scholarly journals Public health utility of cause of death data: applying empirical algorithms to improve data quality

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Charlotte Johnson ◽  
Matthew Cunningham ◽  
Ilse N. Dippenaar ◽  
Fablina Sharara ◽  
Eve E. Wool ◽  
...  

Abstract Background Accurate, comprehensive, cause-specific mortality estimates are crucial for informing public health decision making worldwide. Incorrectly or vaguely assigned deaths, defined as garbage-coded deaths, mask the true cause distribution. The Global Burden of Disease (GBD) study has developed methods to create comparable, timely, cause-specific mortality estimates; an impactful data processing method is the reallocation of garbage-coded deaths to a plausible underlying cause of death. We identify the pattern of garbage-coded deaths in the world and present the methods used to determine their redistribution to generate more plausible cause of death assignments. Methods We describe the methods developed for the GBD 2019 study and subsequent iterations to redistribute garbage-coded deaths in vital registration data to plausible underlying causes. These methods include analysis of multiple cause data, negative correlation, impairment, and proportional redistribution. We classify garbage codes into classes according to the level of specificity of the reported cause of death (CoD) and capture trends in the global pattern of proportion of garbage-coded deaths, disaggregated by these classes, and the relationship between this proportion and the Socio-Demographic Index. We examine the relative importance of the top four garbage codes by age and sex and demonstrate the impact of redistribution on the annual GBD CoD rankings. Results The proportion of least-specific (class 1 and 2) garbage-coded deaths ranged from 3.7% of all vital registration deaths to 67.3% in 2015, and the age-standardized proportion had an overall negative association with the Socio-Demographic Index. When broken down by age and sex, the category for unspecified lower respiratory infections was responsible for nearly 30% of garbage-coded deaths in those under 1 year of age for both sexes, representing the largest proportion of garbage codes for that age group. We show how the cause distribution by number of deaths changes before and after redistribution for four countries: Brazil, the United States, Japan, and France, highlighting the necessity of accounting for garbage-coded deaths in the GBD. Conclusions We provide a detailed description of redistribution methods developed for CoD data in the GBD; these methods represent an overall improvement in empiricism compared to past reliance on a priori knowledge.

2021 ◽  
pp. 003335492097842
Author(s):  
Jo Marie Reilly ◽  
Christine M. Plepys ◽  
Michael R. Cousineau

Objective A growing need exists to train physicians in population health to meet the increasing need and demand for physicians with leadership, health data management/metrics, and epidemiology skills to better serve the health of the community. This study examines current trends in students pursuing a dual doctor of medicine (MD)–master of public health (MPH) degree (MD–MPH) in the United States. Methods We conducted an extensive literature review of existing MD–MPH databases to determine characteristics (eg, sex, race/ethnicity, MPH area of study) of this student cohort in 2019. We examined a trend in the MD community to pursue an MPH career, adding additional public health and health care policy training to the MD workforce. We conducted targeted telephone interviews with 20 admissions personnel and faculty at schools offering MD–MPH degrees in the United States with the highest number of matriculants and graduates. Interviews focused on curricula trends in medical schools that offer an MD–MPH degree. Results No literature describes the US MD–MPH cohort, and available MD–MPH databases are limited and incomplete. We found a 434% increase in the number of students pursuing an MD–MPH degree from 2010 to 2018. The rate of growth was greater than the increase in either the number of medical students (16%) or the number of MPH students (65%) alone. Moreover, MD–MPH students as a percentage of total MPH students more than tripled, from 1.1% in 2010 to 3.6% in 2018. Conclusions As more MD students pursue public health training, the impact of an MPH degree on medical school curricula, MD–MPH graduates, and MD–MPH career pursuits should be studied using accurate and comprehensive databases.


Author(s):  
Jason Reece

Housing quality, stability, and affordability have a direct relationship to socioemotional and physical health. Both city planning and public health have long recognized the role of housing in health, but the complexity of this relationship in regard to infant and maternal health is less understood. Focusing on literature specifically relevant to U.S. metropolitan areas, I conduct a multidisciplinary literature review to understand the influence of housing factors and interventions that impact infant and maternal health. The paper seeks to achieve three primary goals. First, to identify the primary “pathways” by which housing influences infant and maternal health. Second, the review focuses on the role and influence of historical housing discrimination on maternal health outcomes. Third, the review identifies emergent practice-based housing interventions in planning and public health practice to support infant and maternal health. The literature suggests that the impact of housing on infant health is complex, multifaceted, and intergenerational. Historical housing discrimination also directly impacts contemporary infant and maternal health outcomes. Policy interventions to support infant health through housing are just emerging but demonstrate promising outcomes. Structural barriers to housing affordability in the United States will require new resources to foster greater collaboration between the housing and the health sectors.


2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S843-S843
Author(s):  
John M McLaughlin ◽  
Farid L Khan ◽  
Heinz-Josef Schmitt ◽  
Yasmeen Agosti ◽  
Luis Jodar ◽  
...  

Abstract Background Understanding the true magnitude of infant respiratory syncytial virus (RSV) burden is critical for determining the potential public-health benefit of RSV prevention strategies. Although global reviews of infant RSV burden exist, none have summarized data from the United States or evaluated how RSV burden estimates are influenced by variations in study design. Methods We performed a systematic literature review and meta-analysis of studies describing RSV-associated hospitalization rates among US infants. We also examined the impact of key study characteristics on these estimates. Results After review of 3058 articles through January 2020, we identified 25 studies with 31 unique estimates of RSV-associated hospitalization rates. Among US infants < 1 year of age, annual rates ranged from 8.4 to 40.8 per 1000 with a pooled rate= 19.4 (95%CI= 17.9–20.9). Study type was associated with RSV hospitalization rates (P =.003), with active surveillance studies having pooled rates per 1000 (11.1; 95%CI: 9.8–12.3) that were half that of studies based on administrative claims (21.4; 95%CI: 19.5–23.3) or modeling approaches (23.2; 95%CI: 20.2–26.2). Conclusion Applying the pooled rates identified in our review to the 2020 US birth cohort suggests that 73,680 to 86,020 RSV-associated infant hospitalizations occur each year. To date, public-health officials have used conservative estimates from active surveillance as the basis for defining US infant RSV burden. The full range of RSV-associated hospitalization rates identified in our review better characterizes the true RSV burden in infants and can better inform future evaluations of RSV prevention strategies. Disclosures John M. McLaughlin, PhD, Pfizer (Employee, Shareholder) Farid L. Khan, MPH, Pfizer (Employee, Shareholder) Heinz-Josef Schmitt, MD, Pfizer (Employee, Shareholder) Yasmeen Agosti, MD, Pfizer (Employee, Shareholder) Luis Jodar, PhD, Pfizer (Employee, Shareholder) Eric Simões, MD, Pfizer (Consultant, Research Grant or Support) David L. Swerdlow, MD, Pfizer (Employee, Shareholder)


PEDIATRICS ◽  
1960 ◽  
Vol 25 (2) ◽  
pp. 343-347
Author(s):  
George M. Wheatley ◽  
Stephen A. Richardson

IN ALL COUNTRIES for which there are vital statistics, accidents are a major cause of death and disability among children. In countries where the food supply is adequate and infectious diseases have been brought under control, accidents have become the leading cause of death in the age group 1 to 19 years. For example, in such countries as Australia, Canada, Sweden, West Germany, and the United States, more than one-third of all deaths in this age group are caused by accidents. The number of children who are injured by accidents fan exceeds the number who are killed. Although no accurate international figures are available, the Morbidity Survey conducted by the United States Public Health Service indicates that in the United States, for every child under 15 killed by accident, 1,100 children are injured severely enough to require medical attention or to be restricted in their activity for at least a day.


Sexual Health ◽  
2012 ◽  
Vol 9 (3) ◽  
pp. 272 ◽  
Author(s):  
Kellie S. H. Kwan ◽  
Carolien M. Giele ◽  
Heath S. Greville ◽  
Carole A. Reeve ◽  
P. Heather Lyttle ◽  
...  

Objectives To describe the epidemiology of congenital and infectious syphilis during 1991–2009, examine the impact of public health interventions and discuss the feasibility of syphilis elimination among Aboriginal people in Western Australia (WA). Methods: WA congenital and infectious syphilis notification data in 1991–2009 and national infectious syphilis notification data in 2005–2009 were analysed by Aboriginality, region of residence, and demographic and behavioural characteristics. Syphilis public health interventions in WA from 1991–2009 were also reviewed. Results: During 1991–2009, there were six notifications of congenital syphilis (50% Aboriginal) and 1441 infectious syphilis notifications (61% Aboriginal). During 1991–2005, 88% of notifications were Aboriginal, with several outbreaks identified in remote WA. During 2006–2009, 62% of notifications were non-Aboriginal, with an outbreak in metropolitan men who have sex with men. The Aboriginal : non-Aboriginal rate ratio decreased from 173 : 1 (1991–2005) to 15 : 1 (2006–2009). Conclusions: These data demonstrate that although the epidemiology of syphilis in WA has changed over time, the infection has remained endemic among Aboriginal people in non-metropolitan areas. Given the continued public health interventions targeted at this population, the limited success in eliminating syphilis in the United States and the unique geographical and socioeconomic features of WA, the elimination of syphilis seems unlikely in this state.


2010 ◽  
Vol 5 (1) ◽  
Author(s):  
Heather Goodall ◽  
Allison Cadzow ◽  
Denis Byrne

Post war problems of rising urban, industrial pollution and intractable waste disposal are usually considered as technical and economic problems only, solutions to which were led by experts at State level, and filtered into Australia from the ferments occurring in the United States and Britain in the 1960s and 70s. This paper investigates the change which arose from the localities in which the impact of those effects of modern city development were occurring. In particular, this study looks at a working class, industrial area, the Georges River near Bankstown Municipality, which was severely affected by Sydney’s post-war expansion. Here, action to address urgent environmental problems was initiated first at the local level, and only later were professional engineers and public health officials involved in seeking remedies. It was even later that these local experts turned from engineering strategies to environmental science, embracing the newly developed ecological analyses to craft changing approaches to local problems. This paper centres on the perspective of one local public health surveyor, employed by a local municipal council to oversee waste disposal, to identify the motives for his decisions to intervene dramatically in river health and waste disposal programs. Rather than being prompted to act by influences from higher political levels or overseas, this officer drew his motivation from careful local data collection, from local political agitation and from his own recreational knowledge of the river. It was his involvement with the living environments of the area – the ways in which he knew the river - through personal and recreational experiences, which prompted him to seek out the new science and investigate emerging waste disposal technologies.


2005 ◽  
Vol 120 (3) ◽  
pp. 288-293 ◽  
Author(s):  
Donna L. Hoyert ◽  
Ann R. Lima

Objective. Data from death certificates are often used in research; however, little has been published on the processing of vague or incomplete information reported on certificates. The goal of this study was to examine the querying efforts in the United States used to clarify such records. Methods. The authors obtained data on the querying efforts of the 50 states, New York City, and the District of Columbia. Descriptive statistics are presented for two units of analysis: registration area and death record. Using data from a single registration area, Washington State, the authors compared the percent change in age-adjusted death rates for data from before and after querying to analyze the effect of querying on selected causes of death. Results. Fifty-one of the 52 registration areas queried either demographic or cause-of-death information. Almost 90% of queries were returned; the underlying cause of death changed in approximately 68% of these records. This data translates into about 3% of total U.S. death records, given that 4% of total U.S. death records were queried about cause of death. The impact of queries on age-adjusted death rates varied by cause of death. Generally, the effect is most obvious for cause-of-death categories that are specific and relatively homogenous. Conclusion. Querying continues to be widely practiced. In the case of cause-of-death queries, this method refines the assigned underlying cause of death for records reported with vague or incomplete information.


2020 ◽  
Vol 12 (18) ◽  
pp. 7567
Author(s):  
Yuval Arbel ◽  
Chaim Fialkoff ◽  
Amichai Kerner

Previous research demonstrates that the 1965 American immigration wave has tended to attenuate the obesity pandemic in the United States. Based on a survey carried out by the Israeli Central Bureau of Statistics (ICBS) in 2012 and 2016, we observe the correlation between BMI, age, native language, and years-since-migration to Israel. BMI (=kgm2) is a conventional measure of obesity, where BMI ≥ 25 is considered overweight and BMI ≥ 30 as type I obesity. The results indicate that compared to 11 groups of immigrants, the median BMI among native Israelis is lower. While the prevalence of overweight (BMI ≥ 25) among Hebrew speakers is below 50%, in 11 groups of immigrants, the prevalence of overweight is above 50%. A noteworthy exception is the immigrants from Ethiopia, who exhibit lower overweight prevalence compared to native Israelis and all other population groups. Finally, while male Hebrew and Russian speakers cross the overweight benchmark at the same age (35 years), native Israeli women (Hebrew speakers) cross this benchmark only when they reach 50 years (15 years after the males) and Russian women cross this benchmark only five years after the Russian men. These research findings may be of assistance in public health and culture-oriented medicine.


2021 ◽  
Author(s):  
Ashlynn R. Daughton ◽  
Courtney Diane Shelley ◽  
Martha Barnard ◽  
Dax Gerts ◽  
Chrysm Watson Ross ◽  
...  

BACKGROUND Health authorities can minimize the impact of an emergent infectious disease outbreak through effective and timely risk communication, which can build trust and adherence to subsequent behavioral messaging. Monitoring the psychological impacts of an outbreak, as well as public adherence to such messaging is also important for minimizing long term effects of an outbreak. OBJECTIVE We used social media data to identify human behaviors relevant to COVID-19 transmission and the perceived impacts of COVID-19 on individuals as a first step toward real time monitoring of public perceptions to inform public health communications. METHODS We develop a coding schema for 6 categories and 11 subcategories, which includes both a wide number of behaviors, as well codes focused on the impacts of the pandemic (e.g., economic and mental health impacts). We use this to develop training data and develop supervised learning classifiers for classes with sufficient labels. Classifiers that perform adequately are applied to our remaining corpus and temporal and geospatial trends are assessed. We compare the classified patterns to ground truth mobility data and actual COVID-19 confirmed cases to assess the signal achieved here. RESULTS We apply our labeling schema to ~7200 tweets. The worst performing classifiers have F1 scores of only 0.18-0.28 when trying to identify tweets about monitoring symptoms and testing. Classifiers about social distancing, however, are much stronger with F1 scores of 0.64-0.66. We applied the social distancing classifiers to over 228 million tweets. We show temporal patterns consistent with real-world events, and show correlations of up to -0.5 between social distancing signals on Twitter and ground-truth mobility throughout the United States. CONCLUSIONS Behaviors discussed on Twitter are exceptionally varied. Twitter can provide useful information for parameterizing models that incorporate human behavior as well as informing public health communication strategies by describing awareness of and compliance with suggested behaviors. CLINICALTRIAL N/A


2016 ◽  
Vol 24 (2) ◽  
pp. 29-32
Author(s):  
D.L. Posthumus ◽  
G.B. Woollatt

Dioxins and furans are toxic chemicals. A draft report released for public comment in September 1994 by the US Environmental Protection Agency clearly describes dioxin as a serious public health threat. The public health impact of dioxins may rival the impact that dichlorodiphenyltrichloroethane (DDT) had on public health in the 1960’s. According to the United States Environmental Protection Agency(USEPA) report, not only does there appear to be no “safe” level of exposure to dioxin, but levels of dioxin and dioxin-like chemicals have been found in the general US population that are “at or near levels associated with adverse health effects.”  With this in mind the purpose of this paper is to provide an overview of the current dioxin and furan emissions from industry in South Africa, in terms of compliance with the relevant emission limit values (ELVs) and the current challenges faced with the monitoring and analysis thereof.


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