Mortality of a cohort of U.S. workers employed in the crushed stone industry, 1940-1980

The mortality of 3,246 males who had been employed 1 or more years during 1940-1980 at 20 crushed stone operations was evaluated for possible association between employment and death from lung cancer, pneumoconiosis, and other respiratory diseases. Four deaths were attributed to pneumoconiosis. Based on available work histories, at least two of these deaths were probably due to dust exposures in the crushed stone industry. Mortality attributed to pneumoconiosis and other nonmalignant respiratory diseases, including chronic obstructive lung disease, was significantly increased overall (SMR: 1.98; 95%CI: 1.21-3.05), and especially so for a subcohort of crushed stone workers that processed granite (SMR: 7.26; 95%CI: 1.97-18.59). With regard to lung cancer, overall SMRs were elevated (although not statistically significant). Analyzed by rock type, there was a significantly elevated lung cancer SMR among granite workers with at least 20 years latency (SMR: 3.35; 95%CI: 1.34-6.90). Although not definitive, results of this study are consistent with the hypothesis that exposure to respirable silica dust is a risk factor for lung cancer.     

Changes in perceived health in war-displaced population, Ayacucho, Peru: 1980-2004

The current study aims to show the individual and familiar changes in health patterns suffered by indigenous communities which were displaced from their Andean communities to Ayacucho city, Peru, for war-related political reasons, during the period of 1980 and 2004. Information about health self-perception was collected from displaced farmers living in Ayacucho city, and analyzed by using ethnographic research tools in: origin communities; during the displaced process to town, and during the integration process once the war was over in 1993. It was found out that these poor Andean communities had traditionally lived under severe social exclusion conditions, and were characterized by low access to health services and high childhood and maternal mortality rates. Vulnerability to disease, malnutrition and death reached a higher impact during the early years after the displacement, followed by a reconstructive process in order to set up a new social network. It gets consolidated once the war is over. At that time, life conditions start becoming more favorable, identification documents were regularized, and an improvement in access to health programs and services is detected. These changes also reflected the improvement on health self-perception. Nevertheless, mental health will remain causing distress in every age group of the population.     

Tubal sterilization in women 15-24 years of age: demographic trends in the United States, 1970-1980.

Between 1970-1980, approximately 942,000 women 15-24 years of age underwent tubal sterilization in the United States. These women represented about 17 per cent of all women ages 15-44 years who underwent tubal sterilization in the United States during this 11-year period. During 1970-1980, sterilization rates rose steadily from three per 1,000 to 11 per 1,000 for women in the 20- to 24-year age group, but remained stable at less than one per 1,000 for women in the 15- to 19-year age group. For each year, rates for Black women were greater than those for White women. Sterilization rates increased over the time period for both currently and previously married women, but remained low for never-married women. Most tubal sterilizations were performed after delivery of an infant.     

The teaching of preventive medicine in American medical schools, 1940–1980

The concept of incorporating prevention into clinical medicine has been addressed by academic medicine since the 1940s. Results reflect the dominant interests of academic medicine over time. This paper reviews this experience, as reflected in national conferences and related activities largely sponsored by the Association of Teachers of Preventive Medicine, and assesses implications for the 1980s. The consensus of the 1940s was that medical education should focus upon quantitative disciplines. Clinical applicability was considered important, but little was developed. Convening in 1952, deans, clinicians, and preventive medicine faculty strongly recommended teaching clinical prevention in “comprehensive care” programs. This movement was eclipsed by research and specialization. Academic preventive medicine focused on residency training and research, culminating in a major conference in 1963. Epidemiology and biostatistics flourished, while teaching clinical prevention received little attention. By 1970, dominant interest shifted to health services policy and research. Currently, some preventive medicine departments have affiliated with primary care training programs, and policy makers are focusing upon prevention. A number of nationally sponsored curriculum development projects deal with preventive aspects of primary care. Under these circumstances, incorporation of prevention into medical practice seems likely to succeed at the academic level. This may in turn stimulate similar occurrences in the medical care system.     

Changes in epidemiological parameters in colorectal carcinoma in Basel 1970-1980

Summary In the Basel Cancer Registry, the age standardized incidence rate remained stable from 1970 to 1980: 54 to 60 in men, 33 to 34 in women. One third of all cancers are located in the right colon. The age specific incidence rate has not changed, the values being higher for men in every age group. Only 5% of patients are under 50 years old. In radically operated cancers the number of small primary tumors remained low: 17% were confined to the muscularis propria. During the same period (1970–1980) the proportion of cancers with regional lymph node metastases remained stable at 40%. Short term and long term survival depend on the nodal status. Adenomas accompanying invasive cancers are more frequently found in men (30%) than in women (20%).     

Nonmarital childbearing in the United States, 1940-99.

OBJECTIVES: This report presents information on trends and variations in nonmarital childbearing in the United States and includes information on the factors that have contributed to the recent changes. Data are presented for 1940-99 with emphasis on the trends in the 1990's. METHODS: Data in this report are presented on a variety of measures of nonmarital childbearing, including numbers, rates, and percent of births to unmarried women. Most of the data is from the National Vital Statistics System. Additional data explaining the trends shown are from the National Survey of Family Growth, the U.S. Census Bureau, and other national surveys. Data are presented and interpreted principally in charts and related tables. RESULTS: After rising dramatically during the half century from 1940 to 1990, out-of-wedlock childbearing leveled off, or slowed its rate of increase, in the 1990's. Many factors contributing to the long-term changes as well as more recent trends are described. These include changes in marriage patterns, sexual activity, contraceptive use, and abortion. The experience of the United States is put into context with data on nonmarital childbearing for other industrialized countries. Possible future trends in out-of-wedlock births are considered in the context of current population and birth patterns.     

Trends in the physician workforce, 1980-2000

Over the past twenty-five years the nation has struggled with a series of physician workforce issues: determining the appropriate number of physicians needed and the appropriate number to produce; the role of international medical school graduates; the mix of primary care and non-primary care physicians; efforts to increase the number of underrepresented minorities in medicine and the supply of physicians in rural areas; and the impact of the growing number of female physicians. This paper documents physician workforce trends over the past twenty years, especially as they relate to these issues.     

Changes in the distribution of physicians in rural areas of Minnesota, 1965-85.

The purpose of this study was to assess changes in the physician-population ratio in non-SMSA Minnesota counties between 1965 and 1985 using county specific data published by the American Medical Association. The physician-population ratio actually decreased by 2 per cent for primary care physicians and by 11 per cent for family practitioners in the non-SMSA counties. The large increase in the number of physicians in Minnesota has not translated into improved access to primary care physicians in Minnesota's rural areas.