Ecologic correlates of cancer mortality patterns in an industrialized urban population.

Cancer mortality data for the period 1968-80 were analyzed to examine whether the high cancer burden for the city of Philadelphia was "evenly" distributed spatially and, if not, whether this distribution could be associated with socioeconomic variables and air pollution. Areas with significantly higher-than-expected rates tended to cluster; lung cancer and non-lung cancers showed distinctive cluster patterns, which were evident only for males; female rates for any cancer or groups of cancers were almost uniformly distributed over the neighborhoods. Both the high lung cancer and the high non-lung cancer clusters were characterized by low socioeconomic status, but only the high lung cancer clusters exhibited high levels of air pollution. These neighborhood characteristics suggested that socioeconomic variables explain non-lung cancer mortality patterns; socioeconomic variables, together with air pollution, could be responsible for the observed lung cancer patterns. The uniform distribution of female lung cancer rates suggested that air pollution by itself cannot be a prominent factor in lung cancer mortality.

Breast cancer mortality in relation to a measure of early childbearing.

Mortality rates for breast cancer have been calculated for white women at ages 35-44, 45-54, 55-64 and 65-74 for the 50 states of the United States based on deaths in 1969-1971. To test the extent of association of breast cancer death rates with the possible low-risk factor of early age at first full-term pregnancy, the proportions of women who entered marriage before age 20 were calculated for women at these ages living in each state. Statistically significant negative correlations were observed between breast cancer mortality rates by state and proportions of all women first married before age 20. States with low age-specific breast cancer mortality rates and high proportions of women married in their teens tend to be in the South and Southwest; those with high mortality rates and later marriage (and childbearing) tend to be in the Northeast. The limitations of correlation data are discussed.

Causes of death among elderly Jews in New York City, 1979-1981.

Important differentials in mortality exist among ethnic and religious groups in the US but available statistics frequently preclude their examination. In the absence of mortality data for US Jews researchers have developed various alternatives, including using New York City's unique coding of death certificates according to religious affiliation of cemetery. Based on mortality rates for a sample of Medicare enrollees assumed to be representative of the Jewish population, in combination with New York City death record data, estimated death rates by sex and cause of death are developed for that city's elderly Jewish population. Comparisons made with rates for the white population of New York indicate low death rates for smoking-related diseases (lung cancer, chronic obstructive pulmonary diseases) among Jewish males. Other findings include above-average mortality from breast cancer among 65-74 year old Jewish women and from pancreatic cancer among Jewish women aged > or = 85. Below average mortality for both sexes is estimated for cerebrovascular disease and accidents, and for males from prostate cancer. The estimates produced are consistent with data from previous studies.

Changes in mortality among Cubans in the United States following an episode of unscreened migration.

This paper discusses the effect of the Mariel migration, a massive boatlift from Cuba to the United States in 1980, on mortality among Cuban Americans. Estimates of the Cuban-born population in the US were made for 1979 and 1981, the years prior to and following the boatlift. A comparison of age-adjusted rates showed that while general mortality did not change greatly (an increase of only about 5%), there was a 151% increase in homicide mortality. The increase in the homicide rate among Cubans in metropolitan Miami (Dade County), the major area of concentration, was 109%; it was still greater among Cubans elsewhere (240%). The demographic differences between the Mariel migrants who settled in Dade and those who were settled elsewhere are discussed.

Trends in cancer mortality among Puerto Rican-born migrants to New York City.

Age-standardized cancer death rates in Puerto Rican-born males and females residing in New York City have been calculated for 1979-81, and compared with those for white non-Puerto Rican-born people. For all population groups the rates in 1979-81 have been compared with rates in 1969-71. For some cancer sites, in particular cancers of the lung, breast and ovary, the Puerto Rican migrant population exhibited rates well below those of other residents of New York at both time periods. For other sites, most notably colon cancer (and to a lesser extent, prostate and bladder cancer), the rates for Puerto Ricans were somewhat lower than those of other New Yorkers in 1979-81, but had very markedly increased from levels shown in the earlier period. The Puerto Rican-born population at each time period had considerably higher rates of stomach cancer and cervical cancer than did 'other' white New Yorkers. Although substantial reductions in risk for these sites occurred among Puerto Ricans during the intercensal period examined, these corresponded to the reductions among 'other' white New York residents. The trends are discussed with reference to differences in lifestyle patterns, especially diet.

Violent deaths among Mexican-, Puerto Rican- and Cuban-born migrants in the United States.

This paper analyzes nationwide and regional mortality rates for violent causes of death among persons born in Mexico, Puerto Rico and Cuba, living in the continental United States. The Mexican-born had the highest death rates from accidents, the Puerto Rican-born from homicide and the Cuban-born from suicide. In each case of excess mortality in an Hispanic nativity group, the death rates for men by cause were higher than the comparative rates for white and blacks both nationally and regionally. Mortality rates for their major cause of violent death were highest for the Puerto Rican-born and Cuban-born men in their areas of concentration. Mexican-born men had higher accident death rates outside their areas of concentration. Contributing factors to violent causes of death include the interaction of socioeconomic, behavioral, cultural and psychological factors.

Differential mortality by ethnicity: foreign-born Irish, Italians and Jews in New York City, 1979-81.

This paper compares the mortality experience of foreign-born Irish, Italians and Jews in New York City in 1979-81. For the Irish and Italian groups, 1980 census data were used to calculate age-specific and age-standardized death rates. For the Jewish group, denominator data were not available, so proportional mortality analysis was used. An estimate was made to show the degree to which standardized proportional mortality ratios approximated relative standard mortality measures. Major causes of death and other selected causes were examined. The results of this analysis support previous studies showing mortality is significantly greater among Irish-born immigrants than among the Italian born. The proportional mortality data suggest that the Jewish and Italian groups have cause of death distributions relatively similar to each other and dissimilar to the Irish group. Alcohol-related causes of death appear to be a major source of the uniqueness of the Irish mortality experience.

Can data from the decennial census measure trends in mobility limitation among the aged?

We evaluate whether trends in the prevalence of disability among the aged can be investigated using the 1980 U.S. Census' public transportation question and the 1990 query on mobility limitation. Despite the obvious difference in the two questions, we found remarkable similarity in major cross-sectional patterns, such as those by age and sex, when comparing results from the two data sets. This result, coupled with the large number of observations available in the U.S. censuses, suggests that census data may be a suitable data source to study mobility limitation patterns in the small subgroups of the population that are frequently underrepresented in sample surveys.

Cancer mortality among Mexican immigrants in the United States.

In 1980 there were more than 2 million Mexican-born immigrants living in the United States. Mortality statistics for 1979-81 indicate that the standardized mortality ratio for cancer among Mexican immigrants is 72 percent of that among all white males and 77 percent of that among all white females. The age-adjusted death rates of the Mexican-born population for cancers of the lung, colon, rectum, bladder, and breast are significantly lower: less than 60 percent of those for the entire U.S. white population. Excessive levels of cancers of the stomach, liver, and cervix occur among Mexican-born U.S. residents; age-adjusted rates for these sites exceed the rates among the total U.S. white population by more than 75 percent. These data, based on U.S. diagnostic practices, confirm that broad differences--twofold, for some cancer sites--exist between the cancer rates among immigrants from Mexico and other whites in the United States. The close correspondence between the mortality data presented in this study and comparable incidence data from another study indicates that differential survival does not explain the differences in cancer mortality among Mexican immigrants.

Mortality among three Puerto Rican populations: residents of Puerto Rico and migrants in New York City and in the balance of the United States, 1979-81.

"This study attempts to explain similarities and differences in the mortality experience of three population groups: Puerto Ricans on the island commonwealth, Puerto Rican born persons in New York City and Puerto Rican born persons in the rest of mainland United States. Mortality is much higher among Puerto Ricans in New York City than among those residing elsewhere. Much of the difference is due to excess mortality caused by cirrhosis of the liver and homicide. Puerto Rican born persons living on the mainland but outside New York City generally have low mortality, even when compared with U.S. whites."

The Social Security Administration's Death Master File: the completeness of death reporting at older ages.

We examine the completeness of death reporting in the Social Security Administration's Death Master File (DMF) through comparison with deaths by year and age group reported in official U.S. vital statistics. For most years since 1973, results suggest that the DMF includes 93 percent to 96 percent of deaths of individuals aged 65 or older. Although studies have shown that the National Center for Health Statistics' National Death Index provides superior coverage of deaths, for many researchers the DMF may be a desirable choice. Some advantages of the Death Master File are discussed.

Mortality differentials among persons born in Cuba, Mexico, and Puerto Rico residing in the United States, 1979-81.

This paper examines the mortality experience in 1979-81 of three first generation Hispanic subpopulations in the United States, as defined by area of birth (Cuba, Mexico, Puerto Rico). Numerators were derived from National Center for Health Statistics (NCHS) mortality tapes, which included codes for selected places of birth appearing on the death certificate. Denominators were based on decennial census data for these migrant populations from the 1980 census. Generally, mortality is relatively high among Cuban-born, Mexican-born and Puerto Rican-born adolescents and young adults, particularly males, largely due to violent deaths. Aged migrants, despite their disadvantaged socioeconomic status, exhibit relatively low death rates from heart disease and cancer.

Cancer mortality among Puerto Rican-born residents in New York City.

More than half the 800,000 Puerto Rican migrants living in the United States resided in New York City in 1970. Mortality statistics from 1969-1971 indicate that Puerto Rican natives in the metropolis have a standardized mortality ratio for cancer which is 77% of that of non-Puerto Rican white males and 81% of that of non-Puerto Rican white females. The age-adjusted death rates of the Puerto Rican-born residing in New York City for cancers of the lung, prostate, bladder, ovary, and rectum are low, ranging from 43-70% of those of non-Puerto Rican whites; rates for breast cancer and colon cancer are somewhat lower relative to those for non-Puerto Rican whites. As is true for Puerto Ricans on the island, migrants to New York City have excessive levels of cancer of the cervix and esophagus (each roughly three times that of non-Puerto Rican whites) and cancer of the stomach (almost twice that of non-Puerto Rican whites).

Changing patterns of lung cancer among socio-cultural groups in New York City.

Mortality statistics for New York City were used to examine lung cancer trends and differentials among Whites in three major religious groups. The percentage of deaths attributed to lung cancer increased among all groups of females and among all categories of males except those under age 45. The relatively low lung cancer levels among Jewish men observed in earlier studies have continued and are consistent with patterns of smoking reported for socio-cultural groups. Mortality from lung cancer among Jewish women was still relatively higher than for other women at some age groups.

Migration patterns of the elderly: the case of the American Jewish population.

"This article examines the growing concentration of the elderly Jewish population of the U.S. in one metropolitan region of the Sun Belt. The principal data sources used are U.S. Census counts of the population with a Yiddish mother tongue or speaking Yiddish at home, as well as 1980 data on the population of Russian ancestry. The limitations of these measures are discussed and data from local community surveys also are presented. The data show that relocation of the elderly from the North, especially to South Florida, has been occurring since the 1950s and accelerated during the 1970s. The need for further study, which may document the migration patterns of elderly members of diverse religions and ethnic groups, is pointed out."

A new evaluation of United States census data on the extreme aged.

Population and mortality data for the extreme aged have generally been considered subject to a large degree of error, particularly for nonwhites. In this study, estimates of the United States population 85 years of age and over in 1960 are devised through a procedure known as the "method of extinct generations," which permits the reconstruction of "extinct" population cohorts from a series of annual death statistics. Estimates of the total population by single year of age and of sex-color groups by five-year age groups are compared with the 1960 census. With some exceptions, the data for whites show remarkable correspondence; the tally for nonwhites developed from death records falls considerably short of the census count, indicating a greater overstatement of age in the latter source.

A note on new estimates of the mortality of the extreme aged.

This note reports on the utilization of the "extinct generation" method, a procedure that permits a reconstruction of "extinct" population cohorts from the death statistics for a series of years and provides alternative estimates of the mortality of the extreme aged population (persons 85 years of age and over) in the United States during the period 1951-1965. Remarkably close correspondence was found between the annual mortality rates thus derived and figures published by the National Center for Health Statistics. It was concluded that the quality of the mortality rates produced was superior to the official figures but not markedly so. An advantage of the method is the ability to produce rates in detail, such as for five-year age groups, not ordinarily published for the 85 and over population.

A demographic portrait of the oldest old.

Persons aged 85 years and over have been the most rapidly growing group for some time, although their numbers are yet relatively small. However meager the official data, they do reveal striking differences from other Americans, including a unique sex ratio, higher rates of institutionalization, and lower family income. Examination of recent demographic trends portends the direction of future changes among the oldest old.

Mortality patterns among elderly American Jews.

"Mortality studies of ethnic and religious subgroups within a nation are of interest as they provide indicators of health differentials that may result from differences in life style and risk-factor exposures. The mortality experience of North American Jews has been documented over many years and is of particular interest because of the unusual pattern that has been observed, a crossover from relatively low rates at younger ages to relatively high rates at older ages. This study examines mortality in 1979-81 among more than 100,000 Medicare enrollees who held 22 surnames common among American Jews. The findings substantiate those of a recent mortality study of a Canadian Jewish population which indicated more rapid improvement in life expectancy among elderly Jewish than non-Jewish males, and a lessening of the relative disadvantage of elderly Jewish women."