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Repeated claims that a dwindling supply of potential caregivers is creating a crisis in care for the U.S. aging population have not been well-grounded in empirical research. Concerns about the supply of family care do not adequately recognize factors that may modify the availability and willingness of family and friends to provide care to older persons in need of assistance or the increasing heterogeneity of the older population. In this paper, we set forth a framework that places family caregiving in the context of older adults' care needs, the alternatives available to them, and the outcomes of that care. We focus on care networks, rather than individuals, and discuss the demographic and social changes that may alter the formation of care networks in the future. Last, we identify research areas to prioritize in order to better support planning efforts to care for the aging U.S. population. [ABSTRACT FROM AUTHOR]

The article discusses articles in the issue written in response to the authors' article on data quality in nonprobability sampling within the issue. Topics, including response rates to probability surveys, survey design, demographic variables, research bias, propensity modeling and adjustment methods in research, are discussed.

One of the longest running questions that has been regularly included in US national public opinion polls is 'Are you in favor of the death penalty for persons convicted of murder?'. Because the death penalty is governed by state laws rather than federal laws, it is of special interest to know how public opinion varies by state, and how it has changed over time within each state. We combine dozens of national polls taken over a 50-year span and fit a Bayesian multilevel logistic regression model to estimate support for the death penalty as a function of the year, the state, state level variables and various individual level demographic variables. Among our findings were that support levels in northeastern and southern states have moved in opposite directions over the past 50 years, support among blacks has decreased relative to non-blacks, but at slightly different rates for men and women, and support among some education groups varies widely by region. Throughout the paper, we highlight the use of a variety of analytical and graphical tools for model understanding, including average predictive comparisons, finite population contrasts for overparameterized models and graphical summaries of posterior distributions of group level variance parameters. [ABSTRACT FROM AUTHOR]

This paper uses block-group data from the US decennial censuses to document changes in concentrated poverty. It provides several substantive and methodological lessons. First, the majority of poor sub-county areas were located (and hidden) in low poverty counties. Second, the 1990s brought large declines in the share of high-poverty (sub-county) areas and the share of people, including poor people, who lived in them. Third, poor minorities—both in metro and non-metro areas—are highly ghettoized in high-poverty neighbourhoods and are highly segregated from whites and the nonpoor population. Discussions of concentrated poverty cannot be uncoupled from minority residence patterns. [ABSTRACT FROM PUBLISHER]

One shortcoming in the literature on policy framing has been the absence of analytic models through which to explicate change. This paper advances research in this area in three related ways. First, it links policy frames to the actors who employ them. Second, based upon this linkage it proposes two complementary approaches for examining longitudinal change in policy framing: an actor representation approach and a frame adoption approach. Third, it assesses the relative contribution of each process using demographic decomposition analysis. This analytic framework is illustrated using the case of debates over welfare reform in the United States during the 1960s and 1970s. The findings are consistent with expectations from the frame adoption approach, suggesting that ideational diffusion was largely responsible for changing discourse during this period. [ABSTRACT FROM AUTHOR]

This paper investigates the effect of (potential) market size on entry of new drugs and pharmaceutical innovation. Focusing on exogenous changes driven by U. S. demographic trends, we find a large effect of potential market size on the entry of nongeneric drugs and new molecular entities. These effects are generally robust to controlling for a variety of supply-side factors and changes in the technology of pharmaceutical research. [ABSTRACT FROM AUTHOR]

This paper explores the "tree ring" hypothesis that reaching young adulthood during certain historical periods raises or lowers attitudes above and beyond the contribution of demographic variables and long-term cohort trends. It examines the deviations from long-term, linear, cohort trends for twenty-eight National Opinion Research Center (NORC) General Social Survey (GSS) attitude items in birth cohorts reaching age 16 in the 1950s, 1960s, and post-1960s. Long-term cohort trends are estimated from regressions of attitudes on cohorts reaching age 16 from 1917 to 1950 (net of year and five demographics). Popular impressions are supported in that "rings" (residuals) are more liberal for Americans reaching age 16 in the 1960s. However, those reaching age 16 in the l950s are more liberal than their immediate predecessors, not more conservative. Furthermore, the three periods are not strikingly distinctive as the items showing positive rings tend to be the same in each period. [ABSTRACT FROM AUTHOR]

Objectives The prevalence of dementia varies geographically in the United States. However, the extent to which this variation reflects contemporary place-based experiences versus embodied exposures from earlier in the life course remains unclear, and little is known regarding the intersection of place and subpopulation. This study, therefore, evaluates whether and how risk for assessed dementia varies by place of residence and birth, overall and by race/ethnicity and education. Methods We pool data from the 2000 to 2016 waves of the Health and Retirement Study, a nationally representative panel survey of older U.S. adults (n  = 96,848 observations). We estimate the standardized prevalence of dementia by Census division of residence and birth. We then fit logistic regression models of dementia on region of residence and birth, adjusting for sociodemographic characteristics, and examine interactions between region and subpopulation. Results The standardized prevalence of dementia ranges from 7.1% to 13.6% by division of residence and from 6.6% to 14.7% by division of birth, with rates highest throughout the South and lowest in the Northeast and Midwest. In models accounting for region of residence, region of birth, and sociodemographic covariates, Southern birth remains significantly associated with dementia. Adverse relationships between Southern residence or birth and dementia are generally largest for Black and less-educated older adults. As a result, sociodemographic disparities in predicted probabilities of dementia are largest for those residing or born in the South. Discussion The sociospatial patterning of dementia suggests its development is a lifelong process involving cumulated and heterogeneous lived experiences embedded in place. [ABSTRACT FROM AUTHOR]

The Women's Liberation Movement has sparked off a great deal of research into the role of women in economic life, much of which was recently surveyed by Kahne and Kohen.[2] One aspect of women's role in the economy which has received scant attention, however, is their part in the distribution of personal wealth. This paper presents new evidence on the importance of inheritance, marriage and "entrepreneurship" in the creation of women's fortunes. This paper has considered the source of women's wealth and the marriage patterns of top wealth leaven. It appears to us that the most important conclusions are that: (1) Wedgwood's observations on the sources of women's property in the 1920s remain valid: only a very small minority of women (no more than 5 %) accumulated their wealth through what is generally regarded as "entrepreneurship"; and (2) some 60 % of rich sons (daughters) of rich fathers marry daughters (sons) from wealthy families. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper examines the trend in the fertility difference between the South and the remainder of the United States--a differential which has existed since colonial times. The paper begins with a consideration of the reasons why there might be a regional fertility differential. The rest of the paper examines the trend in this differential. It is found that the long-standing higher fertility of the South, relative to the rest of the country, has ceased. But this does not mean that the differential has disappeared. The South currently has lower levels of fertility than the non-South, and this is because southerners prefer fewer children than nonsoutherners. [ABSTRACT FROM AUTHOR]

Nonprobability samples have gained mass popularity and use in many research circles, including market research and some political research. One justification for the use of nonprobability samples is that low response rate probability surveys have nothing significant to offer over and above a "well built" nonprobability sample. Utilizing an elemental approach, we compare a range of samples, weighting, and modeling procedures in an analysis that evaluates the estimated bias of various cross-tabulations of core demographics. Specifically, we compare a battery of bias related metrics for nonprobability panels, dualframe telephone samples, and a high-quality in-person sample. Results indicate that there is roughly a linear trend, with nonprobability samples attaining the greatest estimated bias, and the in-person sample, the lowest. Results also indicate that the bias estimates vary widely for the nonprobability samples compared to either the telephone or in-person samples, which themselves tend to have consistently smaller amounts of estimated bias. Specifically, both weighted and unweighted dual-frame telephone samples were found to have about half the estimated bias compared to analogous nonprobability samples. Advanced techniques such as propensity weighting and sample matching did not improve these measures, and in some cases made matters worse. Implications for "fit for purpose" in survey research are discussed given these findings. [ABSTRACT FROM AUTHOR]

Objectives To better understand the temporal dynamics of progression from cognitive decline to onset of dementia in the dementia-free older population in the United States. Methods We used longitudinal data from a diverse national population-based sample of older adults (N = 531) in the Aging, Demographics, and Memory Study from the Health and Retirement Study with repeated measures of cognitive function and dementia diagnosis during 12 years of follow-up from 1996 to 2009. We employed joint latent class mixed models to estimate the association between cognitive change and competing risks of dementia and nondementia death and identify heterogeneity in the age profiles of such association adjusting for baseline characteristics. Results Our analyses found 3 latent classes with distinct age profiles of cognitive decline and associated risk of dementia and mortality: "Rapid Cognitive Decline" (19.6%), "Moderate Progression" (44.6%), and "Optimal Cognitive Aging" (35.8%). When simultaneously accounting for cognitive trajectories and time-to-dementia/death, we also found associations of baseline covariates with slope of cognitive decline (e.g. steeper decline among non-Hispanic Blacks and more educated) and risk of dementia (e.g. greater risk for females and apolipoprotein E-4 carriers, but no difference by education level) that differ substantially from those in separate longitudinal mixed models or survival models. Discussion The differential age patterns of cognitive decline predicting dementia incidences identified in this study suggest variation in the course of cognitive aging in older adults that may inform future etiological and intervention studies. [ABSTRACT FROM AUTHOR]

Objectives The articles examines the contribution of internal socioeconomic disparities in mortality to the U.S. international disadvantage in life expectancy at birth. Methods Using individual death records from the U.S. national vital statistics system for years 1982–2019 and data for other countries from the Human Mortality Database, we compare age-specific death rates and life expectancy between counties classified into 10 socioeconomic categories and 20 high-income countries. We also calculate the number of years of life lost in each socioeconomic decile in relation to the comparison set. Results There is a clear and increasing socioeconomic gradient of mortality in the United States, but the growing divergence in internal mortality trends does not explain the rising gap between the country and its peers. In 2019, even American women in the most socioeconomically advantaged decile lived shorter lives, while only 10% of men in the most affluent decile fared better than their peers. The long-standing U.S. disadvantage in young adult mortality has been growing and the country's previous advantage in mortality at ages 75 years and older has virtually disappeared for all but for Americans in the most affluent counties. Discussion The similar age pattern of differences in mortality rates between each socioeconomic deciles and the comparison group suggests that the underlying factors might be the same. The role of external causes (including drug overdoses) for middle-aged adults and a slowing down in progress to control cardiovascular diseases at older ages at the national level are consistent with this pattern. [ABSTRACT FROM AUTHOR]

Objectives This study assesses how American life expectancy compares to other high-income countries and identifies key age groups and causes of death responsible for the U.S. life expectancy shortfall. Methods Data from the Human Mortality Database, World Health Organization Mortality Database, and vital statistics agencies for 18 high-income countries are used to examine trends in U.S. life expectancy gaps and how American age-specific death rates compare to other countries. Decomposition is used to estimate the contribution of 19 age groups and 16 causes to the U.S. life expectancy shortfall. Results In 2018, life expectancy for American men and women was 5.18 and 5.82 years lower than the world leaders and 3.60 and 3.48 years lower than the average of the comparison countries. Americans aged 25–29 experience death rates nearly 3 times higher than their counterparts. Together, injuries (drug overdose, firearm-related deaths, motor vehicle accidents, homicide), circulatory diseases, and mental disorders/nervous system diseases (including Alzheimer's disease) account for 86% and 67% of American men's and women's life expectancy shortfall, respectively. Discussion American life expectancy has fallen far behind its peer countries. The U.S.'s worsening mortality at the prime adult ages and eroding old-age mortality advantage drive its deteriorating performance in international comparisons. [ABSTRACT FROM AUTHOR]

Objectives To investigate the slowdown in mortality improvement in the United States, United Kingdom, and comparator countries observed in the first decade of the twenty-first century and critically evaluate proposed explanations. Methods Change-point analysis to identify the year of change in comparison of national mortality trends and linear spline models in the investigation of subnational differences using data from the Human Mortality Database, Global Burden of Disease cause-specific data, and, for the United Kingdom, national statistics data. Consideration of the impact of using different methods to estimate overall mortality is also concluded together with a review of methodological assumptions made in previous studies. Results The results confirm the slowdown in mortality improvement observed in the early twenty-first century but indicate that proposed explanations for this are inadequate on a range of counts. Discussion Mortality improvement slowed down in the early twenty-first century but the explanations advanced, such as opioid use in the United States or influenza epidemics and austerity programs in the United Kingdom, seem unlikely to account for this. Further research considering longer-term life course and cohort influences is needed. [ABSTRACT FROM AUTHOR]

Objectives This study describes living arrangement-specific life expectancy for older Americans with and without children, by sex and race/ethnicity. Method We use life tables from the Human Mortality Database and data from the Health and Retirement Study over a 17-year period (2000–2016) to calculate living arrangement-specific life expectancy at age 65 using Sullivan's method. Results describe the lives of older Americans aged 65 and older with and without children in terms of the number of expected years of life in different living arrangements. Results With the exception of Hispanic men, older Americans without children spend over half of their remaining life living alone. Among the childless, it is White women and Black men who spend the largest percent of remaining life living alone (65% and 57%, respectively). Relative to parents, childless older Americans have an overall life expectancy at age 65 that is 1 year lower and spend 5–6 years more living alone and fewer years living with a spouse (8 years less for men and 5 years less for women). Childless older Americans spend more time in nursing homes, but average expected duration in this living arrangement is short and differences between those with and without children are small. Discussion This descriptive analysis demonstrates the fundamental ways in which children shape the lives of older Americans by showing that later-life living arrangements of childless Americans differ markedly from their counterparts with children. These results provide a valuable empirical foundation for broader efforts to understand relationships between childlessness, living arrangements, and well-being at older ages. [ABSTRACT FROM AUTHOR]

Background Identifying risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection could help health systems improve testing and screening strategies. The aim of this study was to identify demographic factors, comorbid conditions, and symptoms independently associated with testing positive for SARS-CoV-2. Methods This was an observational cross-sectional study at the Veterans Health Administration, including persons tested for SARS-CoV-2 nucleic acid by polymerase chain reaction (PCR) between 28 February and 14 May 2020. Associations between demographic characteristics, diagnosed comorbid conditions, and documented symptoms with testing positive for SARS-CoV-2 were measured. Results Of 88 747 persons tested, 10 131 (11.4%) were SARS-CoV-2 PCR positive. Positivity was associated with older age (≥80 vs <50 years: adjusted odds ratio [aOR], 2.16 [95% confidence interval {CI}, 1.97–2.37]), male sex (aOR, 1.45 [95% CI, 1.34–1.57]), regional SARS-CoV-2 burden (≥2000 vs <400 cases/million: aOR, 5.43 [95% CI, 4.97–5.93]), urban residence (aOR, 1.78 [95% CI, 1.70–1.87]), black (aOR, 2.15 [95% CI, 2.05–2.26]) or American Indian/Alaska Native Hawaiian/Pacific Islander (aOR, 1.26 [95% CI, 1.05–1.52]) vs white race, and Hispanic ethnicity (aOR, 1.52 [95% CI, 1.40–1.65]). Obesity and diabetes were the only 2 medical conditions associated with testing positive. Documented fevers, chills, cough, and diarrhea were also associated with testing positive. The population attributable fraction of positive tests was highest for geographic location (35.3%), followed by demographic variables (27.1%), symptoms (12.0%), obesity (10.5%), and diabetes (0.4%). Conclusions The majority of positive SARS-CoV-2 tests were attributed to geographic location, demographic characteristics, and obesity, with a minor contribution of chronic comorbid conditions. [ABSTRACT FROM AUTHOR]

I process satellite-generated data on terrain elevation and presence of water bodies to precisely estimate the amount of developable land in U.S. metropolitan areas. The data show that residential development is effectively curtailed by the presence of steep-sloped terrain. I also find that most areas in which housing supply is regarded as inelastic are severely land-constrained by their geography. Econometrically supply elasticities can be well characterized as functions of both physical and regulatory constraints, which in turn are endogenous to prices and demographic growth. Geography is a key factor in the contemporaneous urban development of the United States. [ABSTRACT FROM AUTHOR]

Objectives The prevalence of dementia in the United States seems to have declined over the last few decades. We investigate trends and their underlying mechanisms in cognitive functioning (CF) across 7 decades of birth cohorts from the Greatest Generation to Baby Boomers. Methods Data come from 30,191 participants of the 1996–2014 Health and Retirement Study. CF is measured as a summary score on a 35-point cognitive battery of items. We use generalized linear models to examine the trends in CF and explanatory variables across birth cohorts. Then, Karlson–Holm–Breen decomposition method is used to evaluate the contribution of each explanatory variable to the trend of CF. Results CF has been improving from the Greatest Generation to Late Children of Depression and War Babies, but then significantly declines since the Early-Baby Boomers and continues into Mid-Baby Boomers. This pattern is observed universally across genders, race/ethnicities, education groups, occupations, income, and wealth quartiles. The worsening CF among Baby Boomers does not originate from childhood conditions, adult education, or occupation. It can be attributed to lower household wealth, lower likelihood of marriage, higher levels of loneliness, depression and psychiatric problems, and more cardiovascular risk factors (e.g. obesity, physical inactivity, hypertension, stroke, diabetes, and heart disease). Discussion The worsening CF among Baby Boomers may potentially reverse past favorable trends in dementia as they reach older ages and cognitive impairment becomes more common if no effective interventions and policy responses are in place. [ABSTRACT FROM AUTHOR]

Background Food bank users suffer high food insecurity. Food insecurity increases risk for chronic health conditions. However, chronic pain and its relation to food insecurity among food bank users is unknown. Knowledge about populations with chronic pain is important to direct appropriate public health nutritional strategies. Methods Participants completed a survey including sleep, pain, depressive symptoms and food insecurity measures. Descriptive statistics characterized the burden of chronic pain among the sample, and a series of chi-square and t-tests assessed for demographic differences between food bank users who reported pain compared to those who did not. Logistic regression tested for variables predicting food insecurity. Results Within the sample (N  = 207), 53% reported a chronic pain diagnosis. Adults with pain were more likely to receive food stamps and to have a mental health condition than those without pain. Regression analyses revealed that depressive symptoms and chronic pain significantly predicted food insecurity when controlling for age and gender. Conclusions Exploring the link between depression, pain and nutritional resources may enhance understanding of causal relationships driving food insecurity. Public health officials should address nutritional needs of adults including those with chronic pain who use food bank services. [ABSTRACT FROM AUTHOR]

Suicide is a unique phenomenon in humans. In 2017, over 47,000 Americans died by suicide, prompting a public health crisis. Suicide by burning, while one of the rarest forms of suicide, could be mitigated in part by early recognition and treatment of the underlying psychosocial factors. To date, investigators have attempted to tease out the risk factors associated with this phenomenon through the examination of burn center chart reviews and repository data, but these studies were limited by small sample sizes. In order to fill this gap in the literature, the authors analyzed 14 years of data (2003-2016) from the National Violent Death Reporting System. Suicides by burning (n = 722) were compared with a reference group containing all other suicide types (n = 166,949). Socio-demographic variables and psychosocial factors (eg, mental health, substance use, and alcohol use) were included in the model. Due to the imbalance between the target and reference groups, rare event data analysis was used to reduce potential small sample estimation bias. Results indicated that females (OR = 1.6, 95% CI: .50-2.83, P < .001), Caucasians (OR = 1.7, 95% CI: 1.1-2.7, P < .001), victims with schizophrenia (OR = 5.4, 95% CI: 3.7-7.8, P < .001), and victims with eating disorders (OR = 5.6, 95% CI: 1.9-8.6, P < .001) are significantly more likely to commit suicide by burning. These results contribute new knowledge to what is currently known about suicidal burn-related behaviors and supports interventions that focus on mitigating this insidious public health problem. [ABSTRACT FROM AUTHOR]

ABSTRACT The development of a system of interstate highways in the U.S. has rekindled an interest in demographic responses to transportation innovation. In this paper we examine the relationship between date of completion of an interstate highway and changes in nonmetropolitan county population and employment characteristics during three time periods, 1950-60, 1960-70, and 1970-75. We also attempt to explicate the underlying process by which access to a modem highway affects growth or net migration. This is accomplished by decomposing the association between presence of a highway and net migration into direct and indirect (through industrial employment change) components. Results indicate that interstate counties consistently maintained an advantage over noninterstate counties in net migration, proportion experiencing net immigration (or a turnaround in net migration), and employment growth. Data also suggest that the positive effect of highways on net migration was most in evidence in less remote areas and that it operated largely by promoting employment change in service employment-both nonlocal and tourist-related. There is little evidence that the demographic effect of highways proceeded through expanded manufacturing which, in turn, promoted immigration. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper explores the relationship between selected state demographic variables and two measures of public welfare activity--coverage and closeness for 1960 and 1970. Generally, state wealth accounts for differentials in coverage (State AFDC Recipients/Totals Persons in Poverty in State) while the proportions of poor, proportions nonwhites and state growth in the preceding decade are influential in explaining differential closeness. (Average Monthly State AFDC Grant, Per Recipient/Monthly Per Capita Income of the State.) The two welfare measures are seen as linked to the societal-wide contest between norms of achievement and norms of equality. [ABSTRACT FROM AUTHOR]

ABSTRACT The degree of change in the hierarchy of occupations over long periods is the focus of this paper. Our concern is with the mechanism by which the hierarchy changes. Taxable wealth of incumbents of detailed occupations from 1789 Philadelphia is related to income data from the last three dicennial censuses. Several models of how change might occur are evaluated. We conclude that (1) change in occupational reward differentials is slower than previous estimates, and (2) the first-order causal mechanism by which change in the hierarchy has been presumed to take place is implausible. We also note within-occupation variability in assets of approximately the same magnitude in the two periods. [ABSTRACT FROM AUTHOR]

American working conditions have deteriorated over the last 40 years. One commonly-noted change is the rise of nonstandard and unstable work schedules. Such schedules, especially when held by mothers, negatively affect family functioning and the well-being and development of children; they have implications for the intergenerational transmission of disadvantage. This article describes and compares the working schedules—in terms of type, duration, and variability—of American mothers in 1990 and 2012 in an attempt to assess whether nonstandard and unstable schedules are growing more common. Analyses demonstrate that evening work has increased in prevalence for single mothers but not for their partnered peers. Mothers in both single-mother and two-partner households experienced considerably greater within-week schedule variability and higher likelihood of weekend work in 2012 than they did in 1990. These changes resulted from widespread shifts in the nature of work, especially affecting less educated mothers. [ABSTRACT FROM AUTHOR]

Objectives To identify levels and trends in life expectancy at age 65 (e65) by geographic region and metropolitan status in the United States. Methods Using county-level data on population and deaths from the Census and National Center for Health Statistics, we consider spatial inequality in e65 across 4 metropolitan types and 10 geographic regions from 2000 to 2016. We examine whether changes in e65 are driven by mortality developments in metro types or geographic regions, and compare spatial patterns in the United States to mortality trends in other Organization of Economic Cooperation and Development (OECD) countries. We use decomposition and regression methods to estimate the contributions of 10 causes of death to changes and inequalities in e65. Results Life expectancy at age 65 increased in all spatial units from 2000 to 2016. Areas with higher e65 in 2000 also experienced larger gains. Longevity increases were greatest in large metropolitan areas and coastal regions. Nonmetropolitan areas and the interior lagged far behind not only other parts of the United States but all OECD comparison countries. Metropolitan status was a better predictor of mortality changes than geographic region. Circulatory diseases and diseases associated with smoking were the principal sources of life expectancy gains and spatial differentiation in those gains. Larger gains in smoking-related mortality accounted for greater improvements among men than women. Discussion Even at advanced ages, large geographic disparities in life expectancy remain. And as mortality has declined, these disparities have widened. Public health efforts should pay special attention to identifying and ameliorating the sources of lagging life expectancy in nonmetropolitan regions. [ABSTRACT FROM AUTHOR]

Temporally and spatially highly resolved information on population characteristics, including demographic profile (e.g. age and sex), ethnicity and socio-economic status (e.g. income, occupation, education), are essential for observational health studies at the small-area level. Time-relevant population data are critical as denominators for health statistics, analytics and epidemiology, to calculate rates or risks of disease. Demographic and socio-economic characteristics are key determinants of health and important confounders in the relationship between environmental contaminants and health. In many countries, census data have long been the source of small-area population denominators and confounder information. A strength of the traditional census model has been its careful design and high level of population coverage, allowing high-quality detailed data to be released for small areas periodically, e.g. every 10 years. The timeliness of data, however, becomes a challenge when temporally and spatially highly accurate annual (or even more frequent) data at high spatial resolution are needed, for example, for health surveillance and epidemiological studies. Additionally, the approach to collecting demographic population information is changing in the era of open and big data and may eventually evolve to using combinations of administrative and other data, supplemented by surveys. We discuss different approaches to address these challenges including (i) the US American Community Survey, a rolling sample of the US population census, (ii) the use of spatial analysis techniques to compile temporally and spatially high-resolution demographic data and (iii) the use of administrative and big data sources as proxies for demographic characteristics. [ABSTRACT FROM AUTHOR]

Background: This article investigates changes in disease prevalence, incidence, and mortality among four cohorts of older persons in the Health and Retirement Study.Methods: We examine two cohorts initially aged 51 to 61, whom we call younger cohorts, and two older cohorts aged 70 to 80 at the start of observation. Each of the paired cohorts was born about 10 years apart. We follow the cohorts for approximately 10 years.Results: The prevalence of cancer, stroke, and diabetes increased in later-born cohorts; while the prevalence of myocardial infarction decreased markedly in both later-born cohorts. The incidence of heart disease, myocardial infarction, and stroke decreased among those in the later-born older cohort; while only the incidence of myocardial infarction decreased in the later-born younger cohort. On the other hand, diabetes incidence increased among those in both later-born cohorts. Death rates among those with heart disease, cancer, and diabetes decreased in the later-born cohorts. The declining incidence of three cardiovascular conditions among those who are over age 70 reflects improving population health and has resulted in stemming the increase in prevalence of people with heart disease and stroke.Discussion: While these results provide some important signs of improving population health, especially among those over 70; trends for those less than 70 in the United States are not as positive. [ABSTRACT FROM AUTHOR]

The Caribbean spiny lobster Panulirus argus (Latreille, 1804) is an important species in shallow-water coral reefs and target of the most lucrative fishery in the Caribbean Sea. We explored historical demography in P. argus inferred using single nucleotide polymorphisms (SNPs). We expected an increase in population size of P. argus from Florida, USA starting ~18,000–24,000 years ago, after the Last Glacial Maximum, when ice sheets started to retreat and sub-tropical/tropical shallow coastal waters warmed up. A total of 10 lobsters were collected from shallow reefs in the Florida Keys, Florida, USA. One microgram of gDNA extracted from each specimen was used for RAD library construction using established protocols. A panel of 1643 SNPs obtained after interrogation of RAD-tags was used to calculate a site frequency spectrum (SFS). The observed SFS for the Florida population of P. argus exhibited a non-normal distribution peaking at singleton SNPs. The expected SFS in a total of six different candidate demographic models with dissimilar population size changes through time (i.e. standard neutral, exponential growth, bottleneck, bottleneck + growth, two epochs, and three epochs) were numerically computed in the software ∂a∂i and a model selection approach was implemented to test which expected model(s) best fitted the empirical SFS. The model selection approach indicated that the bottleneck + growth model most closely matched the observed SFS; P. argus experienced a population decline at about 1.9 (0.75–5.7) mya, to then recover and growth exponentially until present time. In disagreement with expectations, population expansion started much earlier than ~18,000–24,000 years ago. Fisheries and conservation studies are expected to profit from the evaluation of genomic and population variability in this species using demographic models, as shown here. Studies exploring population connectivity and locality-specific demographic history of P. argus are underway. [ABSTRACT FROM AUTHOR]

Introduction: The US cigar market is diverse, yet until recently most research studies and tobacco surveillance systems have not reported behavioral and related outcomes by cigar type.Methods: The 2013-2014 Population Assessment of Tobacco and Health Study collected data separately for filtered cigars (FCs), cigarillos, and traditional cigars, which were further distinguished as premium or nonpremium. Descriptive statistics for adult established current smokers of each cigar type and cigarettes were calculated for demographic characteristics, tobacco use patterns, purchasing behaviors and reasons for use. Adjusted prevalence ratios (APRs) using a marginal predictions approach with logistic regression assessed correlates of dual cigar and cigarette smoking.Results: Age, sex, race/ethnicity, education level, and poverty status of smokers varied according to cigar type. Daily cigar smoking prevalence and number of cigars smoked per day were higher for FCs (37.3%; median: 1.6 cigars/day, respectively), than all other cigar types (6.7%-25.3%, all p < .01; 0.1-0.4 cigars/day, all p < .01, respectively); daily smoking and cigars per day were similar for nonpremium cigars and cigarillos (p = .11; p = .33, respectively). Cigarette smoking was twice as common among smokers of nonpremium cigars, cigarillos, and FCs (58.0%-66.0%) than among premium cigars (29.9%). Among current cigar smokers, FC smokers (APR = 1.23, 95% confidence interval [CI] = 1.09-1.39), other tobacco product users (APR = 1.27, 95% CI = 1.15-1.41), and those with a GED/high school diploma or less (APR = 1.20, 95% CI = 1.09-1.33) were more likely to also smoke cigarettes.Conclusion: User characteristics, cigar smoking patterns, and dual smoking with cigarettes varied by cigar type highlighting the importance of adequately describing the cigar type studied and, where appropriate, differentiating results by cigar type.Implications: Despite the diversity of the cigar market place, historically many research studies and tobacco surveillance systems have treated cigars as a single product type. This study describes similarities and differences in the user characteristics, tobacco use patterns, and purchasing behaviors of premium, nonpremium, cigarillo, and filtered cigar smokers. To enhance tobacco regulatory science, sufficient descriptions of the cigar type(s) studied and, where appropriate, differentiation of the particular cigar type(s) studied should be undertaken to improve the interpretation of study findings, understanding of cigar use patterns and related behaviors and future approaches to reducing cigar-attributable morbidity and mortality. [ABSTRACT FROM AUTHOR]

Introduction: Legal strategies to raise the minimum age of purchase for tobacco from 18 to 21, known as "Tobacco 21 laws" are a promising means to reduce adolescent tobacco initiation and use. Tobacco 21 laws are enacted at the local and state level, yet prior studies have examined national support. To address this gap, we assessed attitudes of residents in five states toward Tobacco 21 laws, and how attitudes varied by demographic, political, and health status characteristics.Methods: The data are derived from the 2016 Texas Medical Center (TMC) Consumer Health Report, a survey of 5007 adults from five states: California, Florida, Ohio, New York, and Texas. Bivariate and multivariate logistic regression analyses were used to assess differences in support.Results: Eight in 10 respondents supported Tobacco 21. Support was high across all five states, ranging from 78% in Texas to 85% in New York. Tobacco 21 was supported by a majority of respondents in all racial, educational, age, and income groups assessed. While support was generally strong, chi-square analyses revealed differences across states in support by demographic and health status characteristics. Support was generally higher among older individuals, whites, and those with more education, although the size and even direction of the relationship by population subgroup varied across states.Conclusion: Tobacco 21 laws enjoy overwhelming majority support in all five states and across all sociodemographic subgroups assessed. However, the strength of support by population subgroup varies across states.Implications: While earlier studies had found strong support for Tobacco 21 laws at the national level, little data were available about attitudes at the state level, where current Tobacco 21 policymaking efforts are concentrated. Our data indicate that legislators from both liberal and conservative states should feel confident in advancing Tobacco 21 laws to protect the current and future health of adolescents. However, patterns of support vary by population subgroup across states. Understanding variations in support by population subgroup at the state level can guide policymakers in targeted efforts to advance public health laws aimed at reducing adolescent tobacco initiation and use. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco companies have a history of making health claims about their new products. Such claims are now regulated by the US Food and Drug Administration. We examined consumer interest in hypothetical modified risk tobacco products (MRTPs) among current, former, and never established smokers and examined whether interest was associated with beliefs about tobacco and cancer.Methods: Data were analyzed from the US nationally representative 2015 Health Information National Trends Survey (HINTS-FDA 2015; N = 3738). Interest in hypothetical MRTPs was assessed by asking participants their likelihood of using tobacco products claiming to be less addictive and less harmful than other products.Results: About half of current smokers and a tenth of both former and never smokers reported they were "somewhat" or "very" likely to try hypothetical MRTPs claiming to be less harmful or less addictive. Female smokers, former smokers with lower smoking harm perceptions, and never smokers who are young adults or without college education expressed more interest in these products. Interest in using these products was positively associated with believing that smoking status is a changeable individual characteristic and that it is possible for tobacco products to be made without some harmful chemicals.Conclusion: We identified several subgroups of current, former, and never smokers who may be particularly affected by the marketing of MRTPs and therefore important to study to inform models of the potential population health impact of authorizing the marketing of MRTPs.Implications: Findings about interest in hypothetical MRTPs can inform models of how the marketing of MRTPs could affect population health. Understanding which subgroups are particularly interested in MRTPs can help determine who might be important to study to inform these models. We identified several groups who may warrant specific attention: smokers who are female, former smokers who hold low harm perceptions of smoking, never smokers who are young adults or have a high school education or less, people who believe that smoking is a changeable individual characteristic, and people who believe that it is possible to make low chemical tobacco products. [ABSTRACT FROM AUTHOR]

Introduction: Since the U.S. Food and Drug Administration (FDA) was granted regulatory authority over tobacco products in 2009, few studies have examined perceived credibility of the FDA in this role. The current study assessed knowledge and credibility of the FDA as a regulator of tobacco products.Methods: In a nationally representative survey of U.S. adults (N = 4758), we assessed knowledge that the FDA regulates the manufacture, distribution, and marketing of cigarettes, and credibility of the FDA as a tobacco regulator. We examined demographic differences in knowledge and credibility, and associations of knowledge and trust in government with credibility perceptions.Results: Less than half of respondents reported knowing the FDA regulates how cigarettes are sold (46.8%) and advertised (49.7%), and only 36.0% knew the FDA regulates how cigarettes are made, with few demographic differences. Respondents reported that the FDA was moderately credible in regulating tobacco. Knowledge of the FDA as a tobacco regulator and trust in government were the strongest predictors of credibility. Being of younger age, being White (compared to African American), and being male were associated with higher credibility ratings of the FDA.Conclusions: Much of the public still does not know that the FDA regulates tobacco products, and credibility perceptions are moderate. Greater knowledge of the FDA's regulatory role was associated with higher credibility; efforts that increase the public's understanding of the FDA's role as a tobacco regulator may positively impact views of the agency's credibility. This may in turn improve public reception to the FDA's messages and regulations.Implications: This study is the first to show nationally representative estimates of both knowledge and credibility of the FDA as a tobacco regulator. Our research shows further that knowledge of the FDA's tobacco regulatory roles is likely to be an important factor related to perceived credibility of the FDA. Increasing the public's knowledge of the FDA's roles may enhance the agency's credibility, which can improve public reception to messages and regulations. [ABSTRACT FROM AUTHOR]

Introduction: Smokeless tobacco (SLT) use in the United States has remained constant or even increased slightly in recent years, whereas smoking has continuously decreased. Characterization of transitions between tobacco products is critical to understand the reasons behind the continuing use of smokeless tobacco.Methods: Two longitudinal cohorts of Tobacco Use Supplement of the Current Population Survey (TUS-CPS), 2002-2003 (n = 14996) and 2010-2011 (n = 18226), were used to examine transitions between cigarette and SLT use over 1-year periods. Weighted population percentages of four use categories (exclusive cigarette use, exclusive SLT use, dual use, and neither) were calculated for different demographic groups. Transition between use categories and quit rates by product were calculated for each cohort.Results: Relative to 2002-2003, smoking quit rates of male exclusive smokers significantly increased in 2010-2011 (11.6% vs. 24.4%, p < .0001), but the corresponding SLT use quit rates remained stable (41.3% vs. 40.0%, p = .87). Similar patterns were found in females with smoking quit rates increasing considerably (12.3% vs. 24.2%, p < .0001). Smoking quit rates increased in most sociodemographic groups analyzed. Male SLT use quit rates were significantly lower in SLT exclusive users than in dual users in the 2010-2011 cohort (40.0% vs. 62.2%; p = .04), but smoking quit rates in exclusive smokers and in dual users were roughly equivalent (24.4% vs. 29.5%, p = .68).Conclusions: Although smoking quit rates doubled overall and increased in most sociodemographic groups, SLT quit rates remained constant with little transition between products. Longer-term prospective data examining polytobacco use are needed to better understand transitions between tobacco products.Implications: This study uses two longitudinal surveys to investigate changes in switching behaviors between tobacco products. We found that quit rates of self-reported smoking doubled between 2002-2003 and 2010-2011 in most sociodemographic groups in the United States, whereas in contrast quit rates of self-reported Smokeless Tobacco (SLT) use remained roughly constant. This explains in part the opposing trends of tobacco use by product in the United States, with smoking continuing its decrease, whereas SLT use remains constant. Moreover, smokers were unlikely to switch to other forms of tobacco compared to SLT users. Lastly, smoking cessation for dual users was not significantly different from that of exclusive smokers. Understanding transitions between smoking and SLT use is critical to assess the potential long-term impact of SLT use, and potentially that of other alternative tobacco products, on tobacco-related health outcomes. [ABSTRACT FROM AUTHOR]

Background and Objectives We examine trends in informal care from the perspective of both community-dwelling disabled older Americans and their caregivers from 1982 to 2012. We decompose hours of care received from spouses and children according to changes in: (a) the number of potential spousal and child caregivers (“family structure”), (b) the likelihood that existing spouses and children are caregivers (“caregiving propensity”), and (c) the amount of care provided by individual caregivers (“time burden”). Research Design and Methods We examine two sets of time trends based on distinct samples of community-dwelling disabled older Americans from the 1982–2004 waves of the National Long-Term Care Survey (NLTCS) and the 2000–2012 waves of the Health and Retirement Study (HRS). Results Existing spouses’ and children’s decreasing likelihood of being caregivers led to fewer spousal and child caregivers per disabled older person in the 2004 NLTCS than the 1982 NLTCS. However, the NLTCS and HRS time trends suggest that the amount of care provided by individual caregivers was similar from 1989 to 2012. Discussion and Implications Because individual caregivers’ time burden has remained fairly constant since at least 1989, advocacy on behalf of policies that promote more and better support for caregivers is appropriate. [ABSTRACT FROM AUTHOR]

Multiple classification analysis is used to examine the relative importance of physical/structural, socioeconomic, and demographic factors in shaping household responses to changes in the cost and availability of energy. Two coping strategies analyzed are switching to alternative and less-expensive fuels for space heating and investing in home retrofitting. Results show that physical/structural characteristics of the familial microenvironments are more important than socioeconomic and family factors in molding consumption levels and behavioral adaptations. [ABSTRACT FROM AUTHOR]

Maintaining body temperature is a unique challenge with burn care. We sought to describe core temperature goals in the operating room (OR) and the methods used to achieve and maintain these goals, along with current methods of warming in the intensive care unit (ICU), the perception of effect of increased ambient temperature on work performance, and concerns with contamination of sterile fields due to increased ambient temperature. A 24 question survey was disseminated to burn centers in the United States and Canada. The questions included demographics, target core and ambient temperatures, warming methods, and beliefs on ambient temperature's effects. Of 121 burn centers, 52 questionnaires were completed (43% response rate). The majority of centers targeted a core temperature between 36 and 38°C in the OR and an ambient temperature between 75 and 95°F in the ICU. The most common methods for maintaining core temperature included warmed ambient temperature, forced air devices, and intravenous fluids. Although the majority of centers reported the belief that increased ambient temperature benefits patients, many also reported that there is a negative impact on staff performance and risk of staff perspiration contaminating sterile fields. Burn centers reported a range of target core temperatures and methods to reach target temperatures. More than a third of respondents perceived a negative impact work performance while more than half acknowledged the potential for contamination of sterile fields. A prospective observational study is needed to determine actual temperature regulation practice patterns and its impact on outcomes. [ABSTRACT FROM AUTHOR]

The military has used silver-nylon dressings as a topical antimicrobial on combat-related burns for the past 15 years. However, their clinical efficacy and associated risks have not been evaluated. Herein, the authors document our experience with the use of a specific silver-nylon dressing (Silverlon®) during global evacuation of casualties from combat zones to the United States sArmy Institute of Surgical Research Burn Center. A 10-year retrospective analysis was performed. Variables included patient demographics, total body surface area, length of stay, Injury Severity Score, incidence of urinary tract and burn infections, pneumonia, patient status at the time of discharge, and a composite endpoint. The patient cohort was stratified into two groups: Silverlon® (Group 1) and topical antimicrobial agents (Group 2). Data were analyzed using appropriate statistical tests (P ≤ .05). Nine hundred eighty-eight patients (26 ± 6 years) were identified with 184 patients (Group 1) and 804 patients (Group 2). Silver-nylon dressings trended toward decreased wound infection rate (5.4 vs 9.5%) even when applied to full-thickness burn injuries. When compared with topical antimicrobial agents, the silver-nylon dressing was not associated with significant differences in burn-related complication. The authors demonstrate the antimicrobial efficacy of the silver-nylon dressing during global evacuation of burn casualties from combat zones to the burn center. Compared with topical antimicrobials, the silver-nylon dressing is lightweight and easy to apply and requires minimal wound management which makes it desirable as a burn dressing for combat applications as well as mass casualty situations. [ABSTRACT FROM AUTHOR]

Objectives Studies have reported decreasing dementia prevalence in recent decades in the United States. We explore with a new national data source whether declines have occurred since 2011, whether trends are attributable to shifts in dementia incidence or mortality, and whether trends are related to shifts in population composition or subgroup prevalence. Methods We use the 2011–2015 National Health and Aging Trends Study (N = 27,547) to examine prevalence of probable dementia among the 70 and older population. To minimize the influence of potential learning effects on prevalence rates, we require individuals to meet probable dementia criteria at two consecutive rounds. Results: Prevalence of probable dementia declines over this period by 1.4% to 2.6% per year. Declines are concentrated among women, non-Hispanic white and black groups, and those with no vascular conditions or risk factors. The latter group also has experienced declines in dementia incidence. Declines in prevalence are largely attributable to age- and education-related shifts in population composition. Discussion Given the role of age and educational composition in short-term declines, the United States is likely to continue to experience short-term declines in dementia prevalence. However, persistently high rates among minority groups, especially of Hispanic origin, are concerning, and, barring new treatments, long-run trends may reverse course. [ABSTRACT FROM AUTHOR]

Background: General surgery (GS) residents are often required to provide immediate preliminary interpretations of radiological images, especially in critical situations. It is unclear whether residents in Accreditation Council for Graduate Medical Education-accredited GS programmes receive sufficient radiological training to deliver adequate patient care.Objectives: Determine the utilisation of radiology rotations (RR) during GS residency.Methods: Between February and March 2015, a pilot voluntary 19-item survey was electronically distributed to GS programme directors (PDs) regarding the availability and value of a RR during GS training.Results: A total of 234 PDs received the questionnaire and the response rate was 36.8% (n=86). Sixty-five (77.4%) PDs expected their trainees to interpret imaging studies in the acute setting; however, only 8.3% of programmes had a dedicated RR. RRs are more prevalent among community-based than university-based programmes (71.4% vs 27.9% p=0.003). The implementation of a RR may be limited due to insufficient number of GS residents in the department (p=0.002). 75.4% of PDs expect GS residents to confirm their findings with a radiologist. In those programmes with RR, most PDs (85.7%) believed that a dedicated rotation improved GS residents' understanding of radiological imaging.Conclusion: The majority of PDs are currently not confident that GS residents are capable of interpreting radiological imaging independently; however, the implementation of a mandatory RR in GS residency curriculum yet seems to be controversial. Given the expectation of PDs and the continued need to improve patient care, the integration of a dedicated RR in GS training should be encouraged. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) incidence in the United States is declining rapidly overall but, curiously, is increasing among young adults. Age-specific and birth cohort patterns can provide etiologic clues, but have not been recently examined.Methods: CRC incidence trends in Surveillance, Epidemiology, and End Results areas from 1974 to 2013 (n = 490 305) were analyzed by five-year age group and birth cohort using incidence rate ratios (IRRs) and age-period-cohort modeling.Results: After decreasing in the previous decade, colon cancer incidence rates increased by 1.0% to 2.4% annually since the mid-1980s in adults age 20 to 39 years and by 0.5% to 1.3% since the mid-1990s in adults age 40 to 54 years; rectal cancer incidence rates have been increasing longer and faster (eg, 3.2% annually from 1974-2013 in adults age 20-29 years). In adults age 55 years and older, incidence rates generally declined since the mid-1980s for colon cancer and since 1974 for rectal cancer. From 1989-1990 to 2012-2013, rectal cancer incidence rates in adults age 50 to 54 years went from half those in adults age 55 to 59 to equivalent (24.7 vs 24.5 per 100 000 persons: IRR = 1.01, 95% confidence interval [CI] = 0.92 to 1.10), and the proportion of rectal cancer diagnosed in adults younger than age 55 years doubled from 14.6% (95% CI = 14.0% to 15.2%) to 29.2% (95% CI = 28.5% to 29.9%). Age-specific relative risk by birth cohort declined from circa 1890 until 1950, but continuously increased through 1990. Consequently, compared with adults born circa 1950, those born circa 1990 have double the risk of colon cancer (IRR = 2.40, 95% CI = 1.11 to 5.19) and quadruple the risk of rectal cancer (IRR = 4.32, 95% CI = 2.19 to 8.51).Conclusions: Age-specific CRC risk has escalated back to the level of those born circa 1890 for contemporary birth cohorts, underscoring the need for increased awareness among clinicians and the general public, as well as etiologic research to elucidate causes for the trend. Further, as nearly one-third of rectal cancer patients are younger than age 55 years, screening initiation before age 50 years should be considered. [ABSTRACT FROM AUTHOR]

The article explores on the history of the U.S. including the political economy, foreign relations and the nation's infrastructure as well as the offshore commercial and military base. It highlights the importance of American community in order to recognize the Americans in the foreign territory. It also cites the rights, protections, and duties of U.S. law for the Americans citizens and residents in the country wherein the nation made treaties and alliances with the polities through internal migrations and negotiations.

Scholars have long merged election and census geography to correlate census demographics and election results to infer political behavior (Ogburn and Goltra 1919; Gosnell and Gill 1935; Key 1949). Increasing accessibility of geospatially defined election data provides a valuable tool to understanding voting behavior in the United States at geographic levels unavailable to previous scholars. Here, we describe these data and examine four methods to merge spatial data when precinct and census boundaries are non-conforming: areal weighting, dasy- metric mapping, point kriging, and kriging-based areal interpolation. Through a case study of sixteen states and the District of Columbia, we find that dasymetric mapping--a method that uses external data to construct more accurate and realistic weights for areal weighting, in this case the National Land Cover Database--is the best method to estimate demographic characteristics of precincts when census block boundaries do not conform to precinct boundaries. We apply dasymetric mapping to generate a publicly available national database of merged election results and census data for precincts. [ABSTRACT FROM AUTHOR]

Introduction: For years, national US surveys have found a lower prevalence of cigarette smoking among non-Hispanic (NH) black adolescents and young adults than their NH white counterparts while finding either similar or higher prevalence in NH blacks among older adults. We present results from four US surveys, including one supplemented by cotinine data, to determine if a race-gender-age crossover effect exists between NH black and NH white current cigarette smokers.Methods: We present NH black and NH white current cigarette smoking estimates in the National Youth Tobacco Survey (2004-2013), National Survey on Drug Use and Health (2002-2013), National Health Interview Survey (2001-2013), and National Health and Nutrition Examination Survey (2001-2012).Results: All surveys consistently found that NH black females aged 12-25 years had a lower smoking prevalence than NH white females of the same age while NH black males aged 26 years or older had a higher smoking prevalence than NH white males of the same age. Results were inconsistent between surveys for current smoking estimates for males 12-25 years and females aged 26 years or older.Conclusion: Our results are inconclusive in consistently detecting the existence of a race-gender-age crossover effect for current cigarette smoking between NH blacks and NH whites. National birth cohort studies are better suited to detect a race-gender-age crossover effect in smoking prevalence between these two racial groups. [ABSTRACT FROM AUTHOR]

Since the 1950s, one-of-four American adults has been a Catholic. That constant fraction hides substantial change. Higher fertility, more immigrants, and a relatively young age distribution implies growth, not stasis. The demographic advantage is reflected in the growing fraction of adults who were raised Catholic. The fraction raised Catholic exceeded one-of-three Americans in recent years. The difference between one-of-four and one-of-three means substantial defection. More than ever, people raised Catholic are leaving; most drop out of organized religion altogether. Measures of core beliefs and strength of identity changed less, overall, implying that it was inactive and weakly identified Catholics who left. Identities, beliefs, and practices among millennials with no religious preference, but Catholic roots underscore the degree to which changes are rooted in disaffection with organized religion. Among people who were raised Catholic, the traditional sexual ethic continued to erode, but papal authority has not changed across recent cohorts. [ABSTRACT FROM AUTHOR]

This article explores intersections between place, race/ethnicity, and gender amongst American Twitter users and makes an argument that studying the intensity of tweets provides insights into how and why particular groups tweet. Given recent events in American political life such as the shooting in Ferguson, Missouri and the reactions by young, urban African Americans on Twitter, understanding the role of race, place, gender, and age is important. We observed the time between tweets of urban American Twitter users and explored whether the medium may be providing traditionally marginalized groups, such as young Black men, with potential avenues for mobilizing communication and access to resources. [ABSTRACT FROM AUTHOR]

Past patterns of infectious disease transmission set the stage on which modern epidemiologic dynamics are played out. Here, we present a comprehensive account of pertussis (whooping cough) transmission in the United States during the early vaccine era. We analyzed recently digitized weekly incidence records from Morbidity and Mortality Weekly Reports from 1938 to 1955, when the whole-cell pertussis vaccinewas rolled out, and related them to contemporary patterns of transmission and resurgence documented in monthly incidence data from the National Notifiable Diseases Surveillance System. We found that, during the early vaccine era, pertussis epidemics in US states could be categorized as 1) annual, 2) initially annual and later multiennial, or 3) multiennial. States with predominantly annual cycles tended to have higher per capita birth rates, more household crowding, more children per family, and lower rates of school attendance than the states with multiennial cycles. Additionally, states that exhibited annual epidemics during 1938-1955 have had the highest recent (2001-2010) incidence, while those states that transitioned from annual cycles to multiennial cycles have had relatively low recent incidence. Our study provides an extensive picture of pertussis epidemiology in the United States dating back to the onset of vaccination, a back-story that could aid epidemiologists in understanding contemporary transmission patterns. [ABSTRACT FROM AUTHOR]

Cohort mortality studies of underground miners have been used to estimate the number of lung cancer deaths attributable to radon exposure. However, previous studies of the radon-lung cancer association among underground miners may have been subject to healthy worker survivor bias, a type of time-varying confounding by employment status. We examined radon-mortality associations in a study of 4,124 male uraniumminers from the Colorado Plateau who were followed from 1950 through 2005. We estimated the time ratio (relative change in median survival time) per 100 working level months (radon exposure averaging 130,000 mega-electron volts of potential α energy per liter of air, per working month) using G-estimation of structural nested models. After controlling for healthy worker survivor bias, the time ratio for lung cancer per 100 working level months was 1.168 (95% confidence interval: 1.152, 1.174). In an unadjusted model, the estimate was 1.102 (95% confidence interval: 1.099, 1.112)-39% lower. Controlling for this bias, we estimated that among 617 lung cancer deaths, 6,071 person-years of life were lost due to occupational radon exposure during follow-up. Our analysis suggests that healthy worker survivor bias in miner cohort studies can be substantial, warranting reexamination of current estimates of radon's estimated impact on lung cancer mortality. [ABSTRACT FROM AUTHOR]

The author reflects on the issue over a perinatal and infant mortality in the U.S. He states that mortality is recognized as indicators of the health status of a population, and a major public health and social problems. The author mentions that reductions in perinatal and infant mortality have been described in most areas of the world.

Introduction: Nondaily smoking in the United States is increasing. Although differences in smoking and cessation behaviors between daily and nondaily smokers have been documented, differences among nondaily smokers are poorly understood. This study provides updated national data on smoking and cessation characteristics among nondaily versus daily smokers and between subgroups of nondaily smokers. Methods: Data were obtained from the 2009–2010 National Adult Tobacco Survey, a stratified, dual-frame telephone survey conducted in the United States. Participants were categorized into daily smokers, never-daily nondaily smokers (NDNS), recently converted (≤1 year) nondaily smokers (RCNS), and established-converted (>1 year) nondaily smokers (ECNS). Chi-square tests were used to assess differences across groups, and multivariable logistic regression was used to identify factors associated with past-year quit attempts. Results: Among nondaily smokers (17.8% of the total sample), 27.1% were NDNS, 37.4% were RCNS, and 35.4% were ECNS. RCNS were the most likely to report ever having tried to quit (p < .0001), having tried to quit in the past year (p < .0001), having used cessation treatment during their last quit attempt (p < .05), and wanting to quit smoking for good (p < .001). Compared with NDNS, RCNS had more than twice the odds of trying to quit in the past year after adjusting for demographics and smoking characteristics (adjusted odds ratio = 2.1, 95% confidence interval = 1.3–3.2). No significant differences existed between NDNS and ECNS. Conclusions: RCNS are potentially more interested in quitting and should be specifically targeted with cessation interventions to avoid relapse to daily or long-term nondaily smoking. [ABSTRACT FROM PUBLISHER]