Who is Asian? A category that remains contested in population and health research.
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Continuing inconsistent use of the term 'Asian' and its appearance for the first time in the 2001 Census justifies an examination of its utility in population and health research. Given the potential for 'Asian' to describe either persons with origins in the Indian subcontinent or those originating from continental Asia, there is a strong argument in studies employing ethnicity as a measure of broad historical processes of colonialism, migration, and discrimination for privileging 'South Asian' over this contested term. Where the focus is on ethnicity as personal identity, there is some evidence of the emergence of bicultural terms such as 'Asian British' and 'Scottish Asian' and of more limited use regionally of 'Asian' and qualified terms such as 'Hindu Asian'. However, such usage cannot be generalized to the acceptance of a pan-Asian identity. Further, the different meanings that attach to terms such as 'Asian' and 'Indian' in the USA and Canada in terms of the specificity of each country's historical process of ethnogenesis mean that, where international comparisons are being made, accurate description of the population is needed to explain the terminology. (+info)
Income inequality, household income, and health status in Canada: a prospective cohort study.
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OBJECTIVES: This study sought to determine whether income inequality, household income, and their interaction are associated with health status. METHODS: Income inequality and area income measures were linked to data on household income and individual characteristics from the 1994 Canadian National Population Health Survey and to data on self-reported health status from the 1994, 1996, and 1998 survey waves. RESULTS: Income inequality was not associated with health status. Low household income was consistently associated with poor health. The combination of low household income and residence in a metropolitan area with less income inequality was associated with poorer health status than was residence in an area with more income inequality. CONCLUSIONS: Household income, but not income inequality, appears to explain some of the differences in health status among Canadians. (+info)
Variations in state-level definitions: children with special health care needs.
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Multiple agencies at the federal and state level provide for children with special health care needs (CSHCN), with variation in eligibility criteria. Epidemiological studies show that 3.8%-32% of children could be classified as children with special health care needs, depending on the definition and method of determination used. OBJECTIVES: To determine the extent of variation between definitions used and funding by Supplemental Security Income (SSI), Title V, and Medicaid for CSHCN. METHODS: Statistics on children receiving SSI and the amount of funding were obtained from the SSI website. This was compared to information on Title V children from the Maternal and Child Health Bureau (MCHB) website and eligibility definitions published by the Institute of Child Health Policy in Gainesville, Florida. Medicaid definitions were obtained through interviews with state Medicaid agencies and confirmed with state regulations. RESULTS: The population enrolled in SSI has varied with alterations in eligibility criteria. The number of children enrolled in SSI and the amount of funding per child in each state correlate with the state poverty rate (r=0.56, p<0.0001; r=0.44, p<0.001). Enrollment in Title V does not correlate with state poverty rates (r=0.16, p=0.25). Title V definitions vary widely among states, but there was no correlation between the number of children served or amount of funding per child and the type of definition used (Z=-0.12, p=0.91; Z=-0.59, p=0.55). State Medicaid agencies rarely define CSHCN. CONCLUSIONS: There is significant variation in definitions used by agencies serving CSHCN. Agencies need to be more explicit with eligibility criteria so the definitions are logical to those making referrals for services. (+info)
United States Census 2000 population with bridged race categories.
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OBJECTIVES: The objectives of this report are to document the methods developed at the National Center for Health Statistics (NCHS) to bridge the Census 2000 multiple-race resident population to single-race categories and to describe the resulting bridged race resident population estimates. METHOD: Data from the pooled 1997-2000 National Health Interview Surveys (NHIS) were used to develop models for bridging the Census 2000 multiple-race population to single-race categories. The bridging models included demographic and contextual covariates, some at the person-level and some at the county-level. Allocation probabilities were obtained from the regression models and applied to the Census Bureau's April 1, 2000, Modified Race Data Summary File population counts to assign multiple-race persons to single-race categories. RESULTS: Bridging has the most impact on the American Indian and Alaska Native (AIAN) and Asian or Pacific Islander (API) populations, a small impact on the Black population and a negligible impact on the White population. For the United States as a whole, the AIAN, API, Black, and White bridged population counts are 12.0, 5.0, 2.5, and 0.5 percent higher than the corresponding Census 2000 single-race counts. At the sub-national level, there is considerably more variation than observed at the national level. The bridged single-race population counts have been used to calculate birth and death rates produced by NCHS for 2000 and 2001 and to revise previously published rates for the 1990s, 2000, and 2001. The bridging methodology will be used to bridge postcensal population estimates for later years. The bridged population counts presented here and in subsequent years may be updated as additional data become available for use in the bridging process. (+info)
Health and behavior risks of adolescents with mixed-race identity.
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OBJECTIVES: This study compared the health and risk status of adolescents who identify with 1 race with those identifying with more than 1 race. METHODS: Data are derived from self-reports of race, using the National Longitudinal Study of Adolescent Health (Add Health), which provides a large representative national sample of adolescents in grades 7 through 12. Respondents could report more than 1 race. RESULTS: Mixed-race adolescents showed higher risk when compared with single-race adolescents on general health questions, school experience, smoking and drinking, and other risk variables. CONCLUSIONS: Adolescents who self-identify as more than 1 race are at higher health and behavior risks. The findings are compatible with interpreting the elevated risk of mixed race as associated with stress. (+info)
Using publicly available directories to trace survey nonresponders and calculate adjusted response rates.
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In population-based surveys, sample lists are often out of date by the time data collection begins. Consequently, response rates, and the perceived validity of the survey, may be compromised by the unknowing inclusion of ineligible subjects. A strategy to address this issue is ascertainment of survey nonrespondents' eligibility status, enabling post hoc adjustment of response rates. In 1995-1996, population surveys were carried out in two Ontario, Canada, communities. Despite intensive follow-up, the status of 8949 (18.6%) of the 48218 potential subjects in these surveys remained unknown. In response, 500 "unknowns" from each community were randomly selected for tracing by using publicly available telephone directories and, where applicable, city directories. These tracing efforts classified persons into one of three groups: "ineligible" (moved before the mailing), "true nonresponder" (present when the survey was mailed), and "remains unknown" (no directory listing found). Publicly available directories clarified the status of 76.0% of potential participants, reducing the proportion of "unknowns" from 18.6% to 4.6%. Applying the estimated proportions of "ineligibles" from each area resulted in response rates adjusted from 63.8% to 71.2% and from 72.8% to 74.9% in the survey areas. Publicly available directories were used to successfully trace the majority of survey nonresponders, thus strengthening confidence in the survey's results. (+info)
Social gradients in years of potential life lost in Ireland.
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BACKGROUND: The study of mortality differentials by class or socio-economic group is underdeveloped in Ireland in comparison to other countries. The work that has been done has used a standardized mortality ratio (SMR) methodology to measure deaths. There has been no previous work exploring the social gradient in years of potential life lost (YPLL) in Ireland. METHODS: The aim is to investigate socio-economic mortality differentials for men aged between 15 and 69 in Ireland, using YPLL as a measure of premature mortality. The design is a mortality trends study. The study is based on mortality data supplied by the Central Statistics Office in Ireland and population data taken from the Census for the years 1981 and 1991. The data covers all male deaths aged 15-69 in the years 1981 and 1991. Social position is measured by a 12-category socio-economic group (SEG) framework and by a more aggregate four-category occupational classification system. RESULTS: When age at death is taken into account through YPLL, injury and poisoning is a major cause of premature mortality in Ireland for all socio-economic groups. The results also show significant differentials in YPLL by 12-category SEG in Ireland. There was a widening of the social gap during the period 1981 to 1991 as measured by the YPLL ratio between lower manual/upper non-manual occupational groups. The use of YPLL as a measure of premature mortality highlights the importance of respiratory disease and injury and poisoning as the major sources of health inequality in 1981 and 1991. CONCLUSIONS: YPLL is an important indicator of general mortality and for monitoring mortality differentials by socio-economic group. Current health inequalities as measured by YPLL are unacceptably high in Ireland. A comprehensive government strategy to reduce inequalities in mortality is required, having the primary objective of improving the economic and social circumstances of people in the lower manual occupational category. There is also a need to develop measurable priorities and programmes for the reduction of premature mortality in the injury and poisoning category for all social groups, and especially for people in the lower manual group. This means action now to prevent future deaths from road accidents, accidents at work and suicides. (+info)
Unusually strong association between education and mortality in young adults in a community with a high rate of injection-drug users.
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BACKGROUND: To examine the association between education and mortality for various causes of death in young adults in a community with a high rate of injection-drug users. METHODS: Linked mortality study based on mortality records for 1996 and 1997 and on 1996 population census data from the Region of Madrid (Spain). The association between educational level and mortality was estimated by the mortality rate ratio. RESULTS: After adjustment for age and other socioeconomic variables the mortality rate in men and women aged 25-44 years with no education was, respectively, 4.7 and 3.7 times higher than in men and women with the highest educational level. The causes of death with the strongest association were chronic liver disease and cirrhosis, AIDS and diseases of the heart in both sexes and suicide in men. For these causes of death the mortality rate ratio between persons with the lowest and highest educational level ranged from 6.8 to 21.8 in men and from 4.1 to 16.9 in women. CONCLUSIONS: These causes of death are the leading specific causes of death in persons aged 25-44 years. Given that probably a substantial part of deaths from diseases of the heart in this age category are drug-related, the common denominator of the excess mortality related poor education seems to be drug injection. (+info)