Browsing by Author "Panas, Lawrence John"
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Item Presentation And Understanding Of Mortality Through Geospatial And Administrative Boundaries: An Examination Of Rates And Correlates Of Mortality In Texas Census TractsPanas, Lawrence John; Prochaska, John D; Eschbach, Karl; Baillargeon, Jacques GThis capstone project analyses Texas vital statistics data through visual and tabular presentation of county-level age-adjusted mortality rates for all-cause and cause-specific mortality (including heart, cancer, and stroke) and through multilevel regression analyses of deaths at the census tract level, adjusting for individual and tract and demographic and socioeconomic factors. County-level, mortality rates were developed for three racial/ethnic groups in Texas, non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. The rates were age-standardized based on the age structure of the total population of Texas. Rates are presented in tabular and visual formats using Texas Department of State Health Services Public Health Regions to allow for finer discussion of geographic areas within the state. For the tract data, deaths are analyzed using hierarchical Poisson regression model. This model used demographic factors including age, racial/ethnic category, and gender to identify correlates of deaths on the individual level. For the tract-level demographic factors (i.e. percent Hispanic (quartiles)), socioeconomic factors (percent in poverty (quartile)), and geographic identifiers (e.g. tracts in border counties and urban/rural tracts) were used to identify are-level effects that influence the number of deaths in a tract. These models used population size within each tract as a variable exposure to account for larger population areas having more deaths. The visual and tabular analyses of counties showed that non-Hispanic Blacks, overall, had the worst mortality rates of all groups across the state. Hispanics showed lower rates than non-Hispanic Blacks, overall, and non-Hispanic Whites usually had the better rates of all groups. For all groups, within regions, and across the state, there was considerable variability though non-Hispanic Blacks, again, showed the worst patterns of mortality. Hispanics varied greatly across the state, doing very poorly along the eastern border of Texas but much better in the South, along the border. From the tract analyses, Hispanics, overall, did better than non-Hispanic Whites and non-Hispanic Blacks. This was especially true in areas of higher poverty and higher Hispanic populations.Item TRENDS IN LIFE EXPECTANCY AND MORTALITY: A COMPARISON OF HISPANICS AND NON-HISPANICS IN THE SOUTHWEST UNITED STATES, 1990 TO 2010Panas, Lawrence John; Eschbach, Karl; Peek, Mary K; Hummer, Robert A; Markides, Kyriakos S; Raji, Mukaila; Kuo, Yong-FangThis project uses data from the National Vital Statistic System to study trends in rates and causes of deaths among Hispanics compared to non-Hispanics in the Southwest United States. Denominators are from the Modified Age, Race/Ethnicity, and Sex file (1990) and Bridged Race Files (2000, 2010) while numerator data are from the mortality detail files and Linked Infant Birth and Death files. The study had three specific aims: 1) estimate life expectancy for Hispanics and non-Hispanics, 2) decompose life expectancy by cause-specific mortality, and 3) develop cohort and cause-specific mortality rates from 1990 to 2010. Analyses included evaluation, adjustment and correction of classification and age-reporting for data, development and evaluation of life tables and life expectancy, decomposition analysis, and development of cohorts and related cause-specific rates of mortality. Results of the lifetable analyses showed that Hispanics had a mortality advantage over non-Hispanic Whites and Blacks from 1990 to 2010 but that the advantage was shrinking, especially compared to non-Hispanic Whites. The decomposition analyses showed that compared to non-Hispanic Whites, homicide was the primary contributor to mortality for Hispanics in 1990 but dropped to the third leading cause by 2010. Diabetes rose from the third leading cause to the highest contributor from 1990 to 2010. Alternatively, non-Hispanic Whites had higher smoking related mortality from causes including lung cancer, heart diseases, and chronic lower respiratory disease. These effects differed through time, with the effects of smoking decreasing for Whites while diabetes was largely unchanged in effect. Compared to non-Hispanic Blacks, Hispanics had lower death rates from almost all causes and maintained a sizeable mortality advantage from 1990 to 2010. The cohort mortality rates showed confirmation of the patterns of life expectancy and cause-specific mortality, with Hispanics maintaining the lowest mortality rate of all groups as the cohorts aged. Hispanics have higher rates of diabetes than Whites, White have higher rates of smoking-related mortality than Hispanics, and non-Hispanic Blacks having the highest mortality rates amongst major causes. Analysis of nativity showed less persistent and meaningful patterns across time for native- and foreign-born Hispanics.