Volume 55 - Number 2 - Summer 1989

E. Mortality

Studies that treat quantitative mortality data analytically. Methodological studies primarily concerned with mortality are cited in this division and cross-referenced to N. Methods of Research and Analysis Including Models , if necessary. The main references to crude data are in the vital statistics items in S. Official Statistical Publications .

E.1. General Mortality

Studies of overall mortality and comparisons of several types of mortality. Studies dealing with two or more of the topics listed in this division are classified under the major section covered, or, if this is not self-evident, included here under General Mortality.

55:20120 Benjamin, Bernard. Years of life lost and other mortality indices. Journal of the Institute of Actuaries, Vol. 115, Pt. 4, No. 462, 1988. 709-19 pp. London, England. In Eng.
Some alternative indices of mortality are reviewed and illustrated using data for England and Wales.
For a related paper, published in 1953, see 24:4177.
Location: Princeton University Library (SM).

55:20121 Curwen, Michael; Devis, Tim. Winter mortality, temperature and influenza: has the relationship changed in recent years? Population Trends, No. 54, Winter 1988. 17-20 pp. London, England. In Eng.
"Death rates in the winter months are higher than at other times of the year and there are no satisfactory explanations of why this is so. This paper examines the relationship between winter deaths, temperature and influenza deaths over the last 35 years in England and Wales using the latest available information." The analysis shows a clear relationship between excess winter deaths, temperature, and influenza mortality over the period 1949-1985.
For a related study, published in 1981, see 48:20237.
Correspondence: M. Curwen, Medical Statistics Division, Office of Population Censuses and Surveys, St. Catherines House, 10 Kingsway, London WC2B 6JP, England. Location: Princeton University Library (SPR).

55:20122 Czechoslovakia. Ceskoslovenska Akademie Ved. Ceskoslovenska Demograficka Spolecnost (Prague, Czechoslovakia). Mortality and population aging in Czechoslovakia. [Umrtnost a starnuti obyvatelstva v Ceskoslovensku.] Acta Demographica, No. 8, 1988. 204 pp. Prague, Czechoslovakia. In Cze. with sum. in Eng; Rus.
These are the proceedings of a conference of the Czechoslovak Demographic Society, held in Liblice, October 28-30, 1987, on the topic of mortality and demographic aging in Czechoslovakia. The 29 papers are grouped under the subject headings of the secular evolution of mortality, infant and child mortality, regional differences in mortality levels, the health situation of the population, demographic aging, and health care.
Location: Princeton University Library (SPR).

55:20123 Dalla Zuanna, Giampiero. Mortality by cause and age in the Veneto. [La mortalita per causa e per eta nel Veneto.] 1986. 213 pp. Franco Angeli: Milan, Italy. In Ita.
Trends in mortality by age and cause in the Northern Italian region of the Veneto are analyzed and comparisons are made with other regions in Italy. The analysis covers the period since World War II and is presented separately for adults and children. Consideration is given to differences in causes of death for the various major age groups. The author attributes the relatively poor mortality record of the Veneto to characteristics of the region's socioeconomic development. The need for improvements in preventive medical facilities is stressed.
Correspondence: Franco Angeli, Viale Monza 106, 20127 Milan, Italy. Location: Princeton University Library (SPR).

55:20124 Damiani, Paul; Masse, Helene. Linkage of mortality by cause with urbanization and socio-professional status. [Liaison de la mortalite par cause avec l'urbanisation et la categorie socio-professionnelle.] Journal de la Societe de Statistique de Paris, Vol. 129, No. 4, 1988. 269-76 pp. Nancy, France. In Fre.
The statistical linkage of causes of death with urbanization and socio-professional class is examined using official French medical data for the period 1968-1970, data from the 1968 census, and a regression model. Results are compared with those determined by using data from a longitudinal INSEE survey.
Correspondence: P. Damiani, Institut National de la Statistique et des Etudes Economiques, 18 Boulevard Adolphe Pinard, 75675 Paris Cedex 14, France. Location: Princeton University Library (SPR).

55:20125 de Waal, Alex. Famine mortality: a case study of Darfur, Sudan 1984-5. Population Studies, Vol. 43, No. 1, Mar 1989. 5-24 pp. London, England. In Eng.
"A survey was undertaken in the Darfur Region of Sudan, to collect retrospective mortality data for the famine period of 1984-5. During the famine the crude death rate trebled to 40 per thousand. Most of the excess mortality consisted of a sharp seasonal rise in child deaths. Infant and adult mortality rose only to a lesser extent. Fertility was lowered. The main causes of death were diarrhoeas, measles and malaria. Health factors, such as water supply, were associated with mortality differentials, and socio-economic variables such as wealth were not. It is argued that the excess mortality can be explained by severe localised health crises which caused increased exposure to life-threatening diseases. This conflicts with the established 'starvation model' of famine mortality, in which it is suggested that excess mortality occurs mainly through increased risk of death due to malnutrition."
Correspondence: A. de Waal, Nuffield College, Oxford University, Oxford OX1 1NF, England. Location: Princeton University Library (SPR).

55:20126 Demoliates, Giannes D. A biostatistical investigation of mortality in Greece, 1956-1982. [Biostatistike diereunese tes thnesimotetas stin Ellada, 1956-1982.] 1988. 167 pp. University of Ioannina, Medical School, Department of Social Medicine and Mental Health, Laboratory of Hygiene: Ioannina, Greece. In Gre. with sum. in Eng.
Mortality trends in Greece over the period 1956-1982 are analyzed using official vital statistics data. Consideration is given to mortality differentials by age and sex, by geographical region and for rural and urban areas, and by season. Special attention is paid to infant and maternal mortality. An analysis of causes of deaths is also presented. A chapter is included on life expectancy and life tables for the population of Greece. The results indicate that infant and maternal mortality have continued to decline, although the crude death rate has increased because of the demographic aging of the population.
Correspondence: University of Ioannina, Medical School, Department of Social Medicine and Mental Health, Ioannina, Greece. Location: Princeton University Library (SPR).

55:20127 Dutta, Jayasri; Mallick, Soumitra. On land and life: life expectancy, population policy and the land-labor ratio. First Boston Working Paper Series, No. FB-88-05, Oct 1987. 40 pp. Columbia University, Graduate School of Business: New York, New York. In Eng.
"This paper examines the impact of changes in life expectancy in the context of a simple overlapping generations model. We contrast the optimal allocation with the equilibrium solution in a competitive economy with inheritance. The mortality rate indexes the nature of competitive inefficiency; in addition, the qualitative effect of changes in the mortality rate on welfare differ at the optimal and at the equilibrium solutions."
Correspondence: Columbia University, Graduate School of Business, 6N Uris Hall, New York, NY 10027. Location: Joint Bank-Fund Library, Washington, D.C.

55:20128 Fargues, Philippe; Nassour, Ouaidou. Twelve years of urban mortality in the Sahel. Levels, trends, seasons, and causes of mortality in Bamako, 1974-1985. [Douze ans de mortalite urbaine au Sahel. Niveaux, tendances, saisons et causes de mortalite a Bamako, 1974-1985.] INED Travaux et Documents Cahier, No. 123, ISBN 2-7332-0123-9. 1988. 198 pp. Institut National d'Etudes Demographiques [INED]: Paris, France; Institut du Sahel: Bamako, Mali. In Fre.
Mortality trends in Bamako, capital of Mali, during the period 1974-1985 are analyzed, using data compiled from public health administrative registers, which record information on mortality by age, sex, cause, and month of death. The first chapter provides a general description of Bamako and its environment, particularly the health infrastructure and data collection system. The second chapter contains data on mortality levels and trends, including age-specific mortality, differential mortality by sex, and late fetal mortality. The third chapter considers seasonal variations in mortality. The fourth and final chapter presents a detailed analysis of causes of death.
Correspondence: Presses Universitaires de France, 14 Avenue du Bois-de-l'Epine, B.P. 90, 91003 Evry Cedex, France. Location: Princeton University Library (SPR).

55:20129 Gavrilov, L. A. Biological-demographic aspects of investigating the duration of life. [Biologo-demograficheskie aspekty issledovaniya prodolzhitel'nosti zhizni.] Demograficheskie Issledovaniya, 1988. 105-21 pp. Moscow, USSR. In Rus.
The author discusses the importance of investigating the biological factors that influence mortality, with a focus on the positive impact such investigations have on research concerning population reproduction.
Location: Princeton University Library (SPR).

55:20130 Hansluwka, Harald. Mortality data in Europe--availability, validity and comparability. In: Demographie in der Bundesrepublik Deutschland: vier Jahrzehnte Statistik, Forschung und Politikberatung. Festschrift fur Karl Schwarz, edited by Charlotte Hohn, Wilfried Linke, and Rainer Mackensen. Schriftenreihe des Bundesinstituts fur Bevolkerungsforschung, Vol. 18, 1988. 123-40 pp. Boldt-Verlag: Boppard am Rhein, Germany, Federal Republic of. In Eng.
This paper focuses on the availability, validity, and comparability of mortality data in Europe. The role of the World Health Organization is first described, and some of the main issues encountered in studying mortality patterns are then reviewed. Topics covered include denominator (population) data, definitions of vital events, completeness of coverage of mortality statistics, accuracy of recording demographic and socioeconomic variables on death certificates, and the quality of recording causes of death.
Location: Princeton University Library (SPR).

55:20131 Headland, Thomas N. Population decline in a Philippine Negrito hunter-gatherer society. American Journal of Human Biology, Vol. 1, No. 1, 1989. 59-72 pp. New York, New York. In Eng.
"The Casiguran Agta constitute a Negrito hunter-gatherer society in northeastern Luzon [Philippines]. The hypothesis presented is that this population has suffered serious decline over the last half-century. Demographic data collected over a 24-year period are used to substantiate this hypothesis. Agta figures on crude death rate, rate of natural decrease, infant mortality, life expectancy at birth, and homicide are among the most extreme known for any human population. Reasons for this decline are described, with emphasis on the factor of homicide." Data are from anthropological research conducted in the Philippines by the author from 1962 to 1986.
Correspondence: T. N. Headland, Summer Institute of Linguistics, 7500 West Camp Road, Dallas, TX 75236. Location: Princeton University Library (SPR).

55:20132 Johnston, Francis E.; Reid, William; De Baessa, Yetilu; Macvean, Robert B. Socioeconomic correlates of fertility, mortality, and child survival in mothers from a disadvantaged, urban Guatemalan community. American Journal of Human Biology, Vol. 1, No. 1, 1989. 25-30 pp. New York, New York. In Eng.
"Social and economic determinants of fertility, mortality, and child survival were studied in a sample of 519 mothers from El Progreso, a disadvantaged community located on the outskirts of Guatemala City. Fertility...and mortality...data were obtained from interviews, along with data on the characteristics of the mothers, fathers, and the households." Years of schooling of the father and the mother, the type of fuel used for cooking, and contraceptive use were analyzed for their impact on fertility, mortality, and child survival.
Correspondence: F. E. Johnston, Department of Anthropology, University of Pennsylvania, Philadelphia, PA 19104-6398. Location: Princeton University Library (SPR).

55:20133 Kalkstein, Laurence S.; Davis, Robert E. Weather and human mortality: an evaluation of demographic and interregional responses in the United States. Annals of the Association of American Geographers, Vol. 79, No. 1, Mar 1989. 44-64 pp. Washington, D.C. In Eng.
"This study describes the impact of weather on human mortality at numerous locations around the United States. We evaluate forty-eight cities and determine the differential impact of weather on mortality on an intercity and interregional level. The mortality data are analyzed separately for different age, race, and cause of death categories. The possible impact of geographical and within-season acclimatization is also analyzed." Mortality data are from the National Center for Health Statistics (NCHS) for selected years from 1964 to 1980. The results indicate that in summer, warm, humid, and calm conditions relate to highest mortality, particularly in areas where hot weather is uncommon. "Winter relationships are generally weaker, and cloudy, damp, snowy conditions are associated with the greatest mortality. In both seasons, the elderly appear to be disproportionately stressed when compared to other age groups." Regional and ethnic differences are also included.
Correspondence: L. S. Kalkstein, Center for Climatic Research, University of Delaware, Newark, DE 19716. Location: Princeton University Library (PR).

55:20134 Klinger-Vartabedian, Laurel; Wispe, Lauren. Age differences in marriage and female longevity. Journal of Marriage and the Family, Vol. 51, No. 1, Feb 1989. 195-202 pp. Saint Paul, Minnesota. In Eng.
The authors discuss the influence of age differences in marriage on female longevity. Data drawn from the 1968 portion of the U.S. National Mortality Followback Survey and the 1970 U.S. census show that "women married to younger men tended to live longer than expected, while women married to older men tended to die sooner than expected....Two possible explanations are discussed: (a) mortality outcomes are predetermined by mate selection, or (b) psychological, social, and/or biological interaction within marriage influences longevity."
Correspondence: L. Klinger-Vartabedian, 95 Jynteewood Drive, Canyon, TX 79015. Location: Princeton University Library (SPR).

55:20135 Kotler, Pamela; Wingard, Deborah L. The effect of occupational, marital and parental roles on mortality: the Alameda County study. American Journal of Public Health, Vol. 79, No. 5, May 1989. 607-12 pp. Washington, D.C. In Eng.
"This study investigated the impact of combining marital, parental, and occupational roles upon 18-year risk of mortality from all causes. The respondents were 3,700 participants in the [California] Human Population Laboratory cohort ages 35-64 who completed a comprehensive health and psychosocial questionnaire in 1965 and were followed for mortality status through 1982. Employment status and type of employment were not found to predict mortality risk among women. Contrary to the multiple roles hypothesis, there was virtually no impact upon mortality of increasing numbers of children among employed women, except possibly among single working parents. The major impact of children was felt by housewives who had significantly elevated risks when a child was present in the home or when they had four or more children. Neither the number of children nor the presence of a child in the home affected mortality risk of men."
Correspondence: P. Kotler, Human Population Laboratory, California Department of Health Services, Annex 2, 3rd floor, Berkeley, CA 94704. Location: Princeton University Library (PR).

55:20136 Plaut, Renate; Roberts, Edna. Preventable mortality: indicator or target? Applications in developing countries. World Health Statistics Quarterly/Rapport Trimestriel de Statistiques Sanitaires Mondiales, Vol. 42, No. 1, 1989. 4-15 pp. Geneva, Switzerland. In Eng. with sum. in Fre.
"The purpose of this [article] is to show some applications of mortality statistics based on the concepts of 'excess' and 'premature' mortality, in the hope that they may become useful components of health situation analyses performed by countries with the aim of contributing to priority setting in the health-services system, and to the surveillance and evaluation of service and programme outcomes. Specifically, there will be a discussion of the scope and limitations of some simple procedures to analyse usually available data for: estimating gains in mortality from all causes assessed against a country's own experience; and quantifying the gap between the country's current mortality situation and one observed in a more developed country." The examples of developing countries illustrated are Argentina and Mexico; the developed country data concern the United States.
Correspondence: R. Plaut, Health Situation and Trend Assessment, Pan American Health Organization, 525 23rd Street NW, Washington, D.C. Location: Princeton University Library (SPR).

55:20137 Rogers, Richard G.; Wofford, Sharon. Life expectancy in less developed countries: socioeconomic development or public health? Journal of Biosocial Science, Vol. 21, No. 2, Apr 1989. 245-52 pp. Cambridge, England. In Eng.
"Various studies have enquired into the influence of socioeconomic development or public health measures on life expectancies in less developed countries. Analysis of the effect of these two groups of factors upon life expectancy, using data for 95 less developed countries, indicates that mortality is primarily influenced by such socioeconomic development measures as urbanization, industrialization, and education, and secondarily by such [public health] measures as access to safe water, physicians, and adequate nutrition."
Correspondence: R. G. Rogers, Department of Sociology, University of Colorado, Boulder, CO 80309. Location: Princeton University Library (SPR).

55:20138 Shannon, Harry S.; Jamieson, Ellen; Walsh, Christine; Julian, Jim A.; Fair, Martha E.; Buffet, Allan. Comparison of individual follow-up and computerized record linkage using the Canadian mortality data base. Canadian Journal of Public Health/Revue Canadienne de Sante Publique, Vol. 80, No. 1, Jan-Feb 1989. 54-7 pp. Ottawa, Canada. In Eng. with sum. in Fre.
"We compared two methods of ascertaining mortality in a historical prospective mortality study. Computerized Record Linkage (CRL) with the centralized historical Canadian Mortality Data Base (CMDB) was carried out on 2,469 men and an attempt was also made to trace the subjects by individual follow-up (IFU). All but 88 were traced and 60 were reported to be dead....Overall, CRL using the CMDB performed very well. We also consider factors that affect the relative costs of the two methods, which should be balanced against the accuracy of information obtained."
Correspondence: H. S. Shannon, Occupational Health Program, McMaster University Medical Centre, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada. Location: Princeton University Library (SPR).

55:20139 Stahelin, H. B.; Thurneysen, J.; Buess, E.; Rosel, F.; Eichholzer-Helbling, M.; Torhorst, J.; Widmer, L. K. Mortality and causes of death in a 20-year-follow-up of the Basel study. [Todesfalle und Todesursachen im 20-Jahres-follow-up der Basler Studie.] Schweizerische Medizinische Wochenschrift/Journal Suisse de Medecine, Vol. 118, No. 27-28, Jul 12, 1988. 1,039-47 pp. Basel, Switzerland. In Ger. with sum. in Eng.
Results are presented from a follow-up study on mortality conducted during the period 1965-1986 in Basel, Switzerland. The data concern 4,224 males and 936 females. Comparisons are made concerning mortality by age, sex, and cause of death. The authors conclude that the Basel study cohort is representative of the Swiss population as a whole.
Correspondence: H. B. Stahelin, Chefarzt, Medizinisch-geriatrische Klinik, Kantonsspital, CH-4031 Basel, Switzerland. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20140 Tabeau, Ewa. Dynamics and conditions affecting female mortality. [Dynamika i uwarunkowania umieralnosci kobiet w Polsce.] Wiadomosci Statystyczne, Vol. 33, No. 8, Aug 1988. 11-3 pp. Warsaw, Poland. In Pol.
Female mortality in Poland is analyzed for the period 1960-1985. The analysis is presented separately for women aged up to 24, 25 to 59, and over 60 years of age. Comparisons are made with male mortality for the same period and age groups. Consideration is also given to causes of death.
Correspondence: E. Tabeau, Szkola Glowna Planowania i Statystyki, Al. Niepodleglosci 162, 00 925 Warsaw, Poland. Location: Princeton University Library (SPR).

55:20141 Taylor, Richard; Nemaia, Harry; Connell, John. Mortality in Niue, 1978-82. New Zealand Medical Journal, Vol. 100, No. 829, Aug 12, 1987. 477-81 pp. Dunedin, New Zealand. In Eng.
"This report is an analysis of mortality in the population of Niue Island over the years 1978-82." The authors note that the overall level of mortality is low, life expectancy has risen to 66.5 years, and infant mortality declined from 200 per 1,000 in the 1940s to 10 per 1,000 during the period studied. With the exception of mortality from dengue fever, mortality patterns were found to be similar to those of developed countries.
Correspondence: J. Connell, Department of Geography, University of Sydney, Sydney NSW 2006, Australia. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20142 Uemura, Kazuo. Excess mortality ratio with reference to the lowest age-sex-specific death rates among countries. World Health Statistics Quarterly/Rapport Trimestriel de Statistiques Sanitaires Mondiales, Vol. 42, No. 1, 1989. 26-41 pp. Geneva, Switzerland. In Eng. with sum. in Fre.
"This article proposes a new indicator of excess mortality with reference to the lowest age-sex-specific death rates recorded among countries in the world. Two sets of the lowest rates are considered, namely one comprising the lowest age-sex-specific rates recorded in each calendar year (the current minimum) and the other comprising the lowest rates ever recorded since 1950 (the historical minimum). The lowest death rates are applied to the age-sex composition of the population of a given country for a given calendar year to obtain the number of deaths which would have been expected under the lowest mortality pattern; the expected number is then subtracted from the actual number of deaths recorded in the country during the calendar year to yield the 'excess'. The indicator is finally calculated by taking the ratio of the excess to the expected minimum. Various uses of the indicator are described...."
Correspondence: K. Uemura, Division of Epidemiological Surveillance, World Health Organization, Avenue Appia, CH-1211 Geneva 27, Switzerland. Location: Princeton University Library (SPR).

55:20143 Wilmoth, John; Vallin, Jacques; Caselli, Graziella. When does a cohort's mortality differ from what we might expect? Materiali di Studi e di Ricerche, No. 12, May 1988. 43 pp. Universita degli Studi di Roma La Sapienza, Dipartimento di Scienze Demografiche: Rome, Italy. In Eng.
A matrix of probabilities of death indexed by age and calendar year is analyzed for France for the period 1899-1981. The descriptive model used in the analysis allows the documentation of the peculiar mortality experience of certain cohorts whose histories differ noticeably from those of surrounding cohorts. "It is thus possible to confirm the existence of certain long-term effects of the two World Wars already documented by other authors, whether concerning the men involved in combat or the men and women who were adolescent or who were born during the wars. Other effects appear as well: the long-term effect of the Spanish flu epidemic of 1918, and the curiously negative aftereffects of the generalization of hospitalized childbirth in the 1950s. This analysis, first applied to all-cause mortality, was duplicated on cause-specific mortality, considering only large etiological categories. All causes seem to contribute to the excess mortality of the peculiar cohorts, but certain groups of causes play a particular role (most notably, malnutrition and alcoholism, infection, and degenerative disease) and serve to illustrate the peculiar experience of yet another group of cohorts (those born in 1867-1868, at the time of a cholera epidemic)."
Correspondence: Universita degli Studi de Roma La Sapienza, Dipartimento di Scienze Demografiche, Via Nomentana 41, Rome 00161, Italy. Location: Princeton University Library (SPR).

E.2. Prenatal and Perinatal Mortality

Studies dealing primarily with fetal and neonatal mortality, except those dealing with spontaneous abortions, which are classified under F.3. Sterility and Other Pathology , and those studies dealing with induced abortions, which are classified under F.4.5. Induced Abortion . Perinatal mortality is defined as mortality occurring between the twenty-eighth week of gestation and the seventh day of life.

55:20144 Fung, Kam Pui; Wong, Tze Wai; Lau, Sum Ping. Ethinc determinants of perinatal statistics of Chinese: demography of China, Hong Kong and Singapore. International Journal of Epidemiology, Vol. 18, No. 1, Mar 1989. 127-31 pp. Oxford, England. In Eng.
"This paper compares the determinants of perinatal statistics of Chinese in geographical areas with different socioeconomic structures and discusses their relevance to developed countries." The geographical areas compared are China, Hong Kong, and Singapore. Data are from official sources for the year 1980.
Correspondence: K. P. Fung, Department of Pediatrics, National University Hospital, Lower Kent Ridge Road, Singapore 0511. Location: Princeton University Library (SPR).

55:20145 Wildschut, H. I. J.; Wiedijk, V.; Oosting, J.; Voorn, W.; Huber, J.; Treffers, P. E. Predictors of foetal and neonatal mortality in Curacao, Netherlands Antilles. A multivariate analysis. Social Science and Medicine, Vol. 28, No. 8, 1989. 837-42 pp. Elmsford, New York/Oxford, England. In Eng.
Factors associated with increased risk of fetal and neonatal mortality in Curacao, Netherlands Antilles, are analyzed. Data are from a survey conducted in 1984 and 1985 and concern 205 women experiencing pregnancy loss and 913 women who did not sustain such loss. Five factors emerged as significant predictors of mortality: gestational age, birth weight, sex, fetal presentation, and congenital abnormality.
Correspondence: H. I. J. Wildschut, Department of Obstetrics and Gynaecology, Academisch Medisch Centrum, University of Amsterdam, Meibergdreef 9, 1005 AZ Amsterdam, Netherlands. Location: Princeton University Library (PR).

E.3. Infant and Childhood Mortality

Studies of infant mortality under one year of age, including neonatal mortality occurring after the seventh day of life, and childhood mortality after one year of age. The subject of infanticide, deliberate or implied, is also classified under this heading.

55:20146 Agarwal, D. K.; Agarwal, K. N. Early childhood mortality in Bihar and Uttar Pradesh. Indian Pediatrics, Vol. 24, No. 8, Aug 1987. 627-32 pp. New Delhi, India. In Eng.
Trends in infant and early child mortality in India are analyzed. Data are from a survey of some 10,000 individuals conducted in Bihar and Uttar Pradesh in 1985-1986. The infant mortality rate ranged from 122-246 per 1,000 live births in Bihar to 118-175 in Uttar Pradesh. Mortality in children under five years of age ranged from 28 to 52 per 1,000. Mortality was higher among children of young and illiterate mothers with low incomes.
Correspondence: D. K. Agarwal, Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221 005, India. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20147 Bankole, Akinrinola. Maternal employment and infant mortality: an examination of the role of breastfeeding as an intermediate factor. Biology and Society, Vol. 6, No. 1, Mar 1989. 19-26 pp. London, England. In Eng.
The relationship between infant mortality and maternal employment in Nigeria is analyzed using data on 2,111 mothers obtained from a sample survey conducted in Ile-Ife in 1980 and 1981. "By the use of logit regression taking socioeconomic variables and breastfeeding into account, it was shown that children of working class mothers are likely to experience higher rates of infant death than those of non-working mothers, and these rates are higher in mothers working in the informal than in the formal sector. No effect of duration of breastfeeding was detectable, probably due to the universal practice of long lactation among the Yoruba. Intensity of breastfeeding is a key variable, for when this is taken into account, the effect of maternal occupation on infant death disappears. Other variables associated with infant mortality are mother's education, father's income, mother's age, and age of infant."
Correspondence: A. Bankole, Population Studies Center, University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA 19104-6298. Location: Princeton University Library (SPR).

55:20148 Barrett, John C. A simple model for birth interval survival. Genus, Vol. 44, No. 1-2, Jan-Jun 1988. 41-51 pp. Rome, Italy. In Eng. with sum. in Fre; Ita.
"A simple model for birth interval survival is described, assuming independence of fertility and mortality." The birth interval following the death of the previous child is found using a function fitted to African data.
Correspondence: J. C. Barrett, London School of Hygiene and Tropical Medicine, London University, Keppel Street, London WC1E 7HT, England. Location: Princeton University Library (SPR).

55:20149 Betancourt, Jose F. Different roads to a common goal: the lowering of infant mortality rates in Latin America. Revista Geografica, No. 107, Jan-Jun 1988. 49-66 pp. Mexico City, Mexico. In Eng. with sum. in Spa.
Recent trends in infant mortality in the countries of Latin America are analyzed. Particular attention is paid to the similarities and differences among Cuba, Costa Rica, and Chile, the three countries that have achieved rates of infant mortality lower than 20 per 1,000. The author concludes that the example of these three countries shows that it is possible to reduce infant mortality significantly before underdevelopment and poverty are eliminated by means of improving the basic health infrastructure.
Correspondence: J. F. Betancourt, Department of Geography, State University of New York, Oneonta, NY 13820. Location: Princeton University Library (PR).

55:20150 Bhandari, B.; Mandowara, S. L.; Agarwal, H. R.; Jagdev, D. K. High infant mortality in rural areas of Rajasthan: an analysis based on prospective study. Indian Pediatrics, Vol. 25, No. 6, Jun 1988. 510-4 pp. New Delhi, India. In Eng.
Infant mortality rates (IMR) in 14 villages in rural Rajasthan, India, during 1984-1985 are examined. "The birth rate was found to be 31.9 per thousand population and IMR was computed to be 202.4 per thousand live births, which is higher than ever reported from India. Neonatal and post neonatal deaths were 51.5 and 48.5...respectively. The IMR was higher among the families of Scheduled Castes, Scheduled Tribes, other Backward Castes, babies born to illiterate mothers, when birth order was four or higher, when age of the mother was on either side of 20-30 years and when birth spacing was less than 2 years."
Correspondence: B. Bhandari, Department of Pediatrics, RNT Medical College, Udaipur and Directorate of Medical, Health and Family Welfare Services, Government of Rajasthan, Jaipur, India. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20151 Braunsdorf, A.; Fuchs, M.; Bohm, B. The extension of mortality statistics by means of birthweight-related mortality and percentile curves. [Die Erweiterung der Mortalitatsstatistik im ersten Lebensjahr unter Nutzung der geburtsgewichtsbezogenen Mortalitat und Standardwachstumskurven.] Zeitschrift fur die Gesamte Hygiene und Ihre Grenzgebiete, Vol. 34, No. 10, 1988. 570-3 pp. Berlin, German Democratic Republic. In Ger. with sum. in Eng.
The relationship between birthweight and neonatal, perinatal, and infant mortality is analyzed using data for the East German district of Gera from 1978 to 1982. The authors examine the applicability of percentiles by birthweight to gestational age. They conclude that such percentiles are useful to provide standardized data for comparative analysis of mortality among low birthweight infants.
Correspondence: A. Braunsdorf, z. Z. Pathologisches Institut der Friedrich-Schiller-Universitat Jena, Ziegelmuhlenweg 1, Jena, German Democratic Republic. Location: New York Academy of Medicine.

55:20152 Choe, Minja Kim; Retherford, Robert D.; Gubhaju, Bhakta B.; Thapa, Shyam. Ethnic differentials in early childhood mortality in Nepal. Journal of Biosocial Science, Vol. 21, No. 2, Apr 1989. 223-33 pp. Cambridge, England. In Eng.
"This paper investigates the association of early childhood mortality (between birth and second birthday) with ethnicity in Nepal, based on data from the 1976 Nepal Fertility Survey, which was part of the World Fertility Survey. The approach is through a series of hazard models, which incorporate ethnicity, year of birth, mother's illiteracy, father's illiteracy, rural-urban residence, region, sex, maternal age, survival of previous birth, previous birth interval, and breast-feeding as covariates." The results suggest that none of the socioeconomic or demographic covariates contribute significantly to explaining ethnic differences in early childhood mortality, except the modest effect of illiteracy. However, it is noted that breast-feeding reduced age-specific mortality risks during the first two years of life by 76 percent.
Correspondence: M. K. Choe, Population Institute, East-West Center, 1777 East-West Road, Honolulu, HI 96822. Location: Princeton University Library (SPR).

55:20153 D'Souza, Stan. The assessment of preventable infant and child deaths in developing countries: some applications of a new index. World Health Statistics Quarterly/Rapport Trimestriel de Statistiques Sanitaires Mondiales, Vol. 42, No. 1, 1989. 16-25 pp. Geneva, Switzerland. In Eng. with sum. in Fre.
"This article briefly reviews epidemiological and demographic measures used to assess preventable deaths in developing country situations. Problems with the use of the infant mortality rate (IMR) as a health-policy indicator are illustrated. The Matlab experience of rural Bangladesh is used to develop a new index for preventable infant and child deaths. This index, based on a statistical transformation of usual demographic measures, links mortality levels and cause-of-death structure." Using data for Asia and Africa, it is shown how this index illustrates the difficulties involved in the control of particular causes of death.
Correspondence: S. D'Souza, Senior Demographer, United Nations Development Programme, Cotonou, Benin. Location: Princeton University Library (SPR).

55:20154 Das Gupta, Monica. Death clustering, maternal education and the determinants of child mortality in rural Punjab, India. Center for Population Studies Discussion Paper, No. 89-1, Feb 1989. 26, [7] pp. Harvard University, Center for Population Studies: Cambridge, Massachusetts. In Eng.
The author examines the behavioral and social determinants of death clustering of children in rural Punjab, India. She "hypothesizes that this clustering of deaths can be explained to a very large extent by the basic abilities and personality characteristics of the mother, independent of education, occupation, income and wealth....The data indicate that education helps women to overcome the barriers posed by low autonomy, low social status, and low economic status....The present analysis strongly supports the view that increasing female education is one of the most effective ways of reducing child mortality." Data are from various sources beginning in 1984 including a personal interview survey of 1,800 married women of reproductive age in rural Punjab.
Correspondence: Center for Population Studies, Harvard University, 9 Bow Street, Cambridge, MA 02138. Location: Princeton University Library (SPR).

55:20155 Duboz, Pierre; Vaugelade, Jacques. Malnutrition as a risk factor in mortality. [La malnutrition comme facteur de risque de la mortalite.] In: African Population Conference/Congres Africain de Population, Dakar, Senegal, November/novembre 7-12, 1988. Vol. 2, 1988. 3.5.17-30 pp. International Union for the Scientific Study of Population [IUSSP]: Liege, Belgium. In Fre. with sum. in Eng.
The relationship between nutrition and levels of infant and child mortality is analyzed using data for Burkina Faso. The results indicate not only that there is a strong correlation between malnutrition and high rates of child mortality, but that improving nutrition in itself has little effect on mortality.
Correspondence: P. Duboz, ORSTOM, B.P. 182, Ouagadougou, Burkina Faso. Location: Princeton University Library (SPR).

55:20156 Gonzalez Perez, Guillermo; Galvez Gonzalez, Ana M.; Jaramillo Villarreal, Melfa. Socioeconomic factors and infant mortality in Ecuador, 1970-1981. [Factores socioeconomicos y mortalidad infantil en Ecuador, 1970-1981.] Revista de Saude Publica, Vol. 22, No. 4, Aug 1988. 273-80 pp. Sao Paulo, Brazil. In Spa. with sum. in Eng.
Recent trends in infant mortality in Ecuador are reviewed. The authors note that infant mortality has declined 35 percent between 1970 and 1981, although significant geographical differences persist. Multiple regression techniques are used to identify socioeconomic factors associated with both the decline and differentials in infant mortality. "The reduction of the crude birth rate and the proportional increase of health expenditure on one hand and the literacy rate on the other would seem to be the key socio-economic elements in any explanation of recent changes in Equadorian infant mortality."
Correspondence: G. Gonzalez Perez, Facultad de Salud Publica, Instituto Superior de Ciencias Medicas de la Habana, Calle 146, No. 2504 entre 25 y 31, Cubanacan, Municipio Playa, Apartado de Correos No. 14063, Zona Postal No. 14, Havana, Cuba. Location: New York Academy of Medicine.

55:20157 Guillaume, Agnes; Koffi, N'Guessan. Infant-child morbidity and mortality in Akan country (Ivory Coast). [Morbidite et mortalite infanto-juvenile en pays akan (Cote d'Ivoire).] In: African Population Conference/Congres Africain de Population, Dakar, Senegal, November/novembre 7-12, 1988. Vol. 2, 1988. 3.4.33-49 pp. International Union for the Scientific Study of Population [IUSSP]: Liege, Belgium. In Fre. with sum. in Eng.
The authors examine differences in infant and child morbidity and mortality between two ethnically homogeneous regions of the Ivory Coast. The focus is on seasonal variations in morbidity and mortality due to malaria, diarrhea, and bronchial infections. Aspects considered include differences in the socioeconomic conditions, sanitation, and ecology of the two regions considered.
Correspondence: A. Guillaume, Centre de Recherches Oceanographiques, ORSTOM, BP V18, Abidjan, Ivory Coast. Location: Princeton University Library (SPR).

55:20158 Hill, Allan G.; David, Patricia H. Monitoring changes in child mortality: new methods for use in developing countries. Health Policy and Planning, Vol. 3, No. 3, Sep 1988. 214-26 pp. Oxford, England. In Eng.
The authors describe ways of measuring changes in child mortality in developing countries that supplement the methods of indirect estimation in general use. These alternative methods involve the use of data obtained in health centers and the inclusion of a set of additional questions in small surveys concerning the survival of recently born children. The emphasis is on the use of such measures to evaluate the impact of health programs on mortality. Examples from developing countries are provided.
Correspondence: A. G. Hill, Centre for Population Studies, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 6AZ, England. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20159 Hoekelman, Robert A.; Pless, I. Barry. Decline in mortality among young Americans during the 20th century: prospects for reaching national mortality reduction goals for 1990. Pediatrics, Vol. 82, No. 4, Oct 1988. 582-95 pp. Elk Grove Village, Illinois. In Eng.
Trends since 1900 in U.S. mortality under age 25 are reviewed. Significant declines in mortality at all ages are noted, and the reasons for this decline are discussed. "For the decade 1975 through 1984, the overall death rate decreased by 20%, with declines for all causes except suicide, cardiovascular diseases, and renal diseases. All of the surgeon general's mortality reduction goals for 1990 for America's youth should be reached except those for infant mortality and suicide."
Location: U.S. National Library of Medicine, Bethesda, MD.

55:20160 Joyce, Theodore; Corman, Hope; Grossman, Michael. A cost-effectiveness analysis of strategies to reduce infant mortality. Medical Care, Vol. 26, No. 4, Apr 1988. 348-60 pp. Philadelphia, Pennsylvania. In Eng.
"This study compares the cost-effectiveness of various health inputs and government programs in reducing race-specific neonatal mortality or death in the first 27 days of life....The programs and inputs at issue are teenage family planning use; the supplemental food program for women, infants, and children (WIC); use of community health centers and maternal and infant care projects; abortion; prenatal care; and neonatal intensive care. Using an economic model of the family as the analytic framework, effectiveness is determined by using ordinary least squares and two-stage least squares to estimate infant health production functions across large counties in the United States in 1977." The results suggest that early initiation of prenatal care is the most cost-effective means of reducing neonatal mortality for both blacks and whites.
Correspondence: T. Joyce, National Bureau of Economic Research, 269 Mercer Street, 8th Floor, New York, NY 10003. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20161 Koenig, Michael A.; Phillips, James F.; Campbell, Oona; D'Souza, Stan. Birth intervals and childhood mortality in rural Bangladesh. International Programs Working Paper, No. 23, Nov 1988. 33 pp. Population Council: New York, New York. In Eng.
"In this article, further evidence is presented on the relationship between birth intervals and childhood mortality, based upon an analysis of longitudinal data from rural Bangladesh." Data are from the Demographic Surveillance System conducted by the International Centre for Diarrhoeal Disease Research, Bangladesh. The authors conclude that "birth intervals influence childhood mortality in rural Bangladesh, and that, while both are significant, the previous and subsequent birth intervals may influence mortality through quite separate and distinct mechanisms."
Correspondence: Population Council, One Dag Hammarskjold Plaza, New York, NY 10017. Location: Princeton University Library (SPR).

55:20162 Laurenti, Ruy. Infant mortality in the United States, Sweden, and the state of Sao Paulo. [Mortalidad infantil nos Estados Unidos, Suecia e Estado de Sao Paulo.] Revista de Saude Publica, Vol. 21, No. 3, Jun 1987. 268-73 pp. Sao Paulo, Brazil. In Por. with sum. in Eng.
"Data regarding infant, early neonatal, neonatal, post-neonatal and perinatal mortality are presented for the U.S.A., Sweden and the State of Sao Paulo, Brazil, for the period from 1950 to 1982. Sweden, throughout the period presents the lowest rates and the State of Sao Paulo the highest. The rates for the State of Sao Paulo can be considered very high and the data show that at the beginning of the 80's the infant mortality was similar to that observed in Sweden half a century before and the mortality under one day of life was higher than that for all the first year of life. For the three populations there is a decline in all the rates, but in Sweden and the U.S.A., although presenting...lower rates, the decline is more pronounced."
Correspondence: R. Laurenti, Departamento de Epidemiologia da Faculdade de Saude Publica da Universidade de Sao Paulo, Av. Dr. Arnaldo 715, 01255 Sao Paulo, SP, Brazil. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20163 Levy, Susan J.; Booth, Heather. Infant mortality in the Marshall Islands. Asian and Pacific Population Forum, Vol. 2, No. 3-4, Dec 1988. 11-20, 31-2 pp. Honolulu, Hawaii. In Eng.
Trends in infant mortality in the Marshall Islands of the western Pacific are analyzed. Infant mortality rates are estimated using indirect methods and data from the 1973 and 1980 censuses and from the Women's Health Survey of 1985. "Comparing the results with estimates of infant mortality obtained from vital registration data enabled us to estimate the extent of underregistration of infant deaths. Before presenting the results, we discuss the sources of error in the data and the consequent problems in interpreting the estimates."
Correspondence: H. Booth, South Pacific Commission, Noumea, New Caledonia. Location: Princeton University Library (SPR).

55:20164 Morocco. Direction de la Statistique. Centre d'Etudes et de Recherches Demographiques (Rabat, Morocco). The impact of education on mortality. [Effets de l'education sur la mortalite.] Nov 1988. 34 pp. Rabat, Morocco. In Fre.
Socioeconomic factors, including mothers' education, and their effect on infant mortality in Morocco are analyzed in order to identify the causes of the differentials observed. Data are from three main sources: national surveys of fertility and family planning conducted in 1979-1980 and 1983-1984, and the 1982 census. A conceptual model after that proposed by W. Henry Mosley is developed to analyze the impact of education on infant mortality. Intermediate variables affecting infant mortality considered are fertility and attitudes toward health and preventive medicine. Some attention is also given to the effect of declining mortality on education.
Correspondence: Direction de la Statistique, B.P. 178, Avenue Maa El Ainain, Rabat, Morocco. Location: Princeton University Library (SPR).

55:20165 Parazzini, Fabio; La Vecchia, Carlo; Negri, Eva. Descriptive epidemiology of perinatal and infant mortality in various Italian geographic areas. Sozial- und Praventivmedizin/Medecine Sociale et Preventive, Vol. 33, No. 4-5, 1988. 245-9 pp. Bern, Switzerland. In Eng. with sum. in Fre; Ger.
Trends in perinatal and infant mortality in Italy from 1955 to 1984 are analyzed using official data. The authors note that despite significant reductions in stillbirths, perinatal mortality, and infant mortality over time, the broad differences among geographical areas has remained constant. They also find that lower infant and perinatal mortality rates are strongly correlated with general indicators of health care, such as number of hospital beds per inhabitant and per capita health expenditure.
Correspondence: F. Parazzini, Istituto di Ricerche Farmacologiche Mario Negri, via Eritrea 62, I-20157 Milan, Italy. Location: New York Academy of Medicine.

55:20166 Riveron Corteguera, Raul; Rios Massabot, Norma E.; Carpio Sabatela, Roberto. Infant mortality in Cuba, 1969-1987. [Mortalidad infantil en Cuba, 1969-1987.] Boletin de la Oficina Sanitaria Panamericana, Vol. 106, No. 1, Jan 1989. 1-12 pp. Washington, D.C. In Spa. with sum. in Eng.
"The available statistical data indicate that Cuba's infant mortality fell substantially, by roughly 71.5%, between 1969 and 1987. Especially great gains were made against late neonatal (7-27 days) and postneonatal (28 days-11 months) mortality, though reduction in early neonatal (0-6 days) mortality was also substantial, amounting to about 54.3%. In general, the gains were spread fairly evenly among the country's provinces, with infant mortality tending to remain higher in the eastern provinces than in the central and western regions." This decline is attributed to policy decisions taken in the early 1960s to improve health services and to general improvements in living standards.
Correspondence: R. Riveron Corteguera, Facultad de Medicina General Calixto Garcia, Departamento de Pediatria, Hospital Pediatrico Docente de Centro Habana, Morales y Benjumeda, Cerro, Havana ZP 6, Cuba. Location: Princeton University Library (SPR).

55:20167 Riveron Corteguera, Raul. Mortality from acute diarrheal diseases in children under five: Cuba, 1959-1987. [Mortalidad por enfermedades diarreicas agudas en menores de 5 anos. Cuba, 1959-1987.] Boletin de la Oficina Sanitaria Panamericana, Vol. 106, No. 2, Feb 1989. 117-26 pp. Washington, D.C. In Spa. with sum. in Eng.
Infant mortality from acute diarrheal diseases in Cuba is examined for the period 1959-1987 using data from official sources. The author notes that "the death rate in children under 5 declined from 28.5 per 10,000 in 1959 to 1.4 in 1987, or 95.1%....In 1959 the deaths from acute diarrheal diseases represented 30.6% of all deaths in children under 5; 29.5% in those under 1 year, and 34.0 in those between 1 and 4. In contrast, by 1987 the respective figures had fallen to 4.1, 4.5, and 2.2%." Comparisons are made with other Latin American countries, and reasons for the decline in infant mortality from this cause discussed.
Correspondence: R. Riveron Corteguera, Hospital Pediatrico Docente de Centro Habana, Morales y Benjumeda, Cerro, Havana, ZP 6, Cuba. Location: Princeton University Library (SPR).

55:20168 Rodrigues, Laura; Botting, Beverley. Recent trends in postneonatal mortality in England. Population Trends, No. 55, Spring 1989. 7-15 pp. London, England. In Eng.
Trends in infant mortality in England are analyzed for the period 1975-1986. "A number of different patterns are observed. First, the postneonatal mortality rate decreased slowly and small increases were observed in 1979, 1982, 1985 and 1986. Second, there was a marked increase in the rate attributed to sudden infant death syndrome which was largely counter-balanced by a decrease in that attributed to respiratory conditions. Third, the rate for infants of Indian-born mothers decreased so that by 1986 it was lower than that for children of U.K.-born women. Fourth, although the proportion of live births born outside marriage which were registered jointly by both parents increased substantially, these children showed both a sizeable proportional and absolute decrease in postneonatal mortality. Fifth, differences between socio-economic and geographic groups appeared to diminish."
Correspondence: L. Rodrigues, Medical Statistics Division, Office of Population Censuses and Surveys, St. Catherine's House, 10 Kingsway, London WC2 6JP, England. Location: Princeton University Library (SPR).

55:20169 Rogers, Richard G. Ethnic and birth weight differences in cause-specific infant mortality. Demography, Vol. 26, No. 2, May 1989. 335-43 pp. Alexandria, Virginia. In Eng.
"This article examines ethnic differences in cause-specific infant mortality, using linked birth and infant death records from a cohort of New Mexican singleton infants, 1980-1983. The research, which applies log-linear analysis, focuses on the combined influences of ethnicity, birth weight, maternal age, and plurality on birth outcomes--that is, on infant survival and deaths due to perinatal, congenital, and respiratory diseases and to sudden infant death syndrome. The results confirm the pronounced impact of birth weight on infant mortality and identify similarities and differences among Anglo, Hispanic, and American Indian babies with respect to cause-specific infant mortality."
Correspondence: R. G. Rogers, Population Program, Institute of Behavioral Science, University of Colorado, Boulder, CO 80309-0484. Location: Princeton University Library (SPR).

55:20170 Utomo, Budi. An analysis of the SUPAS 1985 mortality estimates. [Telaah terhadap hasil perkiraan angka kematian bayi yang dihitung dari data SUPAS 1985.] Majalah Demografi Indonesia/Indonesian Journal of Demography, Vol. 15, No. 30, Dec 1988. i-ii, 13-36 pp. Jakarta, Indonesia. In Ind. with sum. in Eng.
The accuracy of estimates of child mortality based on data from the 1985 SUPAS survey is assessed. Comparisons are made with estimates using 1971 and 1980 census data and with indirect estimation techniques. The results indicate that, although the estimates for Java are reasonably accurate, those for other parts of the country are subject to error.
Correspondence: B. Utomo, Lembaga Penelitian Pusat Penelitian Kesehatan, Universitas Indonesia, Salemba Raya 4, Jakarta, Indonesia. Location: Princeton University Library (SPR).

55:20171 van Ginneken, Jerome K. Levels and determinants of morbidity and mortality of acute respiratory infections in children under five in Sub-Saharan Africa. In: African Population Conference/Congres Africain de Population, Dakar, Senegal, November/novembre 7-12, 1988. Vol. 2, 1988. 3.5.1-16 pp. International Union for the Scientific Study of Population [IUSSP]: Liege, Belgium. In Eng. with sum. in Fre.
"In this paper we will summarize and review various studies which have been undertaken on one group of diseases, namely acute respiratory infections (ARI)....This review will for the most part focus on longitudinal, population-based studies which have been carried out in a number of places in [Sub-Saharan] Africa....The nature and various types of acute respiratory infections will be described first. Results of studies on levels of ARI mortality and morbidity [among children under five] including differences by age and season will be presented in the next two sections. This is followed by three sections on the impact of socioeconomic factors, family structure, nutritional factors, breastfeeding and availability of medical care. Conclusions will be drawn in the last section."
Correspondence: J. K. van Ginneken, Netherlands Institute of Preventive Health Care TNO, P.O. Box 124, 2300 AC Leiden, Netherlands. Location: Princeton University Library (SPR).

55:20172 Vaugelade, Jacques. Seasonal variations in mortality before age five according to the biotope in tropical Africa. [Variations de la mortalite saisonniere avant 5 ans selon le biotope en Afrique intertropicale.] In: African Population Conference/Congres Africain de Population, Dakar, Senegal, November/novembre 7-12, 1988. Vol. 2, 1988. 3.4.51-61 pp. International Union for the Scientific Study of Population [IUSSP]: Liege, Belgium. In Fre. with sum. in Eng.
The author analyzes seasonal variations in infant and child mortality in tropical Africa, with a focus on the biotope of the region. The correlation between month of death and climatic variables such as rainfall and temperature is investigated.
Correspondence: J. Vaugelade, ORSTOM, B.P. 182, Ouagadougou, Burkina Faso. Location: Princeton University Library (SPR).

55:20173 Wagner, Marsden G. Infant mortality in Europe: implications for the United States. Journal of Public Health Policy, Vol. 9, No. 4, Winter 1988. 473-84 pp. South Burlington, Vermont. In Eng.
This is the text of a statement to the National Commission to Prevent Infant Mortality in the United States. The author sees the key to lower infant mortality in providing more social and educational support to families with pregnant women and infants. Other factors considered include the prevalence of Cesarean sections in the United States, and the widespread use of midwives in deliveries in Europe.
Location: New York Academy of Medicine.

55:20174 Wakisaka, Ichiro; Yanagihashi, Tsugo; Eguchi, Satoshi; Tomari, Tsutomu; Hatano, Hiromichi. A study of infant mortality in Kagoshima prefecture over the period 1968-1985. Minzoku Eisei/Japanese Journal of Health and Human Ecology, Vol. 54, No. 3, May 1988. 143-52 pp. Tokyo, Japan. In Jpn. with sum. in Eng.
The impact of socioeconomic conditions on regional differences in infant mortality in Kagoshima prefecture, Japan, is analyzed for the period 1968-1985 using official mortality data issued by the prefecture. It is found that infant mortality declined drastically over this period, primarily due to a decline in mortality from infectious disease and prematurity. The authors conclude that infant mortality may be higher in communities with a decreasing population, regardless of socioeconomic conditions.
Correspondence: I. Wakisaka, Department of Public Health, Faculty of Medicine, Kagoshima University, 21-24, 1-chome, Kourimoto, Kagoshima-shi 890, Japan. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20175 Wise, Paul H.; First, Lewis R.; Lamb, George A.; Kotelchuck, Milton; Chen, D. W.; Ewing, Andrea; Hersee, Heather; Rideout, Jeffrey. Infant mortality increase despite high access to tertiary care: an evolving relationship among infant mortality, health care, and socioeconomic change. Pediatrics, Vol. 81, No. 4, Apr 1988. 542-8 pp. Elk Grove Village, Illinois. In Eng.
The determinants of an apparent increase in infant mortality in Boston, Massachusetts, from 1980 to 1983 are examined using data for the 422 infant deaths that occurred during this period. The authors associate the increase in the infant mortality rate that took place in 1982 with inadequate levels of prenatal care. The impact of the stabilization of mortality rates for low birth weight infants on the infant mortality rate as a whole is considered.
Correspondence: P. H. Wise, Harvard University, Division of Health Policy Research and Education, 641 Huntington Avenue, Boston, MA 02115. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20176 Woods, R. I.; Watterson, P. A.; Woodward, J. H. The causes of rapid infant mortality decline in England and Wales, 1861-1921. Part II. Population Studies, Vol. 43, No. 1, Mar 1989. 113-32 pp. London, England. In Eng.
Reasons for the rapid decline in infant mortality at the beginning of the twentieth century in England and Wales are explored. "In Part I we presented a detailed demographic analysis of the pattern of infant mortality variation over time and through space, by type of environment (especially urban and rural), and by social class. In Part II we consider the approach of contemporaries to the infant mortality problem, but especially that of Sir Arthur Newsholme. It concludes by presenting an interpretation of the origins of infant mortality decline in terms of the prior decline of fertility, but also of the supporting role played by improvements in the quality of milk; the availability of more highly qualified midwives; the institution of ante-natal care and the post-natal health visitor service; as well as advances in the education of mothers in particular, and women in general."
For Part I, published in 1988, see 55:10170.
Correspondence: R. I. Woods, Department of Geography, University of Sheffield, Sheffield S10 2TN, England. Location: Princeton University Library (SPR).

55:20177 Yumkella, Fatu. The contribution of the environment and behaviour in explaining regional variations in infant and childhood mortality in Africa. In: African Population Conference/Congres Africain de Population, Dakar, Senegal, November/novembre 7-12, 1988. Vol. 2, 1988. 3.4.19-32 pp. International Union for the Scientific Study of Population [IUSSP]: Liege, Belgium. In Eng. with sum. in Fre.
"This paper...aims at reviewing the existing literature in order to assess...the influence of the environment and behaviour on levels of infant and child mortality for some countries in Africa. The approach will be a separate examination of the influence of each factor followed by a discussion on inter-relationships."
Correspondence: F. Yumkella, Centre for Population Studies, London School of Hygiene and Tropical Medicine, 99 Gower Street, London WC1E 6AZ, England. Location: Princeton University Library (SPR).

55:20178 Zeger, Scott L.; Edelstein, Sharon L. Poisson regression with a surrogate X: an analysis of vitamin A and Indonesian children's mortality. Journal of the Royal Statistical Society, Series C: Applied Statistics, Vol. 38, No. 2, 1989. 309-18 pp. London, England. In Eng.
"A Poisson regression model with a surrogate X variable is proposed to help to assess the efficacy of vitamin A in reducing child mortality in Indonesia. In a recent community trial, the mortality rate in villages receiving vitamin A supplementation was 35% less than in control villages. However, at base-line, control villages were found to have slightly higher rates of xerophthalmia, an ocular disease caused by vitamin A deficiency. It was therefore desirable to adjust the mortality comparison for base-line vitamin A levels as indicated by xerophthalmia prevalence. This paper presents a parametric errors-in-X regression model developed for this purpose. Likelihood methods for fitting and inference are discussed. The model is illustrated on the Indonesian data set."
Correspondence: S. L. Zeger, School of Hygiene and Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205. Location: Princeton University Library (PF).

E.4. Mortality at Other Ages

Studies of age-specific mortality and of mortality in special groups defined by age.

55:20179 Blacker, John; Mukiza Gapere, Jackson. The indirect measurement of adult mortality in Africa: results and prospects. In: African Population Conference/Congres Africain de Population, Dakar, Senegal, November/novembre 7-12, 1988. Vol. 2, 1988. 3.2.23-38 pp. International Union for the Scientific Study of Population [IUSSP]: Liege, Belgium. In Eng. with sum. in Fre.
"This paper is concerned with attempts to measure adult mortality in Africa by means of techniques generally known as orphanhood, widowhood and sisterhood....Most of this paper will be concerned with orphanhood. But we will also try to assess the strengths and weaknesses of the widowhood questions, and to speculate on the potentialities of those on sisterhood....Despite the shortcomings of the results in countries such as Kenya and Malawi, we believe that the orphanhood and widowhood questions should continue to be asked in African censuses and surveys, and that they will continue to make a real contribution to our knowledge of levels and trends in adult mortality in Africa."
Correspondence: J. Blacker, Centre for Population Studies, London School of Hygiene and Tropical Medicine, 99 Gower Street, London W.C.1, England. Location: Princeton University Library (SPR).

55:20180 Caselli, Graziella; Capocaccia, Riccardo. Age, period, cohort and early mortality: an analysis of adult mortality in Italy. Population Studies, Vol. 43, No. 1, Mar 1989. 133-53 pp. London, England. In Eng.
"Changes in adult mortality in Italy for cohorts born between 1882 and 1953 are analysed and interpreted by means of two different statistical models. The first, an Age-Period-Early Mortality (APEM) model, is employed to analyse the possible relationships between adverse conditions during the first 15 years of life and subsequent mortality. It is shown that higher mortality early in life is associated with higher mortality up to age 45 and lower mortality at latter ages. Finally, possible links between the observed decline in early mortality and the evolution of adult mortality are analysed and discussed."
Correspondence: G. Caselli, Dipartimento di Scienze Demografiche, Universita di Roma, Rome, Italy. Location: Princeton University Library (SPR).

55:20181 Gadalla, S.; Saleh, S.; Fortney, J. A.; Rogers, S. M. Causes of death to women of reproductive age in Menoufia, Egypt. Population Sciences, Vol. 7, 1987. 57-70 pp. Cairo, Egypt. In Eng.
The author analyzes trends in mortality and morbidity among 1,691 Egyptian women of reproductive age (15-49 years). Included in the study are cause-specific mortality rates, age-specific mortality rates, and deaths caused by complications of pregnancy and childbirth. Data are from the World Health Organization for the period 1979-1983.
Correspondence: S. Gadalla, Social Research Center, American University in Cairo, P.O. Box 2511, 113 Sharia Kasr El-Aini, Cairo, Egypt. Location: Princeton University Library (SPR).

55:20182 Gadalla, S.; Saleh, S.; Fortney, J. A.; Rogers, S. M. Preventability of deaths to married women of reproductive age in Menoufia, Egypt. Population Sciences, Vol. 7, 1987. 71-84 pp. Cairo, Egypt. In Eng.
Egyptian adult female mortality rates are examined and estimates are made concerning what proportion of deaths is preventable. Two aspects of prevention of death from a disease are considered. One is preventing the disease from occurring, and the second is preventing fatal complications of a disease. Comparisons of mortality rates are made between the Netherlands, a developed country, and Egypt. Data for both countries are for the period 1981-1983 for women of reproductive age (15-49).
Correspondence: S. Gadalla, Social Research Center, American University in Cairo, P.O. Box 2511, 113 Sharia Kasr El-Aini, Cairo, Egypt. Location: Princeton University Library (SPR).

55:20183 Martinelle, Sten. A generalized Perks formula for old-age mortality. R and D Report, Research-Methods-Development, U/STM, No. 38, 1987. 55 pp. Statistiska Centralbyran: Stockholm, Sweden. In Eng.
The author presents a mathematical model of old-age mortality. "A heterogeneous cohort with intensity functions of individuals following the Makeham law is considered. It is shown that if the frailty variable obeys a generalized form of the gamma distribution then the total force of mortality can be seen as a generalization of Perks formula. The model is applied to mortality of centenarians in Sweden and [France, the Netherlands, and Switzerland]."
Correspondence: Enheten for Statistiska Metoder, Statistiska Centralbyran, S-115 81 Stockholm, Sweden. Location: Princeton University Library (SPR).

55:20184 Tabeau, Ewa. Econometric models of changes in specific death rates of adults in Poland for the period 1960-1983. [Ekonometryczne modele zmian czastkowych wspolczynnikow zgonow doroslej ludnosci Polski w latach 1960-1983.] Studia Demograficzne, No. 2/92, 1988. 107-15 pp. Warsaw, Poland. In Pol. with sum. in Eng; Rus.
The author presents death rates for the adult population by age, sex, and place of residence to show changes in mortality for the years 1960-1983.
Location: Princeton University Library (SPR).

55:20185 Timaeus, Ian. Regional differentials in adult mortality in Sub-Saharan Africa. In: African Population Conference/Congres Africain de Population, Dakar, Senegal, November/novembre 7-12, 1988. Vol. 2, 1988. 3.2.39-52 pp. International Union for the Scientific Study of Population [IUSSP]: Liege, Belgium. In Eng. with sum. in Fre.
"In this paper estimates of adult mortality are presented for as many sub-Saharan African countries as possible in order to examine adult mortality patterns across the continent." The focus is on the difficulty of collecting reliable data. Several sources of data are assessed. Estimates of expectation of life in the 1970s are presented for 16 countries, and age and sex patterns of mortality are considered.
Correspondence: I. Timaeus, Centre for Population Studies, London School of Hygiene and Tropical Medicine, 99 Gower Street, London W.C.1, England. Location: Princeton University Library (SPR).

55:20186 Waltisperger, D.; Rabetsitonta, T. A summary of 30 years of direct measures of adult mortality in Africa. [Un bilan de trente ans de mesures directes de la mortalite adulte en Afrique.] In: African Population Conference/Congres Africain de Population, Dakar, Senegal, November/novembre 7-12, 1988. Vol. 2, 1988. 3.2.1-22 pp. International Union for the Scientific Study of Population [IUSSP]: Liege, Belgium. In Fre. with sum. in Eng.
The authors evaluate the use of direct observation techniques to measure adult mortality. Results of an analysis of approximately 100 life tables for various African countries indicate that the quality of data is generally not good enough to provide an accurate picture of mortality trends.
Correspondence: D. Waltisperger, Ministere des Affaires Sociales et de l'Emploi, Service des Etudes et des Systemes d'Information, CEPED, Paris 75007, France. Location: Princeton University Library (SPR).

E.5. Life Tables

Studies that present actual life table data and all studies concerned primarily with life tables, including the appropriate methodological studies. Life table studies that are concerned with topics other than mortality are classified under the appropriate heading and cross-referenced to this heading.

55:20187 Daw, R. H. The improving accuracy of the basic data and the exposed to risk of the English life tables (updated to E.L.T. No. 14). Journal of the Institute of Actuaries, Vol. 115, Pt. 4, No. 462, 1988. 721-5 pp. London, England. In Eng.
The author presents an update of a paper on the accuracy of the official data on mortality for England and the official life tables based on them. The update includes consideration of the English Life Table, No. 14, published in 1987. The results indicate that for the age range 20 to 80, the data and life tables are accurate, but that problems remain with data concerning those over age 80.
For a related article, published in 1982, see 48:40202.
Location: Princeton University Library (SM).

55:20188 Golini, A.; Capocaccia, R.; Lori, A.; Verdecchia, A. Abridged life tables by cause for Italian regions and divisions, 1980-1982. [Tavole ridotte di mortalita per causa per le regioni e le ripartizioni italiane, 1980-82.] Rapporto sulla Situazione Demografica in Italia, No. 3, 1987. 155 pp. Consiglio Nazionale delle Ricerche, Istituto di Ricerche sulla Popolazione: Rome, Italy. In Ita. with sum. in Eng.
Abridged life tables and probabilities of dying from selected causes of death are presented for Italy for the period 1971-1982, and for the regions and divisions of Italy for 1980-1982. Data are also presented on geographical differences in mortality from selected causes and on excess male mortality.
Correspondence: Istituto di Ricerche sulla Popolazione, Viale Beethoven 56, 00144 Rome, Italy. Location: Princeton University Library (SPR).

55:20189 Hartmann, Michael. Past and recent attempts to model mortality at all ages. Journal of Official Statistics, Vol. 3, No. 1, 1987. 19-36 pp. Stockholm, Sweden. In Eng.
"Most laws of mortality are partial in the sense that they apply only to a broad age group and not to all ages. This paper focuses on three laws of mortality that apply to all ages. Two of them were developed by the actuaries Thiele and Wittstein in the late 19th century. The third, developed by Heligman and Pollard, is of recent origin. The three laws are discussed with references to Scandinavian mortality data. The results suggest that the most recently proposed law can be used for generation of model life tables, for making population projections, simulations, and other statistical work where there is a need for a realistic model of human mortality."
Correspondence: M. Hartmann, National Census Program, Office of Planning and Statistics, Federated States of Micronesia, P.O. Box 538, Kolonia, Pohnpei, Eastern Caroline Islands 96941. Location: Joint Bank-Fund Library, Washington, D.C.

55:20190 Hungary. Kozponti Statisztikai Hivatal (Budapest, Hungary). Studies in mortality differentials, 3. Geographical mortality differentials in Hungary, 1987 (complete and abridged life tables). [Halandosagi vizsgalatok, 3. A halandosag foldrajzi kulonbsegei Magyarorszagon, 1987 (koreves es roviditett halandosagi tablak).] 1987. 100 pp. Budapest, Hungary. In Hun. with sum. in Eng.
This is the fifth in a series of annual publications presenting life tables for Hungary by sex and geographical area. Abridged life tables are included for towns, villages, Budapest, towns of county rank, counties, and population size of the settlements.
For a report for 1986, published in 1988, see 54:20210.
Correspondence: Kozponti Statisztikai Hivatal, Keleti Karoly, U.5-7, 1525 Budapest II, Hungary. Location: Princeton University Library (SPR).

55:20191 Luo, Sheng. Reconstruction of life tables and age distributions for the population of China, by year, from 1953 to 1982. Pub. Order No. DA8816201. 1988. 208 pp. University Microfilms International: Ann Arbor, Michigan. In Eng.
The author develops a new method for making an intercensal life table for China, which is found to give better results than methods developed previously by Coale and by Preston. "An estimated age pattern of the intercensal mortality is taken as a general standard, is combined with the Brass logit system improved by adding a characteristic term to the system, and is used to solve for annual survival ratio functions of life tables by iteration. Based on the estimated survival ratio functions, annual life tables and annual age distributions of the population are constructed from 1953 to 1982. The completeness of birth and death registration is then assessed. The excess number of deaths during the 1959-1961 famine period is also estimated."
This work was prepared as a doctoral dissertation at the University of Pennsylvania.
Correspondence: University Microfilms International, 300 North Zeeb Road, Ann Arbor, MI 48106. Source: Dissertation Abstracts International, A: Humanities and Social Sciences 49(7).

55:20192 Schoen, Robert. Practical uses of demographic models. Working Papers in Population Studies, No. WP8901, Feb 24, 1989. 54 pp. University of Illinois, Department of Sociology: Urbana, Illinois. In Eng.
"This review will examine the life table and its extensions, including multistate life tables and stable populations, and consider their uses in describing and estimating demographic behavior." The logical structure and central concepts of demographic modeling are explained.
Correspondence: Department of Sociology, University of Illinois, 326 Lincoln Hall, 702 South Wright Street, Urbana, IL 61801. Location: Princeton University Library (SPR).

55:20193 Silber, Jacques. On inequality before death and life table summary measures. Genus, Vol. 44, No. 1-2, Jan-Jun 1988. 25-39 pp. Rome, Italy. In Eng. with sum. in Fre; Ita.
"This study has suggested the use of two new summary indices of the level and structure of mortality, called equivalent lengths of life. These are adjusted life expectancies, a correction being made for the dispersion, and eventually also for the asymmetry of the distribution of ages at death. Their computation is based on the use of Gini's Mean Difference. A short illustration is also presented, based on Italian life tables for the period 1881-1970."
Correspondence: J. Silber, Department of Economics, Bar Ilan University, Ramat-Gan, Israel. Location: Princeton University Library (SPR).

55:20194 Vasin, S. A. Regional model life tables. [Regional'nye model'nye tablitsy dozhitiya.] Sotsiologicheskie Issledovaniya, No. 4, Jul-Aug 1988. 63-70 pp. Moscow, USSR. In Rus.
The author describes various model life tables, including those that have been developed by the League of Nations, the United Nations, and at Princeton University by Coale and Demeney. The relative merits of the various models are discussed.
Location: Princeton University Library (PR).

E.6. Differential Mortality

Studies on the ratio of mortality in different subgroups of a population, classified according to certain criteria, such as sex, social class, occupation, and marital status. Also includes studies on excess mortality and comparative mortality.

55:20195 Behrman, Jere R.; Sickles, Robin; Taubman, Paul. Age-specific death rates. In: Issues in contemporary retirement. 1988. 162-90 pp. Hoover Institution: Stanford, California. In Eng.
Time-to-failure and hazard models are used to examine the relationship between mortality and various socio-demographic and life-style measures. Data are for the United States and are from the Retirement History Survey (RHS), started in 1969, and the Dorn sample, started in 1953. "We find that regular tobacco users have shorter lives and that there are regional variations and occupational differences. In the RHS, married and divorced men live longer than those widowed or never married. We also find than pensions and Social Security benefits...have strong effects on life expectancy with Social Security having somewhat stronger effects. We also find that having a child at home or a working spouse when a man is in his sixties is associated with shorter life spans, though in both cases the direction of causality is questionable. Those in the professional and managerial occupations live longer. Education, however, is not statistically significant."
Location: University of Pennsylvania, Demography Library, Philadelphia, PA.

55:20196 Carlson, Elwood. Concentration of rising Hungarian mortality among manual workers. Sociology and Social Research, Vol. 73, No. 3, Apr 1989. 119-28 pp. Los Angeles, California. In Eng.
"Between 1960 and 1984, male death rates rose substantially among manual workers in Hungary but remained essentially unchanged or even declined among nonmanual earners. This focus of mortality increase within clear age and occupational boundaries highlights the social roots of the phenomenon." The data for the analysis are taken from official sources.
Correspondence: E. Carlson, Department of Sociology, University of South Carolina, Columbia, SC 29208. Location: Princeton University Library (PR).

55:20197 Duleep, Harriet O. Measuring socioeconomic mortality differentials over time. Demography, Vol. 26, No. 2, May 1989. 345-51 pp. Alexandria, Virginia. In Eng.
"Using 1973 Current Population Survey data matched to 1973-1978 Social Security mortality records, this study measures the relationship between the income and education of men and their subsequent mortality. The estimated relationships are compared with socioeconomic mortality differentials found by Kitagawa and Hauser in their study of 1960 census-death certificate matched data. The comparison suggests that there has been no improvement in the relative mortality experience of low socioeconomic status men. More generally, the article discusses how Social Security data could be used to monitor, on a continual basis, our progress toward eradicating significant mortality differentials in the United States."
Correspondence: H. O. Duleep, U.S. Commission on Civil Rights, 1121 Vermont Avenue NW, Washington, D.C. 20435. Location: Princeton University Library (SPR).

55:20198 Freed, Ruth S.; Freed, Stanley A. Beliefs and practices resulting in female deaths and fewer females than males in India. Population and Environment, Vol. 10, No. 3, Spring 1989. 144-61 pp. New York, New York. In Eng.
"A preference for sons and the low status of females are implicated in the preponderance of males over females as reported in each census of India from the first one taken in the 19th century. A number of cultural practices, some of which are quite ancient, are involved in this sexual imbalance, namely, maternal mortality due to unhygienic lying-in and postpartum conditions and practices, female infanticide, female feticide, Sati, murder, dowry murder, and suicide. This discussion is based both on 19th and 20th century sources and on fieldwork conducted in the North Indian village of Shanti Nagar in 1958-59 and 1977-78."
Correspondence: R. S. Freed, American Museum of Natural History, Central Park West at 79th Street, New York, NY 10024-5192. Location: Princeton University Library (SPR).

55:20199 Hartel, Ursula. Sex differences in mortality, with examples from the Federal Republic of Germany. [Die unterschiedliche Sterblichkeit von Mannern und Frauen, mit Beispielen aus der Bundesrepublik Deutschland.] Sozial- und Praventivmedizin/Medecine Sociale et Preventive, Vol. 33, No. 3, 1988. 135-9 pp. Bern, Switzerland. In Ger. with sum. in Eng; Fre.
"Sex differences in mortality are described and discussed, using data from the national causes of death statistics of West Germany. As in other industrialized countries, men in the FRG, compared to women, have higher mortality rates in all leading causes of death. The sex differences are most prominent in coronary heart disease, lung cancer, fatal accidents, suicide and liver cirrhosis....The cause-specific death rates and the results from corresponding epidemiological studies indicate that genetic disadvantages of men are reinforced by factors of social environment and 'deleterious' individual behavior. Thus a great part of the sex differences in total mortality could be influenced and should not be judged as inevitable."
Correspondence: U. Hartel, GSF Medis-Institut, AG Epidemiologie, Ingoldstadter Landstrasse 1, D-8042, Neuherberg b. Munich, Federal Republic of Germany. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20200 Hoffmans, M. D. A. F.; Kromhout, D.; Coulander, C. de L. The impact of body mass index of 78,612 18-year old Dutch men on 32-year mortality from all causes. Journal of Clinical Epidemiology, Vol. 41, No. 8, 1988. 749-56 pp. Elmsford, New York/Oxford, England. In Eng.
The impact of body composition, and particularly body fat content, on morbidity and mortality is examined using logistic regression analysis of data from the 1932 cohort of 78,612 18-year-old Dutch men who were followed up over a 32-year period. Very lean men had an increased mortality risk, which was mainly associated with impaired health status. The negative effect of being overweight was only demonstrable after 20 years of follow-up. "The results of this study support the hypothesis that moderately obese young men have an increased mortality risk."
Correspondence: M. D. A. F. Hoffmans, Institute of Social Medicine, University of Leiden, P.O. Box 9605, 2300 RC Leiden, Netherlands. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20201 Nordic Statistical Secretariat (Copenhagen, Denmark). Occupational mortality in the Nordic countries, 1971-1980. Nordisk Statistisk Skriftserie/Statistical Reports of the Nordic Countries, No. 49, ISBN 87-88083-33-0. 1988. 148 pp. Copenhagen, Denmark. In Eng.
"This study presents the results of a study of the relationship between mortality and occupation in the five Nordic countries during the ten-year period 1971-80." The countries examined are Denmark, Finland, Norway, Sweden, and Iceland. The data concern approximately 775,000 deaths occurring in a population of more than 12 million aged 20-64 as of January 1, 1971, and were compiled primarily through linkage of the census and death registers of the countries concerned. The analysis also considers mortality differentials by sex.
Correspondence: Nordic Statistical Secretariat, c/o Danmarks Statistik, Postbox 2550, DK-2100 Copenhagen 0, Denmark. Location: Princeton University Library (SPR).

55:20202 Paul, Elizabeth A.; Evans, Jennifer; Barry, Joseph; Bouvier-Colle, Marie-Helene; Carstairs, Vera; Cayolla da Motta, Luis; Hansen-Koenig, Diter; Juel, Knud; Kern, Klaus; Lagasse, Raphael; Mackenbach, Johan P.; Medrano, Maria; Morosini, Piero L.; Papavangelou, George. Geographical variations in mortality from conditions amenable to medical intervention in Europe. The Commission of the European Community: atlas of avoidable death. [Variations geographiques de la mortalite due a des maladies justiciables d'une intervention medicale en Europe. Commission des Communautes Europeennes: atlas de deces evitables.] World Health Statistics Quarterly/Rapport Trimestriel de Statistiques Sanitaires Mondiales, Vol. 42, No. 1, 1989. 42-9 pp. Geneva, Switzerland. In Fre. with sum. in Eng.
A collaborative project concerned with the development of measures to evaluate health services in 10 member countries of the European Economic Community is presented. Mortality from 17 selected disease groups was compared across 380 health-service administrative areas in the participating countries. The authors suggest that the mortality differentials observed are of significance to health service administrators, and that the high levels of moratlity in certain areas are indicative of health service failures.
Correspondence: E. A. Paul, Department of Community Medicine, United Medical and Dental Schools of Guy's and St. Thomas's Hospitals, POB 254, London SE1 7EH, England. Location: Princeton University Library (SPR).

55:20203 Rosenwaike, Ira; Shai, Donna. Changes in mortality among Cubans in the United States following an episode of unscreened migration. International Journal of Epidemiology, Vol. 18, No. 1, Mar 1989. 152-7 pp. Oxford, England. In Eng.
"This paper discusses the effect of the Mariel migration, a massive boatlift from Cuba to the United States in 1980, on mortality among Cuban Americans. Estimates of the Cuban-born population in the U.S. were made for 1979 and 1981, the years prior to and following the boatlift. A comparison of age-adjusted rates showed that while general mortality did not change greatly (an increase of only about 5%), there was a 151% increase in homicide mortality....The demographic differences between the Mariel migrants who settled in Dade and those who were settled elsewhere are discussed."
Correspondence: I. Rosenwaike, Graduate School of Social Work, University of Pennsylvania, Philadelphia, PA 19104. Location: Princeton University Library (SPR).

55:20204 Snowdon, David A.; Kane, Robert L.; Beeson, W. Lawrence; Burke, Gregory L.; Sprafka, J. Michael; Potter, John; Iso, Hiroyasu; Jacobs, David R.; Phillips, Roland L. Is early natural menopause a biologic marker of health and aging? American Journal of Public Health, Vol. 79, No. 6, Jun 1989. 709-14 pp. Washington, D.C. In Eng.
"The relation between age at natural menopause and all-cause mortality [in the United States] was investigated in a sample of 5,287 White women, ages 55 to 100 years, naturally-postmenopausal, Seventh-day Adventists who had completed mailed questionnaires in 1976." The results of the analysis suggest that an early age at natural menopause is associated with substantial excess mortality. Furthermore, women who report menopause at ages 55 or older may have a slightly higher risk of death than women with natural menopause between ages 50 and 54.
Correspondence: D. A. Snowdon, Division of Epidemiology, School of Public Health, University of Minnesota, Stadium Gate 27, 611 Beacon Street SE, Minneapolis, MN 55455. Location: Princeton University Library (PR).

55:20205 Stein, Dorothy. Burning widows, burning brides: the perils of daughterhood in India. Pacific Affairs, Vol. 61, No. 3, Fall 1988. 465-85 pp. Vancouver, Canada. In Eng.
"Indian women are subjected to intense economic and social discrimination, and continue to suffer death rates that are well in excess of male rates, despite forty years of independence in a secular democracy with universal suffrage. Certain practices, such as sati and dowry have spread from high status Hindu groups across social boundaries. This paper traces the evolution of these practices and argues that the peculiarity of Indian civilization that enables the general devaluation of the female sex to be taken to such extremes lies in the inferior social power of the families of girls and women, and the consequent insistence on universal female marriage."
Location: Princeton University Library (SF).

55:20206 Taamallah, Khemaies. Inequality in the face of death in Tunisia. [L'inegalite devant la mort en Tunisie.] Cahiers de Tunisie, Vol. 34, No. 135-136, 1986. 255-77 pp. Tunis, Tunisia. In Fre.
Mortality differentials in Tunisia are explored. The author first considers the reliability of existing data. Mortality trends as a whole are then outlined, as are differentials by sex and age, changes in causes of death over time, socio-professional status, and geographical region.
Location: Princeton University Library (SY).

55:20207 Trovato, Frank. Mortality differentials in Canada, 1951-1971: French, British, and Indians. Culture, Medicine and Psychiatry, Vol. 12, No. 4, Dec 1988. 459-77 pp. Dordrecht, Netherlands. In Eng.
"In this paper, the relationship between ethnic origin and mortality is investigated from the point of view of convergence and minority group status hypotheses. Multivariate methods are used to study differences among the French, the British and Native Indian (includes Metis and Eskimos) populations of Canada over three census periods from 1951 to 1971. A significant downward trend in the death rates of all three subpopulations is noted, but substantial differences persist, as the pace of mortality decline over time varies across the three ethnic groups." The analysis provides strong support for the minority status effect and some support for the convergence thesis. Differences in causes of death among the various groups are also analyzed.
Correspondence: F. Trovato, Department of Sociology, University of Alberta, Edmonton, Alberta T6G 2H4, Canada. Location: Princeton University Library (PR).

55:20208 Wang, Zhi Jin; Ramcharan, Savitri; Love, Edgar J. Cancer mortality of Chinese in Canada. International Journal of Epidemiology, Vol. 18, No. 1, Mar 1989. 17-21 pp. Oxford, England. In Eng.
"Cancer deaths determined from national vital statistics in Canadian ('Chinese') immigrants who were born in mainland China, Hong Kong or Taiwan were compared with those in the Canadian-born population. Standardized mortality ratios (SMR) based on 1981 census data and on 755 deaths among 81,740 Chinese males and 586 deaths among 83,965 females during 1980-1984, showed that the overall cancer mortality in Chinese males (SMR 141), and females (SMR 116), was significantly higher than in the Canadian-born." Variations according to cancer site and sex are also presented.
Correspondence: Z. J. Wang, Department of Community Health Services, Faculty of Medicine, University of Calgary, Calgary, Alberta T2N 1N4, Canada. Location: Princeton University Library (SPR).

E.7. Mortality by Cause

Studies of demographic relevance on causes of death. Studies of morbidity and of public health measures are included only if they relate specifically to mortality. Also included are maternal mortality and comparisons of causes.

55:20209 Anderson, R. M.; May, R. M.; McLean, A. R. Possible demographic consequences of AIDS in developing countries. Nature, Vol. 332, No. 6161, Mar 17, 1988. 228-34 pp. London, England. In Eng.
"Simple mathematical models of the transmission dynamics of HIV that incorporate demographic and epidemiological processes to assess the potential impact of AIDS on human population growth and structure in developing countries suggest that AIDS is capable of changing population growth rates from positive to negative values over timescales of a few decades. The disease is predicted to have little if any impact on the dependency ratio of a population, defined as the number of children below age 15 years and elderly people over 64 years, divided by the number of adults between 15 to 64 years."
Correspondence: R. M. Anderson, Parasite Epidemiology Research Group, Department of Pure and Applied Biology, Imperial College, London University, London SW7 2BB, England. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20210 Bang, Ki Moon; White, Jack E.; Gause, Barry L.; Leffall, Lasalle D. Evaluation of recent trends in cancer mortality and incidence among blacks. Cancer, Vol. 61, No. 6, Mar 15, 1988. 1,255-61 pp. Philadelphia, Pennsylvania. In Eng.
"Recent trends in the cancer incidence, mortality, and 5-year survival rate for the [U.S.] black population were evaluated using the available national data up to 1981. Blacks have the highest overall age-adjusted cancer rates in both incidence and mortality of any U.S. population group. The overall cancer incidence rates for blacks rose 17%, while for whites it increased 13% from 1969 to 1981. The rate in black men has increased 22.9%, while the rate in black women has increased 13.1%." Changes in various cancer sites over time are noted. The authors also note that although whites had slightly higher cancer survival rates for the period 1973-1981, the pattern for blacks was virtually unchanged.
Correspondence: K. M. Bang, Department of Community Health and Family Practice, Howard University College of Medicine, 2041 Georgia Avenue NW, Washington, D.C. 20059. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20211 Barraclough, Brian. International variation in the suicide rate of 15-24 year olds. Social Psychiatry and Psychiatric Epidemiology, Vol. 23, No. 2, Apr 1988. 75-84 pp. Secaucus, New Jersey/Berlin, Germany, Federal Republic of. In Eng.
"The incidence of suicide in the 15-24 age group reported by 70 member states to WHO for the period 1972 to 1984 was examined." The data primarily concern the countries of Europe or those populated predominantly by those of European descent. They show that the countries of Northern and Eastern Europe tend to have the highest rates of suicide for this age group. "Unlike the familiar European pattern, the female suicide rate is greater than the male for some Latin American and Asian countries. The mean suicide rate of the countries considered after increasing in the late seventies has declined, although not to the original level."
Correspondence: B. Barraclough, Southampton University, School of Medicine, Royal South Hants Hospital, Southampton SO9 4PE, England. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20212 Beaglehole, Robert; Bonita, Ruth; Stewart, Alistair. Cardiovascular disease mortality trends in the western Pacific, 1968-1984. New Zealand Medical Journal, Vol. 101, No. 849, Jul 13, 1988. 441-3 pp. Dunedin, New Zealand. In Eng.
"A comparison of 1984 age standardized mortality rates in five western Pacific countries indicates a wide variation for all cause mortality and all cardiovascular disease mortality, with Singapore having rates twice as great as Japan which has the lowest rates. New Zealand has the highest rate of coronary heart disease, and with Australia the lowest rate of stroke mortality. Mortality rates for each disease category studied were lower among women than men for each country. In the period 1968-1984 all countries experienced a decline in all cause mortality. All cardiovascular disease mortality rates have declined in all countries except Singapore; coronary heart disease mortality rates have increased in Singapore. The improvements in stroke mortality in Japan have been dramatic in comparison with the other four countries."
Correspondence: R. Beaglehole, Department of Community Health, University of Auckland School of Medicine, Private Bag, Auckland, New Zealand. Location: New York Academy of Medicine.

55:20213 Bongaarts, John; Way, Peter. Geographic variation in the HIV epidemic and the mortality impact of AIDS in Africa. Population Council Research Division Working Paper, No. 1, 1989. 27 pp. Population Council, Research Division: New York, New York. In Eng.
Geographic variation in the size of AIDS epidemics in Africa is reviewed. "The most severely affected countries are found in Central and East Africa, while levels of infection are still low or negligible in North Africa and much of West Africa. HIV seroprevalence in urban areas, particularly in capital cities, is typically much higher than in rural areas. The total number of infected African adults in 1987 is estimated at 2.5 million, which corresponds to an HIV seroprevalence rate of 0.9 percent among adults. The causes of these geographic differences in epidemic size are not well understood, but probably include variations in sexual behavior, timing of onset of the epidemic, male circumcision practices, and the prevalence of infectious agents, in particular sexually transmitted diseases that produce genital ulcers." Consideration is also given to projections of the future impact of AIDS. "In the worst case scenario HIV seroprevalence is assumed to reach 21 percent in all of Africa in 2000, and the related AIDS death rate at that time is estimated at 12.0 per 1,000 population. On the other hand, the best case scenario assumes a three-fold increase in HIV seroprevalence from 0.9 percent in 1987 to 2.7 percent in 2000. In this case the AIDS death
projected to rise to 1.5 deaths per 1,000 population by the end of this century."
Correspondence: Population Council, 1 Dag Hammarskjold Plaza, New York, NY 10017. Location: Princeton University Library (SPR).

55:20214 Brown, Charles C.; Kessler, Larry G. Projections of lung cancer mortality in the United States: 1985-2025. JNCI: Journal of the National Cancer Institute, Vol. 80, No. 1, Mar 2, 1988. 43-51 pp. Bethesda, Maryland. In Eng.
"This article presents an analysis of smoking and lung cancer data using an age-period-cohort model for projecting lung cancer mortality [in the United States] through the year 2025. The projections are based on the initial parameterization of the model and on prevention objectives related to smoking behavior established by the National Cancer Institute. It is concluded that the recent trends in lung cancer are unlikely to be affected by changes in cigarette composition and consumption in the near term, but increasing the effectiveness of anti-smoking campaigns can have a considerable effect on lung cancer rates in the more distant future."
Correspondence: C. C. Brown, Biometry Branch, Division of Cancer Prevention Control, National Cancer Institute, Bethesda, MD 20892-4200. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20215 Burch, P. R. J. Period and cohort trends for mortality and cigarette consumption in England and Wales, 1946 to 1980, with emphasis on sex ratios. Journal of Clinical Epidemiology, Vol. 41, No. 4, 1988. 373-84 pp. Elmsford, New York/Oxford, England. In Eng.
This study continues previous work on the relationship between smoking and mortality using data for England and Wales for the period 1946-1980. "In this paper temporal changes in the sex ratio of cumulative cigarette consumption by cohort, and of smoking rates by age, are considered in relation to changes in the sex ratio of mortality. Again, no consistent correlations emerge and it is evident that factors other than smoking have played a dominant part in determining recent changes in the sex ratio of mortality in all age groups from 35-39 to 80-84 years. Among these 'other factors' are birth cohort effects that can be attributed, in part, to birth cohort changes in the sex ratio of mortality from bronchitis and emphysema."
For an earlier study, published in 1981, see 47:4209.
Location: U.S. National Library of Medicine, Bethesda, MD.

55:20216 Chin, J.; Mann, J. Global surveillance and forecasting of AIDS. Bulletin of the World Health Organization/Bulletin de l'Organisation Mondiale de la Sante, Vol. 67, No. 1, 1989. 1-7 pp. Geneva, Switzerland. In Eng. with sum. in Fre.
"This article reviews the surveillance and global patterns of infections with the human immunodeficiency virus (HIV), the etiologic agent of AIDS, and provides some short-term forecasting of the HIV/AIDS situation in several major areas of the world." The authors conclude that "by the early 1990s, the cumulative total of global AIDS cases can be expected to be over one million, and by the late 1990s to be about two to three million. Health care systems throughout the world will need to be strengthened to respond to this toll of disease and death."
Correspondence: J. Chin, Global Programme on AIDS, World Health Organization, 1211 Geneva 27, Switzerland. Location: Princeton University Library (SPR).

55:20217 Clarke, Ronald V.; Jones, Peter R. Suicide and increased availability of handguns in the United States. Social Science and Medicine, Vol. 28, No. 8, 1989. 805-9 pp. Elmsford, New York/Oxford, England. In Eng.
"During the 25 years between 1959 and 1984, the suicide rate in the United States increased from 10.5/100,000 to 12.4/100,000. The increase was confined to those suicides using a firearm, which had reached 58.5% of the total by the end of the period. At the same time, there was a marked increase in the household ownership of handguns (but not of shotguns and rifles). The present study investigates whether the increase in suicide might be due to the increase in the ownership of handguns." Regression analysis provides evidence that the rise in handgun ownership has lead to an increase in gun suicides, but does not provide sufficient evidence to show that more people are committing suicide because there are more handguns available, or if people who kill themselves with guns would have chosen a different method if guns were not available.
Correspondence: R. V. Clarke, School of Criminal Justice, Rutgers University, 15 Washington Street, Newark, NJ 17102. Location: Princeton University Library (PR).

55:20218 Crews, Douglas E. Multiple causes of death and the epidemiological transition in American Samoa. Social Biology, Vol. 35, No. 3-4, Fall-Winter 1988. 198-213 pp. Madison, Wisconsin. In Eng.
"Multiple-cause mortality data were used to examine changing patterns of mortality between 1950 and 1979 in American Samoa. This period coincided with a transition from infectious to chronic diseases as the primary causes of death. The available data indicate that as mortality rates from infections declined, the first chronic disease to increase in frequency was cancer. The absence of a lag period suggests that increased cancer mortality may be a consequence of life extension in the presence of modernization. In contrast, mortality rates from cardiovascular diseases tended to increase only after a lag period....The transition to degenerative disease mortality in American Samoa was neither as rapid nor as simple as a tabulation by underlying cause of death indicates. Patterns of change were interrelated."
Correspondence: D. E. Crews, Center for the Study of Population, Florida State University, Tallahassee, FL 32306. Location: Princeton University Library (SPR).

55:20219 Crombie, I. K. Trends in suicide and unemployment in Scotland, 1976-86. British Medical Journal, Vol. 298, No. 6676, Mar 25, 1989. 782-4 pp. London, England. In Eng.
The relationship between unemployment and suicide in Scotland for the period 1976-1986 is analyzed using official data. "The trends in regional unemployment for men during 1971-81 were compared with the suicide rates for the period before the increase (1974-7) and the period after the rapid increase (1983-6). No association was observed between trends in suicide and unemployment when analysed by health board areas or aggregates of local government districts."
Correspondence: I. K. Crombie, Department of Community Medicine, University of Dundee Medical School, Ninewells Hospital, Dundee DD1 9SY, Scotland. Location: Princeton University Library (SZ).

55:20220 Dyck, R. J.; Newman, S. C.; Thompson, A. H. Suicide trends in Canada, 1956-1981. Acta Psychiatrica Scandinavica, Vol. 77, No. 4, Apr 1988. 411-9 pp. Copenhagen, Denmark. In Eng.
"Using official suicide statistics, this study examined suicide rates in Canada over a 25-year span (1956 to 1981) as a function of age, gender, and geographical region. The analysis revealed that, for both sexes, the risk of suicide among the 15-24 year-olds increased at a faster rate than in any other age group. Male and female age-standardized suicide rates demonstrated an overall increase between 1956 and 1981. The trend for males was one of continuous increase, whereas female rates reached a maximum in 1976 and then decreased. Regional differences in suicide rates were also apparent."
Correspondence: R. J. Dyck, Mental Health Services, 10030 107th Street, Edmonton, Alberta T55 3E4, Canada. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20221 Edye, Bettina; Ackermann-Liebrich, Ursula. Reproductive mortality in Switzerland between 1952 and 1982. [Reproduktive Mortalitat in der Schweiz zwischen 1952 und 1982.] Sozial- und Praventivmedizin/Medecine Sociale et Preventive, Vol. 33, No. 3, 1988. 144-7 pp. Bern, Switzerland. In Ger. with sum. in Eng; Fre.
"Reproductive mortality includes mortality attributable to pregnancy and childbirth and its sequelae, termination of pregnancy and contraception....An estimate of reproductive mortality in Switzerland is based on available figures on cardiovascular mortality, smoking and use of oral contraceptives. The reproductive mortality has been steadily declining since 1952 in the age group...15-34, [but] a stagnation of this risk can be observed for women over 35 since 1962. Theoretically this stagnation might be due to the use of oral contraceptives and an increase in smoking."
Correspondence: B. Edye, rue Daniel-Dardel 17, 2072 St.-Blaise, Switzerland. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20222 Epstein, F. H. International trends in mortality and morbidity from ischaemic heart disease. Annals of Clinical Research, Vol. 20, No. 1-2, 1988. 21-5 pp. Helsinki, Finland. In Eng.
"International mortality trends for ischaemic heart disease are summarized for the period 1972 to 1984, comparing the most recent with earlier changes in total mortality. A review of data on changes in incidence, short-term and long-term prognosis indicate that major declines in coronary heart disease mortality must have been due primarily to prevention, but improvements in short-term prognosis and, according to some studies, long-term prognosis have most likely contributed to the downward trends. Based on information available to date, changes in life styles, health-promoting or detrimental as the case may be, correlate with changes in risk factors and observed trends in coronary heart disease mortality."
Correspondence: F. H. Epstein, Lindenstrasse 37, CH-8008 Zurich, Switzerland. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20223 Fauveau, Vincent; Wojtyniak, Bogdan; Koenig, Michael A.; Chakraborty, J.; Chowdhury, A. I. Epidemiology and cause of deaths among women in rural Bangladesh. International Journal of Epidemiology, Vol. 18, No. 1, Mar 1989. 139-45 pp. Oxford, England. In Eng.
The authors present a detailed assessment of the causes and determinants of mortality among women living in rural Bangladesh. Data are from the Demographic Surveillance System for the period 1976-1985 for women aged 15-44. "Cause-specific and proportionate mortality rates showed a positive association with age for deaths due to infectious diseases, non-infectious diseases and unspecified causes, and an inverse association with age for deaths due to injuries. These rates showed a peak in the intermediate age group 25 to 34 years for deaths due to direct obstetric causes. No consistent trends were visible when annual rates were studied over time....Demographic impact is discussed, emphasizing the contribution of obstetric causes to overall mortality."
Correspondence: V. Fauveau, International Centre for Diarrhoeal Disease Research, Bangladesh, GPO Box 128, Dhaka-2, Bangladesh. Location: Princeton University Library (SPR).

55:20224 Fauveau, Vincent; Koenig, Michael A.; Wojtyniak, Bogdan; Chakraborty, J. Impact of a family planning and health services programme on adult female mortality. Health Policy and Planning, Vol. 3, No. 4, Dec 1988. 271-9 pp. Oxford, England. In Eng.
The demographic impact of the family planning and health program in Matlab, Bangladesh, over a 10-year period is analyzed. Data are from the International Centre for Diarrhoeal Diseases Research, Bangladesh. The results show that the overall mortality rate among women of reproductive age was significantly lower in the project area than in an adjacent control area. "An analysis of cause-specific mortality rates revealed that half of the difference observed was due to a lower number of deaths due to obstetrical causes in the intervention area, suggesting that this intensive family planning programme was successful in limiting pregnancies and their related deaths."
Correspondence: V. Fauveau, GPO Box 128, Dhaka-1000, Bangladesh. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20225 Gadalla, S.; Fortney, J. A.; Saleh, S.; Kane, T.; Potts, M. Maternal mortality in Egypt. Journal of Tropical Pediatrics, Vol. 33, Suppl. 4, 1987. 11-3 pp. London, England. In Eng.
"This paper examines maternal mortality in the rural Egyptian delta governorate of Menoufia and determines its importance as a cause of death in married women of reproductive age (15-49)." Data are from the Reproductive Age Mortality Survey and concern 437 deaths of pregnant or postpartum women that occurred during the period 1981-1983.
Correspondence: J. A. Fortney, Family Health International, 1 Triangle Drive, Research Triangle Park, NC 27709. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20226 Garcia Rodriguez, Luis A.; Cayolla da Motta, Luis. Years of potential life lost: application of an indicator for assessing premature mortality in Spain and Portugal. World Health Statistics Quarterly/Rapport Trimestriel de Statistiques Sanitaires Mondiales, Vol. 42, No. 1, 1989. 50-6 pp. Geneva, Switzerland. In Eng. with sum. in Fre.
"In this article, the authors present an analysis of causes of death in Spain and Portugal in 1984 based on a calculation of the 'years of potential life lost'...between the first and the 70th birthdays, the latter age corresponding approximately to the average life expectancy in both countries." The analysis indicates that the main causes of premature death in both countries are malignant tumors and violent deaths. The implications for the provision of health services are assessed.
Correspondence: L. A. Garcia Rodriguez, Medical Department, Pharmacoepidemiology, Ciba-Geigy Ltd., Basel, Switzerland. Location: Princeton University Library (SPR).

55:20227 Garland, Frank C.; Lilienfeld, Abraham M.; Garland, Cedric F. Declining trends in mortality from cerebrovascular disease at ages 10-65 years: a test of validity. Neuroepidemiology, Vol. 8, No. 1, Jan-Feb 1989. 1-23 pp. Basel, Switzerland. In Eng.
Data from Baltimore, Maryland, for the period 1950-1970 are used to investigate the validity of the reported decline in mortality from cerebrovascular disease in the United States. These data are checked for validity by reference to individual medical records concerning causes of death. The results show that overall accuracy of death certificate diagnoses did not change significantly over this period, and that death rates from most cerebrovascular diseases declined for most sex and ethnic groups.
Correspondence: F. C. Garland, Occupational Medicine Department, Naval Health Research Center, PO Box 85122, San Diego, CA 92138-9174. Location: New York Academy of Medicine.

55:20228 Haynes, Robin. The urban distribution of lung cancer mortality in England and Wales 1980-1983. Urban Studies, Vol. 25, No. 6, Dec 1988. 497-506 pp. Harlow, England. In Eng.
"Lung cancer area mortality rates for the period 1980-1983 in England and Wales followed the pattern observed for previous years, with high rates concentrated in urban districts and low rates in remote rural districts. Using data for 401 local government districts, estimates of smoking prevalence were made from socio-economic distributions and regional smoking variations. Confounding effects of migration and errors in mortality records were investigated by comparing the pattern of recorded lung cancer mortality with that of all other cancers. Holding these variables constant by statistical means reduced the correlation between lung cancer SMRs and population density from 0.65 to 0.53 for males and from 0.54 to 0.46 for females, so a large proportion of the urban-rural gradient remained unexplained. It is likely that a combination of several effects rather than a single urban risk factor is responsible for the urban concentration of lung cancer mortality."
Correspondence: R. Haynes, School of Environmental Sciences, University of East Anglia, Norwich, Norfolk NR4 7TJ, England. Location: Princeton University Library (UES).

55:20229 Heilig, Gerhard K.; Wils, Anna E. AIDS costs more "years of potential life" before age 65 than diabetes, TBC, or viral hepatitis! Patterns of premature mortality in Switzerland, Austria, and the Federal Republic of Germany. POPNET, No. 15, Feb 1989. 1-8 pp. Laxenburg, Austria. In Eng.
An attempt is made to estimate the present and future extent of AIDS mortality in Austria, the Federal Republic of Germany, and Switzerland. The results indicate an increase in premature mortality attributable to AIDS in these countries in 1984. The authors conclude that "it must be expected that during the 1990s AIDS will be one of the major causes of years of potential life lost among young adults, next to suicides and car accidents."
Correspondence: G. K. Heilig, International Institute for Applied Systems Analysis, A-2361 Laxenburg, Austria. Location: Princeton University Library (SPR).

55:20230 Holinger, Paul C. Violent deaths in the United States: an epidemiologic study of suicide, homicide, and accidents. ISBN 0-89862-672-2. LC 87-10720. 1987. xii, 274 pp. Guilford Press: New York, New York. In Eng.
Trends in violent deaths in the United States are analyzed. The epidemiology of violent deaths is first described, with separate consideration given to suicide, homicide, motor vehicle accidents, other accidents, and total accidents. The author then examines the extent to which all forms of violent death may reflect an individual's self-destructive tendencies. A major section is devoted to the potential for predicting violent death trends in populations. Appendixes present violent death rates for the United States from 1900 to 1984 by cause, sex, race, and from 1914, by age.
Correspondence: Guilford Press, 200 Park Avenue South, New York, NY 10003. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20231 Hopkins, David D.; Grant-Worley, Joyce A.; Bollinger, Terrie L. Survey of cause-of-death query criteria used by state vital statistics programs in the U.S. and the efficacy of the criteria used by the Oregon vital statistics program. American Journal of Public Health, Vol. 79, No. 5, May 1989. 570-4 pp. Washington, D.C. In Eng.
The authors describe the efforts of the Oregon Center for Health Statistics to query certifying physicians at a comprehensive level concerning causes of death. "During August 1986-July 1987, a total of 2,453 of 23,238 death certificates were returned to the certifiers for additional information, not including those returned in a tobacco use study. More than one-half (56.1 per cent) resulted in new and more specific underlying cause-of-death data. Only 5.2 per cent of the queries were unanswered." One probable result of these efforts is that Oregon reports the highest percentage of liver cirrhosis and disease deaths attributed to alcohol drinking in the United States. The state has also succeeded in identifying a higher percentage of maternal deaths than would otherwise have been the case.
Correspondence: D. D. Hopkins, Oregon Center for Health Statistics, Oregon State Health Division, P.O. Box 231, Portland, OR 97207. Location: Princeton University Library (PR).

55:20232 Iso, Hiroyasu; Jacobs, David R.; Wentworth, Deborah; Neaton, James D.; Cohen, Jerome D. Serum cholesterol levels and six-year mortality from stroke in 350,977 men screened for the multiple risk factor intervention trial. New England Journal of Medicine, Vol. 320, No. 14, Apr 6, 1989. 904-10 pp. Boston, Massachusetts. In Eng.
The relationship between serum total cholesterol level and risk of death from stroke among 350,977 U.S. males aged 35 to 57 with no history of heart attack or current treatment for diabetes mellitus is examined. Data are from the Multiple Risk Factor Intervention Trial and were originally collected in the period 1973-1975 and from a follow-up study conducted over six years. The authors conclude that "there is an inverse relation between the serum cholesterol level and the risk of death from hemorrhagic stroke in middle-aged American men, but that its public health impact is overwhelmed by the positive association of higher serum cholesterol levels with death from nonhemorrhagic stroke and total cardiovascular disease...."
Correspondence: D. Wentworth, Division of Biometry, School of Public Health, University of Minnesota, A-460 Mayo Memorial Building, Box 197, 420 Delaware Street S.E., Minneapolis, MN 55455. Location: Princeton University Library (SZ).

55:20233 Koonin, Lisa M.; Atrash, Hani K.; Rochat, Roger W.; Smith, Jack C. Maternal mortality surveillance, United States, 1980-1985. Morbidity and Mortality Weekly Report, Vol. 37, No. SS-5, Dec 1988. 19-29 pp. Atlanta, Georgia. In Eng.
An analysis is presented of the 601 maternal deaths reported in the United States during the period 1980-1985 by the voluntary reporting system, Maternal Mortality Collaborative. "Overall, women over 30 years of age had a higher risk of dying than did younger women. For each age group, women of black and other races had a greater risk of dying than white women, with women of black and other races who were 30 years and older having the highest risk. The leading causes of maternal deaths were embolism, hypertension in pregnancy, sequelae from ectopic pregnancy, hemorrhage, cerebrovascular accidents, and anesthesia complications."
Correspondence: L. M. Koonin, Research and Statistics Branch and Pregnancy Epidemiology Branch, Division of Reproductive Health, Centers for Disease Control, 1600 Clifton Avenue, Atlanta, GA 30333. Location: Princeton University Library (SPR).

55:20234 La Vecchia, Carlo; Decarli, Adriano. Decline of childhood cancer mortality in Italy, 1955-1980. Oncology, Vol. 45, No. 2, Mar-Apr 1988. 93-7 pp. Basel, Switzerland. In Eng.
The decline in cancer mortality during childhood in Italy over the period 1955-1980 is reviewed. The authors conclude that although some 300 cancer deaths per year were avoided in 1979-1980 based on a comparison with rates for 1955-1960, comparisons with other developed countries indicate that further improvements could be made.
Correspondence: C. La Vecchia, Istituto di Ricerche Farmacologiche Mario Negri, Via Eritrea 62, I-20157 Milan, Italy. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20235 Lantum, Daniel N. The impact of malaria on mortality and prospects of change through eradication. In: African Population Conference/Congres Africain de Population, Dakar, Senegal, November/novembre 7-12, 1988. Vol. 2, 1988. 3.4.1-18 pp. International Union for the Scientific Study of Population [IUSSP]: Liege, Belgium. In Eng. with sum. in Fre.
The author analyzes the global impact of malaria on mortality. Demographic changes resulting from the eradication of malaria are considered, with a focus on possible shifts in the demographic and economic structures of developing countries.
Correspondence: D. N. Lantum, University Center for Health Sciences (CUSS), University of Yaounde, B.P. 1364, Yaounde, Cameroon. Location: Princeton University Library (SPR).

55:20236 Mazur, Alicja. Cause-specific mortality in large cities in Poland. [Umieralnosc wedlug przyczyn w wielkich miastach w Polsce.] Studia Demograficzne, No. 2/92, 1988. 89-106 pp. Warsaw, Poland. In Pol. with sum. in Eng; Rus.
The author analyzes cause-specific mortality in cities in Poland with populations of at least 100,000 residents. The analysis was performed separately for men and women. Sex differentials among cities were found for causes of death.
Location: Princeton University Library (SPR).

55:20237 Metropolitan Life Insurance Company (New York, New York). Progress against mortality from stroke. Statistical Bulletin, Vol. 70, No. 2, Apr-Jun 1989. 18-28 pp. New York, New York. In Eng.
This is the second in a planned series of analyses of regional mortality by age and sex. In this article, the decrease in cerebrovascular mortality that has occurred in the United States since the 1950s is reviewed. "The significant decrease in cerebrovascular mortality since 1968 was equally experienced by men and women, but was somewhat greater for persons of all other races than for whites....A result of the substantial relative decline in stroke death rates since 1968 has been a narrowing of the sex and race disparities."
For a previous article in this series, also published in 1989, see 55:10199.
Correspondence: Metropolitan Life Insurance Company, One Madison Avenue, New York, NY 10010. Location: Princeton University Library (SPR).

55:20238 O'Carroll, Patrick W. A consideration of the validity and reliability of suicide mortality data. Suicide and Life-Threatening Behavior, Vol. 19, No. 1, Spring 1989. 1-16 pp. New York, New York. In Eng.
Some issues concerning the validity of data on suicide in the United States are considered. The author "first briefly [outlines] the problems associated with the definition and official certification of suicide, and then [reviews] the literature pertaining to the validity and reliability of suicide statistics. Finally, [he considers] the process of suicide certification as a 'test' and [estimates] its sensitivity, specificity, and predictive value, using data from [the] studies reviewed...."
Correspondence: P. W. O'Carroll, Centers for Disease Control, Mailstop F-36, 1600 Clifton Road NE, Atlanta, GA 30333. Location: Princeton University Library (PR).

55:20239 Pitkanen, K. J.; Mielke, J. H.; Jorde, L. B. Smallpox and its eradication in Finland: implications for disease control. Population Studies, Vol. 43, No. 1, Mar 1989. 95-111 pp. London, England. In Eng.
Late nineteenth- and early twentieth-century sources are used to describe the history, decline, and eventual eradication of smallpox in Finland. Primary vaccination is confirmed as the principal cause of the initial decline in smallpox mortality. "To interpret the final phases of smallpox history in Finland, however, several factors must be taken into consideration. These include revaccination, virulence of the virus, containment (quarantine) of infected individuals, vaccination of contacts, and importation of the virus from surrounding countries. While these factors were not of equal causal importance, they exerted a synergistic effect on the course of Finnish smallpox history. This in-depth historical case study demonstrates that multiple factors must be taken into account when disease control policies in developing countries are formulated to-day."
Correspondence: K. J. Pitkanen, Department of Economic and Social History, University of Helsinki, Aleksanterinkatu 7, Helsinki 00100, Finland. Location: Princeton University Library (SPR).

55:20240 Senra, A.; Herrero, J. I.; Millan, J. Prediction of cancer mortality in Spain. [Prediccion de la mortalidad por cancer en Espana.] Revista de Sanidad e Higiene Publica, Vol. 61, No. 9-10, Sep-Oct 1987. 1,029-34 pp. Madrid, Spain. In Spa. with sum. in Eng; Fre.
Trends in cancer mortality in Spain are predicted for the period 1980-2000. An increase is noted in male cancer mortality, both in absolute values and corrected rates, while an increase for women is seen only in absolute values. Probable changes in types of cancer mortality over time are also described.
Correspondence: A. Senra, Facultad de Medicina, Cadiz, Spain. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20241 Slattery, Martha L.; Randall, D. Elizabeth. Trends in coronary heart disease mortality and food consumption in the United States between 1909 and 1980. American Journal of Clinical Nutrition, Vol. 47, No. 6, Jun 1988. 1,060-7 pp. Bethesda, Maryland. In Eng.
"This study is an ecological comparison of coronary heart disease (CHD) mortality trends and trends in food consumption in the United States population between 1909 and 1980. CHD mortality data were obtained from published vital statistics. National food disappearance data, compiled regularly by the U.S. Department of Agriculture (USDA), were the primary source of dietary information used....Dietary substitutions towards less-saturated fatty acids support the hypothesized relationship between dietary fat and CHD. These changes preceded CHD mortality changes by 10-20 [years]."
Correspondence: M. L. Slattery, Department of Family and Preventive Medicine, University of Utah School of Medicine, 50 North Medical Drive, Room 1C377, Salt Lake City, UT 84132. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20242 Stack, Steven. The impact of divorce on suicide in Norway, 1951-1980. Journal of Marriage and the Family, Vol. 51, No. 1, Feb 1989. 229-38 pp. Saint Paul, Minnesota. In Eng.
"The present study does a comparative analysis of a well-substantiated relationship based principally on American-based research: that between marital integration and suicide....Specifically, it tests the generalizability of the divorce-suicide relationship" in Norway using data for the period 1951-1980. Despite institutional and cultural buffers in Norway thought to account for a historically low suicide rate, the author finds the recent rise in the suicide rate to be related to destabilizing trends in family life. Data are from the World Health Organization and other official sources.
Correspondence: S. Stack, Department of Sociology, Anthropology, and Social Work, 6090 Haley Center, Auburn University, Auburn, AL 36849-3501. Location: Princeton University Library (SPR).

55:20243 United States. Centers for Disease Control [CDC] (Atlanta, Georgia). Chronic disease reports: mortality trends--United States, 1979-1986. Morbidity and Mortality Weekly Report, Vol. 38, No. 12, Mar 31, 1989. 189-93 pp. Atlanta, Georgia. In Eng.
Mortality trends in the United States from 1979 to 1986 are described using data that were age-adjusted to the 1980 total population and groupings to form specific diagnostic categories. Total age-standardized mortality declined by eight percent during this period. Significant declines in mortality due to stroke, coronary heart disease, and cirrhosis are contrasted with significant increases in mortality from lung cancer and obstructive pulmonary disease related to smoking.
Correspondence: CDC, Public Health Service, Department of Health and Human Services, 1600 Clifton Road, Atlanta, GA 30333. Location: Princeton University Library (SPR).

55:20244 Walker, Weldon J.; Brin, Burton N. U.S. lung cancer mortality and declining cigarette tobacco consumption. Journal of Clinical Epidemiology, Vol. 41, No. 2, 1988. 179-85 pp. Elmsford, New York/London, England. In Eng.
The relationship between smoking and mortality in the United States is analyzed using an estimation method based on actual tobacco consumption by weight rather than by the number of cigarettes smoked, taking into account changes in cigarette manufacture between 1953 and 1981. "On average, tobacco content of cigarettes decreased 39.1% from 1953 to 1981. National per capita consumption of cigarette tobacco declined by 43%. Total exposure to cigarette tobacco has been declining for males for approximately 35 years; for females for 20 years. As of 1982, the secular trend for lung cancer mortality was declining for women below age 45 and for most age groups of men below 65. We appear to be at the threshold of a reversal in overall lung cancer mortality."
Correspondence: W. J. Walker, 258 Garfield Street, Ashland, OR 97520. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20245 Wing, Steve; Casper, Michele; Davis, Wayne B.; Pellom, Alvin; Riggan, Wilson; Tyroler, H. A. Stroke mortality maps: United States whites aged 35-74 years, 1962-1982. Stroke, Vol. 19, No. 12, Dec 1988. 1,507-13 pp. Dallas, Texas. In Eng.
Changes in the geographic distribution of stroke mortality in the United States during the period 1962-1982 are presented in map form for white men and women aged 35-74. "An east-west gradient of high-to-low stroke mortality rates was evident for both white men and white women....Within the eastern part of the United States, high rates appeared more commonly in the South, and more so for white men than for white women. The 'stroke belt' (area of very high stroke mortality rates in the coastal plain of the South) became less concentrated over the 2 decades, while a clustering of state economic areas with high rates along the Mississippi River and in the Ohio River valley became more pronounced."
Correspondence: S. Wing, Department of Epidemiology, School of Public Health, CB No. 7400, Rosenau Hall, University of North Carolina, Chapel Hill, NC 27599-7400. Location: U.S. National Library of Medicine, Bethesda, MD.

55:20246 Younis, M. N.; Hassan, A. A. M.; Serour, G.; Hamed, A. F.; Fawzi, G. E. A. Effect of high parity on maternal mortality. Population Sciences, Vol. 7, 1987. 85-94 pp. Cairo, Egypt. In Eng.
The author examines maternal mortality in Cairo, Egypt. "The effects of age, parity, time between admission and death, number of antenatal visits, place of intended delivery before admission to hospital and lastly the cause of death, on maternal mortality were analyzed and tabulated." Multiparity and a maternal age of 30 years or more are found to be the most serious factors elevating the maternal mortality rate. Data are from 6,794 patients giving birth within a 20-month period at a hospital in Cairo.
Correspondence: M. N. Younis, Department of Obstetrics and Gynaecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt. Location: Princeton University Library (SPR).


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