Volume 62 - Number 4 - Winter 1996

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 .

62:40101 Bourdelais, Patrice; Demonet, Michel. The evolution of mortality in an industrial town: Le Creusot in the nineteenth century. History of the Family, Vol. 1, No. 2, 1996. 183-204 pp. Greenwich, Connecticut/London, England. In Eng.
"The article examines the population of the town of Le Creusot [France]...with respect to the characteristics and evolution of mortality in the second third of the nineteenth century....The authors analyze mortality statistics of Le Creusot in relation to other towns in the same department (Saône-et-Loire), to the neighboring city of Lyon, to another industrial town, Seraing, and with France as a whole. The effects of industrialization and the influx of labor on the mortality rate of Le Creusot appear to be undeniable. Life expectancy at birth among inhabitants of Le Creusot in 1836 was thus attained again only in 1876, after forty years of worsening living and environmental conditions. Among the causes noted for excess mortality in industrial towns, it is important to distinguish those due to working conditions (accidents, fatigue) and the direct consequences of industrial activity (factory smoke, toxic waste) from those due to living and housing conditions and the state of public and private hygiene in the town."
Correspondence: P. Bourdelais, Ecole des Hautes Etudes en Sciences Sociales, Centre de Recherches Historiques, 54 boulevard Raspail, 7500 Paris, France. Location: Princeton University Library (PR).

62:40102 Caselli, Graziella; Vallin, Jacques. Is it helpful to take into account causes of death in projecting future mortality trends? [Est-il utile de prendre en compte les causes de décès pour extrapoler les tendances de la mortalité?] Materiali di Studi e di Ricerche, No. 10, Mar 1996. 22 pp. Università degli Studi di Roma La Sapienza, Dipartimento di Scienze Demografiche: Rome, Italy. In Fre.
The authors examine the advantages and disadvantages of taking into account the specifics of recent changes in causes of death when calculating future mortality trends in developed countries; they use data for England and Wales for the period from 1950 onward. They conclude that analyzing current or past trends in specific causes of death is of limited relevance to the projection of future trends in mortality as a whole.
Correspondence: Università degli Studi di Roma La Sapienza, Dipartimento di Scienze Demografiche, Via Nomentana 41, 00161 Rome, Italy. Location: Princeton University Library (SPR).

62:40103 Chaurasia, Alok. A parametric investigation of mortality transition in India: 1970-89. Journal of Institute of Economic Research, Vol. 28, No. 1, Jan 1993. 11-21 pp. Dharwad, India. In Eng.
"This paper attempts to analyze mortality transition in India during [the] 1970s and 1980s through the modelling of the age pattern of mortality by applying the Heligman-Pollard model mortality schedule. The analysis reveals that mortality transition in India has not been uniform in all the age [or sex] groups....Middle-life mortality has been found to be more or less unchanged during the period under reference. Implications of the age pattern of mortality transition [on] health policy [are also] discussed."
Correspondence: A. Chaurasia, Shyam Institute of Public Co-operation and Community Development, Mudian Ka Kuan, Datia, Madhya Pradesh 475 661, India. Location: Princeton University Library (SPR).

62:40104 Chen, Lincoln C.; Wittgenstein, Friederike; McKeon, Elizabeth. The upsurge of mortality in Russia: causes and policy implications. Population and Development Review, Vol. 22, No. 3, Sep 1996. 517-30, 604, 607 pp. New York, New York. In Eng. with sum. in Fre; Spa.
"This note summarizes conclusions reached at a recent international conference that considered the causes and policy implications of the upsurge of mortality in Russia following the collapse of the communist regime in 1989. The mortality crisis is genuine, not a case of `Glasnost in statistics.' There is little evidence to support the popular perception that the crisis is due to environmental deterioration or the collapse of medical services. These problems are real but they do not account for the rise in mortality. Rather, the crisis is the manifestation of economic, social, and political pathologies in Russian society. The responsible causes are probably a combination of historical and contemporary forces: catch-up effects from previous lifestyle risks and deferred deaths from the successful anti-alcohol campaign in the late 1980s; and current turmoil characterized by economic impoverishment, widening social inequality, and the breakdown of political institutions."
Correspondence: L. C. Chen, Harvard University, Center for Population and Development Studies, 9 Bow Street, Cambridge, MA 02138. Location: Princeton University Library (SPR).

62:40105 Dinkel, Reiner H.; Höhn, Charlotte; Scholz, Rembrandt D. Trends in mortality with particular consideration of the cohort approach. [Sterblichkeitsentwicklung--unter besonderer Berücksichtigung des Kohortenansatzes.] Schriftenreihe des Bundesinstituts für Bevölkerungsforschung, Vol. 23, ISBN 3-486-56229-0. 1996. 154 pp. R. Oldenbourg Verlag: Munich, Germany; Bundesinstitut für Bevölkerungsforschung: Wiesbaden, Germany. Distributed by Verlegerdienst München, Gutenbergstraße 1, 82205 Gilching, Germany. In Ger.
This volume contains papers given at a 1995 conference on cohort analysis of mortality in Germany. The contributions all concern the analysis of mortality by cohort, including the creation and interpretation of life tables.
Selected items will be cited in this or subsequent issues of Population Index.
Correspondence: R. Oldenbourg Verlag, Postfach 80 13 60, 81613 Munich, Germany. Location: Princeton University Library (SPR).

62:40106 Goldman, Noreen; Takahashi, Shigesato. Old-age mortality in Japan: demographic and epidemiological perspectives. In: Health and mortality among elderly populations, edited by Graziella Caselli and Alan D. Lopez. 1996. 157-81 pp. Clarendon Press: Oxford, England; International Union for the Scientific Study of Population [IUSSP]: Liège, Belgium. In Eng.
First, the authors "employ a standard demographic approach to analyse the contributions of different age-groups and causes of death to the secular decline in [Japanese] mortality since the mid-1950s. [They] then use the resulting estimates to explore the plausibility of several hypotheses put forth to explain Japan's post-war mortality improvements. [Second, they] focus on one particular set of explanations, namely dietary factors, by reviewing the evidence from several epidemiological studies....In particular, [they] consider (1) whether various aspects of the Japanese diet can account in part for mortality differences between Japan and other industrialized countries, as well as for regional differences within Japan; and (2) whether changes in the Japanese diet over the past few decades are consistent with temporal decreases in mortality from certain causes. [They] conclude by speculating about the future course of Japanese mortality."
Correspondence: N. Goldman, Princeton University, Office of Population Research, 21 Prospect Avenue, Princeton, NJ 08544-2091. Location: Princeton University Library (SPR).

62:40107 Höhn, Charlotte. Cohort mortality with special consideration of the world wars. [Kohortensterblichkeit unter besonderer Berücksichtigung der Weltkriege.] In: Sterblichkeitsentwicklung--unter besonderer Berücksichtigung des Kohortenansatzes, edited by Reiner H. Dinkel, Charlotte Höhn, and Rembrandt D. Scholz. 1996. 45-66 pp. R. Oldenbourg Verlag: Munich, Germany; Bundesinstitut für Bevölkerungsforschung: Wiesbaden, Germany. In Ger.
A method for measuring cohort mortality is presented that includes the effects of war. A direct comparison of the excess mortality caused by war with cohort mortality unaffected by it allows for an estimation of the impact of war on particular cohorts. Official German statistics were not gathered consistently during the war years, so whatever meager statistical evidence is available is examined to measure the excess mortality in Germany resulting from the two world wars.
Correspondence: C. Höhn, Bundesinstitut für Bevölkerungsforschung, Gustav-Stresemann-Ring 6, Postfach 5528, 6200 Wiesbaden, Germany. Location: Princeton University Library (SPR).

62:40108 Il'chenko, A. V. Observed dependence of mortality on age as a consequence of the normal distribution of individuals by the "vitality" criterion. [Real'no nablyudaemaya zavisimost' smertnosti ot vozrasta--sledstvie normal'nogo raspredeleniya osobei v kogorte po kriteriyu "vital'nosti"] Zhurnal Obshchei Biologii, Vol. 55, No. 4-5, 1994. 509-13 pp. Moscow, Russia. In Rus. with sum. in Eng.
"A mathematical model is elaborated to calculate mortality indices in a cohort under various conditions. It is based on experimental data on compensatory mortality, differences of character dispersions between males and females, [and] linear time dependence of compensatory effects. Observed dependence of mortality on age may be obtained under provision of normal distribution of individuals by `vitality'. 7 functional relations that describe variation of `vitality' dependently on [a] time scale are considered. It is concluded that here must be [an] obligatory longevity limit which is responsible for mortality dynamics: increased mortality in younger ages, its correspondence to [a] Gompertz-Meykem low in middle age, and drastic retardation of mortality increasing in older age."
Correspondence: A. V. Il'chenko, N. I. Pirogov Vinnitsa Medical Institute, 54 ul. Pirogova, 286018 Vinnitsa, Ukraine. Location: Princeton University Library (SPR).

62:40109 Kawachi, Ichiro; Colditz, Graham A.; Ascherio, Alberto; Rimm, Eric B.; Giovannucci, Edward; Stampfer, Meir J.; Willett, Walter C. A prospective study of social networks in relation to total mortality and cardiovascular disease in men in the USA. Journal of Epidemiology and Community Health, Vol. 50, No. 3, Jun 1996. 245-51 pp. London, England. In Eng.
"This study aimed to examine prospectively the relationships between social networks and total and cause specific mortality, as well as cardiovascular disease incidence....[Data are for] 32,624 U.S. male health professionals aged 42 to 77 years in 1988, who were free of coronary heart disease, stroke, and cancer at baseline....Social networks were associated with lower total mortality by reducing deaths from cardiovascular disease and accidents/suicides. Strong social networks were associated with reduced incidence of stroke, though not of coronary heart disease. However, social networks may assist in prolonging the survival of men with established coronary heart disease."
Correspondence: I. Kawachi, Harvard School of Public Health, Department of Health and Social Behavior, 677 Huntington Avenue, Boston, MA 02115. Location: Princeton University Library (SPR).

62:40110 Kvasha, A. Concerning demographic crises and catastrophes. [O demograficheskikh krizisakh i katastrofakh.] Voprosy Statistiki, No. 8, 1996. 58-60 pp. Moscow, Russia. In Rus.
The author analyzes trends in mortality and life expectancy in Russia from the 1960s to the present. Emphasis is on the causes of the decline in male life expectancy.
Location: Princeton University Library (SPR).

62:40111 Kytir, Josef; Prskawetz, Alexia. Projections of mortality considering specific causes of death, and consequences for Austria. [Prognose der Sterblichkeit aus einem todesurachenspezifischen Ansatz und Konsequenzen für Österreich.] In: Sterblichkeitsentwicklung--unter besonderer Berücksichtigung des Kohortenansatzes, edited by Reiner H. Dinkel, Charlotte Höhn, and Rembrandt D. Scholz. 1996. 115-27 pp. R. Oldenbourg Verlag: Munich, Germany; Bundesinstitut für Bevölkerungsforschung: Wiesbaden, Germany. In Ger.
The authors analyze changes in Austrian mortality due to changes in causes of death. Based on projections of changes in causes of death, mortality is projected according to a model of simultaneously delayed mortality for selected causes of death. At higher ages, projected life expectancy is significantly higher than in the official life tables.
Correspondence: J. Kytir, Österreichische Akademie der Wissenschaften, Institut für Demographie, Hintere Zollamtsstraße 2b, 1033 Vienna, Austria. Location: Princeton University Library (SPR).

62:40112 Langford, C. M. Reasons for the decline in mortality in Sri Lanka immediately after the Second World War: a re-examination of the evidence. Health Transition Review, Vol. 6, No. 1, Apr 1996. 3-23 pp. Canberra, Australia. In Eng.
"Newman estimated that 42 per cent of the decline in mortality in Sri Lanka between 1930-1945 and 1946-1960 was attributable to DDT-spraying; Molineaux estimated 27 per cent; Gray judged that 23 per cent of the decline between 1936-1945 and 1946-1960 was due to DDT. Here the Newman-Gray-Molineaux approach is criticized, the main point being that they ignored a significant improvement in mortality in the early 1940s, before DDT-spraying. Bearing this, and certain other complexities of the situation, in mind, an attempt is made to assess the impact of DDT on mortality."
Correspondence: C. M. Langford, London School of Economics and Political Science, Department of Social Policy and Administration, Houghton Street, Aldwych, London WC2A 2AE, England. Location: Princeton University Library (SPR).

62:40113 Martikainen, Pekka; Valkonen, Tapani. Mortality after death of spouse in relation to duration of bereavement in Finland. Journal of Epidemiology and Community Health, Vol. 50, No. 3, Jun 1996. 264-8 pp. London, England. In Eng.
The aims of this article are "(1) to assess the extent to which death of a spouse causes excess mortality by controlling for the effects of confounding and other sources of bias. Three possible sources of bias are considered: accidents common to spouses, common socioeconomic environment, and common lifestyles. (2) To assess the duration specific effects of death of a spouse on mortality [by means of a ] prospective study of mortality in Finland among all 35-84 year old married Finnish men and women (1,580,000 people)....[The results indicate that] (1) After controlling for confounding effects, excess mortality was 17% in men and 6% in women. (2) Excess mortality was higher for short durations than long durations of bereavement. (3) Excess mortality after bereavement was higher in men than women....It seems that death of a spouse has a causal effect on mortality. However, although spousal bereavement is a major stressful life event, this causal effect seems to be relatively small and short lived."
Correspondence: P. Martikainen, University of Helsinki, Department of Sociology, Population Research Unit, P.O. Box 33, 00014 Helsinki, Finland. Location: Princeton University Library (SPR).

62:40114 Meslé, France; Shkol'nikov, Vladimir; Hertrich, Véronique; Vallin, Jacques. Recent trends in mortality by cause in Russia, 1965-1994. [Tendances récentes de la mortalité par cause en Russie 1965-1994/Sovremennye tendentsii smertnosti po prichinam smerti v Rossii 1965-1994.] Données Statistiques, No. 2, 1996. 140 pp. Institut National d'Etudes Démographiques [INED]: Paris, France. In Fre; Rus.
A preliminary analysis of mortality trends in Russia from 1965 to 1994 is presented; during this time, life expectancy declined by five years. The report includes chapters on trends in life expectancy and age-specific mortality, availability and quality of cause-of-death data, the reconstitution of series of cause-of-death data using consistent definitions, and trends in causes of death. The report is provided with two floppy discs containing the data analyzed and the means to access them in English, French, and Russian.
Correspondence: Institut National d'Etudes Demographiques, 27 rue du Commandeur, 75675 Paris Cedex 14, France. Location: Princeton University Library (SPR).

62:40115 Prins, C. J. M. Many deaths in the winter of 1995-1996. [Hoge sterfte in winter 1995/1996.] Maandstatistiek van de Bevolking, Vol. 44, No. 6, Jun 1996. 7-10 pp. Voorburg, Netherlands. In Dut. with sum. in Eng.
"In December 1995-February 1996 [in the Netherlands] the number of deaths was higher than usual. In this period the number of excess deaths was over 4 thousand....The high death rates are probably related to the influenza epidemics in December and January, and to the low temperatures of this winter."
Location: Princeton University Library (SPR).

62:40116 Radovanovic, Zoran. Mortality patterns in Kuwait: inferences from death certificate data. European Journal of Epidemiology, Vol. 10, No. 6, 1994. 733-6 pp. Dordrecht, Netherlands. In Eng.
Data from various official sources are used to analyze recent trends in mortality in Kuwait. "Two main features of the mortality pattern in Kuwait are very low crude death rates, not exceeding 2.3 per 1,000, and a high frequency of traffic accidents, ranking as the second leading cause of death. In quantitative terms, mortality statistics in Kuwait have reached their objectives in that coverage approaches 100%. However, quality of data still suffers from apparent shortcomings, as exemplified by senility (without mention of psychosis) as the sixth leading cause of death. Huge oscillations in the frequency of some conditions from one year to the next...are even more indicative of the dubious reliability of the information on the death certificate."
Correspondence: Z. Radovanovic, University of Kuwait, Faculty of Medicine, Department of Community Medicine and Behavioral Sciences, P.O. Box 24923, 13110 Safat, Kuwait. Location: Columbia University Library, New York, NY.

62:40117 Rosenberg, Harry M.; Ventura, Stephanie J.; Maurer, Jeffrey D.; Heuser, Robert L.; Freedman, Mary A. Births and deaths: United States, 1995. NCHS Monthly Vital Statistics Report, Vol. 45, No. 3, Suppl., Pub. Order No. DHHS (PHS) 96-1120. Oct 4, 1996. 40 pp. U.S. National Center for Health Statistics [NCHS]: Hyattsville, Maryland. In Eng.
"This report presents preliminary 1995 data on births and deaths in the United States from a new statistical series from the National Center for Health Statistics. U.S. data on births are shown by age, race, and Hispanic origin of mother. National and State data on marital status, prenatal care, cesarean delivery, and low birthweight are also presented. Mortality data presented include life expectancy, leading causes of death, and infant mortality."
Correspondence: U.S. National Center for Health Statistics, 6525 Belcrest Road, Hyattsville, MD 20782. Location: Princeton University Library (SPR).

62:40118 Schott, Jürgen. On cohort-based analysis of mortality. [Zur kohortengemäßen Analyse der Sterblichkeit.] In: Sterblichkeitsentwicklung--unter besonderer Berücksichtigung des Kohortenansatzes, edited by Reiner H. Dinkel, Charlotte Höhn, and Rembrandt D. Scholz. 1996. 103-14 pp. R. Oldenbourg Verlag: Munich, Germany; Bundesinstitut für Bevölkerungsforschung: Wiesbaden, Germany. In Ger.
Using mortality in Germany as an example, the author attempts to generalize the cohort-based approach to mortality. The generalized model is based on a differential equation and includes more detailed information than standard life tables; it classifies causes of death into aging, catastrophes, long-term effects on cohorts, and accidental death. Long-term and short-term effects of war on subsequent mortality become apparent, and it is shown that the foundations for the survival dynamic of a cohort are laid in childhood. The model allows representation of the influence of changes in age and period effects.
Correspondence: J. Schott, Technische Universität Dresden, Abteilung für Sozialmedizin, 01062 Dresden, Germany. Location: Princeton University Library (SPR).

62:40119 Shkolnikov, Vladimir M.; Meslé, France. The Russian epidemiological crisis as mirrored by mortality trends. In: Russia's demographic "crisis", edited by Julie DaVanzo and Gwendolyn Farnsworth. 1996. 113-62 pp. RAND: Santa Monica, California. In Eng.
Recent mortality trends in Russia are analyzed. The authors note that Russia currently has the lowest level of life expectancy for males among the developed countries (59 years) and the largest gap between the levels of male and female life expectancy in the world (13 years). "The data presented...show that the recent mortality increase has been especially dramatic among working-age men. When the mortality rate is disaggregated by the cause of death, it becomes obvious that deaths from accidents, violence, poisoning, and other non-natural causes are primarily responsible for the latest rise in mortality. Although death rates from chronic and degenerative diseases have also risen, reflecting the poor state of the country's health care, these changes are generally comparable to those elsewhere in Eastern Europe." Brief comments by discussants are included (p. 162).
Correspondence: V. M. Shkolnikov, Russian Academy of Sciences, Institute for Economic Forecasting, Center for Demography and Human Ecology, Leninsky Pr. 14, 117901 Moscow, Russia. Location: Princeton University Library (SPR).

62:40120 Sommer, Bettina. Trends in mortality as shown by official statistics. [Zur Entwicklung der Sterblichkeit aus der Sicht der amtlichen Statistik.] In: Sterblichkeitsentwicklung--unter besonderer Berücksichtigung des Kohortenansatzes, edited by Reiner H. Dinkel, Charlotte Höhn, and Rembrandt D. Scholz. 1996. 11-25 pp. R. Oldenbourg Verlag: Munich, Germany; Bundesinstitut für Bevölkerungsforschung: Wiesbaden, Germany. In Ger.
Current trends in mortality in Germany are analyzed using official data. The author highlights changes in age- and sex-specific mortality between 1987 and 1992 by means of life tables, differentiating between East and West Germany. Some consideration is given to possible future trends in mortality.
Correspondence: B. Sommer, Statistisches Bundesamt, Gustav-Stresemann-Ring 11, 6200 Wiesbaden 1, Germany. Location: Princeton University Library (SPR).

62:40121 Unicef. International Child Development Centre (Florence, Italy). Crises in mortality, health and nutrition. Regional Monitoring Report, No. 2, ISBN 88-85401-18-X. Aug 1994. vi, 110 pp. Florence, Italy. In Eng.
This report analyzes the mortality and health crisis affecting the countries of eastern and central Europe since 1989. "In most of the region, this crisis has caused, and continues to cause, large numbers of avoidable deaths and threatens to erode social stability and indeed the entire transition process....Recent changes in mortality, nuptiality and fertility parallel or even surpass those normally observed in wartime conditions....Contrary to most expectations, the health and mortality crisis afflicting the region during the last four years has not hit the traditionally most vulnerable groups, that is, children, adolescents, women and the elderly. Indeed, while most of the population has been affected to some degree, the highest increases in mortality have been recorded for male adults in the 20-59 age group. This surge is largely dependent on three broad, transition-related factors: widespread impoverishment, erosion of preventive health services, sanitary infrastructure and medical services, and social stress."
Correspondence: Unicef, International Child Development Centre, Piazza Santissima Annunziata 12, 50122 Florence, Italy. Location: Princeton University Library (UN).

62:40122 White, Kevin M.; Preston, Samuel H. How many Americans are alive because of twentieth-century improvements in mortality? Population and Development Review, Vol. 22, No. 3, Sep 1996. 415-29, 603, 605 pp. New York, New York. In Eng. with sum. in Fre; Spa.
"The article estimates the number of living Americans who owe their existence to mortality declines that have occurred in the twentieth century. The estimate is made by projecting the U.S. population from 1900 to 2000 using the mortality rates of 1900 rather than the rates actually observed. A distinction is made between people who would have been born and died and those who would never have been born because of a prereproductive death of an ancestor. Results indicate that the U.S. population would be only one-half its current size if the mortality conditions of 1900 had been maintained: one-quarter of the population would have been born and died, and one-quarter would never have been born. The proportion alive because of mortality improvements shows little variation by sex and age, although it is greatest among the very young and the very old. Mortality reductions below age 15 contributed about two-thirds of the increase in the number of persons alive today."
Correspondence: S. H. Preston, University of Pennsylvania, Population Studies Center, 3718 Locust Walk, Philadelphia, PA 19104-6298. Location: Princeton University Library (SPR).

62:40123 Wilmoth, John R. Mortality projections for Japan: a comparison of four methods. In: Health and mortality among elderly populations, edited by Graziella Caselli and Alan D. Lopez. 1996. 266-87 pp. Clarendon Press: Oxford, England; International Union for the Scientific Study of Population [IUSSP]: Liège, Belgium. In Eng.
"In this chapter, trends in death-rates for total and cause-specific mortality for Japan are examined in an attempt to forecast the future level and pattern of Japanese mortality. In particular, an attempt is made to answer the following questions: `Will life expectancy continue to rise in Japan, or will it reach an upper limit?' `How will the proportion of the Japanese population that is older than age 65 (or 85) change in the future?' `What causes of death will have the greatest influence on trends in total death rates?'" Particular attention is given to some methodological issues involved in making these mortality projections.
Correspondence: J. R. Wilmoth, University of California, Department of Demography, 2232 Piedmont Avenue, Berkeley, CA 94720. 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.

62:40124 McDermott, J.; Steketee, R.; Wirima, J. Perinatal mortality in rural Malawi. Bulletin of the World Health Organization/Bulletin de l'Organisation Mondiale de la Santé, Vol. 74, No. 2, 1996. 165-71 pp. Geneva, Switzerland. In Eng. with sum. in Fre.
"Reported are the results of a study to assess the prevalence and risk factors for perinatal death among pregnant women in Malawi over the period 1987-90. There were 264 perinatal deaths among the 3,866 women with singleton pregnancies (perinatal mortality rate, 68.3 per 1,000 births). Among the risk factors for perinatal mortality were the following: reactive syphilis serology, nulliparity, a late fetal or neonatal death in the most recent previous birth, maternal height..., home delivery, and low socioeconomic status. Although unexplained perinatal deaths will continue to occur, perinatal mortality can be reduced if its causes and risk factors in a community are given priority in antenatal and intrapartum care programmes."
Correspondence: J. McDermott, Centers for Disease Control and Prevention, Division of Reproductive Health, Mailstop K22, Atlanta, GA 30333. Location: Princeton University Library (SPR).

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.

62:40125 Amankwaa, Adansi A. Prior and proximate causes of infant survival in Ghana, with special attention to polygyny. Journal of Biosocial Science, Vol. 28, No. 3, Jul 1996. 281-95 pp. Cambridge, England. In Eng.
"This study examines the role of marriage form [on] infant mortality and tests the relative effects and mechanisms through which polygyny affects infant survival. A sample of infants born in the 5 years preceding the 1988 Ghana Demographic and Health Survey was used. A causal model was constructed and polygyny was found to be an important mediating factor in understanding infant survival. The findings highlight the relevance of family structure (polygyny) as an intervening factor, but also reveal the complex role of ethnicity, dietary supplement and birth interval in accounting for infant survival."
Correspondence: A. A. Amankwaa, Department of Corrections, Tallahassee, FL. Location: Princeton University Library (SPR).

62:40126 Andreev, E. M.; Ksenofontova, N. Ju. Infant mortality in the USSR in 1979-1980. Results of an unpublished survey. [La mortalité infantile en URSS en 1979-1980. Résultats d'une enquête inédite.] Population, Vol. 51, No. 3, May-Jun 1996. 539-71 pp. Paris, France. In Fre. with sum. in Eng; Spa.
"The authors present the results of a broad survey carried out by the Central Statistical Office of the former USSR which deals with socio-demographic differentials in infant mortality in the various republics and regions...in 1979-1980....The study deals with differentials in infant mortality between mothers' level of education, type of occupation, demographic factors, and ethnic affiliation. The conclusion is that the differentials were primarily due to socio-cultural factors, and that further reduction of infant mortality could not be expected, unless a family-planning policy were implemented....The article...highlights the fact that births and deaths were not always properly registered. It also stresses the importance of family life styles as an explanation of differential infant mortality."
Correspondence: N. Ju. Ksenofontova, Goskomstat Russia, Izmailovskoe Shosse 44, 105679 Moscow, Russia. Location: Princeton University Library (SPR).

62:40127 Arntzen, A.; Moum, T.; Magnus, P.; Bakketeig, L. S. The association between maternal education and postneonatal mortality. Trends in Norway, 1968-1991. International Journal of Epidemiology, Vol. 25, No. 3, Jun 1996. 578-84 pp. Oxford, England. In Eng.
"This study examines whether the association between maternal educational level and postneonatal death has changed over time....All single survivors of the neonatal period in Norway in three periods, 1968-1971, 1978-1981 and 1989-1991 were studied. There were 582,046 births and 1,717 postneonatal deaths....There has been an increasing inverse relationship between maternal educational level and postneonatal mortality in recent years. There was no statistically significant association between educational level and postneonatal mortality in the late 1960s. In the second period (1978-1981) the association is statistically significant for first-born children. In the third period (1989-1991) postneonatal mortality for first-born and later-born children was associated with maternal educational level, with adjusted odds ratios of 2.5 and 2.1 respectively."
Correspondence: A. Arntzen, Vestfold College, Department of Social Science, P.O. Box 2243, 3103 Tønsberg, Norway. Location: Princeton University Library (SPR).

62:40128 Becker, Stan; Black, Robert E. A model of child morbidity, mortality, and health interventions. Population and Development Review, Vol. 22, No. 3, Sep 1996. 431-56, 603, 605-6 pp. New York, New York. In Eng. with sum. in Fre; Spa.
"The authors present a macro model of morbidity and mortality in children under five years of age. Monthly disease-specific incidence and case fatality rates form the basis of the model, and the efficacy and coverage of disease-specific interventions alter these values. In addition, frailty is modeled via relative risks of mortality based on five groups, determined for newborns by the birthweight distribution and, at ages after the first month, by the proportion of children surviving a given illness who become more frail and the proportion not ill and with adequate nutrition who become less frail. A validation of the model was carried out using data from the Demographic Surveillance System in Matlab, Bangladesh. The model very closely predicts the observed mortality level. Scenarios for improvements in coverage of specific interventions in settings in South Asia, West Africa, and South America are modeled and their effects on mortality gauged. The model provides a useful tool for those wishing to know the mortality impact of specified mixes of interventions in a given setting."
Correspondence: S. Becker, Johns Hopkins University, School of Hygiene and Public Health, Department of Population Dynamics, 615 North Wolfe Street, Baltimore, MD 21205. Location: Princeton University Library (SPR).

62:40129 Bicego, George; Ahmad, Omar B. Infant and child mortality. DHS Comparative Studies, No. 20, Aug 1996. vii, 58 pp. Macro International, Demographic and Health Surveys [DHS]: Calverton, Maryland. In Eng.
"The aim of this report is to assist in the formulation of child health policy and the evaluation of programs intended to improve the well-being and survival prospects of young children. The report is comparative in nature; levels, trends, and differentials in childhood mortality are presented using DHS data collected in 20 [developing] countries over the period 1990-1994....The results indicate wide disparity in the degree of recent improvement in child survival prospects. In sub-Saharan Africa, most countries have shown declines in under-five mortality. However, in all but three of these countries the declines have been modest--less than 25 percent decline in the 10-year period preceding the survey--and in five countries the declines have been 10 percent or less....For the countries outside sub-Saharan Africa, the picture is more encouraging. With the exception of Pakistan, recent declines in under-five mortality have been greater than 25 percent and, using the most recent estimates, less than 1 in 10 children dies before the fifth birthday...."
Correspondence: Macro International, Demographic and Health Surveys, 11785 Beltsville Drive, Suite 300, Calverton, MD 20705-3119. Location: Princeton University Library (SPR).

62:40130 Boehmer, Ulrike; Williamson, John B. The impact of women's status on infant mortality rate: a cross-national analysis. Social Indicators Research, Vol. 37, No. 3, Mar 1996. 333-60 pp. Dordrecht, Netherlands. In Eng.
The impact of the status of women on cross-national differences in infant mortality rates is examined. "The present study, based on a sample of 96 less developed countries circa 1990, tests a series of hypotheses derived from gender stratification theory and industrialism theory. Evidence is presented of an inverse relationship between the status of women and infant mortality rate. The present study shows that it makes a difference whether we use relative or absolute measures of women's status and it shows that in addition to women's educational status, other dimensions of women's status, particularly economic status and autonomy, are also important predictors of infant mortality rate."
Correspondence: U. Boehmer, Boston College, Department of Sociology, Chestnut Hill, MA 02167. Location: Princeton University Library (PR).

62:40131 Brändström, Anders. Life histories of single parents and illegitimate infants in nineteenth-century Sweden. History of the Family, Vol. 1, No. 2, 1996. 205-26 pp. Greenwich, Connecticut/London, England. In Eng.
"This essay presents tentative findings for the Sundsvall area of Sweden, which is being studied in a recent project on the decline of infant and childhood mortality in the Nordic countries. The focus is on the complete reproductive histories of single mothers and the life expectancies among infants born to women who at least once in their reproductive life history experienced the birth of an illegitimate child. In Sundsvall, industrialization only temporarily affected the illegitimacy ratio, but its effect was obvious even in agrarian parishes. The number of illegitimate children per woman remained relatively stable over time, with the exception of the town of Sundsvall. It was more common in the urban environment to give birth to several illegitimate children. Mortality was also higher among these infants, but the negative effects can be seen equally among both legitimate and illegitimate children."
Correspondence: A. Brändström, Umeå University, Department of Historical Demography, 901 87 Umeå, Sweden. Location: Princeton University Library (PR).

62:40132 Caldwell, Pat. Child survival: physical vulnerability and resilience in adversity in the European past and the contemporary third world. Social Science and Medicine, Vol. 43, No. 5, Sep 1996. 609-19 pp. Tarrytown, New York/Oxford, England. In Eng.
"Infant and child physical vulnerability is demonstrated by the extremely high mortality levels in these age groups in the pre-modern West and parts of the contemporary Third World. Some children, such as females or later additions to the family, are subject to disproportionately high mortality risk. In spite of the age-old vulnerability of young children, disproportionate gains have been made in reducing their mortality in modern times. This has been a product of social and individual change, government intervention and biomedical research. These advances exhibit during crises greater resilience to reversal than might be anticipated. Rarely do infant and child mortality levels return more than a fraction of the way to the original levels. The explanation is irreversible changes to individuals and society and the persistence of health knowledge even when health facilities are paralysed."
Correspondence: P. Caldwell, Australian National University, National Centre for Epidemiology and Population Health, Health Transition Centre, Canberra, ACT 0200, Australia. Location: Princeton University Library (PR).

62:40133 Cole, Joshua. "A sudden and terrible revelation": motherhood and infant mortality in France, 1858-1874. Journal of Family History, Vol. 21, No. 4, Oct 1996. 419-45 pp. Thousand Oaks, California. In Eng.
"In 1874, legislators in France passed a law regulating the wet-nursing industry. Citing recent medical research into the causes and social costs of high infant mortality, the law's supporters met little opposition, despite the fact that the law challenged the tradition of paternal authority and familial autonomy that had been inscribed in French law since the promulgation of the Civil Code of 1804. Extending state power into the familial realm required a concerted effort by reformers, who concentrated on two issues: maternal responsibility for newborn infants and the social costs of early death. Because working women in urban areas used wet-nurses to preserve their wage-earning capacity, reformers capitalized on widespread opposition to women's labor outside the home. The law met little opposition in part because the issues of paternal authority had already been thoroughly debated several months earlier in the child labor law of 1874."
Correspondence: J. Cole, University of Georgia, Department of History, Athens, GA 30602. Location: Princeton University Library (SPR).

62:40134 Desgrées du Loû, Annabel. Saving children: the role of vaccination. A longitudinal survey in a rural setting in Bandafassi, Senegal. [Sauver les enfants: le rôle des vaccinations. Une enquête longitudinale en milieu rural à Bandafassi au Sénégal.] Les Etudes du CEPED, No. 12, ISBN 2-87762-089-1. Jun 1996. xxii, 261 pp. Centre Français sur la Population et le Développement [CEPED]: Paris, France. In Fre. with sum. in Eng.
This analysis of child mortality in Senegal concerns a rural area with a population of about 8,000 in the southeastern part of the country. Data are from three surveys carried out between 1970 and 1992. The results indicate that the level of child mortality, which was as high as 313 per 1,000 in 1981, was reduced by half by 1993. This improvement was achieved in spite of the fact that socioeconomic conditions remained virtually unchanged. The decline in the level of childhood mortality is attributed to the immunization program which was launched in 1987 and which has been particularly successful in reducing mortality from measles. The results also indicate that measles vaccination has had a positive effect on mortality from other causes.
Correspondence: Centre Français sur la Population et le Développement, 15 rue de l'Ecole de Médecine, 75270 Paris Cedex 06, France. Location: Princeton University Library (SPR).

62:40135 Farley, Donna O.; Richards, Toni; Bell, Robert M. Effects of reporting methods on infant mortality rate estimates for racial and ethnic subgroups. Journal of Health Care for the Poor and Underserved, Vol. 6, No. 1, Feb 1995. 60-75 pp. Thousand Oaks, California. In Eng.
"Estimation of infant mortality rates for racial and ethnic subgroups has been plagued by uncertainties. Yet policymakers need accurate estimates to allocate resources toward the goal of reducing infant mortality. The authors compared hospital discharge records and death certificate information to birth certificate information from the California Birth Cohort (years 1985-1987) and 1986 Annual Hospital Discharge Abstract. They found discrepancies in infant mortality rates between reporting methods and underreporting of some non-White groups. Infant mortality rates based on death certificates underestimated non-White mortality, particularly for Native Americans and East Asians. Compared to infants who died soon after birth, larger discrepancies in reported race and ethnicity between birth and death certificates for infants who died later also indicated possible errors in hospital reporting methods. These findings extend prior research that documents that standard methods of reporting infant mortality underestimate non-White mortality rates."
Correspondence: D. O. Farley, Physician Payment Review Commission, 2120 L Street NW, Suite 200, Washington, D.C. 20037. Location: Princeton University Library (SPR).

62:40136 Knudsen, Kim M.; Aaby, Peter; Whittle, Hilton; Rowe, Mary; Samb, Badara; Simondon, Francois; Sterne, Jonathan; Fine, Paul. Child mortality following standard, medium or high titre measles immunization in West Africa. International Journal of Epidemiology, Vol. 25, No. 3, Jun 1996. 665-73 pp. Oxford, England. In Eng.
"Long term survival after standard, medium and high titre measles vaccines has been investigated in a combined analysis of all West African trials with mortality data. In trials from Guinea-Bissau, The Gambia and Senegal, children received medium or high titre vaccines from 4 months of age and were compared to control groups recruited at the same time later receiving standard titre vaccine from 9 months of age. All children were followed up to at least 3 years old....The combined analysis showed a decreased survival related to high titre measles vaccine compared with standard titre vaccines, though solely among females. As a result of these studies from West Africa and a study from Haiti, WHO has recommended that high titre measles vaccine no longer be used."
Correspondence: P. Aaby, Danish Epidemiology Science Centre, Epidemiology Research Unit, Statens Seruminstitut, 5 Artillerivej, 2300 Copenhagen, Denmark. Location: Princeton University Library (SPR).

62:40137 Pitt, Mark. Women's schooling, the selectivity of fertility, and child mortality in Sub-Saharan Africa. Living Standards Measurement Study Working Paper, No. 119, ISBN 0-8213-3332-1. LC 95-20999. Aug 1995. ix, 51 pp. World Bank: Washington, D.C. In Eng.
"This paper estimates the reduced-form determinants of child mortality in each of 14 Sub-Saharan countries for which a Demographic and Health Survey (DHS) exists. The intent is to obtain a measure of the effect of mother's schooling on child mortality allowing for the potentially selective nature of fertility....The results...provide substantial evidence of selective fertility and biased estimation of the effect of women's schooling and age on the probability of child death prior to age 2 years."
Correspondence: World Bank, 1818 H Street NW, Washington, D.C. 20433. Location: Princeton University Library (SPR).

62:40138 Rhoades, Everett R.; Brenneman, George; Lyle, Jerry; Handler, Aaron. Mortality of American Indian and Alaska Native infants. Annual Review of Public Health, Vol. 13, 1992. 269-85 pp. Palo Alto, California. In Eng.
"In this review, we examine infant mortality data for American Indians and Alaska Natives and compare these data with those for the general U.S. population. In some instances, comparisons between Indian groups are made."
Correspondence: E. R. Rhoades, Indian Health Service, Rockville, MD 20857. Location: Princeton University Library (FST).

62:40139 Roberts, Ian; Power, Chris. Does the decline in child injury mortality vary by social class? A comparison of class specific mortality in 1981 and 1991. British Medical Journal, Vol. 313, No. 7060, Sep 28, 1996. 784-6 pp. London, England. In Eng.
Between 1981 and 1991, a decline in death rates from child injury occurred in England and Wales. Using data from official sources and emphasizing deaths from injuries and poisoning, this article examines the extent to which this decline varies by social class. The results show that "death rates from injury and poisoning have fallen for children in all social classes....Socioeconomic inequalities in child injury death rates have increased. If these gradients persist, the Health of the Nation's target is likely to be met for children in the non-manual social classes but not for those in the manual social classes."
Correspondence: I. Roberts, University of London, Institute of Child Health, Child Health Monitoring Unit, London WC1N 1EH, England. Location: Princeton University Library (SZ).

62:40140 Ronsmans, Carine. Birth spacing and child survival in rural Senegal. International Journal of Epidemiology, Vol. 25, No. 5, Oct 1996. 989-97 pp. Oxford, England. In Eng.
"This study re-examines the association between short birth intervals and child mortality in rural Senegal and discusses the potential direct effects of efforts to delay births on child mortality in this community....The study uses longitudinal data in a cohort of 4,852 children born between 1983 and 1989....The probability of dying before age five is 224 per 1,000 livebirths....The odds of dying in the neonatal and post-neonatal period is 2.27 and 2.12 times higher respectively for children born after preceding birth intervals of one year or less compared to children born after longer intervals. Children born within two years of a subsequent birth are at 4.09 times higher risk of dying in the second year of life than children whose mother gave birth more than 2 years after the index birth. In this community where prolonged breastfeeding causes women to space their births at long intervals, short birth intervals are a consequence rather than a cause of child mortality and the potential direct effects of birth spacing efforts on child mortality are limited."
Correspondence: C. Ronsmans, London School of Hygiene and Tropical Medicine, Maternal and Child Epidemiology Unit, Keppel Street, London WC1E 7HT, England. Location: Princeton University Library (SPR).

62:40141 Rushton, Gerard; Krishnamurthy, Rajesh; Krishnamurti, Diane; Lolonis, Panos; Song, Hu. The spatial relationship between infant mortality and birth defect rates in a U.S. city. Statistics in Medicine, Vol. 15, No. 17-18, Sep 1996. 1,907-19 pp. Chichester, England. In Eng.
The relationship between infant mortality rates and birth defect rates in the city of Des Moines, Iowa, is analyzed using vital statistics data for the period 1989-1992. The results suggest that there is no relationship between infant mortality and birth defect rates in this region.
Correspondence: G. Rushton, University of Iowa, Department of Geography, Iowa City, IA 52242. Location: Princeton University Library (SPR).

62:40142 Schmertmann, Carl P.; Sawyer, Diana O. Migration bias in indirect estimates of regional childhood mortality levels. Mathematical Population Studies, Vol. 6, No. 2, 1996. 69-93, 171 pp. Amsterdam, Netherlands. In Eng. with sum. in Fre.
"Demographers often use Brass-style indirect methods to obtain childhood mortality estimates for regions within developing countries. Regional populations are not closed to migration, however, and mortality reports of women resident in a certain region on the survey date may contain information on events and exposure that occurred elsewhere as the mother migrated. Including this `imported' mortality information may cause significant bias in regional estimates. In this paper the authors: (1) investigate the possible magnitude of migration bias using a multiregional simulation model, (2) propose a modification to standard methods which should reduce bias in many circumstances, and (3) apply the modified technique to data from Brazil's 1980 Census. We find that migration bias can indeed be significant, and that in the specific case of São Paulo state, imported mortality information may result in overestimates of local mortality levels of 10-15% when using Brass-style methods."
Correspondence: C. P. Schmertmann, Florida State University, Center for the Study of Population, 659-C Bellamy Building, Tallahassee, FL 32306-4063. Location: Princeton University Library (SPR).

62:40143 Stockwell, Edward G.; Goza, Franklin W. Racial differences in the relationship between infant mortality and socioeconomic status. Journal of Biosocial Science, Vol. 28, No. 1, Jan 1996. 73-84 pp. Cambridge, England. In Eng.
"This paper presents an ecological analysis of the relationship between infant mortality and economic status by race in metropolitan Ohio....White-non-white comparisons for total infant mortality are examined for the U.S. censuses of 1960, 1970, 1980 and 1990; and more detailed period- and broad cause-specific rates are presented for 1990. A pronounced inverse association is found between income status and infant mortality for whites, but not for non-whites....It is concluded that low income whites and non-whites at all income levels have infant mortality rates that are substantially higher than the overall rate for the population. Policy implications are discussed."
Correspondence: E. G. Stockwell, Bowling Green State University, Department of Sociology, Bowling Green, OH 43403-0231. Location: Princeton University Library (SPR).

62:40144 Szwarcwald, Célia L.; de Castilho, Euclides A. Estimates of infant mortality in Brazil in the 1980s: a proposal for a methodological procedure. [Estimativas da mortalidade infantil no Brasil, década de oitenta: proposta de procedimento metodológico.] Revista de Saúde Pública, Vol. 29, No. 6, 1995. 451-62 pp. São Paulo, Brazil. In Por. with sum. in Eng.
"A procedure for the estimation of the infant mortality rate in Brazil, in the 1980's, based only on the age distribution of registered deaths, is here proposed. Using this technique, it is possible to estimate the probabilities of dying in the first year of life in a continuous way, year by year, for different regions of the country. The space-time distribution of the main causes of infant deaths is analysed and the relevance of using this coefficient to express the social and economic conditions of the Brazilian population from 1979 to 1989 is discussed."
Correspondence: C. L. Szwarcwald, Fundação Oswaldo Cruz/CICT/DIS, Departamento de Informações para a Saúde, Avenida Brasil 4365, 21045-900 Rio de Janeiro, RJ, Brazil. Location: Princeton University Library (SPR).

62:40145 United Nations. Department for Economic and Social Information and Policy Analysis. Population Division (New York, New York). Child survival, health and family planning programmes and fertility. No. ST/ESA/SER.R/144, Pub. Order No. E.96.XIII.9. ISBN 92-1-151305-7. 1996. ix, 96 pp. New York, New York. In Eng.
This study is concerned with the relationship between mortality and fertility, and with the socioeconomic factors that affect that relationship. "Three case-studies were done in Ecuador, Indonesia and Zimbabwe to examine the interrelationships between child survival and fertility in three different socio-cultural settings. The analysis was focused on how availability and contact with community health and family planning services mediate the relationship between child survival and fertility. The present publication has four chapters. Chapter I gives an overview of conceptual framework, common findings of the case-studies and some generalizations. The details of the case-studies done in Ecuador, Indonesia and Zimbabwe are presented in chapters II, III and IV, respectively."
Correspondence: UN Department for Economic and Social Information and Policy Analysis, Population Division, United Nations, New York, NY 10017. Location: Princeton University Library (SPR).

62:40146 van den Broeck, Jan; Eeckels, Roger; Massa, Guy. Maternal determinants of child survival in a rural African community. International Journal of Epidemiology, Vol. 25, No. 5, Oct 1996. 998-1,004 pp. Oxford, England. In Eng.
"The aim [of this study is] to determine maternal factors related to child survival in the rural area of Bwamanda, Northern Zaire....A prospective study of 30-months mortality was carried out in a cohort of 776 children aged 0-3 months, obtained by random cluster sampling....Factors associated with excess mortality in bivariate and multiple logistic regression analysis were: (i) mother has parity >5...; (ii) distance from the health centre >5km...; (iii) invaliding maternal diseases....Chronic stress situations created by maternal invalidity, high parity and distance from health care facilities increase child mortality. Acute stress in the mother-child dyad seemed to be efficiently compensated for. In subsistence economy areas, maternal school education can be a disadvantage."
Correspondence: J. van den Broeck, Academisch Ziekenhuis Leiden, Department of Paediatrics, 10 Rijnsburgerweg, P.O. Box 9600, Leiden 2300 RC, Netherlands. Location: Princeton University Library (SPR).

62:40147 Yang, Wen-Shan; Knöbel, Harald H.; Chen, Chien-Jen. Gender differences in postneonatal infant mortality in Taiwan. Social Science and Medicine, Vol. 43, No. 10, Nov 1996. 1,461-5 pp. Tarrytown, New York/Oxford, England. In Eng.
An analysis of gender- and cause-specific post-neonatal mortality in Taiwan is undertaken using official data for the period 1981-1990. "Postneonatal mortality decreased from 9.4 per 1,000 live births to 5.5 per 1,000 live births for males, and from 8.3 to 5.0 for females. The trends for cause-specific mortality for male and female infants were similar during the study period. The male-to-female ratio of overall death rates was 1.11. It was slightly higher in cities and lower in rural areas, and lowest in the least developed eastern region of Taiwan....It was concluded that a high level of socio-economic development created conditions of gender equality, whereas in situations of low socio-economic development males were favoured. The tendency to discriminate according to gender is very subtle in Taiwan, much less so than in other regions of Asia...."
Correspondence: W.-S. Yang, Academia Sinica, Sun Yat-Sen Institute for Social Sciences and Philosophy, Taipei 11529, Taiwan. Location: Princeton University Library (PR).

62:40148 Young, Frank W.; Garcia, Felipe. Infant mortality decline in Chile: a replication. Social Indicators Research, Vol. 37, No. 1, Jan 1996. 93-106 pp. Dordrecht, Netherlands. In Eng.
This is a replication of a previous study on the effect of sociological variables on infant mortality rates in Chile. In this study, the authors use more communes for comparisons, present the available data in the form of a path analysis, and expand the theory to include the concept of health practices, such as avoiding teenage pregnancies, that are community backed and sustained. "Urbanization and voting, the two indicators of institutionalized problem-solving capacity, predict reduced infant mortality, as before. Teen pregnancies [are] a positive predictor, as expected, but the number of children already born does not predict. These results are net of two indicators of health technology--whether or not a physician was in attendance, and the number of clinics. Mother's education also predicted low infant mortality, and the theory is applied to this well-known predictor to interpret its effect. In addition, the anomalous role of mother's education in the dominant biomedical explanation is highlighted."
For a related study, published in 1994, see 60:30129.
Correspondence: F. W. Young, Cornell University, Department of Rural Sociology, 134 Warren Hall, Ithaca, NY 14853-7801. Location: Princeton University Library (PR).

E.4. Mortality at Other Ages

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

62:40149 Caselli, Graziella. Future longevity among the elderly. In: Health and mortality among elderly populations, edited by Graziella Caselli and Alan D. Lopez. 1996. 235-65 pp. Clarendon Press: Oxford, England; International Union for the Scientific Study of Population [IUSSP]: Liège, Belgium. In Eng.
Probable future trends in life expectancy among the elderly in Europe are explored using national data on causes of death reported to the World Health Organization for the period 1950-1990. "The projections presented...try to follow an approach which will take into account the possible impact of the new life-styles of more recent cohorts on future mortality levels among the elderly. In particular, to take better account of life-styles and any changes which have occurred, these projections will be made with reference to specific causes of death, selecting those which play a crucial role in determining mortality trends among the elderly."
Correspondence: G. Caselli, Università degli Studi di Roma La Sapienza, Via Nomentana 41, Rome 00161, Italy. Location: Princeton University Library (SPR).

62:40150 Friedlander, Dov; Tamir, Yossi. Socioeconomic characteristics and old age mortality rates in Israel. Oct 1994. xi, 104, [6] pp. JDC-Brookdale Institute of Gerontology and Human Development: Jerusalem, Israel; Hebrew University of Jerusalem, Department of Demography: Jerusalem, Israel. In Heb. with sum. in Eng.
"The studies presented in this publication discuss mortality among the elderly population [in Israel], and focus on differential mortality. They draw on one of two databases. The first was created during a longitudinal study conducted by researchers in the Department of Demography of the Hebrew University, while the second was created during a longitudinal study conducted by researchers at Israel's Central Bureau of Statistics (CBS). Two different but complementary analytical approaches were taken in these studies. The study conducted by the Department of Demography took an aggregate approach, using settlements or statistical regions as research units, while that conducted by the CBS took an individual analysis approach." The three studies were presented at a one-day conference held in Jerusalem on May 6, 1993.
Correspondence: JDC-Brookdale Institute of Gerontology and Human Development, P.O. Box 13087, Jerusalem 91130, Israel. Location: Princeton University Library (SPR).

62:40151 Grundy, Emily; Bowling, Ann; Farquhar, Morag. Social support, life satisfaction and survival at older ages. In: Health and mortality among elderly populations, edited by Graziella Caselli and Alan D. Lopez. 1996. 135-56 pp. Clarendon Press: Oxford, England; International Union for the Scientific Study of Population [IUSSP]: Liège, Belgium. In Eng.
The authors examine the effects of social support on both life satisfaction and survival at older ages, as well as the relations between life satisfaction and survival, in developed countries in general. The analysis is based on a review of the literature. They then use data from a longitudinal study of people living in the London borough of Hackney to analyze some of the factors associated with survival of the very old. The results are suggestive of a link between social support factors and survival in this elderly population.
Correspondence: E. Grundy, University of London, King's College, Strand, London WC2R 2LS, England. Location: Princeton University Library (SPR).

62:40152 Myers, George C. Comparative mortality trends among older persons in developed countries. In: Health and mortality among elderly populations, edited by Graziella Caselli and Alan D. Lopez. 1996. 87-111 pp. Clarendon Press: Oxford, England; International Union for the Scientific Study of Population [IUSSP]: Liège, Belgium. In Eng.
"The purpose of this chapter is to provide an overview of mortality levels and trends for 33 countries that are considered to be more `developed'....Major differentials by age, sex, and major causes of death are examined. An effort is also made to assess, using decomposition procedures, the relative importance of changes in age- and sex-specific causes of death that account for overall improvements in life expectancy. Although the chapter focuses on mortality and survival at older ages, in order to fully understand these trends it is necessary to place them within the context of changes that have been occurring at younger ages as well. The analyses are based on life-tables that have been prepared using recent World Health Organization (WHO) mortality data, which enable us to examine patterns through the year 1990 for most of the developed countries."
Correspondence: G. C. Myers, Duke University, Center for Demographic Studies, Box 90408, Durham, NC 27708-3861. Location: Princeton University Library (SPR).

62:40153 O'Leary, Suzanne R.; Wingard, Deborah L.; Edelstein, Sharon L.; Criqui, Michael H.; Tucker, Joan S.; Friedman, Howard S. Is birth order associated with adult mortality? Annals of Epidemiology, Vol. 6, No. 1, Jan 1996. 34-40 pp. New York, New York. In Eng.
"The objective of this study was to determine whether birth order is associated with total or cause-specific adult mortality and whether the association differed by sex, was confounded by age, number of siblings, or socioeconomic status, or was mediated by personality, education, or health behaviors. Teachers throughout California identified intellectually gifted children as part of a prospective study begun in the 1920s by Lewis Terman. Information on birth order was available on 1,162 subjects (85% of cohort) who have since been followed for over 70 years. Cox proportional hazards models indicated that birth order was not associated with adult all-cause, cardiovascular, or cancer mortality. Among women, middle children were more likely than oldest children to die from causes of death other than cardiovascular disease or cancer, although the numbers in this category were small. This study did not provide evidence that birth order is associated with adult mortality in this highly intelligent, middle-class cohort."
Correspondence: D. L. Wingard, University of California, Department of Family and Preventive Medicine 0607, La Jolla, CA 92093-0607. Location: Princeton University Library (SPR).

62:40154 Sverre, Jan M.; Laake, Petter. Trends in diagnosis-specific mortality for the aging population in Norway, 1966-1986. Scandinavian Journal of Social Medicine, Vol. 24, No. 3, 1996. 199-205 pp. Oslo, Norway. In Eng.
"For the older segment of the Norwegian population, sex, age at time of death, and time-period of death are important factors to consider when describing cause-specific mortality trends. Correspondence analysis was applied to mortality and provided plots which in a conceptually simple way demonstrated the complex relations between sex, age, time-periods and causes of death. Log-linear modelling was used to confirm the findings of the correspondence analyses. During the period of observation, the elderly, regardless of sex, have experienced greater changes in the most important causes of death, than the younger segments of the population."
Correspondence: J. M. Sverre, Ullevaal Hospital, Department of Geriatric Medicine, 0407 Oslo, Norway. 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.

62:40155 Dinkel, Reiner H. Cohort life tables: an overview of their logic, construction, and possibilities for application. [Kohortensterbetafeln: ein Überblick über Logik, Konstruktionsverfahren und Anwendungsmöglichkeiten.] In: Sterblichkeitsentwicklung--unter besonderer Berücksichtigung des Kohortenansatzes, edited by Reiner H. Dinkel, Charlotte Höhn, and Rembrandt D. Scholz. 1996. 27-44 pp. R. Oldenbourg Verlag: Munich, Germany; Bundesinstitut für Bevölkerungsforschung: Wiesbaden, Germany. In Ger.
This chapter examines the fundamentals of cohort life tables and the various methods of analyzing mortality by cohort. An introduction to the cohort approach is given and the value of this approach is explained. Various questions about the applications of cohort life tables are also discussed.
Correspondence: R. H. Dinkel, Universität Bamberg, Bevölkerungswissenschaft, Feldkirchenstraße 21, 8600 Bamberg, Germany. Location: Princeton University Library (SPR).

62:40156 Israel. Central Bureau of Statistics (Jerusalem, Israel). Complete life tables of Israel, 1989-1993. Monthly Bulletin of Statistics, Vol. 46, No. 11, Suppl., Nov 1995. 213-32 pp. Jerusalem, Israel. In Eng; Heb.
Complete life tables are presented for Israel for the period 1989-1993. Data are presented for single ages by sex for the whole population as well as separately for Jews and non-Jews.
Correspondence: Central Bureau of Statistics, P.O. Box 13015, Hakirya, Romema, Jerusalem 91130, Israel. Location: Princeton University Library (FST).

62:40157 Wanner, Philippe. Life tables for Switzerland 1988/1993. [Sterbetafeln für die Schweiz 1988/1993.] Statistik der Schweiz, ISBN 3-303-01071-4. 1996. 123 pp. Bundesamt für Statistik: Bern, Switzerland. In Ger.
Complete life tables for Switzerland are provided for the period 1988-1993; the last complete life tables for Switzerland were for the period 1978-1983, ten years before. Data are presented by age and compared with international statistics. The development of life expectancy in Switzerland since 1876-1880 is analyzed and broken down by age factors; infant and adult mortality are discussed separately. Trends in causes of death are analyzed from the period 1968-1973 onward. Excess male mortality is examined by age and cause of death, and projected into the future. Differential mortality is analyzed by marital status, citizenship, and region as well as by season. Finally, the effects of mortality trends on the structure of the population are discussed and future projections are made.
Correspondence: Bundesamt für Statistik, Hallwylstrasse 15, 3003 Bern, Switzerland.

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.

62:40158 Backlund, Eric; Sorlie, Paul D.; Johnson, Norman J. The shape of the relationship between income and mortality in the United States: evidence from the National Longitudinal Mortality Study. Annals of Epidemiology, Vol. 6, No. 1, Jan 1996. 12-20 pp. New York, New York. In Eng.
"A follow-up study based on a large [U.S.] national sample was used to examine differences in the well-established inverse gradient between income and mortality at different income levels. The study showed the income-mortality gradient to be much smaller at high income levels than at low to moderate income levels in the working age (25 to 64 years) and elderly (over 65 years) populations for men and women both before and after adjustment for other socioeconomic variables. In addition, a much larger gradient existed for working age women at extreme poverty levels than for those women at low to moderate income levels. The income-mortality gradient was much smaller in the elderly than in the working age population. The study also examined the ability of several different mathematic functions of income to delineate the relationship between income and mortality. The study suggested that the health benefits associated with increased income diminish as income increases."
Correspondence: E. Backlund, U.S. Bureau of the Census, Victimization and Expenditures Branch, Federal Building #3, Room 3716, Suitland, MD 20233. Location: Princeton University Library (SPR).

62:40159 Chenet, Laurent; Osler, Merete; McKee, Martin; Krasnik, Allan. Changing life expectancy in the 1980s: why was Denmark different from Sweden? Journal of Epidemiology and Community Health, Vol. 50, No. 4, Aug 1996. 404-7 pp. London, England. In Eng.
The authors aim to "identify the contribution from specific causes of death to the changes in life expectancy at birth in Denmark relative to Sweden in different age groups during the 1980s and to compare the difference in life expectancy between the two countries in 1990....Between 1979 and 1990 life expectancy increased in both Denmark and Sweden. However, the increase in Sweden was more than two years while that in Denmark was less than one year. In both countries a decrease in cardiovascular disease mortality contributed most to the increase in life expectancy in males as well as females. In both sexes the smaller increase in life expectancy in Denmark was a result of differences in mortality trends in cardiovascular diseases and respiratory and non-respiratory cancers....These findings suggest that mortality rates are sensitive to even minor differences in social and cultural factors across countries and over short time periods."
Correspondence: M. Osler, University of Copenhagen, Department of Social Medicine, Panum Institute, Blegdamsvej 3, 2200 Copenhagen N, Denmark. Location: Princeton University Library (SPR).

62:40160 Fang, Jing; Madhavan, Shantha; Alderman, Michael H. The association between birthplace and mortality from cardiovascular causes among black and white residents of New York City. New England Journal of Medicine, Vol. 335, No. 21, Nov 21, 1996. 1,545-51 pp. Boston, Massachusetts. In Eng.
By linking mortality records from 1988-1992 with 1990 census data, the authors explore the relationship between place of birth and mortality from cardiovascular causes among non-Hispanic black and white residents of New York City. The authors conclude that "the higher rate of mortality from cardiovascular causes among blacks, as compared with whites, in New York City masks substantial variation among blacks based on their place of birth."
Correspondence: J. Fang, Albert Einstein College of Medicine, Department of Epidemiology and Social Medicine, 1300 Morris Park Avenue, Bronx, NY 10461. Location: Princeton University Library (SZ).

62:40161 Gao, Ling. A study on the mortality differential for occupation-specific populations in China. Chinese Journal of Population Science, Vol. 8, No. 1, 1996. 77-86 pp. New York, New York. In Eng.
"This article analyzes the mortality differential for occupation-specific populations in China, using data from the fourth census. Its findings show that the mortality differential is the lowest for government officials and their secretarial staff, and specialists and technicians; it is...sequentially higher for commercial, service and manufacturing industry workers in that order, and it is highest for laborers in agriculture, forestry, animal husbandry, sideline production, and fishery. Analysis in this article also shows that in the fourth census, a sizable portion of people who died after retirement had the item for occupation on the death registration form filled in as `usual occupation' rather than `not currently employed', thus making the mortality rate for the unemployed population seem lower than it really should be."
Correspondence: L. Gao, Chinese People's University, Population Research Institute, Beijing, China. Location: Princeton University Library (SPR).

62:40162 Geronimus, Arline T.; Bound, John; Waidmann, Timothy A.; Hillemeier, Marianne M.; Burns, Patricia B. Excess mortality among blacks and whites in the United States. New England Journal of Medicine, Vol. 335, No. 21, Nov 21, 1996. 1,552-67 pp. Boston, Massachusetts. In Eng.
"Using standard demographic techniques, we analyzed death certificates and census data and made sex-specific population-level estimates of the 1990 death rates for people 15 to 64 years of age. We studied mortality among blacks in selected areas of New York City, Detroit, Los Angeles, and Alabama (in one area of persistent poverty and one higher-income area each) and among whites in areas of New York City, metropolitan Detroit, Kentucky, and Alabama (one area of poverty and one higher-income area each). Sixteen areas were studied in all." The results show that "although differences in mortality rates before the age of 65 between advantaged and disadvantaged groups in the United States are sometimes vast, there are important differences among impoverished communities in patterns of excess mortality."
Correspondence: A. T. Geronimus, University of Michigan, School of Public Health, Department of Health Behavior and Health Education, 1420 Washington Heights, Ann Arbor, MI 48109-2029. Location: Princeton University Library (SZ).

62:40163 Gornick, Marian E.; Eggers, Paul W.; Reilly, Thomas W.; Mentnech, Renee M.; Fitterman, Leslye K.; Kucken, Lawrence E.; Vladeck, Bruce C. Effects of race and income on mortality and use of services among Medicare beneficiaries. New England Journal of Medicine, Vol. 335, No. 11, Sep 12, 1996. 791-9 pp. Boston, Massachusetts. In Eng.
The effects of race and income on mortality and the use of Medicare services in the United States are examined using linked data from the 1990 census and 1993 Medicare data. The results show that "race and income have substantial effects on mortality and use of services among Medicare beneficiaries. Medicare coverage alone is not sufficient to promote effective patterns of use by all beneficiaries."
Correspondence: M. E. Gornick, Health Care Financing Administration, Office of Research and Demonstrations, 7500 Security Boulevard, C-3-24-07, Baltimore, MD 21244-1850. Location: Princeton University Library (SZ).

62:40164 Hodge, Allison M.; Dowse, Gary K.; Collins, Veronica R.; Zimmet, Paul Z. Mortality in Micronesian Nauruans and Melanesian and Indian Fijians is not associated with obesity. American Journal of Epidemiology, Vol. 143, No. 5, Mar 1, 1996. 442-55 pp. Baltimore, Maryland. In Eng.
"The association of obesity with mortality was investigated in population-based samples of Micronesian Nauruans (n=1,400), Melanesian Fijians (n=1,279), and Indian Fijians (n=1,182), over 10 years from 1982 in Nauru, and 11 years from 1980 in Fiji....After stratification by diabetes status, there was no relation between mortality and obesity in nondiabetic subjects, but an inverse relation was observed among diabetic subjects in each population....Overall, there was little evidence to suggest that obesity was a risk factor for total or cardiovascular mortality in these populations."
Correspondence: A. M. Hodge, International Diabetes Institute, 260 Kooyong Road, Caulfield, Melbourne, Victoria 3162, Australia. Location: Princeton University Library (SZ).

62:40165 Joossens, J. V.; Kesteloot, H. Mortality trends in Belgium and the Netherlands: closing the gap. Acta Cardiologica, Vol. 51, No. 1, 1996. 9-25 pp. Brussels, Belgium. In Eng.
"Mortality rates observed in Belgium since 1900 were always higher than in the Netherlands. There may be many explanations for those differences: life-style factors, medical care including drug treatment, and even genetic factors. Therefore mortality trends for different causes of death in the Netherlands were analyzed and compared with Belgium and its major regions (Flanders and Wallonia)....Mortality is in general decreasing faster in Belgium than in the Netherlands--more so between 1980 and 1989--for 10 classifications of causes of death. As a result the mortality gap between the Netherlands and Belgium is gradually closing. Life-style changes are more important than medical treatment, which is not better in Belgium, in order to explain the observed mortality patterns."
Correspondence: J. V. Joossens, U.Z. St.-Rafaël, Kapucijnenvoer 35, 3000 Louvain, Belgium. Location: Princeton University Library (SPR).

62:40166 Key, Timothy J. A.; Thorogood, Margaret; Appleby, Paul N.; Burr, Michael L. Dietary habits and mortality in 11,000 vegetarians and health conscious people: result of a 17 year follow up. British Medical Journal, Vol. 313, No. 7060, Sep 28, 1996. 775-9 pp. London, England. In Eng.
The association between diet and mortality is explored using data on 4,336 men and 6,435 women recruited through health-food shops, vegetarian societies, and magazines in the United Kingdom. The cohort was studied between 1973 and 1979 and followed up until 1995. "After a mean of 16.8 years follow up there were 1,343 deaths before age 80. Overall the cohort had a mortality about half that of the general population. Within the cohort, daily consumption of fresh fruit was associated with significantly reduced mortality from ischaemic heart disease...cerebrovascular disease...and for all causes combined...."
Correspondence: T. J. A. Key, Radcliffe Infirmary, Imperial Cancer Research Fund, Cancer Epidemiology Unit, Oxford OX2 6HE, England. Location: Princeton University Library (SZ).

62:40167 Klasen, Stephan. Nutrition, health and mortality in Sub-Saharan Africa: is there a gender bias? Journal of Development Studies, Vol. 32, No. 6, Aug 1996. 913-43 pp. London, England. In Eng.
The author challenges the conclusion of Peter Svedberg that an examination of the available data on nutrition and mortality in Sub-Saharan Africa indicates that there is a pro-girl bias in the region. The relevant anthropometric, mortality, and other demographic data are reanalyzed and supplemented with more recent information. It is concluded that there is a slight and rising anti-female bias in the region and that this is particularly apparent in the mortality and population indicators. A response from Svedberg is included (pp. 933-43) restating his conclusion that male children are more frequently at a disadvantage than female children in this region.
Correspondence: S. Klasen, University of the Witwatersrand, P.O. Wits, Johannesburg 2050, South Africa. Location: Princeton University Library (PF).

62:40168 Kromhout, Daan; Bloemberg, Bennie P. M.; Feskens, Edith J. M.; Hertog, Michael G. L.; Menotti, Alessandro; Blackburn, Henry. Alcohol, fish, fibre and antioxidant vitamins intake do not explain population differences in coronary heart disease mortality. International Journal of Epidemiology, Vol. 25, No. 4, Aug 1996. 753-9 pp. London, England. In Eng.
"Within the Seven Countries Study data we investigated whether population differences in 25-year mortality rates from coronary heart disease could be explained by population differences in alcohol, fish, fibre and antioxidant intake....Baseline surveys were carried out between 1958 and 1964, on 12,763 middle-aged men constituting 16 cohorts in seven countries....These cross-cultural analyses show that alcohol, fish, fibre and antioxidant vitamins do not explain population differences in coronary heart disease mortality, independently of saturated fatty acids and flavonoids intake and cigarette smoking."
Correspondence: D. Kromhout, National Institute of Public Health and Environment, Division of Public Health Research, P.O. Box 1, 3720 BA Bilthoven, Netherlands. Location: Princeton University Library (SPR).

62:40169 Läärä, Esa; Rantakallio, Paula. Body size and mortality in women: a 29 year follow up of 12,000 pregnant women in northern Finland. Journal of Epidemiology and Community Health, Vol. 50, No. 4, Aug 1996. 408-14 pp. London, England. In Eng.
The authors "examine the association between body height, body mass index (BMI), and mortality in fertile women of childbearing age...[using data for] a cohort of women (n=11,997) expected to deliver during 1966 in two northern provinces of Finland....Height had a `U' shaped association with total mortality over the whole follow up time. In women who were shorter than average, the death rate from cardiovascular diseases was increased and in taller women this was true for tumors....Among fertile women of childbearing age, both the short and tall seem to have an increased total mortality compared with those of average body height, resulting from opposite trends in major causes of death. Obesity is associated with raised long term total mortality."
Correspondence: E. Läärä, University of Oulu, Faculty of Medicine, Department of Public Health Science and General Practice, Oulu 90220, Finland. Location: Princeton University Library (SPR).

62:40170 Lillard, Lee A.; Panis, Constantijn W. A. Marital status and mortality: the role of health. Demography, Vol. 33, No. 3, Aug 1996. 313-27 pp. Silver Spring, Maryland. In Eng.
"Prior literature has shown that married men live longer than unmarried men. Possible explanations are that marriage protects its incumbents or that healthier men select themselves into marriage. Protective effects, however, introduce the possibility of adverse selection: Those in poor health have an incentive to marry. In this paper we explore the role of health in explaining mortality and marriage patterns, and distinguish protective effects from two types of selection effects. We find adverse selection on the basis of health (unhealthy men tend to remarry sooner) and positive selection on the basis of unmeasured factors that both promote good health and encourage marriage."
Correspondence: L. A. Lillard, RAND, Center for the Study of Aging, 1700 Main Street, Santa Monica, CA 90407-2138. Location: Princeton University Library (SPR).

62:40171 Lynch, John W.; Kaplan, George A.; Cohen, Richard D.; Tuomilehto, Jaakko; Salonen, Jukka T. Do cardiovascular risk factors explain the relation between socioeconomic status, risk of all-cause mortality, cardiovascular mortality, and acute myocardial infarction? American Journal of Epidemiology, Vol. 144, No. 10, Nov 15, 1996. 934-42 pp. Baltimore, Maryland. In Eng.
"We investigated the association between income, all-cause mortality, cardiovascular mortality, and acute myocardial infarction (AMI) in a prospective study of a population-based sample of eastern Finnish men. Extensive information on medical, biologic, behavioral, psychologic, and social risk factors allowed the most comprehensive examination to date of the potential pathways that mediate the relation between SES [socioeconomic status] and cardiovascular mortality, all-cause mortality, and AMI." Data concern 2,272 men who were participants in the Kuopio Ischemic Heart Disease Risk Factor Study, carried out in Finland between 1984 and 1993.
Correspondence: J. W. Lynch, Human Population Laboratory, 2151 Berkeley Way, Annex 2, Berkeley, CA 94704. Location: Princeton University Library (SZ).

62:40172 Marmot, M. G.; Shipley, Martin J. Do socioeconomic differences in mortality persist after retirement? 25 year follow up of civil servants from the first Whitehall study. British Medical Journal, Vol. 313, No. 7066, Nov 9, 1996. 1,177-80 pp. London, England. In Eng.
The relationship between socioeconomic status and mortality before and after retirement is examined using data from a study involving 18,133 British male civil servants aged 40-69 and first interviewed between 1967 and 1970. The results indicate that "socioeconomic differences in mortality persist beyond retirement age and in magnitude increase with age. Social differentials in mortality based on an occupational status measure seem to decrease to a greater degree after retirement than those based on a non-work measure. This suggests that alongside other socioeconomic factors work itself may play an important part in generating social inequalities in health in men of working age."
Correspondence: M. G. Marmot, University College London Medical School, Department of Epidemiology and Public Health, Gower Street, London WC1E 6BT, England. Location: Princeton University Library (SZ).

62:40173 Martelin, Tuija. Socio-demographic differentials in mortality at older ages in Finland. In: Health and mortality among elderly populations, edited by Graziella Caselli and Alan D. Lopez. 1996. 112-34 pp. Clarendon Press: Oxford, England; International Union for the Scientific Study of Population [IUSSP]: Liège, Belgium. In Eng.
"In this chapter, the patterns and trends of total mortality among the elderly population in Finland will be examined according to five socio-demographic characteristics: educational level, occupational class, marital status, region of residence, and mother tongue. The differentials according to these variables will be described separately for women and men, but gender differences as such are only of peripheral concern in this study. The elderly population is defined here as those aged 60 years or over." The data are from official sources and are for the years 1971-1990. The study concludes with a discussion of the prospects for further declines in mortality among the elderly in Finland.
Correspondence: T. Martelin, University of Helsinki, P.O. Box 33 (Hallituskatu 8), 0014 Helsinki, Finland. Location: Princeton University Library (SPR).

62:40174 Martikainen, Pekka T.; Valkonen, Tapani. Excess mortality of unemployed men and women during a period of rapidly increasing unemployment. Lancet, Vol. 348, No. 9032, Oct 5, 1996. 909-12 pp. New York, New York/London, England. In Eng.
The relationship between unemployment and mortality in Finland is analyzed over the period 1987-1992. Data on the total population aged 25-59 are taken from the 1990 census and from official labor force data files. The results indicate that "individuals who experienced unemployment between 1987 and 1992 had greater mortality than those in employment after control for age, education, occupational class, and marital status....[However] the association between unemployment and mortality weakens as the general unemployment rate increases. Studies that took place when the unemployment rate was low may thus overestimate the effect of unemployment on mortality because of unaccounted confounding."
Correspondence: P. T. Martikainen, University of Helsinki, Department of Sociology, Population Research Unit, P.O. Box 18, 00014 Helsinki, Finland. Location: Princeton University Library (SZ).

62:40175 Merino, Cristina; Vallejo, Francisco. Mortality and potential years of life lost in Ecuador. [Mortalidad y años de vida potencialmente perdidos en el Ecuador.] Correo Poblacional y de la Salud, Vol. 4, No. 3, Sep 1996. 34-41 pp. Quito, Ecuador. In Spa.
The authors discuss differential mortality in Ecuador by geographical area, sex, and potential years of life lost, with a focus on the inequalities that exist in the country.
Location: Princeton University Library (SPR).

62:40176 Noin, Daniel. Spatial inequalities of mortality in the European Union. In: Europe's population: towards the next century, edited by Ray Hall and Paul White. 1995. 69-82 pp. UCL Press: London, England. In Eng.
This is an analysis of geographical differences in mortality in the countries of the European Community which relies on data from a number of international, governmental, and private sources of data. Separate consideration is given to geographic differences in infant mortality and in mortality and life expectancy by sex.
Correspondence: D. Noin, Université de Paris-Sorbonne, Institute of Geography, 191 rue Saint-Jacques, 75005 Paris, France. Location: Princeton University Library (SPR).

62:40177 Phillips, Andrew N.; Wannamethee, S. Goya; Walker, Mary; Thomson, Andy; Smith, George D. Life expectancy in men who have never smoked and those who have smoked continuously: 15 year follow up of large cohort of middle aged British men. British Medical Journal, Vol. 313, No. 7062, Oct 12, 1996. 907-8 pp. London, England. In Eng.
Life expectancy differences between smokers and nonsmokers are analyzed using data on 7,735 British men aged 40-59, who were observed over a 15-year period up to 1993. "When study estimates were combined with those from national mortality statistics for men aged 20-40, only an estimated 42%...of lifelong smokers alive at the age of 20 would be alive at 73, compared with 78%...of lifelong non-smokers."
Correspondence: A. N. Phillips, Royal Free Hospital School of Medicine, Department of Primary Care and Population Sciences, London NW3 2PF, England. Location: Princeton University Library (SZ).

62:40178 Polednak, Anthony P. Segregation, discrimination and mortality in U.S. blacks. Ethnicity and Disease, Vol. 6, No. 1-2, Winter-Spring 1996. 99-108 pp. Atlanta, Georgia. In Eng.
"This paper reviews evidence that variation in mortality rates for black infants and young adults living in large metropolitan areas is associated with the level of black-white segregation. A few metropolitan areas in California with relatively low levels of segregation are shown to have low black death rates and small black-white differences in mortality rates for infants and young adult males (15-44 years old)....Longitudinal studies of potential `risk factors' for disease and death among blacks should include: personal histories of experiences with discrimination, psychological reactions to discrimination, segregation indexes, quality of life in residential areas, and social class indicators."
Correspondence: A. P. Polednak, Connecticut Department of Public Health, 150 Washington Street, Hartford, CT 06101. Location: Princeton University Library (SPR).

62:40179 Shaheen, S. O.; Aaby, P.; Hall, A. J.; Barker, D. J. P.; Heyes, C. B.; Shiell, A. W.; Goudiaby, A. Cell mediated immunity after measles in Guinea-Bissau: historical cohort study. British Medical Journal, Vol. 313, No. 7063, Oct 19, 1996. 969-74 pp. London, England. In Eng.
Data concerning 391 children aged 3-13 years in Guinea-Bissau are used to compare mortality between children who had had measles and those who had been vaccinated against measles. The data were originally collected in 1991, and the children concerned were followed over a three-year period. The results show that children who survive measles are at greater risk of dying in the following few years than those who have been vaccinated. "Reduced general cell mediated immunity may contribute to the higher long term mortality in children who have had measles compared with recipients of standard measles vaccine and to the higher child mortality in the rainy season in west Africa."
Correspondence: S. O. Shaheen, United Medical and Dental Schools of Guy's and St. Thomas's Hospitals, Department of Public Health Medicine, St. Thomas's Hospital, London SE1 7EH, England. Location: Princeton University Library (SZ).

62:40180 Trichopoulou, Antonia; Kouris-Blazos, Antigone; Wahlqvist, Mark L.; Gnardellis, Charalambos; Lagiou, Pagona; Polychronopoulos, Evangelos; Vassilakou, Tonia; Lipworth, Loren; Trichopoulos, Dimitrios. Diet and overall survival in elderly people. British Medical Journal, Vol. 311, No. 7018, Dec 2, 1995. 1,457-60 pp. London, England. In Eng.
Using data on 182 elderly residents living in three Greek villages, the authors explore the influence of diet on overall survival. The results show that the traditional Mediterranean diet is associated with a significant reduction in overall mortality.
Correspondence: A. Trichopoulou, National School of Public Health, National Centre for Nutrition, Leoforos Alexandras 196, Athens 115-21, Greece. Location: Princeton University Library (SZ).

62:40181 Trovato, Frank; Lalu, N. M. The narrowing sex differential in mortality in Canada since 1971. Canadian Studies in Population, Vol. 22, No. 2, 1995. 145-67 pp. Alberta, Canada. In Eng. with sum. in Fre.
"In this study, we confine our observations to Canada and evaluate three questions: (1) What causes of death have contributed to the narrowing of the sex difference in life expectancy between 1971 and 1991? (2) What is the relative contribution of different causes of death to the survival discrepancy within specified age categories? (3) How have cause-specific mortality differences between the sexes changed over time in their impacts on the differential in life expectation? In our discussion section we assess the relevance of our empirical results to the substantive issues underlying this investigation, namely, the importance of bio-demographic and sociological factors for the onset of reversal in the sex gap in death probabilities."
Correspondence: F. Trovato, University of Alberta, Edmonton, Alberta T6G 2H4, Canada. Location: Princeton University Library (SPR).

62:40182 Westerling, Ragnar. Can regional variation in "avoidable" mortality be explained by deaths outside hospital? A study from Sweden, 1987-90. Journal of Epidemiology and Community Health, Vol. 50, No. 3, Jun 1996. 326-33 pp. London, England. In Eng.
"This study aimed to calculate the proportion of deaths outside hospital in Sweden for some conditions for which the acute medical management may be important to the outcome and to analyse whether the proportion of deaths outside hospital can explain regional variations in mortality from these causes of death....Variation in cause-specific mortality among the 26 administrative health areas in Sweden was analysed....The correlation between the proportion of deaths outside hospital in each health area and the cause specific mortality irrespective of place of death was calculated....The high proportion of deaths outside hospital at the national level for some of the conditions studied suggests that in-depth studies of the process preceding death and the functioning of medical care are needed. In most cases, however, no evidence was found that regional variation in mortality could be explained by death outside hospital."
Correspondence: R. Westerling, Uppsala University, Department of Social Medicine, Akademiska Sjukhuset, 751 85 Uppsala, Sweden. Location: Princeton University Library (SPR).

62:40183 Westerling, Ragnar; Gullberg, Anders; Rosén, Måns. Socioeconomic differences in "avoidable" mortality in Sweden, 1986-1990. International Journal of Epidemiology, Vol. 25, No. 3, Jun 1996. 560-7 pp. Oxford, England. In Eng.
"In this study socioeconomic differences in avoidable mortality in Sweden from 1986 to 1990 are analysed and related methodological issues discussed....The 1985 Swedish Population and Housing Census was linked to the National Cause of Death Register 1986-1990. Mortality from potentially `avoidable' causes of death was analysed for the age group 21-64 years. Analyses were performed for different socioeconomic groups, blue-collar workers, white-collar workers and the self-employed as well as for individuals outside the labour market....For all indicators studied, the death rates for those not in work were higher than for people at work....The small difference in mortality outcome for different socioeconomic groups within the work-force indicates an equal quality of care for these groups. The greatly increased risk among the non-working population, however, is a warning sign."
Correspondence: R. Westerling, Uppsala University, Department of Social Medicine, Akademiska Sjukhuset, 751 85 Uppsala, Sweden. Location: Princeton University Library (SPR).

62:40184 Wunsch, Guillaume; Duchêne, Josianne; Thiltgès, Evelyne; Salhi, Mohammed. Socio-economic differences in mortality. A life course approach. European Journal of Population/Revue Européenne de Démographie, Vol. 12, No. 2, Jun 1996. 167-85 pp. Dordrecht, Netherlands. In Eng. with sum. in Fre.
"Differential mortality in Norway has been studied on the basis of a sample of data derived from the linkage of the 1960, 1970, and 1980 censuses to vital registration records. Based on the hypothesis that the determinants of survival act in interaction, two models are proposed. The first is based on states defined at each observation period by the conjunction of attributes characterizing each individual. The second model considers the chronological order of the states. Logistic regression applied to the latter shows that the most favourable male and female life trajectories are those for married people belonging to rather privileged categories. There are however some differences by sex, as favourable trajectories concern both economically inactive females and employees."
Correspondence: G. Wunsch, Catholic University of Louvain, Institute of Demography, Place de l'Université 1, 1348 Louvain-la-Neuve, Belgium. Location: Princeton University Library (SPR).

62:40185 Xie, Weike. Mortality differential for various levels of education in China. Chinese Journal of Population Science, Vol. 8, No. 1, 1996. 41-9 pp. New York, New York. In Eng.
"Using data from the fourth census, this article analyzes the mortality differential for various levels of education in China. Findings for most of the age groups show that an increase in educational level is accompanied by a decline in mortality. Our results suggest that popularizing education and enhancing the public's educational level are of tremendous significance in the country's attempt to reduce the mortality rate and prolong life expectancy. This article also examines and explains causes of mortality differential for various educational levels."
Correspondence: W. Xie, Beijing Medical University, Health Statistics and Medical Population Teaching, Xue Yuan Lu, Northern Suburb, Beijing 100083, China. 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.

62:40186 Al-Meshari, A.; Chattopadhyay, S. K.; Younes, B.; Hassonah, M. Trends in maternal mortality in Saudi Arabia. International Journal of Gynecology and Obstetrics, Vol. 52, No. 1, 1996. 25-32 pp. Limerick, Ireland. In Eng.
This article analyzes maternal mortality in Saudi Arabia and is based on data collected from all hospitals in the country from 1989 to 1992. The results indicate a maternal mortality rate of 18 per 100,000 births, which compares favorably with rates in other oil-producing countries, and with developed countries as a whole. Ways to reduce further the rate of maternal mortality are considered.
Correspondence: A. Al-Meshari, King Saud University, College of Medicine, Department of Obstetrics and Gynecology, P.O. Box 2925, Riyadh 11461, Saudi Arabia. Location: Princeton University Library (SPR).

62:40187 Al-Meshari, Abdulaziz; Chattopadhyay, Sisir K.; Younes, Bassam; Anokute, Charles. Epidemiology of maternal mortality in Saudi Arabia. Annals of Saudi Medicine, Vol. 15, No. 4, 1995. 317-22 pp. Riyadh, Saudi Arabia. In Eng.
"A three year maternal mortality survey in Saudi Arabia has identified the various epidemiologic risk factors for maternal deaths. Unbooked, uneducated and economically underprivileged females were at increased risk of maternal death, especially...females [with parities of seven or more children]....In Saudi Arabia, there are contradictory risk factors for maternal death; e.g. low female literacy rate, early marriage and unregulated high fertility, and affluence which has brought about improvements in all walks of life including health services. Increasing the number of booked patients, especially among the elderly grand multipara, improving the quality of emergency obstetric services and achieving a higher female education rate are likely to bring the present maternal mortality ratio (MMR) of 18 per 100,000 births down to a minimum. The MMR obtained in this study compared favorably with those of the oil-producing gulf countries and the developing and developed countries of the world."
Correspondence: A. Al-Meshari, King Saud University, College of Medicine, Department of Obstetrics and Gynecology, P.O. Box 2925, Riyadh 11461, Saudi Arabia. Location: Princeton University Library (SPR).

62:40188 Atrash, Hani K.; Alexander, Sophie; Berg, Cynthia J. Maternal mortality in developed countries: not just a concern of the past. Obstetrics and Gynecology, Vol. 86, No. 4, pt. 2, Oct 1995. 700-5 pp. New York, New York. In Eng.
"In this paper, we review strategies used in selected developed countries to identify all maternal deaths, demonstrating that the numbers and rates of maternal death are substantially understated. We also outline the types of information needed to understand the causal pathway to the death and the means to prevent such deaths." The authors find that "a variety of methods can be used to improve the ascertainment of maternal deaths, including linkage of birth and fetal death certificates, check-boxes on death certificates, periodic review of deaths of reproductive-age women, and ongoing birth registries and medical audits....The numbers of deaths due to pregnancy and its complications are underestimated in most developed countries."
Correspondence: H. K. Atrash, Centers for Disease Control and Prevention, Division of Reproductive Health, 4770 Buford Highway, MS K-23, Atlanta, GA 30341-3724. Location: Princeton University Library (SPR).

62:40189 Barnett, Elizabeth; Strogatz, David; Armstrong, Donna; Wing, Steve. Urbanisation and coronary heart disease mortality among African Americans in the U.S. South. Journal of Epidemiology and Community Health, Vol. 50, No. 3, Jun 1996. 252-7 pp. London, England. In Eng.
"This study examined urban-rural differentials in coronary mortality trends among African Americans for the period 1968-86....In 1968, observed excesses in coronary mortality were 29% for men and 45% for women, compared with isolated rural areas. Metropolitan areas experienced greater declines in mortality than rural areas, so by 1986 the urban-rural differentials in coronary mortality were 3% for men and 11% for women....Harsh living conditions in rural areas of the South precluded important coronary risk factors and contributed to lower mortality rates compared with urban areas during the 1960s. The dramatic transformation from an agriculturally based economy to manufacturing and services employment over the course of the study period contributed to improved living conditions which promoted coronary mortality declines in all areas of the South; however, the most favourable economic and mortality trends occurred in metropolitan areas."
Correspondence: E. Barnett, West Virginia University, Prevention Research Center, P.O. Box 9005, Morgantown, WV 26506-9005. Location: Princeton University Library (SPR).

62:40190 Carmelli, Dorit; Page, William F. Twenty-four year mortality in World War II U.S. male veteran twins discordant for cigarette smoking. International Journal of Epidemiology, Vol. 25, No. 3, Jun 1996. 554-9 pp. Oxford, England. In Eng.
"This study was undertaken to test the constitutional hypothesis which attributes the association of tobacco smoking with morbidity and mortality to genetic predispositions to smoking and/or disease....Subjects were World War II veterans, born in the U.S. between 1917 and 1927, and surveyed at mean age 47 for present and past smoking habits. Twenty-four year mortality follow-up data were available for 1,515 male twin pairs discordant for lifelong cigarette smoking....We found that active smokers at baseline, regardless of zygosity, had a higher risk of death than their co-twins who had never smoked or quit smoking....The present results, from the largest and longest-studied series of smoking-discordant twins negate the constitutional hypothesis that genetic or early shared familial influences underlie the significant association between tobacco smoking and premature mortality."
Correspondence: D. Carmelli, SRI International, Health Sciences Program, 333 Ravenswood Avenue, Menlo Park, CA 94025. Location: Princeton University Library (SPR).

62:40191 Danel, Isabella; Graham, Wendy; Stupp, Paul; Castillo, Pedro. Applying the sisterhood method for estimating maternal mortality to a health facility-based sample: a comparison with results from a household-based sample. International Journal of Epidemiology, Vol. 25, No. 5, Oct 1996. 1,017-22 pp. Oxford, England. In Eng.
"A study was carried out comparing maternal mortality estimates using the sisterhood method in a population-based household survey and in a captive population of adults attending outpatient health facilities in...Nicaragua in July 1992." Results indicate that "the lifetime risk of maternal death was 0.0144 (1 in 69)....The sisterhood method provided a robust estimate of the magnitude of maternal mortality. Results from the opportunistic health facility-based sample were virtually identical to results from the household-based study. Guidelines need to be developed for applying this low-cost and efficient approach to estimating maternal mortality in suitable opportunistic settings at subnational levels."
Correspondence: I. Danel, Centers for Disease Control and Prevention, Division of Reproductive Health, MS K-35, 1600 Clifton Road, Atlanta, GA 30333. Location: Princeton University Library (SPR).

62:40192 García Molina, Carlos A.; López López, Maria V. Avoidable causes of death and their effects on life expectancy. A socio-demographic interpretation. The case of the northern frontier, 1980-1990. [Causes de muerte evitables y su contribución al incremento en la esperanza de vida. Una interpretación sociodemográfica. El caso de la frontera norte, 1980-1990.] Estudios Demográficos y Urbanos, Vol. 10, No. 1, Jan-Apr 1995. 133-65, 236-7 pp. Mexico City, Mexico. In Spa. with sum. in Eng.
"This study forms part of [a] research project on the health-disease-death process along the [Mexican] Northern Frontier--a by-product of the socio-economic structure of a specific social formation that determines disease and death--to support regional and sectorial design of policies and actions for the improvement of health conditions for its population....An important finding is a 4.1 year increase of life expectancy due, among other causes, to a slight decrease in avoidable death causes, although these still produce about 50% of deaths."
Correspondence: C. A. García Molina, Universidad Nacional Autónoma de México, Centro Regional de Investigaciones Multidisciplinarias, Avenida Universidad s/n, Segundo Circuito, Col. Chamilpa, Cuernavaca, Estado Morelos, Mexico. Location: Princeton University Library (SPR).

62:40193 Granizo, Juan J.; Guallar, Eliseo; Rodríguez-Artalejo, Fernando. Age-period-cohort analysis of suicide mortality rates in Spain, 1959-1991. International Journal of Epidemiology, Vol. 25, No. 4, Aug 1996. 814-20 pp. London, England. In Eng.
"The objective of this study was to investigate nationwide trends in suicide mortality from 1959 to 1991 in Spain, with emphasis on age, period, and cohort effects....Age- and sex-specific suicide mortality rates from 1959 until 1991 were obtained from official vital statistics tables from the Instituto Nacional de Estadística....Suicide mortality rates increased with age, with a proportional increment for each decade of life of 45%....In both males and females, age-adjusted suicide mortality rates decreased from 1959 until the late 1970s and early 1980s. In 1982, trends started to increase, returning to the levels of 1959 in less than 6 years. Cohort effects were small for cohorts born prior to 1940. For cohorts born after 1950, suicide rates increased markedly."
Correspondence: E. Guallar, Escuela Nacional de Sanidad, Instituto de Salud Carlos III, Departamento de Epidemiología y Bioestadística, Sinesio Delgado 8, 28029 Madrid, Spain. Location: Princeton University Library (SPR).

62:40194 Hanley, James A.; Hagen, Catherine A.; Shiferaw, Tesfaye. Confidence intervals and sample-size calculations for the sisterhood method of estimating maternal mortality. Studies in Family Planning, Vol. 27, No. 4, Jul-Aug 1996. 220-7 pp. New York, New York. In Eng.
"The sisterhood method is an indirect method of estimating maternal mortality that has, in comparison with conventional direct methods, the dual advantages of ease of use in the field and smaller sample-size requirements. This report describes how to calculate a standard error to quantify the sampling variability for this method. This standard error can be used to construct confidence intervals and statistical tests and to plan the size of a sample survey that employs the sisterhood method. Statistical assumptions are discussed, particularly in relation to the effective sample size and to effects of extrabinomial variation. In a worked example of data from urban Pakistan, a maternal mortality ratio of 153 (95 percent confidence interval between 96 and 212) deaths per 100,000 live births is estimated."
Correspondence: J. A. Hanley, McGill University, Department of Epidemiology and Biostatistics, 1020 Pine Avenue West, Montreal, Quebec H3A 1A2, Canada. Location: Princeton University Library (SPR).

62:40195 Kafadar, Karen; Freedman, Laurence S.; Goodall, Colin R.; Tukey, John W. Urbanicity-related trends in lung cancer mortality in U.S. counties: white females and white males, 1970-1987. International Journal of Epidemiology, Vol. 25, No. 5, Oct 1996. 918-32 pp. Oxford, England. In Eng.
"The effect of urbanization on age-adjusted lung cancer mortality rates in U.S. counties is investigated. The data come from [the] National Cancer Institute, and urban trends are estimated in [the] time periods 1970-1979 and 1980-1987, for both white males and white females....A measure of urbanness, urbanicity, is defined and is used to stratify counties....Urban-rural gradients are significant for nearly all regions for both white males and white females, diminishing slightly in the latter time period for white males but becoming stronger for white females."
Correspondence: K. Kafadar, University of Colorado, Department of Mathematics, Box 170, Denver, CO 80217-3364. Location: Princeton University Library (SPR).

62:40196 Landry, Yves; Lessard, Rénald. Causes of death in seventeenth- and eighteenth-century Quebec as recorded in the parish registers. Historical Methods, Vol. 29, No. 2, Spring 1996. 49-57 pp. Washington, D.C. In Eng.
"The exhaustive compilation of parish registers of seventeenth- and eighteenth-century Québec by the Programme de Recherche en Démographie Historique of the Université de Montréal...offers the possibility of analyzing the stated causes of death in 208,876 burial certificates. Given the usual deficiencies that we have mentioned, what is the value of this information? How does it affect the distribution of the deceased persons according to sex, age, and time of death? The first part of this article answers these questions; the second part looks into the case of the register of the parish of Lachine, near Montréal, in which the curé recorded almost all causes of death during a period of twenty-five years (1681-1706)."
Correspondence: Y. Landry, Université de la Rochelle, La Rochelle, France. Location: Princeton University Library (SPR).

62:40197 Lanska, Douglas J.; Peterson, Patrick M. Comparison of additive and multiplicative models of regional variation in the decline of stroke mortality in the United States. Stroke, Vol. 27, No. 6, Jun 1996. 1,055-9 pp. Dallas, Texas. In Eng.
The authors examine the extent to which geographic variation in the decline of stroke mortality rates in the United States might be dependent on the type of model used to study it. Both additive and multiplicative models are fitted to official data for the period 1979-1989. The results confirm that "from 1979 through 1989 there was significant geographic variation in the rate of decline of stroke mortality rates, with the most rapid rates of decline in the South. As a result, there has been a decrease in interregional variation in stroke mortality rates."
Correspondence: D. J. Lanska, University of Kentucky, Department of Neurology, Kentucky Clinic, Lexington, KY 40536-0284. Location: Princeton University Library (SPR).

62:40198 Lanska, Douglas J.; Peterson, Patrick M. Geographic variation in the decline of stroke mortality in the United States. Stroke, Vol. 26, No. 7, Jul 1995. 1,159-65 pp. Dallas, Texas. In Eng.
Using official data for the period 1970-1989, this article examines geographic variation in the decline of stroke mortality rates in the United States. "During 1970 to 1989 there was significant geographic variation in the rate of decline of stroke mortality, with the most rapid rates of decline concentrated in the high-rate areas of the South and particularly the Southeast. As a result, there has been a decrease in interregional and interstate variation in stroke mortality rates, which is apparently not due to an artifact of changing reporting patterns."
Correspondence: D. J. Lanska, University of Kentucky, Department of Neurology, Kentucky Clinic, Lexington, KY 40536-0284. Location: Princeton University Library (SPR).

62:40199 Lassalle, Didier. Suicides in Great Britain from 1971 to 1992. [Les suicides en Grande-Bretagne de 1971 à 1992.] Population, Vol. 51, No. 3, May-Jun 1996. 766-75 pp. Paris, France. In Fre.
Suicide rates for England and Wales on the one hand and Scotland on the other are presented for the period 1971-1992. The rates for males, particularly in the age range 15-44, have risen; England and Wales showed a modest increase, while Scottish rates almost doubled. Female suicide rates, however, declined in England and Wales and remained relatively stable in Scotland. The author examines the suicide rates by age, method, socioeconomic class, and profession. He surmises that the increases in male rates may be attributed to societal changes that tend to have a strong effect on the male population, such as rising drug use and increasing social isolation in urban and rural areas, compounded by rising divorce and falling marriage rates. He concludes that the factors underlying suicide are a complex combination of pathologies and social context.
Correspondence: D. Lassalle, Université de Paris XIII, Ave J.-B. Clement, 93430 Villetaneuse, France. Location: Princeton University Library (SPR).

62:40200 Maine, Deborah; Akalin, Murat Z.; Chakraborty, Jyotsnamoy; de Francisco, Andres; Strong, Michael. Why did maternal mortality decline in Matlab? Studies in Family Planning, Vol. 27, No. 4, Jul-Aug 1996. 179-87 pp. New York, New York. In Eng.
"In 1991, an article on the Maternity Care Program in Matlab, Bangladesh, reported a substantial decline in direct obstetric deaths in the intervention area, but not in the control area. The decline was attributed primarily to the posting of midwives at the village level. In this article, data are presented from the same period and area on a variety of intermediate events. They indicate that the decline in deaths was probably due to the combined efforts of community midwives and the physicians at the Matlab maternity clinic. Their ability to refer patients to higher levels of care was important. The data further indicate that the decline in deaths depended upon the functioning of the government hospital in Chandpur, where cesarean sections and blood transfusions were available. Midwives might also have made a special contribution by providing early termination of pregnancy, which is legal in Bangladesh."
Correspondence: D. Maine, Columbia University, Center for Population and Family Health, 60 Haven Avenue, B-3, New York, NY 10032. Location: Princeton University Library (SPR).

62:40201 Meslé, France; Vallin, Jacques. Reconstructing long-term series of causes of death: the case of France. Historical Methods, Vol. 29, No. 2, Spring 1996. 72-87 pp. Washington, D.C. In Eng.
"In 1988, we published the results of a lengthy effort to reconstruct a cause of death series [for France] based on the ICD-8 Detailed List for the period 1925-78....The work included a redistribution of ill-defined causes and an analysis of the results in terms of etio-anatomical groups of diseases and of their impact on life expectancy. However, our study did not include more recent data based on the ICD-9 series, which at that time had not been extended far enough to allow us to make the connections with the previous series....The work in progress is a new opportunity (1) to present our method through specific examples of matching ICD-8 and ICD-9, (2) to summarize the specific difficulties encountered when dealing with previous revisions to obtain the 1925-78 series, and (3) to show examples of changes in coding practices independent of the ICD revision itself."
For the 1988 study referred to, see 55:10209.
Correspondence: F. Meslé, Institut National d'Etudes Démographiques, 27 rue du Commandeur, 75675 Paris Cedex 14, France. Location: Princeton University Library (SPR).

62:40202 Pampel, Fred C. Cohort size and age-specific suicide rates: a contingent relationship. Demography, Vol. 33, No. 3, Aug 1996. 341-55 pp. Silver Spring, Maryland. In Eng.
"Trends in age-specific suicide rates relate to debates about the consequences of population aging and changes in cohort size for social well-being. Easterlin argues that large cohort size increases suicide rates by reducing relative income; Preston claims that suicide rates fall in large cohorts with high levels of political and social power. To integrate these competing arguments, this paper uses aggregate data on 18 high-income nations from 1953 to 1986 to demonstrate that the direction and strength of the relationship between cohort size and suicide depend on (1) age of the cohort, (2) gender, (3) national context, and (4) time period. The results show that large cohort size raises suicide for the young and middle-aged, but reduces it for the elderly. Also, the effects of cohort size prove stronger for men than for women, for nations with less collectivist institutions than for nations with more collectivist institutions, and for the 1950s and 1960s than for the 1970s and 1980s."
This is a revised version of a paper originally presented at the 1996 Annual Meeting of the Population Association of America.
Correspondence: F. C. Pampel, University of Colorado, Population Program, Campus Box 484, Boulder, CO 80309-0484. Location: Princeton University Library (SPR).

62:40203 Peter, I.; Otremski, I.; Livshits, G. Geographic variation in vascular mortality in Eurasia: spatial autocorrelation analysis of mortality variables and risk factors. Annals of Human Biology, Vol. 23, No. 6, Nov-Dec 1996. 471-90 pp. London, England. In Eng. with sum. in Ger; Fre.
"The geographic variation patterns of vascular mortality and their major risk factors from 68 samples in Eurasia are described in this work. The goodness-of-fit tests and analysis of variance indicate significant differences in incidence of mortality from the studied diseases, as well as in risk factors among the various geographic regions in four age groups." Data are from the WHO MONICA project. They date back to 1989 and involve countries in both Europe and Asia. The results indicate that there are "three distinct and significant patterns of variation: (a) a north-south trend for total mortality rate, for death rate from cardiovascular and ischaemic heart diseases, for diastolic and systolic blood pressure and for body mass index; (b) a northwest-southeast pattern for mortality rate from cerebrovascular disease; and (c) local patches for total serum cholesterol."
Correspondence: G. Livshits, Tel Aviv University, Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Ramat-Aviv, 69 978 Tel Aviv, Israel. Location: Princeton University Library (SPR).

62:40204 Pozo Avalos, Arturo. Maternal mortality. [Mortalidad materna.] Correo Poblacional y de la Salud, Vol. 4, No. 3, Sep 1996. 44-50 pp. Quito, Ecuador. In Spa.
The author analyzes maternal mortality in Ecuador, with a focus on causes of death, regional rates, family planning, prenatal care, and professional medical care.
Correspondence: A. Pozo Avalos, Centro de Estudios de Población y Paternidad Responsable, Calle Montes 423 y Daniel Hidalgo, Casilla 17-01-2327, Quito, Ecuador. Location: Princeton University Library (SPR).

62:40205 Quinn, Mike; Allen, Elizabeth. Changes in incidence of and mortality from breast cancer in England and Wales since introduction of screening. British Medical Journal, Vol. 311, No. 7017, Nov 25, 1995. 1,391-5 pp. London, England. In Eng.
"To assess the impact of the [National Health Service] screening programme we compared the age specific incidence of breast cancer in women in England and Wales from 1979 to 1987 with that for 1988 to 1992. We also examined the age specific mortality from breast cancer in women...from 1950 to 1994." The results indicate that "since the introduction of screening there have been pronounced increases in recorded incidence in the screened age group." However, mortality from this cause has fallen over time.
Correspondence: M. Quinn, Office of Population Censuses and Surveys, National Cancer Registration Bureau, St. Catherine's House, 10 Kingsway, London WC2B 6JP, England. Location: Princeton University Library (SZ).

62:40206 Vallin, Jacques; Meslé, France. How can trends in causes of death be tracked despite statistical discontinuities? The case of France from 1925 to 1993. [Comment suivre l'évolution de la mortalité par cause malgré les discontinuités de la statistique? Le cas de la France de 1925 à 1993.] INED Dossiers et Recherches, No. 53, Jul 1996. 45 pp. Institut National d'Etudes Démographiques [INED]: Paris, France. In Fre.
Using the example of France from 1925 to 1993, the authors examine the problems posed in the analysis of causes of death over long periods of time by changes in the way the data are classified. They note that there are three major problems to be resolved: changes in the International Classification of Diseases [ICD], changes in the coding practices employed by government agencies, and inconsistencies among individual physicians in diagnosing the cause of death. They present methods for overcoming each of these difficulties and urge the implementation of a transitional period using both old and new classification for future revisions of the ICD.
Correspondence: Institut National d'Etudes Démographiques, 27 rue du Commandeur, 75675 Paris Cedex 14, France. Location: Princeton University Library (SPR).

62:40207 Wild, Sarah H.; Laws, Ami; Fortmann, Stephen P.; Varady, Ann N.; Byrne, Christopher D. Mortality from coronary heart disease and stroke for six ethnic groups in California, 1985 to 1990. Annals of Epidemiology, Vol. 5, No. 6, Nov 1995. 432-9 pp. New York, New York. In Eng.
"Coronary heart disease and stroke death rates were compared for six ethnic groups (non-Hispanic white, Hispanic, African-American, Chinese, Japanese, and Asian Indian) by sex and age (25 to 44, 45 to 64, 65 to 84, and 25 to 84 years old) using California census and 1985 to 1990 death data. African-American men and women in all age groups had the highest rates of death from coronary heart disease, stroke, and all causes (except for coronary heart disease in the oldest men). Hispanics, Chinese, and Japanese in all age-sex groups had comparatively low death rates for coronary heart disease and stroke, although stroke was proportionally an important cause of death for Chinese and Japanese groups. Coronary heart disease was an important cause of death for Asian Indians although death rates were generally not higher than those for other ethnic groups. Ethnic differences were most marked for women and younger age groups."
Correspondence: S. H. Wild, London School of Hygiene and Tropical Medicine, Department of Epidemiology and Population Sciences, Epidemiology Unit, Keppel Street, London WC1E 7HT, England. Location: Princeton University Library (SPR).

62:40208 Wilkins, Kathryn. Causes of death: how the sexes differ. Canadian Social Trends, No. 41, Summer 1996. 11-7 pp. Ottawa, Canada. In Eng.
An analysis of causes of death in Canada is presented using official data. The author notes that "not only do the causes of death differ between the sexes, but so do the ages at which death occurs. At all ages, death rates for each broad cause are higher for males than for females. But while the male death rate surpasses the female rate throughout the lifespan, the greatest difference is in early and middle adulthood. Much of this difference is due to deaths from external causes (such as motor vehicle crashes), the rate of which is higher for men than it is for women. Because males are more likely to die at a younger age, substantially fewer males than females survive until age 75."
Location: Princeton University Library (PR).

62:40209 Williams, Naomi. The reporting and classification of causes of death in mid-nineteenth-century England: the example of Sheffield. Historical Methods, Vol. 29, No. 2, Spring 1996. 58-71 pp. Washington, D.C. In Eng.
"After outlining registration and certification procedures, I look at the practical implementation of cause of death registration at the local level, drawing partly on an analysis of the civil death registers for the large industrial town of Sheffield [England] in the mid-nineteenth century. These registers allow us to explore how causes of death were described by medical practitioners and to assess the extent to which the official recommended nomenclature prepared by William Farr...was being adopted at the time by medical men. The individual-level cause of death data provided in the Sheffield registers are then grouped, to attempt a comparison with the published classifications and to illuminate how problematic or ambiguous causes of death were assigned to the formal categories of the nosology."
Correspondence: N. Williams, University of Liverpool, Department of Geography, P.O. Box 147, Liverpool L69 3BX, England. Location: Princeton University Library (SPR).

62:40210 Zureik, Mahmoud; Ducimetière, Pierre. High alcohol-related premature mortality in France: concordant estimates from a prospective cohort study and national mortality statistics. Alcoholism: Clinical and Experimental Research, Vol. 20, No. 3, 1996. 428-33 pp. Baltimore, Maryland. In Eng.
"This study examines the magnitude of alcohol-related premature death in the French population, which still has the highest average alcohol intake in the world and a relatively low coronary heart disease mortality rate. Two data sources were used: the national mortality data in 1990 and a prospective mortality experience in a cohort of 2,687 middle-aged working men examined in 1980-1985 and followed-up during an average of 9.3 years. In the general population study, alcohol-related premature mortality (35-64 years) was calculated using alcohol-attributable fractions (AAFs) derived from studies of alcohol involvement in deaths from various causes....This study reports the persisting high alcohol-related premature mortality in the French general population, as well as in middle-aged working men. The results suggest that efforts should be [made] to reduce further the consumption of alcohol in France."
Correspondence: M. Zureik, Hôpital Broussais, Institut National de la Santé et de la Recherche Médicale, Unit 258, 96 rue Didot, 75014 Paris, France. Location: Princeton University Library (SPR).


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