Dataset Information

Stroke-Related Mortality in the United States-Mexico Border Area of the United States, 1999 to 2018.

ABSTRACT: BACKGROUND The United States (US)-Mexico border is a socioeconomically underserved area. We sought to investigate whether stroke-related mortality varies between the US border and nonborder counties. METHODS AND RESULTS We used death certificates from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database to examine stroke-related mortality in border versus nonborder counties in California, Texas, New Mexico, and Arizona. We measured average annual percent changes (AAPCs) in age-adjusted mortality rates (AAMRs) per 100 000 between 1999 and 2018. Overall, AAMRs were higher for nonborder counties, older adults, men, and non-Hispanic Black adults than their counterparts. Between 1999 and 2018, AAMRs reduced from 55.8 per 100 000 to 34.4 per 100 000 in the border counties (AAPC, -2.70) and 64.5 per 100 000 to 37.6 per 100 000 in nonborder counties (AAPC, -2.92). The annual percent change in AAMR initially decreased, followed by stagnation in both border and nonborder counties since 2012. The AAPC in AAMR decreased in all 4 states; however, AAMR increased in California's border counties since 2012 (annual percent change, 3.9). The annual percent change in AAMR decreased for older adults between 1999 and 2012 for the border (-5.10) and nonborder counties (-5.01), followed by a rise in border counties and stalling in nonborder counties. Although the AAPC in AAMR decreased for both sexes, the AAPC in AAMR differed significantly for non-Hispanic White adults in border (-2.69) and nonborder counties (-2.86). The mortality decreased consistently for all other ethnicities/races in both border and nonborder counties. CONCLUSIONS Stroke-related mortality varied between the border and nonborder counties. Given the substantial public health implications, targeted interventions aimed at vulnerable populations are required to improve stroke-related outcomes in the US-Mexico border area.

SUBMITTER: Khan SU

PROVIDER: S-EPMC8403284 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BACKGROUND: Unhealthy lifestyle factors are risk factors for stroke, and they play a key role in stroke secondary prevention. A better understanding of these factors may aid with improvements in public health policy. OBJECTIVE: Our objective was to comprehensively understand the trends in unhealthy lifestyle factors in people who have previously had a stroke in the US. METHODS: Utilizing data from the biannual United States National Health and Nutrition Examination Surveys (NHANESs) between 1999 and 2018, we collated data on unhealthy lifestyle factors (smoking, alcohol drinking, depression, unhealthy diet, high BMI, physical inactivity, and sedentary behavior) in adults with a history of stroke. The Joinpoint Regression model was used to calculate the annual percentage change (APC) and average annual percentage change (AAPC) to identify trends. Logistic regression modeling was used to identify the influence of sociodemographic factors (age, sex, race/ethnicity, marital status, employment status, family income, and highest education level). RESULTS: The analysis included 2017 respondents with a history of stroke. Current alcohol drinking (39.3% (95% confidence interval: 29.8, 48.7) to 57.4% (45.7, 69.0) p = 0.008) and obesity (39.2% (28.3, 50.2) to 49.4% (38.9, 59.8) p = 0.029) increased significantly from 1999 to 2018. The prevalence of smoking and depression remained generally stable. The proportion of respondents with an unhealthy diet decreased from 1999 (44.5% (32.4, 56.5)) to 2011 (29.0% (17.5, 40.4) p = 0.019), but then returned to its original prevalence in 2018 (42.0% (31.4, 52.7)). From 2007 to 2018, the proportion of respondents who were physically inactive decreased significantly, from 70.4% (64.4, 76.3) to 55.1% (46.1, 64.2; p = 0.017). After a gradual increase in sedentary activity from 2007 to 2012, this declined from 2013 to 2018, with no statistical significance. We found stroke survivors who were widowed, divorced, separated, or unemployed were at a higher risk of having unhealthy lifestyles than those who were employed or had other marital statuses. CONCLUSIONS: A modest reduction in the prevalence of physical inactivity was observed in Americans with a history of stroke between 1999 and 2018. The prevalences of smoking, drinking, depression, poor diet, obesity, and sedentary behavior were stable or increasing.

Project description:In April 2018, the U.S. implemented a "zero-tolerance" immigration policy that would lead to the separation of more than 2,000 migrant families over the following months. By that summer, the policy and resultant family separations had generated a media storm that swept up the public. In early June, the government announced its consideration of DNA testing to aid in the detection of human trafficking in immigration contexts. Later that month, as the government retracted the child separation policy, the public began questioning how children and adults would be reunited and discussing the potential usefulness of DNA testing for those reunifications. Then in early July, the government announced that DNA testing was indeed being used, and by mid-month the public's outrage over the use of DNA was strong. We set out to examine the public dialogue on DNA testing-including misunderstandings and miscommunications-both in newspaper coverage and on Twitter in the 2-month summer period of 2018, at the height of public discussion of migrant family separations and then reunifications. We performed database searches identifying 263 newspaper articles and used Twitter's advanced search function identifying 153 Tweets containing discussion of the use of DNA for migrant family reunification. Upon the resulting sources, we performed content analysis, analyzing for slant on the immigration policy and the use of DNA tests using a combination of open and closed codes. Our analysis showed that perspectives on the use of DNA diverged in connection with perspectives on the immigration policy, and that there was a contrast among the cohorts in the stated utility of DNA testing. These findings offer insight into a) how DNA testing in a highly politicized immigration context was represented in media coverage and b) the public's understanding of the role that DNA testing could or should play in immigration. By detailing the role that comments from experts, stakeholders, and the public played in these discussions, we hope to provide lessons for communications with the public about future non-medical applications of genetic technologies.

Dataset Information

Stroke-Related Mortality in the United States-Mexico Border Area of the United States, 1999 to 2018.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets