemodialysis, the supply of physicians placing vascular access is key. We investigated whether area-level demographic and healthcare market attributes were associated with the distribution and supply of AVF/AVG access physicians in the United States.MethodsA nationwide registry of physicians placing AVFs/AVGs in 2015 was created using data from the United States Renal Data System and the American Physician Association’s Physician Masterfile. We linked the registry information to the Area Health Resource File to assess the supply of AVF/AVG access physicians and their professional attributes by hospital referral region (HRR). Bivariate analysis and Poisson regression were performed to examine the relationship between AVF/AVG access physician supply and demographic, socioeconomic, and health resource conditions of HRRs. The setting included all 50 states. The main outcome was supply of AVF/AVG access physicians, defined as the number of physicians performing AVF and/or AVG placement per 1000 prevalent patients with ESKD.ResultsThe majority of vascular access physicians were aged 45–64 (average age, 51.6), male (91%), trained in the United States (76%), and registered in a surgical specialty (74%). The supply of physicians varied substantially across HRRs. The supply was higher in HRRs with a higher percentage white population (β=0.44; SEM=0.14; P=0.002), lower unemployment rates (β=−10.74; SEM=3.41; P=0.002), and greater supply of primary care physicians (β=0.18; SEM=0.05; P=0.001) and nephrologists (β=15.89; SEM=1.22; P<0.001).ConclusionsGeographic variation was observed in the supply of vascular access physicians. Higher supply of such specialist physicians in socially and economically advantaged areas may explain disparities in vascular access and outcomes in the United States and should be the subject of further study and improvement.

scholarly journals The Sunny Side Up: An Interdisciplinary Overview of Sunlight’s Effects on our Health

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Joseph Toth
Keyword(s):  
United States ◽  
The United States ◽  
Census Bureau ◽  
Sunlight Exposure ◽  
United States Census ◽  
Average Life ◽  
United States Census Bureau ◽  
Vitamin D Levels ◽  
Confounding Variables ◽  
The Difference

Do levels of daily sunlight exposure have a measurable effect on peoples’ health? I used to live in Michiganwhere it is cloudy seemingly every day. This is drastically different from Texas, where the sun is almost alwaysshining. It is well known that an increase in sunlight exposure can drastically affect one’s mood; when looking atcloudy areas versus areas full of sunshine, the difference in overall happiness and rates of depression can bequite dramatic. Another factor to consider is that spending more time in direct sunlight can help with vitaminD synthesis. Low vitamin D levels can lead to all sorts of health problems, demonstrating that having directsun exposure has the potential to be very influential in one’s health. To investigate whether sunlight can have ameasurable impact on peoples’ health and life expectancies, I collected data on average life expectancies andreported happiness levels for all 50 U.S. States, as well as over 70 cities within the United States. These citieswere grouped together using K-means clustering to control for confounding variables, and then analyzed. Thisallowed for an accurate representation of whether sunlight really does affect one’s health or not. Data came fromthe United States Census Bureau, the CDC, and other reliable sources. This research highlights how certainclimate areas can affect our health, happiness, and overall life expectancy.

Pediatric Hand Burns Requiring Emergency Care in the United States

2021 ◽  
Author(s):  
Thomas J Sorenson ◽  
William J Mohr ◽  
Ashish Y Mahajan
Keyword(s):  
United States ◽  
Emergency Care ◽  
Census Data ◽  
The United States ◽  
Injury Incidence ◽  
United States Census ◽  
Injury Surveillance System ◽  
Cross Sectional ◽  
White Children ◽  
Epidemiological Characteristics

Abstract Purpose Hand and finger burns represent a relatively common occurrence in children, and serious injuries may require surgical intervention to prevent long-term disability. This study examines the epidemiological characteristics of pediatric patients presenting for emergency care of hand and finger burns within the United States (US). Methods We report a cross-sectional study of patients reported to the National Electronic Injury Surveillance System (NEISS) from January 1, 2010 to December 31, 2019. Patients were included in our study if they were younger than 18 years old and evaluated for an isolated hand or finger burn. United States census data from the same period were utilized for determining epidemiological estimates of injury incidence Results During the 10-year study period, an estimated 300,245 pediatric hand and finger burns were treated in 778,497,380 person-years: an incidence rate of 38.6 burns per 100,000 person years. Most treated burns occurred in the 1- to 2-year age group (28.3%) with an approximate 50% reduction in incidence for each 1-year age stratum until stabilizing at 6 years. Most burns occurred in white children (58%), but Black children had a higher incidence than white children when corrected for US population (45.15 burns versus 21.45 burns per 100,000 person-years). The most common etiology was a stove or oven (1595/10420; 15%). Conclusions Pediatric hand and finger burns occurred most frequently in young children from the oven and/or stove. We urge that parents be assertively counseled about potential burn risks to their young children’s hands and fingers, especially once they reach ambulatory age.

Disability, Life Narrative, and Representation

PMLA ◽  
2005 ◽  
Vol 120 (2) ◽  
pp. 602-606 ◽  
Author(s):  
G. Thomas Couser
Keyword(s):  
United States ◽  
Age Distribution ◽  
The United States ◽  
Census Bureau ◽  
The Body ◽  
Fundamental Aspect ◽  
United States Census ◽  
United States Census Bureau ◽  
Census 2000 ◽  
Enormous Number

Disability is an inescapable element of human existence and experience. Although it is rarely acknowledged as such, it is also a fundamental aspect of human diversity. It is so, first, in the sense that, worldwide, an enormous number of people are disabled. The proportion of disabled people in different national populations varies significantly with factors such as economic development, quality and availability of health care, and the age distribution of the population. (In the United States, people with disabilities make up the population's largest minority: Census 2000 found nearly twenty percent of the population over five years of age to be affected by some sort of disability [United States, Census Bureau].) Furthermore, because of the way this minority is constituted, it is arguably more diverse than those of race, gender, class, and sexual orientation. Disabilities may affect one's senses or one's mobility; they may be static or progressive, congenital or acquired, formal (affecting the shape of the body) or functional, visible or invisible.

Census Mapping Mashup

2014 ◽  
pp. 67-76
Author(s):  
Paul Hunt
Keyword(s):  
United States ◽  
Open Data ◽  
The United States ◽  
Census Bureau ◽  
American Population ◽  
United States Census ◽  
United States Census Bureau ◽  
Web Based ◽  
Web Mapping ◽  
Analyze Data

By mandate, the United States Census Bureau compiles and distributes data on the American population. Open data initiatives have made it possible for users to access and analyze data with simple web-based tools. A new method for requesting data from the Census Bureau is described here, along with two different mapping mashups. Using the technology described in this article, a simple web mapping interface could unlock vast amounts of available data for user exploration.

The Prevalence of Dysphagia among Adults in the United States

2014 ◽  
Vol 151 (5) ◽  
pp. 765-769 ◽  
Author(s):  
Neil Bhattacharyya
Keyword(s):  
United States ◽  
Health Care ◽  
National Health ◽  
Health Care Professionals ◽  
Demographic Data ◽  
The United States ◽  
Cross Sectional ◽  
Seek Health Care ◽  
Swallowing Problems ◽  
Care Survey

Objective To determine the prevalence of dysphagia, reported etiologies, and impact among adults in the United States. Study Design Cross-sectional analysis of a national health care survey. Subjects and Methods The 2012 National Health Interview Survey was analyzed, identifying adult cases reporting a swallowing problem in the preceding 12 months. In addition to demographic data, specific data regarding visits to health care professionals for swallowing problems, diagnoses given, and severity of the swallowing problem were analyzed. The relationship between swallowing problems and lost workdays was assessed. Results An estimated 9.44 ± 0.33 million adults (raw N = 1554; mean age, 52.1 years; 60.2% ± 1.6% female) reported a swallowing problem (4.0% ± 0.1%). Overall, 22.7% ± 1.7% saw a health care professional for their swallowing problem, and 36.9% ± 0.1.7% were given a diagnosis. Women were more likely than men to report a swallowing problem (4.7% ± 0.2% versus 3.3% ± 0.2%, P < .001). Of the patients, 31.7% and 24.8% reported their swallowing problem to be a moderate or a big/very big problem, respectively. Stroke was the most commonly reported etiology (422,000 ± 77,000; 11.2% ± 1.9%), followed by other neurologic cause (269,000 ± 57,000; 7.2% ± 1.5%) and head and neck cancer (185,000 ± 40,000; 4.9% ± 1.1%). The mean number of days affected by the swallowing problem was 139 ± 7. Respondents with a swallowing problem reported 11.6 ± 2.0 lost workdays in the past year versus 3.4 ± 0.1 lost workdays for those without a swallowing problem (contrast, +8.1 lost workdays, P < .001). Conclusion Swallowing problems affect 1 in 25 adults, annually. A relative minority seek health care for their swallowing problem, even though the subjective impact and associated workdays lost with the swallowing problem are significant.

scholarly journals Changes in the Prevalence of Chronic Hypertension in Pregnancy, United States, 1970 to 2010

Hypertension ◽  
2019 ◽  
Vol 74 (5) ◽  
pp. 1089-1095 ◽  
Author(s):  
Cande V. Ananth ◽  
Christina M. Duzyj ◽  
Stacy Yadava ◽  
Marlene Schwebel ◽  
Alan T.N. Tita ◽  
...  
Keyword(s):  
United States ◽  
Black Women ◽  
Birth Cohort ◽  
Rate Ratio ◽  
White Women ◽  
Cohort Analysis ◽  
The United States ◽  
Population Based ◽  
Chronic Hypertension ◽  
Cross Sectional

We estimated changes in the prevalence of chronic hypertension among pregnant women and evaluated the extent to which changes in obesity and smoking were associated with these trends. We designed a population-based cross-sectional analysis of over 151 million women with delivery-related hospitalizations in the United States, 1970 to 2010. Maternal age, year of delivery (period), and maternal year of birth (birth cohort), as well as race, were examined as risk factors for chronic hypertension. Prevalence rates and rate ratios with 95% CIs of chronic hypertension in relation to age, period, and birth cohort were derived through age-period-cohort models. We also examined how changes in obesity and smoking rates influenced age-period-cohort effects. The overall prevalence of chronic hypertension was 0.63%, with black women (1.24%) having more than a 2-fold higher rate than white women (0.53%; rate ratio, 2.31; 95% CI, 2.30–2.32). In the age-period-cohort analysis, the rate of chronic hypertension increased sharply with advancing age and period from 0.11% in 1970 to 1.52% in 2010 (rate ratio, 13.41; 95% CI, 13.22–13.61). The rate of hypertension increased, on average, by 6% (95% CI, 5–6) per year, with the increase being slightly higher among white (7%; 95% CI, 6%–7%) than black (4%; 95% CI, 3%–4%) women. Adjustments for changes in rates of obesity and smoking were not associated with age and period effects. We observed a substantial increase in chronic hypertension rates by age and period and an over 2-fold race disparity in chronic hypertension rates.

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