Legalization of Medical Cannabis and Site of Death: Evidence From National Vital Statistics Mortality Data

2021 ◽  
pp. 073346482110587
Author(s):  
Divya Bhagianadh ◽  
Kanika Arora
Keyword(s):  
State Level ◽  
Positive Association ◽  
Vital Statistics ◽  
Mortality Data ◽  
Medical Cannabis ◽  
Difference In Differences ◽  
Early Adopters ◽  
Level Data ◽  
Hospital Deaths ◽  
Poor Outcomes

We examined whether Medical Marijuana Legislation (MML) was associated with site of death. Using state-level data (1992–2018) from the National Vital Statistics System (NVSS), we employed difference-in-differences method to compare changes in death rate among older adults at four sites—nursing home (NH), hospital, home, hospice/other—over time in states with and without MML. Heterogeneity analyses were conducted by timing of MML adoption, and by decedent characteristics. Results show a negative association between MML implementation and NH deaths. Among early adopters (states with weakly regulated programs) and decedents with musculoskeletal disorders, there was a positive association between MML implementation and hospital deaths, whereas among late adopters (states with “medicalized” programs), there was a positive association between MML implementation and hospice deaths. Decline in NH deaths may reflect increased likelihood of transfers due to threat of Federal enforcement, penalties for poor outcomes, and liability concerns. Future studies should examine these associations further.

Growth, Inequality, Poverty, and Urbanization: the Case of India

2019 ◽  
pp. 674-734
Author(s):  
Arup Mitra
Keyword(s):  
Urban Areas ◽  
Rural Poverty ◽  
Participation Rate ◽  
State Level ◽  
Positive Association ◽  
Strongly Correlated ◽  
Urban Inequality ◽  
Level Data ◽  
Degree Of Association ◽  
The Relationship

In this chapter the analysis is pursued at three levels of disaggregation: states, districts, and cities with populations over one million. At the state level, urbanization does not show any significant impact on rural poverty, though it tends to reduce poverty in urban areas. Growth influences urbanization positively, while urbanization and expansion in non-agricultural activities both contribute to economic growth. Although urban inequality is not strongly correlated with urbanization and growth, the relationship is distinct. While poverty tends to decline, inequality rises in the process of growth and urbanization. The district-level data confirm a positive association between urbanization, work participation rate, percentage of workforce engaged in non-household manufacturing and services, literacy, growth, and inequality, though the degree of association is mild. Urbanization shows a strong beneficial effect on poverty at both the district and city levels.

scholarly journals Do changes in divorce legislation have an impact on divorce rates? The case of unilateral divorce in Mexico

2019 ◽  
Vol 28 (1) ◽  
Author(s):  
Edith Aguirre
Keyword(s):  
Mexico City ◽  
Latin American ◽  
State Level ◽  
Medium Term ◽  
Difference In Differences ◽  
Family Structures ◽  
The Past ◽  
Level Data ◽  
Divorce Rates ◽  
Unilateral Divorce

Abstract In 2008, Mexico City was the first entity to approve unilateral divorce in Mexico. Since then, 17 states out of 31 have also moved to eliminate fault-based divorce. In this paper, I investigate the effect of the changes in unilateral legislation on divorce rates in Mexico, given the remarkable growth of divorce rates over the past few decades in the country, but especially after the introduction of unilateral divorce. Following a difference-in-differences methodology, two models are developed using panel state-level data. The results indicate that divorce on no grounds accounts for a 26.4% increase in the total number of divorces in the adopting states during the period 2009–2015. Moreover, since no-fault divorce has been implemented gradually in the country, the rising trend in divorce rates is expected to continue over the coming years. Unilateral legislation has proved to be an effective tool in modifying family structures in Mexico, so it is important to be aware of the short- and medium-term consequences of the shift toward divorce on no grounds, in order to improve the delivery of these policies in the country. This is especially important at this point in time, when 14 remaining states may potentially adopt unilateral legislation. This paper is the first one to address the effect of adopting unilateral divorce in the context of a Latin American country.

Association of state-level intoxicated driving laws with firearm homicide and suicide

2021 ◽  
pp. injuryprev-2020-044052
Author(s):  
Robert A Tessler ◽  
Miriam Joan Haviland ◽  
Andrew Bowen ◽  
Deidre Bowen ◽  
Frederick P Rivara ◽  
...  
Keyword(s):  
State Level ◽  
Legal Framework ◽  
Cross Sectional Study ◽  
Vital Statistics ◽  
Driving Under The Influence ◽  
Mortality Data ◽  
Federal Law ◽  
Cross Sectional ◽  
Thomson Reuters ◽  
Control And Prevention

ObjectivesTo determine if an association exists between the number of driving under the influence (DUI) convictions required to activate federal firearms prohibitions and annual firearm homicide and suicide rates by state.MethodsEcological cross-sectional study of all US states from 2013 to 2017. We collected DUI law data from Thomson Reuters Westlaw database and firearm mortality data from the Centers for Disease Control and Prevention Vital Statistics programme.ResultsFive states had laws such that one or two DUI convictions could result in prohibitions to firearms access according to federal law. Four states had no legal framework that would restrict firearms access because of DUI convictions; the remaining states could activate federal restrictions at three or more DUI convictions. Firearm-specific homicide (victimisations) rates were 19% lower among women in states where federal restrictions of firearms access occurred after one or two DUI offences (incidence rate ratio (IRR) 0.81; 95% CI 0.64 to 1.01) and 18% lower in states with firearm prohibitions after three or more offences (IRR 0.82; 95% CI 0.71 to 0.95) compared with the states with no legal framework for prohibiting firearms after DUI convictions. There was no association between number of DUI activations and overall, or firearm-specific, suicide among the entire population (men and women) or among only women, or only men.ConclusionsDUI penalties that activate federal firearms prohibitions may be one pathway to reduce firearm homicide of female victims.

Engagement Through the Diaspora Channel

2017 ◽  
Author(s):  
Michael S. Danielson
Keyword(s):  
Civil Society ◽  
Statistical Models ◽  
State Level ◽  
The State ◽  
Multivariate Statistical ◽  
Political Factors ◽  
Data Set ◽  
Level Data ◽  
Municipal Level

The first empirical task is to identify the characteristics of municipalities which US-based migrants have come together to support financially. Using a nationwide, municipal-level data set compiled by the author, the chapter estimates several multivariate statistical models to compare municipalities that did not benefit from the 3x1 Program for Migrants with those that did, and seeks to explain variation in the number and value of 3x1 projects. The analysis shows that migrants are more likely to contribute where migrant civil society has become more deeply institutionalized at the state level and in places with longer histories as migrant-sending places. Furthermore, the results suggest that political factors are at play, as projects have disproportionately benefited states and municipalities where the PAN had a stronger presence, with fewer occurring elsewhere.

scholarly journals Who Really Benefits from Consumption Tax Cuts? Evidence from a Large VAT Reform in France

2019 ◽  
Vol 11 (1) ◽  
pp. 38-63 ◽  
Author(s):  
Youssef Benzarti ◽  
Dorian Carloni
Keyword(s):  
Value Added ◽  
Consumption Tax ◽  
Difference In Differences ◽  
Firm Level ◽  
Employment Effects ◽  
Level Data ◽  
Price Effects ◽  
Firm Level Data ◽  
Material Goods ◽  
Firm Owners

This paper evaluates the incidence of a large cut in value-added taxes (VATs) for French sit-down restaurants in 2009. In contrast to previous studies, which only focus on the price effects of VAT reforms, we estimate the effects of the VAT cut on four groups: workers, firm owners, consumers, and suppliers of material goods. Using a difference-in-differences strategy on firm-level data, we find that: firm owners pocketed more than 55 percent of the VAT cut; consumers, sellers of material goods, and employees shared the remaining windfall with consumers benefiting the least; and the employment effects were limited. (JEL H22, H25, L83)

scholarly journals Validity of an algorithm to identify cardiovascular deaths from administrative health records: a multi-database population-based cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lisa M. Lix ◽  
Shamsia Sobhan ◽  
Audray St-Jean ◽  
Jean-Marc Daigle ◽  
Anat Fisher ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cardiovascular Mortality ◽  
Population Based ◽  
Vital Statistics ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Health Records ◽  
Predictive Values ◽  
Site Specific ◽  
Hospital Deaths

Abstract Background Cardiovascular death is a common outcome in population-based studies about new healthcare interventions or treatments, such as new prescription medications. Vital statistics registration systems are often the preferred source of information about cause-specific mortality because they capture verified information about the deceased, but they may not always be accessible for linkage with other sources of population-based data. We assessed the validity of an algorithm applied to administrative health records for identifying cardiovascular deaths in population-based data. Methods Administrative health records were from an existing multi-database cohort study about sodium-glucose cotransporter-2 (SGLT2) inhibitors, a new class of antidiabetic medications. Data were from 2013 to 2018 for five Canadian provinces (Alberta, British Columbia, Manitoba, Ontario, Quebec) and the United Kingdom (UK) Clinical Practice Research Datalink (CPRD). The cardiovascular mortality algorithm was based on in-hospital cardiovascular deaths identified from diagnosis codes and select out-of-hospital deaths. Sensitivity, specificity, and positive and negative predictive values (PPV, NPV) were calculated for the cardiovascular mortality algorithm using vital statistics registrations as the reference standard. Overall and stratified estimates and 95% confidence intervals (CIs) were computed; the latter were produced by site, location of death, sex, and age. Results The cohort included 20,607 individuals (58.3% male; 77.2% ≥70 years). When compared to vital statistics registrations, the cardiovascular mortality algorithm had overall sensitivity of 64.8% (95% CI 63.6, 66.0); site-specific estimates ranged from 54.8 to 87.3%. Overall specificity was 74.9% (95% CI 74.1, 75.6) and overall PPV was 54.5% (95% CI 53.7, 55.3), while site-specific PPV ranged from 33.9 to 72.8%. The cardiovascular mortality algorithm had sensitivity of 57.1% (95% CI 55.4, 58.8) for in-hospital deaths and 72.3% (95% CI 70.8, 73.9) for out-of-hospital deaths; specificity was 88.8% (95% CI 88.1, 89.5) for in-hospital deaths and 58.5% (95% CI 57.3, 59.7) for out-of-hospital deaths. Conclusions A cardiovascular mortality algorithm applied to administrative health records had moderate validity when compared to vital statistics data. Substantial variation existed across study sites representing different geographic locations and two healthcare systems. These variations may reflect different diagnostic coding practices and healthcare utilization patterns.

scholarly journals The Socioeconomic Profile of Well-Funded Public Libraries: A Regression Analysis

2018 ◽  
Vol 13 (2) ◽  
pp. 13-26
Author(s):  
Michael Carlozzi
Keyword(s):  
Socioeconomic Factors ◽  
Public Libraries ◽  
Public Library ◽  
State Level ◽  
Linear Regression Models ◽  
Library Funding ◽  
Level Data ◽  
Socioeconomic Profile ◽  
Socioeconomic Data ◽  
To Receive

Abstract Objective – This study aimed to explore the well-established link between public library funding and activity, specifically to what extent socioeconomic factors could explain the correlation. Methods – State-level data from the Massachusetts Board of Library Commissioners were analyzed for 280 public libraries using two linear regression models. These public libraries were matched with socioeconomic data for their communities. Results – Confirming prior research, a library’s municipal funding correlated strongly with its direct circulation. In terms of library outputs, the municipal funding appeared to represent a library’s staffing and number of annual visitations. For socioeconomic factors, the strongest predictor of a library’s municipal appropriation was its “number of educated residents.” Other socioeconomic factors were far less important. Conclusion – Although education correlated strongly with library activity, variation within the data suggests that public libraries are idiosyncratic and that their funding is not dictated exclusively by the community’s socioeconomic profile. Library administrators and advocates can examine what libraries of similar socioeconomic profiles do to receive additional municipal funding.

scholarly journals Quality assessment of linked Canadian clinical administrative hospital and vital statistics death data

2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Nancy Rodrigues ◽  
Maureen Kelly ◽  
Tobi Henderson
Keyword(s):  
Assessment Tool ◽  
Vital Statistics ◽  
Data Availability ◽  
Supplementary Information ◽  
Five Dimensions ◽  
Tracking Process ◽  
Data Assessment ◽  
Hospital Deaths ◽  
And Performance ◽  
Discharge From Hospital

IntroductionThree Canadian clinical-administrative hospital databases were linked to the Canadian Vital Statistics Death Database (CVSD) to provide information about patients who died following discharge from hospital as well as supplementary information about patients that died in-hospital. Quality was assessed using a guided approach and through feedback from initial users. Objectives and ApproachThe linked datasets were created to develop and validate health care indicators and performance measures and perform outcome analyses. It is therefore imperative to evaluate the data’s fitness for use. Quality was assessed by calculating coverage of deaths for all linked contributors, creating a profile of the linked dataset and analyzing issues that were identified by users. These analyses were guided by an existing Data Source Assessment Tool, which provides a set of criteria that allow for assessment across five dimensions of quality, thus allowing for appropriate determination of a given set of data’s fitness for use. ResultsDeterministic linkage of the datasets resulted in linkage rates that ranged from 66.9% to 90.9% depending on the dataset or data year. Linkage rates also varied by Canadian jurisdictions and patient cohort. Variables had good data availability with rates of 95% or higher. Initial users identified a significant number of duplicate records that were flagged to and corrected by the data supplier. 1.4\% of acute hospital deaths had discrepancies in the death date captured in the two linked sources; the vast majority had a difference of only one day. A user group and issue tracking process were created to share information about the linked data and guarantee that issues are triaged to the appropriate party and allow for timely follow up with the data supplier. Conclusion/ImplicationsDocumentation provided by the data supplier was vital to understanding the linkage methodology and its impact on linkage rates. A guided data assessment ensured that strengths and limitations were identified and shared to support appropriate use. Feedback to the data supplier is supporting ongoing improvements to the linkage methodology.

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