Ethnicity Significantly Influences Incidence Patterns and Predicts Mortality: Adult Hodgkin Lymphoma (HL) In the United States (US)

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2683-2683
Author(s):  
Andrew M Evens ◽  
Eileen Shiuan ◽  
Soyang Kwon ◽  
Leo I Gordon ◽  
Brian Chiu
Keyword(s):  
Mortality Rate ◽  
Conflicts Of Interest ◽  
The United States ◽  
Annual Percent Change ◽  
Black Females ◽  
The Past ◽  
Seer Data ◽  
Black Populations ◽  
And Gender ◽  
The Impact

Abstract Abstract 2683 Background: Pediatric HL studies have suggested survival differences based on ethnicity. However, little data is available regarding the impact, if any, of ethnicity on incidence patterns, disease histology, and/or survival among adult HL. Methods: We examined data for 13 US SEER areas, several of which contain large Hispanic and Black populations. Case information was obtained from the 11/2009 SEER data submission released April 2010. We analyzed incidence, HL histology, and mortality rates according to ethnicity, age, and gender. We also examined incidence patterns across the past four decades. All analyses used SEER*Stat. Results: A total of 16,783 HL cases were diagnosed among residents in the 13 SEER registry areas during 1992–2007, with non-Hispanic Whites contributing the largest number (n=11,890), followed by Hispanics (n=2,190), and Blacks (n=1,724). Consistent with SEER 9 results (1973 data), Whites show a continued bimodal age-incidence curve (6.0/100,000 ages 25–29, 2.5/100,000 ages 50–54, and 4.5/100,000 age 75–79). However, Blacks have a much less apparent bimodal pattern (4.5/100,000 ages 25–29, 2.6/100,000 ages 50–54, and 3.0/100,000 ages 75–79), while Hispanics are distinctly not bimodal with a small increase at 20–24 (2.4/100,000) followed by an exponential-like increase with peak HL incidence at ages 80–84 (7.0/100,000). Moreover, among persons >65 years, HL is currently significantly more common in Hispanics than Whites (4.7-7.0/100,000 vs 3.9–4.5/100,000, respectively, p<0.05). With gender, HL is more common in males than females, regardless of ethnicity. Interestingly, the male excess, however, does not occur until ages 30–34 (all ethnicities). Furthermore, from 1975–2007, HL incidence increased in Black females (annual percent change (APC) = 2.5; p<0.05) and White females (APC = 0.4; p<0.05). According to histology, both nodular sclerosis and mixed cellularity are more common in Whites followed by Blacks and Hispanics, while in persons age 60–84, both histologies are significantly more common in Hispanics compared with Whites and Blacks. Over the past 20 years, mortality has declined within each race by 10.3%–13.7% (p<0.05). However, age-specific ethnic survival disparities are apparent (Figure 1). For ages 65–84, Hispanics have a significantly increased mortality rate compared with Whites/Blacks (p<0.05). Conversely, among ages 20–44, Hispanics have a lower mortality rate versus Whites and Blacks. Conclusions: Multiple important epidemiologic and mortality differences are evident across and within ethnicities in adult HL. *Both sexes (1992-2007). Rates are per 100,000. Mortality source: US Mortality Files, National Center for Health Statistics, CDC. Accessed August 12th, 2010. Disclosures: No relevant conflicts of interest to declare.

The Fifty-Year Decline of Cancer in America

2001 ◽  
Vol 19 (1) ◽  
pp. 239-241 ◽  
Author(s):  
Brad Rodu ◽  
Philip Cole
Keyword(s):  
United States ◽  
Lung Cancer ◽  
Mortality Rate ◽  
Cancer Mortality ◽  
The United States ◽  
Mortality Rates ◽  
Health Statistics ◽  
The Past ◽  
The Impact

PURPOSE: From 1950 to 1990, the overall cancer mortality rate increased steadily in the United States, a trend which ran counter to declining mortality from other major diseases. The purpose of this study was to assess the impact of lung cancer on all-cancer mortality over the past 50 years. METHODS: Data from the National Centers for Health Statistics were used to develop mortality rates for all forms of cancer combined, lung cancer, and other-cancer (all-cancer minus lung cancer) from 1950 to 1998. RESULTS: When lung cancer is excluded, mortality from all other forms of cancer combined declined continuously from 1950 to 1998, dropping 25% during this period. The decline in other-cancer mortality was approximately 0.4% annually from 1950 to 1990 but accelerated to 0.9% per year from 1990 to 1996 and to 2.2% per year from 1996 to 1998. CONCLUSION: The long-term decline is likely due primarily to improvements in medical care, including screening, diagnosis, and treatment.

scholarly journals Spousal Loss and Cognitive Functioning: Do Pre-Loss Marital Quality and Gender Matter?

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 366-366
Author(s):  
Joohong Min ◽  
Jieun Song
Keyword(s):  
Cognitive Decline ◽  
Cognitive Functioning ◽  
Marital Quality ◽  
The United States ◽  
Cognitive Change ◽  
Life Transitions ◽  
Cognitive Changes ◽  
Spousal Loss ◽  
And Gender ◽  
The Impact

Abstract Prior research has found that the risk of cognitive decline increases after the death of a spouse. In general, the impact of life transitions is contingent on contextual factors such as socio-demographic characteristics or relationship quality. However, there is limited research on how marital quality before spousal loss and gender influence the association between spousal loss and cognitive change. The current study examines the effects of spousal loss on change in cognitive functioning as well as the moderating effects of pre-loss marital quality and gender. Data from two waves of the Midlife in the United States (MIDUS) study were analyzed (MIDUS2: 2004-05, MIDUS3: 2013-14). The analytic sample consists of two groups: (1) 179 bereaved adults who were age 54 or older at MIDUS2 (M = 65.2, SD = 9.5) and whose spouses died between MIDUS2 and MIDUS3, and (2) 179 non-bereaved adults, matched with the bereaved group on age and gender, who did not experience spousal loss between the two waves. Cognitive function was assessed via BTACT (Brief Telephone Adult Cognition Test) at both waves. Regression results show that both pre-loss marital quality and gender significantly moderate the association between spousal loss and change in cognitive functioning. Specifically, relative to their counterparts, men and those who reported better marital relationships prior to spousal death had a greater risk of cognitive decline after a spouse’s death. The findings suggest the significance of pre-loss marital quality and gender for cognitive changes in widowhood and have implications for the development of efficient interventions

scholarly journals Trends in Esophageal Cancer Mortality and Stage at Diagnosis by Race and Ethnicity in the United States

2021 ◽  
Author(s):  
Edgar Corona ◽  
Liu Yang ◽  
Eric Esrailian ◽  
Kevin A. Ghassemi ◽  
Jeffrey L. Conklin ◽  
...  
Keyword(s):  
United States ◽  
Esophageal Cancer ◽  
Race And Ethnicity ◽  
The United States ◽  
Disease Stage ◽  
Stage Migration ◽  
Stage At Diagnosis ◽  
Annual Percent Change ◽  
Seer Data ◽  
Race Ethnicity

Abstract Introduction Esophageal cancer (EC) is an aggressive malignancy with poor prognosis. Mortality and disease stage at diagnosis are important indicators of improvements in cancer prevention and control. We examined United States trends in esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC) mortality and stage at diagnosis by race and ethnicity. Methods We used Surveillance, Epidemiology, and End Results (SEER) data to identify individuals with histologically confirmed EAC and ESCC between 1 January 1992 and 31 December 2016. For both EAC and ESCC, we calculated age-adjusted mortality and the proportion presenting at each stage by race/ethnicity, sex, and year. We then calculated the annual percent change (APC) in each indicator by race/ethnicity and examined changes over time. Results The study included 19,257 EAC cases and 15,162 ESCC cases. EAC mortality increased significantly overall and in non-Hispanic Whites from 1993 to 2012 and from 1993 to 2010, respectively. EAC mortality continued to rise among non-Hispanic Blacks (NHB) (APC = 1.60, p = 0.01). NHB experienced the fastest decline in ESCC mortality (APC = − 4.53, p < 0.001) yet maintained the highest mortality at the end of the study period. Proportions of late stage disease increased overall by 18.5 and 24.5 percentage points for EAC and ESCC respectively; trends varied by race/ethnicity. Conclusion We found notable differences in trends in EAC and ESCC mortality and stage at diagnosis by race/ethnicity. Stage migration resulting from improvements in diagnosis and treatment may partially explain recent trends in disease stage at diagnosis. Future efforts should identify factors driving current esophageal cancer disparities.

Abstract 257: Urban Teaching and Non-Teaching Hospitals Outcomes: Myocardial Infarction

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Priscilla O Okunji ◽  
Johnnie Daniel
Keyword(s):  
Myocardial Infarction ◽  
Mortality Rate ◽  
Income Group ◽  
The United States ◽  
Teaching Hospitals ◽  
Age Difference ◽  
Age Group ◽  
Urban Teaching ◽  
Significant Difference ◽  
The Impact

Background: Patients with myocardial infarction reportedly have different outcomes on discharge according to hospital characteristics. In the present study, we evaluated the differences between urban teaching hospitals (UTH) and non-teaching hospitals (NTH), discharged in 2012. We also investigated on the outcomes. Methods: Sample of 117,808 subjects diagnosed with myocardial infarction were extracted from a nationwide inpatient stay dataset using the International Classification Data, ICD 9 code 41000 in the United States, according to hospital location, size, and teaching status. Results: The analysis of the data showed that more whites were admitted to both teaching and non teaching hospitals with more males (~24%) admitted than their female counterparts. However, blacks were admitted more (~15%) in urban teaching hospitals than medium urban non teaching hospitals. Age difference was noted as well, while age group (60-79 years) were admitted more in UTH, inversely urban non-teaching hospitals admitted more older (80 years or older) age group. A significant difference (~28%) was observed in both hospital categories with UTH admitting more patients of $1.00 - $38,999.00 income group than other income categories. In addition, it was observed that patients with MI stayed more (~5%) for 14 or more days, and charged more especially for income group of $80,000 or above in UTH than NTH. No significant difference was found in the mortality rate for both hospital categories. Conclusion: The overall outcomes showed that the mortality rate between urban teaching and non-teaching hospitals were non significant, though the inpatients MI stayed longer and were charged more in UTH than NTH. The authors call for the study to be replicated with a higher level of statistical measures to ascertain the impact of the variables on the outcomes for a more validated result.

scholarly journals Contingency Plan: Comparison of Health Policies in Managing COVID-19 in Singapore and Indonesia

2021 ◽  
Vol 4 (1) ◽  
pp. 28-34
Author(s):  
Khalish Arsy Al Khairy Siregar ◽  
Deasy Nur Chairin Hanifa
Keyword(s):  
Health Policy ◽  
Mortality Rate ◽  
Good Health ◽  
Disaster Mitigation ◽  
Health Policies ◽  
Economic Activities ◽  
The Past ◽  
System 2 ◽  
The Government ◽  
The Impact

 Introduction: Singapore is one of the countries with the lowest mortality rate and the best handling of COVID-19. Singapore can be an example for Indonesia on COVID 19 pandemic handling.Methods: The method used is a literature review from google platform with these keywords: “Singapore Health Policy in COVID-19, Indonesian Health Policy in COVID-19, Singapore's success in suppressing COVID-19”. The analysis was done by comparing the policies taken from the two countries in dealing with COVID-19.Results: Singapore and Indonesia did indeed have very big differences in terms of government and in broad areas, it cannot be denied that Indonesia can have the same opportunity as Singapore in providing a good health disaster mitigation system for the community. Three factors influence Singapore's success in dealing with COVID-19: 1) having a responsive and efficient health disaster mitigation system, 2) government legitimacy which is determined by the capacity of the state. Singapore has a semi-centralized government with high legitimacy the experience of dealing with pandemics in the past, 3) Singapore's experience with SARS in the past makes Singaporeans understand very well the impact of the pandemic on their economic activities and social life.Conclusion: Several things can be emulated from Singapore in handling COVID-19 was the transparency, strong communication between community and the government, prioritizing the benefit and safety of civil society and building obedience and awareness of Covid 19 prevention.

scholarly journals Monetary Policy and Inequality

2020 ◽  
Vol 12 (4) ◽  
pp. 006-017
Author(s):  
Alexander A. Rakviashvili ◽  
Keyword(s):  
Monetary Policy ◽  
Wealth Inequality ◽  
The United States ◽  
Central Banks ◽  
Distribution Of Wealth ◽  
The Past ◽  
High Propensity ◽  
Debt Market ◽  
The Impact ◽  
American Economy

The article provides a literature review of studies of the impact of monetary policy on income and wealth inequality. Based on the analysis and systematization of the articles mainly written over the past 25–30 years as well as articles written by central bank authorities, the main approaches to assessing the extent to which the Fed's actions are responsible for the growth of wealth inequality in the United States, which began in the 1970s, are identified. It was revealed that the relative unanimity of economists on this issue was replaced by significant pluralism of opinions after the crisis of 2007–2009. Among other reasons this was caused by the activity of central banks and their use of non-conventional approaches in conducting the monetary policy. In addition, the channels through which the actions of central banks affect the distribution of wealth in the economy are identified. In total, five such channels were singled out. Thus, changes in the monetary policy affect the debt market and the structure of assets and liabilities of households, while households with fixed incomes and with a high propensity to use cash are more likely to suffer losses during the expansionary monetary policy. And the fifth channel, which is less popular among the economists, the "Cantillon effect", leads to an increase in the wealth of the first recipients of the issued money at the expense of those who are farthest from the center of emission. The article provides empirical evidence of why this effect is significant for the American economy, and theoretical arguments indicating that taking the Cantillon effect into account can add certainty to studies of both monetary policy costs and institutional changes caused by rising inequality.

scholarly journals The Impact of Past Pandemics on Economic and Gender Inequalities

2021 ◽  
Author(s):  
Michal Brzezinski
Keyword(s):  
Gender Inequality ◽  
Wealth Inequality ◽  
The Other ◽  
Swine Flu ◽  
Gender Inequalities ◽  
The Past ◽  
Cross Country ◽  
Negative Impacts ◽  
And Gender ◽  
The Impact

This paper estimates how previous major pandemic events affected economic and gender inequalities in the short- to medium run. We consider the impact of six major pandemic episodes – H3N2 Flu (1968), SARS (2003), H1N1 Swine Flu (2009), MERS (2012), Ebola (2014), and Zika (2016) – on cross-country inequalities in a sample of up to 180 countries observed over 1950-2019. Results show that the past pandemics have moderately increased income inequality in the affected countries in the period of four to five years after the pandemic’s start. On the other hand, we do not find any robust negative impacts on wealth inequality. The results concerning gender inequality are less consistent, but we find some evidence of declining gender equality among the hardest hit countries, as well as of growing gender gaps in unemployment within the four years after the onset of the pandemic.

Geographic Disparity in the United States Heart Allocation System

2019 ◽  
pp. 65-87
Author(s):  
Fatemeh Karami ◽  
Mehdi Nayebpour ◽  
Monica Gentili ◽  
Naoru Koizumi ◽  
Andrew Rivard
Keyword(s):  
United States ◽  
Mortality Rate ◽  
Waiting Time ◽  
Average Distance ◽  
The United States ◽  
Allocation Model ◽  
Geographic Disparity ◽  
Transplant Candidates ◽  
Geographic Equity ◽  
The Impact

Organ allocation for transplantation across the United States is administered by the United Network for Organ Sharing (UNOS). UNOS recently approved a major policy change of the system used to allocate hearts for adult transplant candidates. The main objective of this study is to investigate the impact of the new policy on geographic disparity measured by four performance indicators (waiting time before a transplant, transplant rate, pre-transplant mortality rate, and average distance traveled by donated hearts). The current policy and the new policy were evaluated using the thoracic simulation allocation model. The results show that the new policy improves the median waiting time, transplant rate, and pre-transplant mortality rate. The overall predicted improvement in geographic equity is modest except in terms of waiting time. The findings highlight the need for a targeted approach for donor heart allocation to achieve equal access to heart transplantation in the US.

scholarly journals Patterns of Change in ACGME-Accredited Residency Programs and Positions: Implication for the Adequacy of GME Positions and Supply of Physicians in the United States

2014 ◽  
Vol 6 (2) ◽  
pp. 399-403 ◽  
Author(s):  
Kathleen D. Holt ◽  
Rebecca S. Miller ◽  
Ingrid Philibert ◽  
Thomas J. Nasca
Keyword(s):  
Medical Education ◽  
Medical School ◽  
Graduate Medical Education ◽  
Primary Care Physicians ◽  
Population Data ◽  
The United States ◽  
Graduate Medical ◽  
The Past ◽  
Accredited Institutions ◽  
The Impact

Abstract Background Recent studies suggest that the supply of primary care physicians and generalist physicians in other specialties may be inadequate to meet the needs of the US population. Data on the numbers and types of physicians-in-training, such as those collected by the Accreditation Council for Graduate Medical Education (ACGME), can be used to help understand variables affecting this supply. Objective We assessed trends in the number and type of medical school graduates entering accredited residencies, and the impact those trends could have on the future physician workforce. Methods Since 2004, the ACGME has published annually its data on accredited institutions, programs, and residents to help the graduate medical education community understand major trends in residency education, and to help guide graduate medical education policy. We present key results and trends for the period between academic years 2003–2004 and 2012–2013. Results The data show that increases in trainees in accredited programs are not uniform across specialties, or the types of medical school from which trainees graduated. In the past 10 years, the growth in residents entering training that culminates in initial board certification (“pipeline” specialties) was 13.0%, the number of trainees entering subspecialty education increased 39.9%. In the past 5 years, there has been a 25.8% increase in the number of osteopathic physicians entering allopathic programs. Conclusions These trends portend challenges in absorbing the increasing numbers of allopathic and osteopathic graduates, and US international graduates in accredited programs. The increasing trend in subspecialization appears at odds with the current understanding of the need for generalist physicians.

scholarly journals Social Vulnerability, Gender and Disasters. The Case of Haiti in 2010

2020 ◽  
Vol 12 (9) ◽  
pp. 3574 ◽  
Author(s):  
Mar Llorente-Marrón ◽  
Montserrat Díaz-Fernández ◽  
Paz Méndez-Rodríguez ◽  
Rosario González Arias
Keyword(s):  
Natural Disasters ◽  
International Development ◽  
Social Vulnerability ◽  
Negative Impact ◽  
Research Work ◽  
The United States ◽  
Negative Effects ◽  
Unequal Distribution ◽  
And Gender ◽  
The Impact

The study of vulnerability constitutes a central axis in research work on sustainability. Social vulnerability (SV) analyzes differences in human capacity to prepare, respond and recover from the impact of a natural hazard. Although disasters threaten all the people who suffer from them, they do not affect all members of society in the same way. Social and economic inequalities make certain groups more vulnerable. Factors such as age, sex, social class and ethnic identity increase vulnerability to a natural disaster. Ten years after the earthquake in Haiti in 2010, this work deepens the relationship between natural disasters, SV and gender, exploring the unequal distribution of the SV in the face of a seismic risk. The source of statistical information has been obtained from the Demographic and Health Survey (DHS), developed by the United States Agency for International Development (USAID). Multicriteria decision techniques (TOPSIS) and the differences in differences (DID) technique are used to analyze variations in gender inequality in SV as a result of the catastrophic event. The results obtained reinforce the idea of the negative impact of the disaster on the SV. Additionally, an intensification of the negative effects is observed when the household is headed by a woman, increasing the gap in SV between households headed by women and the rest of the households. The conclusions obtained show additional evidence of the negative effects caused by natural disasters on women, and important implications for disaster risk management are derived that should not be ignored.

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