Gene/Protein Disease Symptom Drug Enzyme Compound
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The impact, time trends and potential for prevention of premature deaths in Canada were assessed. There were almost 100,000 deaths before age 75 in Canada during 1986 resulting in over 1.7 million potential years of life lost (PYLL). The three leading broad disease categories responsible for PYLL were cancer, injuries/violence and cardiovascular disease. In both sexes, coronary heart disease, car accidents, lung cancer and perinatal conditions ranked in the top 5 specific diseases responsible for PYLL; breast cancer (females) and suicide (males) also ranked in the top 5 conditions. Over the period 1969 to 1986, death rates among persons less than age 75 increased for 3 conditions among females and 11 conditions among males. Lung cancer and brain cancer death rates increased in both sexes, chronic obstructive pulmonary disease death rates increased among females only and death rates for suicide and 8 types of cancer increased among males only. Over the same period, death rates declined for 37 discrete disease categories among both females and males including particularly large improvements for coronary heart disease, stroke, car accidents and perinatal conditions. An estimated 50,000 or over 50% of all premature deaths per year are preventable through control of smoking, hypertension, elevated serum cholesterol, diabetes and alcohol abuse. About 6,000 premature deaths are avoidable through improvements in medical care.
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PMID:Premature deaths in Canada: impact, trends and opportunities for prevention. 225 55

The reduction of socio-economic inequities in health is now an explicit objective of health policy in Canada. This study examines changes in mortality by income in urban Canada from 1971 to 1986 in terms of both relative and absolute differences between income groups. Street address information as shown on death certificates was used to code census tract of usual place of residence for deaths occurring to residents of Canada's Census Metropolitan Areas (CMAs) in 1971 and 1986. After exclusion of residents of health care institutions, 73,995 deaths were included in the study for 1971, and 88,129 for 1986. These deaths were analyzed by income quintile (based on census tract incidence of low income), age, sex, and cause of death. In 1971, the difference in life expectancy at birth between the highest and lowest income quintiles was 6.3 years for men and 2.8 years for women. By 1986, these differences had decreased to 5.6 years for men and 1.8 years for women. However, relative mortality (lowest compared to highest income quintile) at most ages changed only slightly over the 15 years. Relative infant mortality, for example, was 1.97 in 1971 and 1.82 in 1986. In 1986, 21% of total potential years of life lost (PYLL) prior to age 75 could be attributed to differences in quintile death rates compared to rates for the highest income quintile. Approximately 45% of this "excess" PYLL was for persons under 45 years of age. In 1971, the comparable figure was 67%. In 1986, the major causes of death contributing to income inequalities in mortality were: circulatory diseases, accounting for 25% of excess PYLL related to quintile differences; accidents, poisonings and violence, accounting for about 17%; and neoplasms, accounting for 15%. Respiratory diseases, ill-defined conditions, metabolic diseases and perinatal conditions each contributed 6-7% of excess PYLL. From 1971 to 1986, in terms of age-standardized morality rates (ASMRs) for all ages, certain causes of death showed increased mortality together with greater inequality by income, especially for males: these causes included lung cancer, suicide, metabolic diseases other than diabetes, and ill-defined conditions. Other causes of death showed either little change or less inequality by income but higher ASMRs: these included breast cancer, colon and rectal cancer, arterial diseases, alcoholism, mental disorders, and diseases of the nervous system.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Changes in mortality by income in urban Canada from 1971 to 1986. 249 Nov 31

All 995 persons with Down's syndrome who died in the United States during 1976 and whose death certificates listed Down's syndrome as the underlying or a contributing cause of death were identified. This allowed the underlying causes of death of 793 affected persons to be analysed and compared to deaths in the whole US population for that year. Mortality ratios provided evidence that the excess risk of leukemia mortality continues into adulthood and that deaths from other hematopoietic malignancies also occur excessively among Down's syndrome adults. Congenital anomalies of all kinds in infancy and congenital defects of the heart in infancy and later were also excessive. Respiratory tract infections and pneumonia showed persistently high ratios. Diabetes was raised only at ages 24 to 34 years. Ischemic heart disease, non-hematopoietic cancers, accidents, suicides and violence were under-represented among the causes of death. Methodological limitations of proportional mortality analysis are discussed.
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PMID:Leukemia and other cancers, anomalies and infections as causes of death in Down's syndrome in the United States during 1976. 621 2

An analysis of the limited available data confirms that the health status of Australia's Aborigines remains much worse than that of non-Aboriginal Australians. Despite significant improvements over the past decade Aboriginal fetal and infant mortality is still approximately three times that of non-Aborigines. Aboriginal life expectancy remains at least twenty years less than that of the total Australian population. Levels of Aboriginal hospitalisation have declined markedly, but remain well in excess of overall levels, particularly for infants and children. For Aborigines, the reduced overall impact of the communicable diseases has been balanced by a worsening of the "lifestyle" diseases, particularly hypertension, coronary heart disease and diabetes mellitus. Alcohol abuse plays an important role in these diseases, and in the level of accidents and violence amongst Aborigines. The current patterns require a reassessment of Aboriginal health priorities, with more attention being directed at the health problems of Aboriginal adults. Special Aboriginal health programs need to be expanded, and integrated with broad wide-ranging programs aimed at alleviating Aboriginal social inequality.
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PMID:Aboriginal health--current status. 639 81

As health is concerned with all aspects of human life, in a developing country like India plans for improvement of health services to ensure maintenance of health of the population should be an integral part of the total and overall development program. Modern public health measures are facing a difficult situation because of population growth. In regard to population structure, 2 age groups have been a concern of the health services, namely those 0-15 years and those 65 and older. The child's group constituted 42-44% of the total population, now reduced to 38.2% in 1982 and is a heavy dependent group particularly if another contingent of 20.4% in the 15-24 age group and requiring education is added. With an increasing life expectancy, there is now more than a 6% accumulation of aged persons in need of support. The Indian Council of Medical Research has established a National Institute of Nutrition and a Food and Drug Technology Center at Hyderabad, both of which have been doing useful work on nutrition and food technology. Both the history of public health during the last 100 years and all recent studies and observations amply demonstrate the dominant role played by the environment in the development of physical health and well-being of individuals and the community. The majority of iillnesses in a rural setting arise from 3 situations--pollution of water, soil, and air. A serious consequence of uncontrolled use of insecticides has been the health problems arising out of their toxic effects on persons handling them and on the people consuming contaminated foodstuff. Another effect on the health services is the increasing conversion of the vector insects to resistant form. In the field of communicable diseases the problems are vast and varied in India. For tackling all diseases a need exists for training courses to produce field epidemiologists. Among the noncommunicable diseases there is a definite rising trend in cancer, coronary heart disease, hypertension, diabetes, mental disorders, peptic ulcer, allergic disorders, rheumatic conditions, lung cancer, and leukemia. Another cause of morbidity and mortality which are assuming serious proportions is accident and deaths due to violence. India has undertaken to expand maternal and child health services and to establish new services where none exist. Every state has established a Family Planning Training Institute and created clinics throughout. Knowledge about the mental health conditions in India is generally poor as few surveys have been carried out to collect the information. Following the 2nd 5-year plan, industries are being rapidly developed in the country both in public and private sectors. Most of the problems can be solved to a great extent by mobilizing all medical and health personnel and services into 1 integrated service, but it is not considered feasible at this time. A concerted effort to rethink and reorganize present health services is required.
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PMID:Present health status and some suggestions for the future action. 718 59

When challenged by complex medical and social conditions, local providers must participate in information exchanges, resource sharing, continuing education, and service coordination. A community exchange system, flexible enough to share and adapt new knowledge, and able to provide continuing multidisciplinary training and education across different practice settings, was established for the prevention and treatment of HIV/AIDS in East Harlem, New York City. The HIV/AIDS community exchange system supports linkages among disciplines within a medical center, communication among the local community-based organizations, and networks between the two settings. The system, as a model, is applicable to complex socio-medical problems such as diabetes, substance abuse, violence, tuberculosis, or geriatrics.
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PMID:Linking frontline work and state-of-the-art knowledge: a community exchange system. 762 98

By the year 2000, Hispanics will outnumber African Americans and become the majority minority. Statistics reveal that health problems of the three main groups of Hispanics in the United States (Mexican Americans, Puerto Ricans, and Cubans) include diabetes, injuries and violence, substance abuse, HIV/AIDS, limited access to health care, and many other problems shared by the poor and disenfranchised. The health care provider may intervene with Hispanic clients and communities in culturally sensitive ways such as viewing culture as an enabler rather than a resistant force, incorporating cultural beliefs into the plans of care, stressing familialism, taking the time for "pleasant conversation," refraining from harsh criticism, and involving the community in preventive health care programs. Such interventions require providers who are knowledgeable about the culture, customs, beliefs, and language of the Hispanics within their practice area. Health care providers also need to be alert to and active in health care policy making that will improve access to health care for the growing Hispanic population.
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PMID:Providing culturally sensitive health care to Hispanic clients. 793 59

In addition to clearly defined health risks that develop during pregnancy (e.g., toxemia and diabetes), pregnant women are at risk for physical violence inflicted by intimate partners. Although estimates in public and private health-care settings indicate that 4%-17% of women experience violence during pregnancy, population-based prevalence estimates of this problem have not been available. This report uses 1990 and 1991 data from the Pregnancy Risk Assessment Monitoring System (PRAMS) in Alaska, Maine, Oklahoma, and West Virginia to assess the prevalence of physical violence against women during the 12 months preceding childbirth* and its relation to maternal characteristics.
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PMID:Physical violence during the 12 months preceding childbirth--Alaska, Maine, Oklahoma, and West Virginia, 1990-1991. 830 61

Neuropsychiatric disorders make up a large proportion of medical conditions causing disability and death worldwide. This paper reviews the most significant neurological disorders, emphasizing the preventability of most of them. The worldwide impact of cerebrovascular disease, protein-energy malnutrition causing cognitive impairment, tetanus, dementia, meningitis, and epilepsy is summarized. The burden of neurological dysfunction as a complication of tuberculosis, measles, road accidents, congenital anomalies, malaria, falls, war, violence, alcohol, HIV, diabetes, syphilis, and rheumatic heart disease might also be lessened by preventive measures. As in other health problems, major risk factors are poverty, poor access to health care, and social instability.
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PMID:Preventable neurological diseases worldwide. 959 82

To determine the distribution of mortality for non-Hispanic blacks and non-Hispanic whites in New York City, death certificates issued in New York City during 1988 through 1992, and the relevant 1990 US census data for New York City, have been examined. Age-adjusted death rates for blacks and whites by gender and cause of death were computed based on the US population in 1940. Also, standard mortality ratios and excess mortality were calculated using the New York City mortality rate as reference. The results showed that New York City blacks had higher age-adjusted death rates than whites regardless of cause, including stroke, AIDS, homicide, and diabetes. The rate for New York City blacks was also higher than the US total for both genders. Using New York City mortality rates as a reference, more than 80% of excess deaths in blacks occurred before age 65. Injury/poisoning was the leading cause of excess death (20.1%) in black males, while in black females, cardiovascular disease was the largest single cause of excess deaths (24.8%). The higher death rates, especially premature death, of blacks in New York City are related to conditions such as violence, substance abuse, and AIDS, for which prevention rather than medical care is the more likely solution, as well as to cardiovascular diseases, where both prevention through behavioral change, and health and medical care, can influence outcome.
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PMID:Differential mortality in New York City (1988-1992). Part One: excess mortality among non-Hispanic blacks. 1010 83


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