Increase in fatal poisonings involving opioid analgesics in the United States, 1999-2006

"KEY FINDINGS: Data from the National Vital Statistics System Mortality File. From 1999 through 2006, the number of fatal poisonings involving opioid analgesics more than tripled from 4,000 to 13,800 deaths. Opioid analgesics were involved in almost 40% of all poisoning deaths in 2006. In 2006, the rate of poisoning deaths involving opioid analgesics was higher for males, persons aged 35-54 years, and non-Hispanic white persons than for females and those in other age and racial/ethnic groups. In about one-half of the deaths involving opioid analgesics, more than one type of drug was specified as contributing to the death, with benzodiazepines specified with opioid analgesics most frequently. The age-adjusted death rate for poisoning involving opioid analgesics varied more than eightfold among the states in 2006. All material appearing in this report is in the public domain and may be reproduced or copied without permission; citation as to source, however, is appreciated."Margaret Warner, Li Hui Chen, and Diane M. Makuc.Includes bibliographical references (p. 7)1979652

Adolescent health chartbook

"July 2000."Overall responsibility for planning and coordinating the content of this volume rested with the Office of Analysis, Epidemiology, and Health Promotion, National Center for Health Statistics (NCHS), under the general direction of Diane M. Makuc and Jennifer H. Madans.Also available via the World Wide Web.National Center for Health Statistics. Health, United States, 2000 With Adolescent Health Chartbook. Hyattsville, Maryland: 2000

Health, United States, 1998: with socioeconomic status and health chartbook

National Center for Health Statistics."July 1998.""Overall responsibility for planning and coordinating the content of this volume rested with the Office of Analysis, Epidemiology, and Health Promotion, National Center for Health Statistics (NCHS), under the supervision of Kate Prager, Diane M. Makuc, and Jacob J. Feldman." - p. vAlso available via Internet on the World Wide Web

Injury chartbook

National Center for Health Statistics."July 1997."Overall responsibility for planning and coordinating the content of this volume rested with the Office of Analysis, Epidemiology, and Health Promotion, National Center for Health Statistics (NCHS), under the supervision of Kate Prager, Diane M. Makuc, and Jacob J. Feldman.Also available via the World Wide Web

Chartbook on trends in the health of Americans

"September 2003."Overall responsibility for planning and coordinating the content of this volume rested with the Office of Analysis and Epidemiology, National Center for Health Statistics (NCHS), under the direction of Amy B. Bernstein and Diane M. Makuc.Also available via the World Wide Web.Includes bibliographical references and index

Quality of life returns from basic research

<p>Abstract</p> <p>Background</p> <p>Assessing the consequences of research is an increasingly important task in research and innovation policy. This paper takes a broader view of those consequences than the conventional economic approach, placing researchers and their activities in the centre of the assessment process and examining results for professional practice and general education as well as contributions to knowledge.</p> <p>Methods</p> <p>The paper uses historical and documentary analysis to illustrate the approach, focusing on U.S. biomedicine over the past century. At aggregate level, the analysis attributes portions of the change in aggregate health indicators to research and research-based institutions, through several available types of logic: either through correlations between timing of institutional changes and changes in the indicators or through direct or indirect causal connections.</p> <p>Results</p> <p>The analysis shows that while biomedical research has certainly contributed to improved health in the United States, other factors have also contributed. In some ways the institutional structure of science-based medicine has worked against creating benefits for some groups in U.S. society.</p> <p>Conclusions</p> <p>The paper concludes with a call for more strategic attention to dimensions of impact other than knowledge outcomes and for participatory planning for research.</p

Adverse childhood experiences are associated with the risk of lung cancer: a prospective cohort study

Background. Strong relationships between exposure to childhood traumatic stressors and smoking behaviours inspire the question whether these adverse childhood experiences (ACEs) are associated with an increased risk of lung cancer during adulthood. Methods. Baseline survey data on health behaviours, health status and exposure to adverse childhood experiences (ACEs) were collected from 17,337 adults during 1995-1997. ACEs included abuse (emotional, physical, sexual), witnessing domestic violence, parental separation or divorce, or growing up in a household where members with mentally ill, substance abusers, or sent to prison. We used the ACE score (an integer count of the 8 categories of ACEs) as a measure of cumulative exposure to traumatic stress during childhood. Two methods of case ascertainment were used to identify incident lung cancer through 2005 follow-up: 1) hospital discharge records and 2) mortality records obtained from the National Death Index. Results. The ACE score showed a graded relationship to smoking behaviors. We identified 64 cases of lung cancer through hospital discharge records (age-standardized risk = 201 × 100,000-1 population) and 111 cases of lung cancer through mortality records (age-standardized mortality rate = 31.1 × 100,000 -1 person-years). The ACE score also showed a graded relationship to the incidence of lung cancer for cases identified through hospital discharge (P = 0.0004), mortality (P = 0.025), and both methods combined (P = 0.001). Compared to persons without ACEs, the risk of lung cancer for those with 6 ACEs was increased approximately 3-fold (hospital records: RR = 3.18, 95%CI = 0.71-14.15; mortality records: RR = 3.55, 95%CI = 1.25-10.09; hospital or mortality records: RR = 2.70, 95%CI = 0.94-7.72). After a priori consideration of a causal pathway (i.e., ACEs smoking lung cancer), risk ratios were attenuated toward the null, although not completely. For lung cancer identified through hospital or mortality records, persons with 6 ACEs were roughly 13 years younger on average at presentation than those without ACEs. Conclusions. Adverse childhood experiences may be associated with an increased risk of lung cancer, particularly premature death from lung cancer. The increase in risk may only be partly explained by smoking suggesting other possible mechanisms by which ACEs may contribute to the occurrence of lung cancer

Chronic disease prevalence and care among the elderly in urban and rural Beijing, China - a 10/66 Dementia Research Group cross-sectional survey

<p>Abstract</p> <p>Background</p> <p>Demographic ageing is occurring at an unprecedented rate in China. Chronic diseases and their disabling consequences will become much more common. Public policy has a strong urban bias, and older people living in rural areas may be especially vulnerable due to limited access to good quality healthcare, and low pension coverage. We aim to compare the sociodemographic and health characteristics, health service utilization, needs for care and informal care arrangements of representative samples of older people in two Beijing communities, urban Xicheng and rural Daxing.</p> <p>Methods</p> <p>A one-phase cross-sectional survey of all those aged 65 years and over was conducted in urban and rural catchment areas in Beijing, China. Assessments included questionnaires, a clinical interview, physical examination, and an informant interview. Prevalence of chronic diseases, self-reported impairments and risk behaviours was calculated adjusting for household clustering. Poisson working models were used to estimate the independent effect of rural versus urban residence, and to explore the predictors of health services utilization.</p> <p>Results</p> <p>We interviewed 1002 participants in rural Daxing, and 1160 in urban Xicheng. Those in Daxing were more likely to be younger, widowed, less educated, not receiving a pension, and reliant on family transfers. Chronic diseases were more common in Xicheng, when based on self-report rather than clinical assessment. Risk exposures were more common in Daxing. Rural older people were much less likely to access health services, controlling for age and health. Community health services were ineffective, particularly in Daxing, where fewer than 3% of those with hypertension were adequately controlled. In Daxing, care was provided by family, who had often given up work to do so. In Xicheng, 45% of those needing care were supported by paid caregivers. Caregiver strain was higher in Xicheng. Dementia was strongly associated with care needs and caregiver strain, but not with medical helpseeking.</p> <p>Conclusion</p> <p>Apparent better health in Daxing might be explained by under-diagnosis, under-reporting or selective mortality. Far-reaching structural reforms may be needed to improve access and strengthen rural healthcare. The impact of social and economic change is already apparent in Xicheng, with important implications for future long-term care.</p

Chartbook on trends in the health of Americans

"September 2004."Overall responsibility for planning and coordinating the content of this volume rested with the Office of Analysis and Epidemiology, National Center for Health Statistics (NCHS), under the direction of Amy B. Bernstein and Diane M. Makuc.Also available via the World Wide Web.Includes bibliographical references and index