Archive for the 'Health, Disability & Mortality' Category

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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,, 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, | 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, | 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.

    For Americans Under 50, Stark Findings on Health

    By: Sabrina Tavernise
    Source: New York Times

    From article:

    Younger Americans die earlier and live in poorer health than their counterparts in other developed countries, with far higher rates of death from guns, car accidents and drug addiction, according to a new analysis of health and longevity in the United States.

    Researchers have known for some time that the United States fares poorly in comparison with other rich countries, a trend established in the 1980s. But most studies have focused on older ages, when the majority of people die.

    This article is based on U.S. Health in International Perspective: Shorter Lives, Poorer Health from the Institute of Medicine and the National Research Council. The pre-publication edition is available to read online for free here.

    An interactive graph comparing the United States and 16 “peer” countries is here and the project website is here.

    Health at a Glance: Europe 2012

    Source: OECD, Directorate for Employment, Labour and Social Affairs

    From publication website:

    This second edition of Health at a Glance: Europe presents a set of key indicators of health status, determinants of health, health care resources and activities, quality of care, health expenditure and financing in 35 European countries, including the 27 European Union member states, 5 candidate countries and 3 EFTA countries.

    The selection of indicators is based largely on the European Community Health Indicators (ECHI) shortlist, a set of indicators that has been developed to guide the reporting of health statistics in the European Union. It is complemented by additional indicators on health expenditure and quality of care, building on the OECD expertise in these areas.

    Each indicator is presented in a user-friendly format, consisting of charts illustrating variations across countries and over time, a brief descriptive analysis highlighting the major findings conveyed by the data, and a methodological box on the definition of the indicator and any limitations in data comparability.

    Full text (PDF)