We use recently released, nationally representative data from the National Health Interview Survey—Multiple Cause of Death linked file to model the association of religious attendance and sociodemographic, health, and behavioral correlates with overall and cause-specific mortality Religious attendance is associated with US adult mortality in a graded fashion: People who never attend exhibit 187 times the risk of death in the follow-up period compared with people who attend more than once a week This translates into a seven-year difference in life expectancy at age 20 between those who never attend and those who attend more than once a week Health selectivity is responsible for a portion of the religious attendance effect: People who do not attend church or religious services are also more likely to be unhealthy and, conse-quently, to die However, religious attendance also works through increased social ties and behavioral factors to decrease the risks of death And although the magnitude of the association between religious attendance and mortality varies by cause of death, the direction of the association is consistent across causes

/pdf/religious-involvement-and-u-s-adult-mortality-3algtxrr91.pdf

Religious involvement and U.S. adult mortality

https://www.gastrojournal.org/article/S0016-5085%2809%2900523-X/pdf

Increased Prevalence and Mortality in Undiagnosed Celiac Disease

STUDY OBJECTIVE This study examined both individual and neighbourhood correlates of injury mortality to better understand the contribution of socioeconomic status to cause specific injury mortality. Of particular interest was whether neighbourhood effects remained after adjusting for individual demographic characteristics and socioeconomic status.

DESIGN Census tract data (measuring small area socioeconomic status, racial concentration, residential stability, urbanisation, and family structure) was merged with the National Health Interview Survey (NHIS) and a file that links the respondents to subsequent follow up of vital status and cause of death data. Cox proportional hazards models were specified to determine individual and neighbourhood effects on homicide, suicide, motor vehicle deaths, and other external causes. Variances are adjusted for the clustered sample design of the NHIS.

SETTING United States, 1987–1994, with follow up to the end of 1995.

PARTICIPANTS From a sample of 472 364 persons ages 18–64, there were 1195 injury related deaths over the follow up period.

MAIN RESULTS Individual level effects were generally robust to the inclusion of neighbourhood level variables in the models. Neighbourhood characteristics had independent effects on the outcome even after adjustment for individual variability. For example, there was approximately a twofold increased risk of homicide associated with living in a neighborhood characterised by low socioeconomic status, after adjusting for individual demographic and socioeconomic characteristics.

CONCLUSIONS Social inequalities in injury mortality exist for both persons and places. Policies or interventions aimed at preventing or controlling injuries should take into account not only the socioeconomic characteristics of people but also of the places in which they live.

/pdf/socioeconomic-status-and-injury-mortality-individual-and-1tnirgvoin.pdf

Socioeconomic status and injury mortality: individual and neighbourhood determinants

OBJECTIVES: This study examined the rates and predictors of mortality among sheltered homeless men and women in New York City. METHODS: Identifying data on a representative sample of shelter residents surveyed in 1987 were matched against national mortality records for 1987 through 1994. Standardized mortality ratios were computed to compare death rates among homeless people with those of the general US and New York City populations. Logistic regression analysis was used to examine predictors of mortality within the homeless sample. RESULTS: Age-adjusted death rates of homeless men and women were 4 times those of the general US population and 2 to 3 times those of the general population of New York City. Among homeless men, prior use of injectable drugs, incarceration, and chronic homelessness increased the likelihood of death. CONCLUSIONS: For homeless shelter users, chronic homelessness itself compounds the high risk of death associated with disease/disability and intravenous drug use. Interventions mus...

https://ajph.aphapublications.org/doi/pdfplus/10.2105/AJPH.89.4.529

Mortality among homeless shelter residents in New York City.

The reasons for recent declines in AIDS incidence and mortality may include advances in treatment, but these may be confounded by earlier declines in the incidence of human immunodeficiency virus (HIV) infection. To determine whether the declines in AIDS and mortality may, in part, stem from wider use of combination antiretroviral therapy, 622 HIV-positive men with well-characterized dates of seroconversion were followed. In this group, combination therapy came into widespread use in only 1996. In a Cox proportional hazards model, the 1996 calendar period was significantly associated with slower progression to AIDS (relative hazard [RH] = 0.19, 95% confidence interval [CI], 0.05-0.69, P = .01) and death (RH = 0.45, 95% Cl, 0.21-0.95, P =.04). Declines in incidence of HIV infection, changes in HIV virulence, and end-point underreporting cannot fully explain the decline in AIDS and death in 1996. The introduction of combination antiretroviral therapy as the standard of care may already have had measurable effects.

Combination Antiretroviral Therapy and Recent Declines in AIDS Incidence and Mortality

The National Death Index (NDI) is a central file of identifying information on all deaths occurring in the United States since 1979. Potential uses of the NDI as a tool for both short-term and long-term follow-up in cancer treatment, prevention, and occupational studies are suggested. The various steps involved in using the NDI and interpreting the results are described, along with factors influencing the effectiveness of the matching process.

Robert Bilgrad

Papers

Use of the National Death Index in cancer studies.

Use of the national death index in cancer studies