Motor vehicle driver death and high state maximum speed limits: 1991-1993.

OBJECTIVE: To measure the association between motor vehicle crash (MVC) driver death and high state maximum speed limits. METHODS: This study used a case-control design and assessed driver deaths from three major types of MVCs: non-collision; collision with motor vehicles in transit; and collision with stationary objects. The study period was 1991-1993. For each type of crash, case subject populations of fatally injured drivers were obtained from the U.S. Department of Transportation Fatality Analysis Reporting System. Four control subject populations, each associated with a different cause of death, were obtained from a U.S. national death certificate database (the causes of death were unintentional poisoning, non-Hodgkin lymphoma, drowning, and diabetes mellitus). Subjects were considered exposed if the state in which they crashed (for cases) or died (for controls) had a maximum speed limit greater than 55 mph. Each of the three case subject populations was compared against each of the four control subject populations. Odds ratios (ORs) were adjusted for age and gender. RESULTS: For non-collision driver death, ORs ranged from 3.06 to 6.56, depending on the year and control group; all the ORs were significant. For collision with motor vehicles in transit driver death, ORs ranged from 1.12 to 2.22; all the ORs were significant. For collision with stationary objects driver death, ORs ranged from 0.87 to 1.83. CONCLUSIONS: There was a moderately strong and significant association between non-collision driver death and high state maximum speed limits. For collision with motor vehicles in transit driver death, the association was somewhat milder but still consistent. For collision with stationary objects driver death, the presence of an association was unclear. During 1991-1993, the effects of high state maximum speed limits may have been different for different types of MVCs.

A cohort study of tuberculosis and influenza mortality in the twentieth century.

We reviewed period and cohort mortality for tuberculosis and influenza and pneumonia over the twentieth century and data on the roles of influenza and tuberculosis as underlying and contributory causes of death. As would be consistent with long-term trends, each cohort had lower tuberculosis mortality but there was no decisive downturn in age specific tuberculosis mortality for any male cohort until after 1945. Tuberculosis mortality among females fell steadily from cohort to cohort as well as within each cohort. In every cohort born from around 1890 to around 1930, tuberculosis mortality was higher among women than among men at ages under 30, suggesting that prevalence in women was also higher, but death rates of females crossed under those of males at about age 30. Tuberculosis death rates rose more for males than females around 1918; however, any unusual increase that could be attributable to the 1918 influenza pandemic must have been brief. Contrary to expectations in the medical community, tuberculosis mortality did not rise following the 1918 influenza pandemic. Some portion of the rise in death rates around 1918 may have been associated with the influenza, but a comparison of the increase in male tuberculosis mortality during and after World War II, when there was no influenza pandemic, with male mortality in a similar period during and after World War I suggests that any excess in tuberculosis mortality among males in both periods may have been due to wartime mobilization rather than influenza.

Causes for discharge of military working dogs from service: 268 cases (2000-2004).

OBJECTIVE: To determine causes for discharge of military working dogs (MWDs) from service. DESIGN: Retrospective case series. ANIMALS: 268 MWDs. PROCEDURES: Records of all MWDs approved for discharge from December 2000 through November 2004 were evaluated for cause of discharge. RESULTS: 23 dogs had been obtained through the Department of Defense breeding program but had failed to meet prepurchase or certification standards. The remaining 245 (120 German Shepherd Dogs, 100 Belgian Malinois, and 25 dogs of other breeds) had been purchased as adults or obtained through the breeding program and had passed prepurchase and certification standards. Eighty-five of the 245 (34.7%) adult dogs were 1 to < 5 years old at discharge, and 160 (65.3%) were >or= 5 years old at discharge. The proportion of adult dogs < 5 years old at discharge that were German Shepherd Dogs (69.4%) was significantly greater than the proportion of adult dogs >or= 5 years old at discharge that were German Shepherd Dogs (38.1%). Within the subgroup of dogs >or= 5 years old at discharge, median age at discharge for the German Shepherd Dogs (8.59 years) was significantly less than median age at discharge for the Belgian Malinois (10.61 years). For adult dogs < 5 years old at discharge, the most common cause for discharge was behavioral problems (82.3%). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that longevity of service for MWDs may be influenced by breed differences and that selection criteria should be evaluated to reduce behavior-related discharge from service.

Rethinking the Hispanic paradox: death rates and life expectancy for US non-Hispanic White and Hispanic populations.

OBJECTIVES: We examined the "Hispanic paradox," whereby persons of Hispanic origin seemed to experience lower mortality than the non-Hispanic White population. This paradox coincided with a change from the classification of deaths and population by Spanish surname to the use of Hispanic-origin questions in the census and vital statistics. METHODS: To estimate US Hispanic and non-Hispanic White mortality, we applied a familiar relation between death rates for population subgroups to Hispanic and non-Hispanic White population death rates. We calculated age-specific death rates for the Hispanic population and the non-Hispanic White population and computed life tables for each. Result. For Texas between 1980 (surname) and 1990 (origin), the change in Hispanic deaths in persons aged 65 years or older was only half as great as the change in population size, implying a relative omission of 15% to 20% of deaths. By a different approach, the life tables for the US Hispanic and non-Hispanic White populations pointed to a similar omission. CONCLUSIONS: There is no "Hispanic paradox." The Hispanic paradox described in past research derives from inconsistencies in counts of Hispanic-origin deaths and populations.

Variation in life expectancy during the twentieth century in the United States.

The National Center for Health Statistics (NCHS) reports life expectancy at birth (LE) for each year in the United States. Censal year estimates of LE use complete life tables. From 1900 through 1947, LEs for intercensal years were interpolated from decennial life tables and annual crude death rates. Since 1948, estimates have been computed from annual life tables. A substantial drop in variation in LE occurred in the 1940s. To evaluate these methods and examine variation without artifacts of different methods, we estimated a consistent series of both annual abridged life tables and LEs from official NCHS age-specific death rates and also LEs using the interpolation method for 1900-1998. Interpolated LEs are several times as variable as life table estimates, about 2 times as variable before 1940 and about 6.5 times as variable after 1950. Estimates of LE from annual life tables are better measures than those based on the mixed methods detailed in NCHS reports. Estimates from life tables show that the impact of the 1918 influenza pandemic on LE was much smaller than indicated by official statistics. We conclude that NCHS should report official estimates of intercensal LE for 1900-1948 computed from life tables in place of the existing LEs that were computed by interpolation.