Decline in Mortality Among Young Americans During the 20th Century: Prospects for Reaching National Mortality Reduction Goals for 1990

PEDIATRICS ◽  
1988 ◽  
Vol 82 (4) ◽  
pp. 582-595
Author(s):  
Robert A. Hoekelman ◽  
I. Barry Pless
Keyword(s):  
Health Care ◽  
Death Rate ◽  
Access To Health Care ◽  
Medical Science ◽  
The United States ◽  
Renal Diseases ◽  
Mortality Data ◽  
Mortality Reduction ◽  
Death Rates ◽  
National Mortality

A review of mortality data for persons younger than 25 years of age in the United States reveals striking declines in death rates since the turn of the century. Mortality among infants during their first year of life decreased from 1 in 6 in 1900 to 1 in 100 in 1986. Between 1900 and 1984 the annual death rate for children 1 through 4 years of age decreased from 1 in 50 to 1 in 2,000, for children 5 through 14 years of age, from 1 in 250 to 1 in 4,000, and for persons 15 through 24 years of age, from 1 in 165 to 1 in 1,000. Public health measures, advances in medical science, legislative initiatives, and the organization and delivery of health care have all contributed to these improvements in varying degrees during different decades. For the decade 1975 through 1984, the overall death rate decreased by 20%, with declines for all causes except suicide, cardiovascular diseases, and renal diseases. All of the surgeon general's mortality reduction goals for 1990 for America's youth should be reached except those for infant mortality and suicide. Improvement in these death rates will require better access to health care by those in need and reductions in environmental stress.

scholarly journals Not One Pandemic: A Multilevel Mixture Model Investigation of the Relationship Between Poverty and the Course of the COVID-19 Pandemic Death Rate in the United States

2021 ◽  
Vol 6 ◽  
Author(s):  
Holmes Finch ◽  
Maria E. Hernández Finch ◽  
Katherine Mytych
Keyword(s):  
United States ◽  
Mixture Model ◽  
Ethnic Diversity ◽  
Death Rate ◽  
Access To Health Care ◽  
Health Care Services ◽  
The United States ◽  
Rapid Decline ◽  
Death Rates ◽  
Random Intercept

The COVID-19 pandemic, which began in China in late 2019, and subsequently spread across the world during the first several months of 2020, has had a dramatic impact on all facets of life. At the same time, it has not manifested in the same way in every nation. Some countries experienced a large initial spike in cases and deaths, followed by a rapid decline, whereas others had relatively low rates of both outcomes throughout the first half of 2020. The United States experienced a unique pattern of the virus, with a large initial spike, followed by a moderate decline in cases, followed by second and then third spikes. In addition, research has shown that in the United States the severity of the pandemic has been associated with poverty and access to health care services. This study was designed to examine whether the course of the pandemic has been uniform across America, and if not how it differed, particularly with respect to poverty. Results of a random intercept multilevel mixture model revealed that the pandemic followed four distinct paths in the country. The least ethnically diverse (85.1% white population) and most rural (82.8% rural residents) counties had the lowest death rates (0.06/1000) and the weakest link between deaths due to COVID-19 and poverty (b = 0.03). In contrast, counties with the highest proportion of urban residents (100%), greatest ethnic diversity (48.2% nonwhite), and highest population density (751.4 people per square mile) had the highest COVID-19 death rates (0.33/1000), and strongest relationship between the COVID-19 death rate and poverty (b = 46.21). Given these findings, American policy makers need to consider developing responses to future pandemics that account for local characteristics. These responses must take special account of pandemic responses among people of color, who suffered the highest death rates in the nation.

Population-level analysis of antibiotic use and death rates in beef feedlots over ten years in three cattle-feeding regions of the United States

2021 ◽  
pp. 1-7
Author(s):  
Stephanie C. Rutten-Ramos ◽  
Shabbir Simjee ◽  
Michelle S. Calvo-Lorenzo ◽  
Jason L. Bargen
Keyword(s):  
Death Rate ◽  
Live Weight ◽  
Population Level ◽  
Antibiotic Use ◽  
The United States ◽  
Death Rates ◽  
Cattle Feeding ◽  
The Us ◽  
Rate Ratios ◽  
Beef Feedlots

Abstract OBJECTIVE To assess antibiotic use and other factors associated with death rates in beef feedlots in 3 regions of the US over a 10-year period. SAMPLE Data for 186,297 lots (groups) of finished cattle marketed between 2010 and 2019 were obtained from a database representing feedlots in the central, high, and north plains of the US. PROCEDURES Descriptive statistics were generated. Generalized linear mixed models were used to estimate lot death rates for each region, sex (steer or heifer), and cattle origin (Mexico or the US) combination. Death rate was calculated as the (number of deaths/number of cattle placed in the lot) × 100. Lot antibiotic use (TotalActiveMG/KGOut) was calculated as the total milligrams of active antibiotics assigned to the lot per live weight (in kilograms) of cattle marketed from the lot. Rate ratios were calculated to evaluate the respective associations between lot death rate and characteristics of cattle and antibiotic use. RESULTS Mean death rate increased during the 10-year period, peaking in 2018. Mean number of days on feed also increased over time. Mean TotalActiveMG/KGOut was greatest in 2014 and 2015, lowest in 2017, and moderated in 2018 and 2019. Death rate was positively associated with the number of days on feed and had a nonlinear association with TotalActiveMG/KGOut. Feeding medicated feed articles mitigated death rate. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested a balance between disease prevention and control in feedlots for cattle with various risk profiles. Additional data sources are needed to assess TotalActiveMG/KGOut across the cattle lifetime.

scholarly journals Satisfaction with health care system: A comparative study between market-based insurance model of the United States and “out-of-pocket” model in developing and low-income countries

2020 ◽  
Vol 6 (1) ◽  
pp. 41
Author(s):  
Ram Lakhan ◽  
Sean Y. Gillette ◽  
Sean Lee ◽  
Manoj Sharma
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
Undergraduate Students ◽  
Low Income ◽  
Access To Health Care ◽  
The United States ◽  
Low Income Countries ◽  
Healthcare Needs ◽  
Care System

Background and purpose: Access to healthcare services is an essential component for ensuring the quality of life. Globally, there is inequity and disparities regarding access to health care. To meet the global healthcare needs, different models of healthcare have been adopted around the world. However, all healthcare models have some strengths and weaknesses. The purpose of this study was to examine the satisfaction among a group of undergraduate students from different countries with their health care models namely, insurance-based model in the United States and “out-of-pocket” model prevalent in low-income countries.Methods and materials: The study utilized a cross-sectional research design. Undergraduate students, representing different nationalities from a private Southeastern College, were administered a researcher-designed 14-item self-reported electronic questionnaire. Independent t-test and χ2 statistics were used to examine the differences between two health care systems and the qualitative responses were analyzed thematically.Results: Satisfaction towards health care system between the United States and low-income countries was found significantly different (p < .05). However, students in both settings experienced an inability toward affording quality healthcare due to economic factors and disparities.Conclusions: There is dissatisfaction with health care both in the United States and low-income developing countries among a sample of undergraduate students representing these countries. Efforts to ensure low-cost affordable health care should be a global goal.

Surgical Pathology–Based Outcomes Assessment of Breast Cancer Early Diagnosis

2001 ◽  
Vol 125 (3) ◽  
pp. 325-331
Author(s):  
Raouf E. Nakhleh ◽  
Richard J. Zarbo
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
The United States ◽  
Surgical Pathology ◽  
Detection Methods ◽  
Mortality Data ◽  
Breast Cancers ◽  
Improvement Program ◽  
Clinical Method

Abstract Objective.—To develop breast cancer outcomes data relating pathologic tumor variables at diagnosis with clinical method of detection. Design.—Anatomic pathologists assessed 30 consecutive breast cancers at each institution, resulting in an aggregate database of 4232 breast cancers. Setting.—Hospital-based laboratories from the United States (98%), Canada, Australia, and Belgium. Participants.—One hundred ninety-nine laboratories in the 1999 College of American Pathologists Q-Probes voluntary quality improvement program. Main Outcome Measures.—Pathologic variables indicative of favorable outcomes included percentage of carcinomas detected at the in situ stage, tumors ≤1 cm in diameter, and invasive cancers with lymph nodes negative for metastases. Results.—All outcomes measures, including percent in situ carcinomas (26.9% vs 13.8%), tumor size ≤1 cm (57.8% vs 36.5%), and lymph node–negative status (77.8% vs 64%), were more favorable when tumors were detected by screening mammography (P &lt; .001) compared to all other detection methods. Conclusions.—This study demonstrates an opportunity for pathologists to develop outcomes information of interest to health care organizations, providers, patients, and payers by integrating routine oncologic surgical pathology and clinical breast cancer detection data. Such readily obtained interim outcomes data trended and benchmarked over time can demonstrate the relative clinical efficacy of preventive breast care provided by health care systems long before mortality data are available.

Access to Health Care and Voting Behavior in the United States

2008 ◽  
Vol 19 (3) ◽  
pp. 731-742 ◽  
Author(s):  
Jeanette Kane Ziegenfuss ◽  
Micahel Davern ◽  
Lynn A. Blewett
Keyword(s):  
United States ◽  
Health Care ◽  
Voting Behavior ◽  
Access To Health Care ◽  
The United States ◽  
Access To Health

Breast Cancer in Latin America: A Map of the Disease in the Region

2018 ◽  
pp. 451-456 ◽  
Author(s):  
Eduardo Cazap
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Latin America ◽  
Urban Areas ◽  
Access To Health Care ◽  
Cancer Control ◽  
Public Health Problem ◽  
The United States ◽  
High Morbidity ◽  
Patient Organizations

In the next few decades, breast cancer will become a leading global public health problem as it increases disproportionately in low- and middle-income countries. Disparities are clear when comparisons are made with rates in Europe and the United States, but they also exist between the countries of the region or even within the same country in Latin America. Large cities or urban areas have better access and resource availability than small towns or remote zones. This article presents the status of the disease across 12 years with data obtained through three studies performed in 2006, 2010, and 2013 and based on surveys, reviews of literature, patient organizations, and public databases. The first study provided a general picture of breast cancer control in the region (Latin America); the second compared expert perceptions with medical care standards; and the third was a review of literature and public databases together with surveys of breast cancer experts and patient organizations. We conclude that breast cancer is the most frequent cancer and kills more women than any other cancer; we also suggest that aging is the principal risk factor, which will drive the incidence to epidemic levels as a result of demographic transition in Latin America. The economic burden also is large and can be clearly observed: in countries that today allocate insufficient resources, women go undiagnosed or uncared for or receive treatment with suboptimal therapies, all of which results in high morbidity and the associated societal costs. The vast inequities in access to health care in countries translates into unequal results in outcomes. National cancer control plans are the fundamental building block to an organized governance, financing, and delivery of health care for breast cancer.

scholarly journals The Use of Telehealth in School-Based Health Centers

2019 ◽  
Vol 6 ◽  
pp. 2333794X1988419 ◽  
Author(s):  
Hayley Love ◽  
Nirmita Panchal ◽  
John Schlitt ◽  
Caroline Behr ◽  
Samira Soleimanpour
Keyword(s):  
United States ◽  
Health Care ◽  
Public Schools ◽  
Health Care Access ◽  
Access To Health Care ◽  
Care Delivery ◽  
The United States ◽  
Health Centers ◽  
School Based ◽  
School Based Health Centers

Telehealth is a growing model of delivering health care. School-based health centers (SBHCs) provide access to health care for youth in schools and increasingly use telehealth in care delivery. This article examines the recent growth of telehealth use in SBHCs, and characteristics of SBHCs using telehealth, including provider types, operational characteristics, and schools and students served. The percentage of SBHCs using telehealth grew from 7% in 2007-2008 to 19% in 2016-2017. Over 1 million students in over 1800 public schools have access to an SBHC using telehealth, which represents 2% of students and nearly 2% of public schools in the United States. These SBHCs are primarily in rural communities and sponsored by hospitals. This growing model presents an opportunity to expand health care access to youth, particularly in underserved areas in the United States and globally. Further research is needed to fully describe how telehealth programs are implemented in school settings and their potential impacts.

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