Smoking during pregnancy--United States, 1990-2002

Cigarette smoking during pregnancy adversely affects the health of both mother and child. The risk for adverse maternal conditions (e.g., premature rupture of membranes, abruptio placentae, and placenta previa) and poor pregnancy outcomes (e.g., neonatal mortality and stillbirth, preterm delivery, and sudden infant death syndrome) is increased by maternal smoking. Infants born to mothers who smoke weigh less than other infants, and low birthweight (<2,500 grams) is a key predictor for infant mortality. Infertility and conception delay also might be elevated by smoking. National health objectives for 2010 target an increase in cessation to 30% among pregnant smokers during the first trimester and abstinence from cigarettes by 99% of women giving birth. To assess progress toward these goals, CDC analyzed state-specific trends in maternal smoking during 1990-2002 by using data collected on birth certificates. This report summarizes the results of those analyses, which indicated that whereas participating areas observed a significant decline in maternal smoking during the surveillance period, 10 states reported recent increases in smoking by pregnant teens. Although the widespread public health message to abstain from smoking during pregnancy has helped decrease maternal smoking, to reduce prevalence further, implementation of additional interventions are required.     

Suicide trends among youths and young adults aged 10-24 years--United States, 1990-2004

In 2004, suicide was the third leading cause of death among youths and young adults aged 10-24 years in the United States, accounting for 4,599 deaths. During 1990-2003, the combined suicide rate for persons aged 10-24 years declined 28.5%, from 9.48 to 6.78 per 100,000 persons. However, from 2003 to 2004, the rate increased by 8.0%, from 6.78 to 7.32, the largest single-year increase during 1990-2004. To characterize U.S. trends in suicide among persons aged 10-24 years, CDC analyzed data recorded during 1990-2004, the most recent data available. Results of that analysis indicated that, from 2003 to 2004, suicide rates for three sex-age groups (i.e., females aged 10-14 years and 15-19 years and males aged 15-19 years) departed upward significantly from otherwise declining trends. Results further indicated that suicides both by hanging/suffocation and poisoning among females aged 10-14 years and 15-19 years increased from 2003 to 2004 and were significantly in excess of trends in both groups. The results suggest that increases in suicide and changes in suicidal behavior might have occurred among youths in certain sex-age groups, especially females aged 10-19 years. Closer examination of these trends is warranted at federal and state levels. Where indicated, health authorities and program directors should consider focusing suicide-prevention activities on these groups to help prevent suicide rates from increasing further.     

Smoking rates among pregnant women in Tennessee, 1990-2001

BACKGROUND: Pregnant smokers represent a major public health challenge. The objective of this study was to determine trends in smoking during pregnancy in Tennessee, a state with one of the highest smoking burdens in the nation, and to confirm characteristics of high-risk groups to target for smoking prevention. METHODS: Population-based cohort study of pregnant women in Tennessee who delivered live births from 1990-2001. Trends in smoking were determined by maternal age, race and insurance status using vital records and Medicaid data. Characteristics of women who smoked during pregnancy were described for 2001. RESULTS: Among 900,986 pregnant women in the cohort, there were statewide decreases in smoking rates during pregnancy; however, smoking among pregnant women younger than 25 years in Medicaid increased from 1996 to 2001: among whites from 31% to 34%, and among blacks from 6% to 9% (P values for trend shifts <0.0001). Characteristics of pregnant women who smoked during pregnancy included white race, Medicaid enrollment, nonurban residence, and less than a high school education. CONCLUSIONS: Smoking rates increased significantly among pregnant women <25 years enrolled in Medicaid between 1996 and 2001. Tennessee needs smoking cessation and prevention efforts that target young, low-income women with less than a high school education.     

Capital expenditure trends in California hospitals: 2002-2007

From 1997 to 2001, hospitals expanded their capital expenditures by only 1% while future capital investment was expected to grow by 14% (Healthcare Financial Management Association 2004). Analyzing California hospital data from 2002 to 2004 to 2005 to 2007, the author identified and classified capital expenditures into 4 major types. Between the 2 study periods, growth in capital purchases exceeded 23% for medical equipment, expansion, and maintenance types of projects. Large nonprofit hospitals capturing a greater share of the market and serving fewer uninsured and government payers had a greater number of these types of capital purchases.     

Diabetes among Hispanics--Los Angeles County, California, 2002-2003

Diabetes is associated with severe morbidity and premature death and affects U.S. Hispanics disproportionately. Although regional variation in diabetes prevalence has been observed among Hispanics, limited information is available on how sociodemographic factors affect the risk for diabetes among Hispanics in urban settings. Los Angeles County (LAC), California, has the largest urban Hispanic population in the United States. To assess the prevalence of diabetes among Hispanic adults in LAC and to examine variations in diabetes prevalence across sociodemographic groups in this population, the LAC Department of Health Services analyzed data from the 2002-2003 LAC Health Survey (LACHS). This report summarizes the results of that analysis, which indicate that the prevalence of diabetes is approximately two times higher among Hispanics than among non-Hispanic whites and is strongly associated with living below poverty level. These findings underscore the need to provide additional diabetes prevention and treatment interventions for Hispanics in LAC, particularly those living in poverty.     

Acute hepatitis B among children and adolescents--United States, 1990-2002

Since the 1991 adoption of a comprehensive strategy to eliminate hepatitis B virus (HBV) transmission in the United States, the incidence of acute hepatitis B cases has declined steadily. Declines have been greatest among children born after the 1991 recommendations for universal infant hepatitis B vaccination were implemented. In 1995, the elimination strategy was expanded to include routine vaccination of all adolescents aged 11-12 years and, in 1999, to include children aged < or =18 years who had not been vaccinated previously. To describe the epidemiology of acute hepatitis B in children and adolescents in the United States, CDC analyzed notifiable disease surveillance data collected during 1990-2002 and data collected during 2001-2002 through enhanced surveillance of reported cases of acute hepatitis B in children born after 1990. This report summarizes the results of that analysis, which indicated that the rate of acute hepatitis B in children and adolescents decreased 89% during 1990-2002 and that racial disparities in hepatitis B incidence have narrowed. Many confirmed cases in persons born after 1990 occurred among international adoptees and other children born outside the United States. Continued implementation of the hepatitis B elimination strategy and accurate surveillance data to monitor the impact of vaccination are necessary to sustain the decline of acute hepatitis B among children.     

Preventive-care practices among adults with diabetes--Puerto Rico, 2000-2002

Preventive-care practices among persons with diabetes can prevent or delay complications such as eye disease, kidney disease, or nerve damage that is a precursor to disabling foot disease. However, the level of diabetes-related preventive care is inadequate in the United States, and little has been reported about preventive care in Puerto Rico, where an estimated 10% of adults have diagnosed diabetes. CDC analyzed data from 2000, 2001, and 2002 Behavioral Risk Factor Surveillance System (BRFSS) surveys to assess the percentage of adults with diabetes in Puerto Rico who engaged in five selected preventive-care practices. This report summarizes the results of that analysis, which indicated that, with the exception of hemoglobin A1c testing, the percentages of adults engaging in preventive-care practices were lower than the target percentages set by U.S. national health objectives for 2010.     

Smoking cessation and mortality trends among 118,000 Californians, 1960-1997.

We assessed the impact of smoking cessation on subsequent death rates among a cohort of 51,343 men and 66,751 women in California enrolled in late 1959 in the original American Cancer Society (ACS) Cancer Prevention Study (CPS I) and followed for 38 years. We compared the age-adjusted death rate, expressed as deaths per 1,000 person-years, among all subjects who smoked cigarettes in 1959 but who had largely quit as of 1997 with the death rate among never smokers over a 38-year period. The all causes death rate for males decreased from 20.67 during 1960-1969 to 18.68 during 1960-1997 for smokers and decreased from 10.51 to 9.46 for never smokers. The lung cancer death rate for males increased from 1.558 to 1.728 for smokers and increased from 0.127 to 0.133 for never smokers. The all causes death rate for females increased from 9.54 to 10.14 for smokers and decreased from 6.95 to 6.44 for never smokers. The lung cancer death rate for females increased greatly from 0.208 to 0.806 for smokers and increased from 0.094 to 0.116 for never smokers. These results indicate there has been no important decline in either the absolute or relative death rates from all causes and lung cancer for cigarette smokers as a whole compared with never smokers in this large cohort, in spite of a substantial degree of smoking cessation. While cessation clearly reduces the mortality risk among long-term former smokers, the population impact of cessation appears to be less than currently believed.     

1990—2019年中国老年人群跌倒疾病负担分析

目的 分析我国1990—2019年老年人群跌倒疾病负担的时间趋势,为制定老年人群跌倒预防控制策略提供依据。 方法 利用全球疾病负担（GBD）2019数据库的研究结果,选取老年人群因跌倒死亡例数、死亡率、伤残调整生命年（DALY）、DALY率、伤残损失寿命年（YLD）、YLD率、损失寿命年（YLL）、YLL率等指标,对跌倒造成的疾病负担进行分析,并描述1990—2019年疾病负担变化趋势。 结果 2019年,我国60岁及以上老年人因跌倒造成的死亡人数、DALY、YLD、YLL分别是10.07万人、318.29万人年、181.00万人年、137.29万人年;死亡率、DALY率、YLD率、YLL率分别是39.19/10万、1238.95/10万、704.35/10万、534.42/10万。1990—2019年,跌倒造成的老年人死亡人数、DALY、YLD、YLL增长率分别为294.90%、220.70%、213.80%和230.26%,死亡率、DALY率、YLD率、YLL率上升趋势显著。 结论 跌倒给我国老年人造成了沉重的疾病负担,死亡率和疾病负担仍在增长,应当以80岁及以上的高龄老人为重点人群,通过多种途径加强老年人跌倒的预防,降低其疾病负担。     

Health inequalities among older adults in Sweden 1991-2002

BACKGROUND: Current research has shown a decline in health among older adults in Sweden. This study examines health inequalities among older adults in Sweden in 1991-1992 and 2000-2002 and explores the development of these inequalities during this period. METHODS: A data set was constructed out of four levels of living surveys, comprising 4085 individuals aged 55 and above. Multivariate logistic regressions were used to assess the association between social class, sex, age and four different domains of self-reported health: global self-rated health, impaired mobility, musculoskeletal pain and psychological distress. Adjustments were made for period of interview. Interaction terms were also used to assess change over time. Levin's attributable risk was used to assess the magnitude of the health inequalities. RESULTS: The results indicate an increase in reports of all specific health problems, but not in the global health measure during the period. Significant sex differences and a clear social gradient in health were discernible during both periods. Women were more likely than men to report problems with impaired mobility, pain and psychological distress. Manual workers were significantly more likely than non-manuals to report problems in all four domains of health. However, both the sex differences and the social gradient seemed to remain constant during the period. CONCLUSION: Although it seems there are significant differences in health depending on sex and social class among older adults in Sweden, these inequalities appear to be unaffected by the general increase in ill health that has been observed in these groups over the last decade.     

Alcohol-impaired driving among U.S. adults, 1993-2002

BACKGROUND: Motor vehicle-related injury is the leading cause of death in the United States for people aged 1 to 34 years. In 2002, 17,419 (41%) of 42,815 traffic deaths were alcohol related. OBJECTIVE: To estimate trends in alcohol-impaired driving among U.S. adults from 1993 through 2002. DESIGN, SETTING, AND PARTICIPANTS: The Behavioral Risk Factor Surveillance System, a random-digit telephone survey of adults aged >/=18 years in all states (and the District of Columbia). MAIN OUTCOME MEASURES: The percentage of respondents who reported alcohol-impaired driving (AID) in the past month, total estimated annual number of AID episodes, and annual rate per 1000 adult population. RESULTS: The estimated annual number of episodes of AID in the United States declined from 123 million in 1993 to 116 million in 1997, but then increased to 159 million in both 1999 and 2002. In varying magnitudes, this increase was observed among most subgroups of the population. In each study year, over 80% of total AID episodes were reported by people who also reported binge drinking (more than five drinks on a single occasion). CONCLUSIONS: After a general decline in the United States in the mid-1990s, self-reported AID increased substantially by the turn of the century. AID is strongly associated with binge drinking. Effective interventions to prevent AID and binge drinking should be widely adopted.     

Persistent socio-demographic differences in physical activity among Scottish schoolchildren 1990-2002

BACKGROUND: Regular participation in physical activity can have significant health gains in terms of physical and psychological wellbeing but there is evidence to suggest that many young people are not sufficiently active to benefit their health. This paper examines the socio-demographic patterning of leisure-time vigorous physical activity among Scottish schoolchildren between 1990 and 2002. METHODS: The Health Behaviour in School-Aged Children survey of 11-, 13- and 15-year-old schoolchildren has been carried out in Scotland since 1990 at four-yearly intervals. Levels of vigorous physical activity were measured in relation to gender, age and socio-economic status (SES). RESULTS: Girls reported lower levels of vigorous physical activity than boys and this gender difference persisted throughout the four survey years, irrespective of changes in overall levels of physical activity. Vigorous physical activity was also consistently lower among lower SES groups and older adolescents. The effect of gender was greatest, with high-SES girls reporting lower levels of vigorous activity than low-SES boys, and low-SES girls being the least active overall. CONCLUSION: Scottish adolescent females, especially those from low SES groups, may be at particular risk of the adverse health effects associated with low levels of physical activity. Health promotion programmes to promote physical activity need to address these persistent gender and socio-economic inequalities.     

Weight-control practices among U.S. adults, 2001-2002

BACKGROUND: Approximately $50 billion a year is spent by Americans on weight-loss products and services. Despite the high cost, few national studies have described specific weight-loss and weight-maintenance practices among U.S. adults. This analysis describes the use of specific practices by U.S. adults who tried to lose weight or tried only not to gain weight during the previous 12 months. METHODS: Data were analyzed from the 2001-2002 National Health and Nutrition Examination Survey (NHANES) conducted on a nationally representative sample of the U.S. population. This study focused on adults aged 20 years or older who were both interviewed and examined (n =5027). RESULTS: Fifty-one percent of U.S. adults tried to control their weight in the previous 12 months, including those who tried to lose weight (34% of men, 48% of women) and those who tried only not to gain weight (11% vs 10%, respectively). Among 2051 adults who tried to control their weight, the top four practices were the same: ate less food (65% among those who tried to lose weight, 52% among those who tried only not to gain weight); exercised (61% vs 46%, respectively); ate less fat (46% vs 42%); and switched to foods with lower calories (37% vs 36%). Less than one fourth combined caloric restriction with the higher levels of physical activity (300 or more minutes per week) recommended in the 2005 dietary guidelines by the U.S. Department of Health and Human Services and U.S. Department of Agriculture. CONCLUSIONS: Although weight control is a common concern, most people who try do not use recommended combinations of caloric restriction and adequate levels of physical activity.     

Suicide and attempted suicide--China, 1990-2002

Suicide is the fifth leading cause of death overall in China and the leading cause of death in persons aged 15-34 years. During 1995-1999, approximately 287,000 persons died each year from suicide, a national rate of 23 per 100,000 population. In addition, an estimated 2 million suicide attempts occur each year. To characterize suicides and attempted suicides in China, analyses were conducted of 1) a psychological autopsy study comparing suicides with other injury deaths and 2) three studies of attempted suicides. This report summarizes the results of these analyses, which indicated that 58% of China's suicides were caused by ingesting pesticide, 91% of suicide victims had never visited a mental health professional, and 45% of suicide attempts were impulsive acts performed after considering suicide for 相似文献   

1990-2010年我国城乡成年女性人群乳腺癌死亡率的流行趋势

目的 探讨近20年我国城乡成年女性人群乳腺癌死亡率的变动趋势.方法 研究中采用了《卫生统计年报(/鉴)》的数据,将20岁及以上女性作为研究人群.分析中采用直接标化法进行乳腺癌死亡率的标化,采用Joinpoint回归估计死亡率的年平均变化率;利用年龄-时期-队列模型法探讨年龄、时期和队列三因素对乳腺癌死亡率的影响.结果 近20年我国农村人群乳腺癌死亡率平均每年增长1.79％ (Z =4.44,P＜0.001),快于城市人群,城乡的差距正逐步缩小(P=0.026).年龄-时期-队列模型的拟合优度检验结果表明,城市女性时期效应对死亡率的影响作用不大(F=0.92,P=0.441),其他模型拟合良好(均有P＜0.001);控制年龄和出生队列的效应后,1990-2010年农村女性人群乳腺癌的死亡率呈现上升趋势;控制时期和队列影响后,女性人群60岁以前随着年龄的增加,乳腺癌的死亡风险升高,50～59岁达到峰值;控制时期和年龄效应后,出生年代越晚的人,女性乳腺癌的死亡风险越低.结论 乳腺癌的人群防治不但需要综合防治策略,降低全人群的发病风险;农村人群的二级和三级预防也不容忽视;也需要为乳腺癌病人提供必要的康复指导和心理咨询等,提高病人的生活质量.     

Incidence of end-stage renal disease among persons with diabetes--United States, 1990-2002

Diabetes mellitus is the leading cause of end-stage renal disease (ESRD) (i.e., kidney failure requiring dialysis or transplantation) in the United States, accounting for 44% of new cases of treated ESRD in 2002. To examine trends in ESRD attributed to diabetes mellitus (ESRD-DM) in the United States, CDC analyzed 1990-2002 data from the United States Renal Data System (USRDS) and the National Health Interview Survey (NHIS). This report summarizes the findings of that analysis, which indicated that, although the number of new cases of ESRD-DM increased overall, the incidence of ESRD-DM among persons with diabetes is not increasing among blacks, Hispanics, men, and persons aged 65-74 years, and is declining among persons aged <65 years, women, and whites. Continued interventions to reduce the prevalence of risk factors for kidney disease and improve diabetes care are needed to sustain and improve these trends.