Archive for the 'Health, Disability & Mortality' Category

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Widening racial disparity in breast cancer deaths

The New York Times has a great interactive visualization of the widening racial disparity in breast cancer deaths drawn from data from the Cancer Institute. Previously, black women had lower breast cancer mortality than whites, but it is now higher. The trend is not exactly the same across all states.

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[Click here for Data Visualization]

The New York Times article was inspired by a publication based on the trend in racial disparities in cancer mortality in the 25-largest cities in the US:

The racial disparity in breast cancer mortality in the 25 largest cities in the United States
Steven Whitman, Jennifer Orsi and Marc Hurlbert | Cancer Epidemiology
October 2011

Relevant to this topic is a link to the latest Health Disparities, 2013 report from CDC.

Plan B: Recommended Readings

In yesterday’s brown bag, Jim Trussell recommended reading some of the coverage of the Plan B, FDA, political interference story in the New York Times. I have listed a few of the articles on this issue. The article that reports on the judge in these cases, Korman, is dated June 14, 2013. The articles are listed in most recent to oldest order. You can waste a lot of time reading the comments, so be judicious.

New Birth Control Label Counters Lawsuit Claim
Pam Belluck | New York Times
November 27, 2013

F.D.A. Grants Exclusivity to Plan B One-Step
Pam Belluck | New York Times
June 24, 2013

Behind Scolding of the F.D.A., a Complex and Gentle Judge
Pam Belluck | New York Times
June 14, 2013

Federal Plan for ‘Morning After’ Pill’s Sale Is Approved
Pam Belluck | New York Times
June 13, 2013

Obama Waves White Flag in Contraceptive Battle
By Michael Shear | New York Times
June 12, 2013

Lifting Restrictions of ‘Morning After’ Pill has Little Impact for Drug Maker
Katie Thomas | New York Times
June 11, 2013

U.S. Drops Bid to Limit Sales of Morning-After Pill
Michael Shear and Pam Belluck
June 10, 2013

Judge Orders All Restrictions Lifted on Some ‘Morning-After’ Pills
Pam Belluck and Michael Shear
June 5, 2013

Temporary Limit Put on Sales of Morning-After Pill
Pam Belluck | New York Times
May 13, 2013

U.S. to Defend Age Limits on Morning-After Pill Sales
Pam Belluck and Michael Shear | New York Times
May 1, 2013

Drug Agency Lowers Age for Next-Day Birth Control
Pam Belluck | New York Times
April 30, 2013

Judge Strikes Down Age Limits on Morning-After Pill
Pam Belluck | New York Times
April 5, 2013

Good Sense on the Morning-After Pill
The Editorial Board | New York Times
April 5, 2013

Abortion Qualms on Morning-After Pill May Be Unfounded
Pam Belluck | New York Times
June 5, 2012

Drug’s Nickname May Have Aided Politicization
Pam Belluck | New York Times
June 5, 2012

Religious Groups Equate Abortion With Some Contraceptives
Pam Belluck and Erik Eckholm | New York Times
February 16, 2012

Obama Endorses Decision to Limit Morning-After Pill
Jackie Calmes and Gardiner Harris | New York Times
December 8, 2011

More Detail on Risk Urged for a Contraceptive Label
Pamm Belluck | New York Times
December 8, 2011

Massachusetts: Governor Overruled On Pill Bill
Pam Belluck | New York Times
September 16, 2005

Massachusetts Veto Seeks to Curb Morning-After Pill
Pam Belluck | New York Times
July 26, 2005

Pharmacies Balk on After-Sex Pill and Widen Fight in Many States
Monica Davey and Pam Belluck | New York Times
April 19, 2005

Project Tycho: Historical Disease Data

Project Tycho is funded by NIH and the Bill and Melinda Gates Foundation. It has taken historical data from the National Notifiable Diseases Surveillance System (NNDSS) and created count data for diseases by location for the 125 year history of the surveillance system. Three levels of data have been made available to users from the Project Tycho website.

Other useful resources:

  • Materials and Methods: Digitication of US Weekly Surveillance Reports between 1888 and 2011
  • Preliminary State Reports (scroll down for access – here’s an example for Michigan)
  • What does Tycho stand for?
  • And, here is a paper published in the New England Journal of Medicine based on these data. It estimates that over 100 million cases of contagious diseases have been prevented in the U.S. since 1924 by vaccination programs against polio, measles, mumps, rubella, hepatitis A, diphtheria, and pertussis (whooping cough).

    Contagious Diseases in the United States from 1888 to the Present
    New England Journal of Medicine
    November 28, 2013
    html | pdf

    Medical Spending and Morbidity Compression

    Evidence for Significant Compression of Morbidity In the Elderly U.S. Population
    D. Cutler, K. Ghosh, and M. Landrum | NBER
    July 2013
    Using what is becoming a go-to-resource for health economists, Cutler, et.al., use data from the Medicare Current Beneficiary Survey to examine how health is changing by time period until death. On average, they find evidence for compression of morbidity, which would help contain health-care spending. But, they do not imply that decadents lived a disease-free period up until death.

    Physician-Induced Demand

    Physicians Treating Physicians: Information and Incentives in Childbirth
    Erin Johnson and M. Marit Rehavi | NBER Working Paper, No. 19242
    July 2013
    [Abstract] [Paper]
    This paper has a medical sounding title, but should be of interest to health economists as it sheds light on physician-induced demand for medical services. It should also be of interest to all researchers – very creative use of data. I shudder to think how long it took the researchers to assemble the file and go through the restricted data bureaucracies.

    Death Certificates: Studies cast doubt on recorded cause-of-death

    Making the Right Call, Even in Death
    Lawrence Altman, MD | New York Times
    July 1, 2013
    This article discusses two studies, which illustrate problems with the recorded cause of death in death certificates.

    The studies, published in the May issue of the journal Preventing Chronic Disease, support what researchers have long suspected: that heart disease is overreported as a cause of death, while diseases like pneumonia and cancer tend to be underreported. Equally disturbing, one of the studies suggests that the health system is far too cavalier about the accuracy of death certificates.

    Survey of New York City Resident Physicians on Cause-of-Death Reporting, 2010
    B. Wexelman, E. Eden & K. Rose | Preventing Chronic Disease
    May 2013

    Impact of a Hospital-Level Intervention to Reduce Heart Disease Overreporting on Leading Causes of Death
    Teeb Al-Samarrai, et.al. | Preventing Chronic Disease
    May 2013

    Risk factor for a stroke? Living in the stroke-belt as a teen

    This study is based on a cohort study most demographers are probably not familiar with, “The Reasons for Geographic and Racial Differences in Stroke study.” It is a relatively large study with residential histories of panel participants. If you are interested in finding out more about these data, here’s a link to the researcher portal to the project website.

    Maybe this should be replicated and extended with the PSID as it covers a longer time period. Stroke mortality patterns have also experienced a shift according to Casper ML, Wing S, Anda RF, Knowles M, Pollard RA (May 1995).”The shifting stroke belt. Changes in the geographic pattern of stroke mortality in the United States, 1962 to 1988″. Stroke 26 (5): 755–60. PMID 7740562.

    Teenage Years in the Stroke Belt
    Nicholas Bakalar | The New York Times
    April 29, 2013

    Effect of duration and age at exposure to the Stroke Belt on incident stroke in adulthood
    Virginia Howard, et.al. | Neurology
    April 29, 2013
    Abstract | pdf

    Essay: Linking, Exploring and Understanding Population Health Data

    This is a nice data essay by former PSC trainee Michael Bader. He discusses multiple sources of data that one might use to understand population health. I especially like his point about the need to archive neighborhood conditions – after all neighborhoods change. But he also touches on the range of data available for analysis from focus groups to big data.

    Linking, Exploring and Understanding Population Health Data
    Michael Bader | Human Capital Blog (RWJ)
    June 25 2012

    The opening paragraph deserves a highlight, but read the entire entry. It is worth it:

    Data are the sustenance of population health research, and like the food that sustains us, it comes in many forms, shapes and sizes. Also like food, it’s best appreciated in combination. A single data source in the absence of context is unfulfilling; but combining datasets that are rich with information and contours — now that’s a meal!

    The Sister Study: Breast Cancer

    The Sister Study
    From 2004 to 2009, more than 50,000 women across the US and Puerto Rico, who were between ages 35–74 and whose sister had breast cancer, joined this landmark research effort to find causes of breast cancer. Because of their shared environment, genes, and experiences, studying sisters provides a greater chance of identifying risk factors that may help us find ways to prevent breast cancer.

    The Sister Study is currently tracking the health of women in the cohort. Participants complete health updates each year, as well as detailed questionnaires about health and experiences every two-to-three years. Research in the Sister Study focuses on causes of breast cancer and other health issues in women, as well as on factors that influence quality of life and outcomes after a breast cancer diagnosis.

    Data Access
    Access to the data is not completely open, but there is a process for access. Click on the above link for instructions.

    Underestimating Alcohol Consumption

    How is alcohol consumption affected if we account for under-reporting? A hypothetical scenario
    Sadie Boniface, Nicola Shelton | European Journal of Public Health
    February 26, 2013
    These researchers compared reported alcohol consumption from survey data with published reports of alcohol sales and determined there is under-reporting of alcohol consumption in England, which is comparable to other studies.

    This was mostly posted as an impetus to others to think of additional ways to get at this under-reporting problem. And, luckily the time period does not include the Olympics, which might have involved lots of tourists.