Browsing by Subject "Mortality"
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Item A Micro and Macro Analysis of Adult U.S. Mortlaity(2010-07-14) Russell, Christi N.This study utilized individual and county-level analysis to examine the impact of demographic and distal factors on individual level mortality as well as spatial and county specific attributes on county death rates. The data used in the individual level analyses come from the linked NHANES NDI data set and the county level data come from multiple sources including spatially referenced sources. Findings suggest that having private or Federal insurance attenuates the mortality discrepancy between racial groups at the individual level and that spatial factors have an impact on county death rates that are not explained by county attributes. These analyses present questions about using common indicators to measure mortality at different levels suggesting that the variables used to understand mortality on the individual level are different from those that should be used to understand mortality at the county level.Item A social demographic study of the likelihood of sustaining an occupational fatality resulting in death(2009-05-15) Traut, Rachel LynnThis thesis explores occupational fatalities to American males for the years 1998 and 1999. The focus is on predicting the likelihood that the individual will sustain an occupational injury resulting in death based on an occupational status score. Demographic variables measuring Southern residence, race, ethnicity, marital status, education and age were also included in analyses. Research questions include whether or not individuals in higher status occupations are at a decreased risk of sustaining an occupational fatality, and how the demographic variables included effect occupational fatalities. Using data from death certificates allowed me to measure the individual?s occupational status based on their ?usual occupation? and find out whether or not differences exist. The thesis involves two analyses, one with the sample comprised of only males between the ages of 25 and 55 and one including only married males between the ages of 25 and 55. Logistic regression is employed as the method of analysis to model the odds of the risk of sustaining an occupational fatality that results in death. The results of the first model found only marital status to be positively and significantly related to occupational fatalities. Black, Hispanic, South and education were found to be negatively related to occupational fatalities. The main hypothesis of this thesis was not supported, however because the regression shows that with each increase on the occupational status index, no significant increase or decrease occurred in sustaining an occupational injury that resulted in death. In the second regression that included only married males, many of the relationships no longer existed. Hispanic and the education variable both lost statistical significance. The only variables to maintain significance were black and South, which were both associated with a decreased risk of sustaining an occupational injury that resulted in death. Problems with the occupational status index as a predictor for the likelihood of sustaining an occupational fatality and restrictions of the data may be the main issue that resulted in a lack of findings.Item A cohort perspective of U.S. adult mortality(2011-05) Masters, Ryan Kelly; Hummer, Robert A.; Hayward, Mark D.; Powers, Daniel A.; Umberson, Debra J.; Krueger, Patrick M.This dissertation advances a cohort perspective to analyze trends in racial and educational disparities in U.S. adult mortality. The project is organized around three themes. First, I emphasize that recent temporal changes in U.S. adult mortality risk are rooted in cohort forces. Unfortunately, much of the mortality literature has failed to account for the fact that the sociohistorical conditions of U.S. cohorts have changed dramatically, and these changes have tremendous implications for population health and mortality trends. My work clearly shows the pitfalls of omitting these cohort effects from analyses of U.S. adult mortality risk. Second, I illustrate that because exposure to social and health conditions have changed over time, resources in adulthood are growing increasingly important in shaping U.S. adult mortality risk. In this regard, my findings also highlight growing disparities in U.S. mortality across race/ethnic gender groups. Third, I advance a cohort theory of U.S. mortality, drawing from both “fundamental cause” theory and a life course perspective of mortality but couching them in a cohort framework to highlight the importance of historical changes in U.S. social and health contexts in both childhood and adulthood. This cohort perspective is then used to analyze three central topics in the U.S. mortality literature: the black-white crossover in older-adult mortality, the growing educational gap in U.S. adult mortality, and the origins and persistence of black-white inequalities in U.S. adult mortality. I estimate hierarchical age-period-cohort cross-classified random effects models using National Health Interview Survey-Linked Mortality Files between 1986 and 2006 to simultaneously analyze age, period, and cohort patterns of U.S. adult mortality rates. I find (1) the black-white crossover is a cohort-specific phenomenon, (2) educational disparities in U.S. adult mortality rates are growing across birth cohorts, not time periods, and (3) racial disparities in U.S. adult mortality rates stem from cumulative racial stratification across both cohorts and the life course. Such findings have direct consequences for both mortality theories and policy recommendations. Only by considering the disparate sociohistorical conditions that U.S. cohorts have endured across their life courses can we fully understand and address current and future health disparities in the United States.Item Educational differentials in U.S. adult mortality : trends and causes(2014-12) Sasson, Isaac; Weinreb, Alexander; Hayward, Mark D; Hummer, Robert A; Powers, Daniel A; Tuljapurkar, Shripad; Umberson, Debra JAs life expectancy at birth in the United States approaches eighty years of age, educational differentials in adult mortality are greater than ever. One of the key sociological insights of our time is that these two processes are fundamentally interrelated. As society gains greater social capacity to control health and disease socioeconomic status (SES) becomes increasingly important for shaping healthy social environments and lifestyles, which reduce the risk of mortality. Of all SES indicators, educational attainment is perhaps the single most important predictor of mortality in the United States. Not only do low-educated Americans have shorter lifespans compared to their college-educated counterparts, on average, but they have recently suffered absolute declines in life expectancy. However, debates surrounding the extent, causes, and even validity of those trends continue. This dissertation makes several unique contributions to our understanding of lifespan inequality by educational attainment in the United States. First, using vital statistics data, it documents trends in life expectancy and lifespan variation—a unique dimension of lifespan inequality—by educational attainment for black and white Americans of both genders from 1990 to 2010. Second, it decomposes those trends by age and cause of death in order to understand the proximate causes of the educational disparity in adult mortality. Third, it evaluates the extent to which changes in the composition of education groups account for the rising education-mortality gradient. The findings reveal that the gap in life expectancy at age 25 between the low educated (having fewer than twelve years of schooling) and the college educated has doubled among men and more than tripled among women over the study period; that life expectancy declined among low-educated white men and women (by 0.6 and 3.1 years, respectively); and that much of these trends is attributed to an increase in premature deaths from smoking-related diseases and external causes. While both sides of the selection-causation debate have merit, changes in group composition do not fully account for the increase in mortality among low-educated Americans, for whom economic circumstances have worsened. Overall, the association between educational attainment and adult mortality is pervasive, enduring, and increasing in magnitude.Item Gender differences in the life course origins of adult functioning and mortality(2011-08) Montez, Jennifer Karas; Hayward, Mark D.; Hummer, Robert A.; Umberson, Debra J.; Pudrovska, Tetyana; Osborne, CynthiaA high degree of physical functioning is necessary for independently performing the numerous routine and valued tasks of daily life. Poor functioning not only hinders independent living, it can lower the quality of life, impede full social participation, and elevate the risk of death. However, not all adults are at equal risk of poor functioning: women experience worse functioning and live a greater number of years functionally impaired compared with men. Studies of this gap have focused on inequities in adult circumstances, such as socioeconomic status, but have generally fallen short of fully accounting for it. Recasting this research within a life-course, epidemiological framework points to the potential role of early-life circumstances. Early-life circumstances may impart a biological imprint, and they may also launch long-term trajectories of social circumstances, that could differentially shape functioning for men and women. Thus, this dissertation examines the life course origins of the gender gap in functioning and active life expectancy among older U.S. adults using two nationally-representative datasets: the National Survey of Midlife Development in the United States and the Health and Retirement Study. In sum, the findings reveal that: (a) a host of early-life circumstances, such as parents’ education levels, leave an indelible stamp on functional ability and active life expectancy for women and men, irrespective of adult circumstances, (b) while some early-life adversities, such as extreme poverty, were marginally more consequential for women’s than men’s functioning, they appear to be primarily more consequential for precipitating metabolic conditions such as diabetes and obesity rather than directly impacting functioning, (c) explanations of the gap must incorporate endogenous biological differences between men and women; explanations that focus exclusively on socially-structured inequities are insufficient, and (d) exposures to socioeconomic resources accumulate across the life course to shape functioning differently for men than women; particularly between white men, who enjoy better functioning with higher educational attainment irrespective of early-life socioeconomic exposures, and white women whose functioning gains plateau if they experienced early-life socioeconomic adversities. Overall, the results underscore the importance of a life course perspective in explicating gender disparities in functioning, longevity, and active life expectancy.Item Global change : projecting expansion of invasive species and climate change impacts at the tree-tundra ecotone in the Himalaya(2014-08) Mainali, Kumar Prasad; Parmesan, Camille, 1961-; Singer, Micheal; White, Joseph; Young, Kenneth; Simpson, BerylModeling the distribution of species, especially of invasive species in non-native ranges, has multiple challenges. We develop some novel approaches to species distribution modeling aimed at reducing the influences of these challenges and improve realism of projections. We estimated species-environment relationship with four modeling methods, viz., random forest (RF), boosted regression trees (BRT), generalized linear models (GLM), and generalized additive models (GAM), running each of them with multiple scenarios of (1) sources of occurrences and geographically isolated background ranges, (2) approaches of drawing background points, (3) alternate sets of predictor variables. When a species' distribution is in a non-equilibrium state, as is the case for most invasive species, model projections are very sensitive to the choice of training dataset. Contrary to previous studies, we found that model accuracy is much improved by using a global dataset for model training (both presences and background points from the world), rather than restricting data input to the species' native range. Projections outside the training region, especially in invaded regions, can be very different depending on the modeling method used. Globally projecting, we show that vast stretches of currently uninvaded geographic spaces in multiple continents harbor highly suitable habitats for Parthenium. Projections away from the sampled space (i.e. into areas of potential future invasion), can be very different with different modeling methods, raising questions about the reliability of ensemble projection. Data-driven models that efficiently fit the dominant pattern but exclude highly local features in dataset and model interactions as they appear in data (e.g., boosted regression trees) improve generalization of the species distribution modeling. Alpine treelines are responding to current climate change worldwide. To understand tree line dynamics and its potential drivers, we studied the primary two dominant tree species, Abies spectabilis (AS) and Rhododendron campanulatum (RC), on the north facing slope of two mountains in central Nepal. We determined spatial pattern of regeneration potential, mortality and abundance for various size/age classes, and we identified the most important drivers of such patterns. We also conducted a reciprocal transplant experiment on saplings of RC, moving them between species limit and treeline that were spaced apart by 150m. Young plants (<2m tall) of RC have higher density above treeline than below treeline. Mature plants (>2m tall) of RC, on the contrary, show insignificant trend towards higher density below treeline than above. Mortality of RC was always lower above treeline than below, independent of size class. AS saplings have extremely lower density above treeline than below, with mature plants being virtually absent above treeline. Elevation was identified as the only significant predictor of the decrease in density of both species above treeline. The saplings are progressively younger and shorter with distance above treeline. Both species are regenerating faster above treeline than below. These results are consistent with upward shift of the tree line of RC as a result of recent amelioration of temperature. Climatic extremes during spring affect mortality and leaf size whereas growth is affected by summer climate. Individuals from the species limit, if they survive, perform better when moved downhill than they do at home, and also out-perform the locals. Although the upper elevational boundary of RC is shifting upward, these results indicate that strong differences still exist between individuals across a short elevational gradient, with individuals at the extreme limit of the species range being more tolerant to extreme climate conditions but less tolerant of competition compared to individuals only 150m lower in elevation.Item Hazard Analysis of Mortality Among Twins and Triplets in the United States: From 20 Weeks Gestation Through the First Year of Life(2011-08-08) DeSalvo, Bethany S.Infant mortality is viewed as an important indicator of the health and social conditions of a population. However, the infant mortality rate in the United States is estimated to be much lower than those of other developed nations. This dissertation analyzes the hazard of fetal and infant death for twins and triplets in the United States between the years of 1995 and 2000. This dissertation had two main objectives: first, to examine the effects of the birthweight and gestational age on the hazards of fetal, neonatal, postneonatal, and infant death; and second, to better understand the timing of mortality among multiples during their early life. I show that after controlling for relevant characteristics of the mother and child, gestational age and birthweight significantly influence the hazard of mortality for twins and triplets. The major finding in this dissertation shows that there is a higher hazard for twins than triplets. The unexpected higher hazard of mortality for twins compared to triplets may well be due to the social and demographic characteristics of parents of twins and triplets, particularly the possible use of Assisted Reproductive Technologies.Item HIV/AIDS Mortality Differential Across Provinces in Kenya and Through Time(Texas Tech University, 2004-12) Adari, Johnson Samuel; Rahnama, MashaHIV/AIDS mortality differential across provinces in Kenya and through time.Item The household production of men's and women's health in the United States(2013-08) Brown, Dustin Chad; Hayward, Mark D.; Hummer, Robert A.The inverse association between individuals' own education and adverse health outcomes is well established, but the influence of other people's education -- particularly those with close social ties or who are family members -- and adult health outcomes is not. The material and non-material resources available to individuals via their own education likely are shared within a marriage to become resources at the household or family-level. Research on spousal education and adult health outcomes is sparse -- especially in the United States. Therefore, this dissertation examines how husbands and wives' education combine within marriage to influence each other's self-rated health and annual risk of death in the United States. The analyses utilize two nationally representative data sources: the National Health Interview Survey (NHIS) and the National Health Interview Survey Linked Mortality File (NHIS-LMF). Chapter Two establishes an inverse association between spousal education and poor/fair self-rated health among married adults in the United States. The results also showed that spousal education attenuated the association between one's own education and fair/poor self-rated health more for married women than married men and age-specific analyses revealed that these differences were largest among married persons ages 45-64. Chapter Three reveals that individuals' own education and their spouse's education each share an inverse association with the annual risk of death among married adults. Although this association generally does not vary by gender, spousal education apparently is a more important determinant of all-cause mortality risk among married non-Hispanic whites in comparison to married non-Hispanic blacks. Age-specific analyses also suggest that the influence of own and spousal education on adult mortality risk weakened with increasing age. Chapter Four assesses life expectancy differentials between men and women in different marital status groups at different points in the educational distribution. The results imply that spousal education substantially contributes to life expectancy disparities between married and unmarried persons. The results also imply that focusing only on the relationship between married persons' own education and life expectancy masks substantial heterogeneity within educational groups attributable to spousal education. Overall, the findings strongly suggest that education is a shared or household health resource among husbands and wives.Item The impact of Medicare Part D coverage on medication adherence and health outcomes in end-stage renal disease (ESRD) patients(2013-05) Park, Haesuk; Rascati, Karen L.The purpose of this study was to investigate the impact of Medicare Part D coverage on medication adherence and health outcomes in dialysis patients. A retrospective analysis (2006-2010) using the United States Renal Data System was conducted for Medicare-eligible dialysis patients. Cardiovascular disease morbidity, healthcare utilization and expenditures, medication adherence, and mortality rates were compared, categorized based on patients’ Part D coverage in 2007 for those who: 1) did not reach the coverage gap (cohort 1); 2) reached the coverage gap but not catastrophic coverage (cohort 2); 3) reached catastrophic coverage (cohort 3); and 4) did not reach the coverage gap but received a low-income subsidy (cohort 4). Cox proportional hazards models, Kaplan-Meier methods, logistic regressions, generalized linear models, and generalized estimating equations were used. A total of 11,732 patients were included as meeting inclusion criteria: 1) cohort 1: 3,678 patients had out-of-pocket drug costs <$799; 2) cohort 2: 4,349 patients had out-of-pocket drug costs between $799 and $3,850; 3) cohort 3: 1,310 patients had out-of-pocket drug costs > $3,850; and 4) cohort 4: the remaining 2,395 patients had out-of-pocket drug costs <$799 but received a low-income subsidy. After adjusting for demographic and clinical factors, patients in cohort 2 and cohort 3 had 42 percent and 36 percent increased risk of cardiovascular disease (odds ratio (OR)=1.42, 95% confidence interval (CI):1.20-1.67; OR=1.38, 95% CI:1.10-1.72); and had 36 percent and 37 percent higher death rates compared to those in cohort 4, respectively (hazard ratio (HR)=1.36, 95% CI:1.27-1.44; HR=1.37, 95% CI:1.27-1.48). Patients in cohort 2 were more likely to be nonadherent to medications for diabetes (OR=1.72, 95% CI:1.48-1.99), hypertension (OR=1.69, 95% CI:1.54-1.85), hyperlipidemia (OR=2.01, 95% CI:1.76-2.29), hyperphosphatemia (OR=1.74, 95% CI:1.55-1.95), and hyperparathyroidism (OR=2.08, 95% CI:1.66-2.60) after reaching the coverage gap. These patients had total health care costs that were $2,644 higher due to increased rates of hospitalization and outpatient visits, despite $2,419 lower pharmacy costs compared to patients in cohort 4 after controlling for covariates (p<0.0001). Reaching the Part D coverage gap was associated with decreased medication adherence and unfavorable clinical and economic outcomes in dialysis patients.Item Interactions among Silvicultural Intensity, Genotype, and Environment and Their Effects on the Growth and Mortality of Loblolly Pine and Slash Pine Families(2013-08-13) Zhai, LuManaged pine forests are central to the economic vitality of the southeastern US. Over the past fifty years, the productivity of managed pine forests of this region have increased significantly with the development of new silvicultural technologies and the use of improved tree genetic material. Of the pine species present in the southeastern US, loblolly pine has arguably been the most intensively studied and widely planted by forest managers. Efficient operational deployment of improved genetic materials requires an understanding of how possible site conditions and silvicultural treatment may interact to affect maximum yield. There are a wide range of site conditions in the south as the result of regional climate gradients, soil type and soil drainage patterns. On the western edge of loblolly pine?s natural extent, Texas has a drier climate than areas to the east, and in Louisiana, there are also poorly drained Ultisols that are found in areas with little relief and are prone to flooding. However, on the basis of 10-year forest inventory data of pure-family plots from three different sites and under two levels of cultural regime intensity, my study found that superior genotype, Lob 5 from South Carolina, still showed best performance in the Western Gulf area, and high intensive treatment could improve stand growth and resistance to wind damage significantly. Further, my study compared the stand production and dynamics between pure- and mixed-family plots. I found that Lob 5 and Lob 4 showed the growth traits of competitive ideotype, and low intensive treatment increased the deployment effect significantly for competitive ideotype. Finally, my study examined leaf area index (LAI) and foliar nitrogen concentration (foliar N). The result showed that fast growing genotype had lower LAI and foliar N than slow growing one. It indicated that fast growing genotype had high resource use efficiency and nutrient requirement. This research provided critical information to guide industrial forest management in the WG (Western Gulf) area. First, introduced superior genotype continued to show good performance in this area. Second, combination of good genotype and high intensive treatment would increase plantation production significantly. Third, identification of ideotype would increase the accuracy of growth potential estimation in progeny test.Item Investigation into Possible Factors Affecting the Recruitment of Rocky Mountain Elk on the Valles Caldera National Preserve(2013-05) Bernal, Lance; Gipson, Philip S.; Wallace, Mark C.; Parmenter, Robert R.; Liley, StewartThe Valles Caldera National Preserve (VCNP) is a relatively new public land holding located in the Jemez Mountains in north-central New Mexico. For the past decade, low calf:cow ratios of elk (Cervus elaphus) have been recorded on the VCNP prompting concern by both the Valles Caldera Trust, the managing body for the VCNP, and the New Mexico Department of Game and Fish (NMDGF) managers who are responsible for ensuring a sustainable elk population. These studies were done to look at possible factors that may be contributing to the low recruitment of elk on the VCNP as well as simulate how the population may respond to different management actions. A serological survey was conducted on hunter-harvested elk from the VCNP during the 2010 and 2011 fall hunting seasons. We tested 119 (2010, n =74; 2011, n = 45) for brucellosis, bovine viral diarrhea virus (BVDV), infectious bovine rhinotracheitis (IBR), bluetongue (BT), epizootic hemorrhagic disease (EHD), parainfluenza-3 (PI-3) and 5 serovars of Leptospirosis. Exposure rates were highest for PI-3 (34.5%) and IBR (10.1%) for total samples. Exposure for BVDV was found in 2.5% of the total samples. Exposure to EHD and BT was in 1.7% and 0.8% of the total samples. Exposure to the Leptospirosis serovars hardjo (n=2) and canicola (n=1) were found in the samples tested. All samples tested negative for brucellosis. The low to medium positive exposure to all the diseases except brucellosis indicate these diseases are present within the VCNP elk population but are not likely causing the low recruitment rates. A secondary study was done to address the hypothesis that the observed low calf:cow ratios on the VCNP may be the result of low calf survival rates. To determine cause-specific mortality and estimate survival, we radio marked elk calves (n =140) born within the VCNP from 2009-2011. Two approaches were done to estimate 14 day survival, overall summer survival (t = 13 weeks), and annual survival. First, biological covariates were used to model survival for 14 day post capture and weekly summer survival for all calves. This was done in order to compare survival estimates to other studies experiencing low calf:cow ratios in the western United States. Then, the data were re-analyzed by censoring calves (n = 9) which died the day after tagging. This provided a more conservative survival estimate reduced possible biases due to handling calves and its potential effect on survival. Fourteen day survival was 0.57 (SE = 0.05, 95%CI: 0.48-0.66) when using uncensored data; survival was 0.64 (SE = 0.05, 95%CI 0.54-0.72) using censored data. Summer survival was estimated to be 0.37 (SE = 0.05, 95%CI 0.28-0.47) using uncensored data; summer survival was estimated 0.43 (SE = 0.05, 95%CI: 0.33-0.53) using censored data. Fall/winter survival (mid-August-April) ranged from 0.76-0.95 based on study year. Annual survival ranged from 0.32-0.55 with a mean of 0.42 using uncensored data; annual survival ranged from 0.32-0.59 with a mean of 0.46 using censored data. Predation accounted for 94.8% of the known deaths. Black bears (Ursus americanus) were the highest source of predation (47.3%, n = 26) and overall mortality (40.6%). Coyotes (Canis latrans) were the second highest source of predation (41.8%, n = 23) and overall mortality (35.9%). The results using both uncensored and censored data are comparable to other studies which were experiencing low calf:cow ratios. Therefore predation of elk calves is likely additive and causing suppressed recruitment rates in the elk population on the VCNP. However, it is highly recommended to estimate the large predator population prior to any large predator management to ensure the population of large predators is not reduced to a level from which they cannot recover. For the third part of this study the overall objective was to incorporate data that were available into the population simulation program POP-II, to model current population trends based the current data and then run simulated population trends based on possible management decisions. Data that were used included: summer survey data which used distance sampling to estimate population size and herd ratios; fall harvest numbers for adult male and adult female elk; and estimated summer survival rates of elk calves born on the VCNP. Models were developed based on current preseason mortality of neonatal elk with a reduction in harvest of adult males and females by 10%, both separately and collectively. Current harvest numbers were maintained while preseason mortality of neonates was reduced by 25% and 50%. Comparisons of the model output were then made for both the reduction of preseason mortality along with a reduction in harvests. Models showed that decreasing preseason mortality while maintaining current harvest rates would either stabilize or begin a positive increase in the population trend. The models also showed that making a 10% sex-specific (males only or females only) harvest reduction while maintaining current preseason mortality would maintain the current population trend. Making a 10% harvest reduction of either sexes or both sexes along with a reduction in preseason mortality should lead to positive population trends. The results of this study might be used to help guide adaptive management decisions regarding population trends of the elk herd in the Valles Caldera National Preserve.Item Racial and ethnic inequality in adult survival in the United States(2013-08) Lariscy, Joseph Tyler, 1984-; Hummer, Robert A.While all racial/ethnic groups in the U.S. exhibited an increase in longevity during the twentieth century, inequalities in survival remain. Hispanics have the highest life expectancy at birth in the United States, non-Hispanic blacks have the lowest, and non-Hispanic whites exhibit life expectancy between the two minority groups. An overarching objective of Healthy People 2020 is to "achieve health equity, eliminate disparities, and improve the health of all groups." Yet, a similar objective based on the Healthy People 2010 campaign regarding reduction of health inequalities was clearly not met. As the population of the United States becomes increasingly diverse as a result of immigration, intermarriage, and evolving notions regarding race and ethnicity, health demographers must monitor adult survival outcomes and inequalities across racial and ethnic subpopulations. This dissertation examines current inequalities in survival among Hispanic, non-Hispanic black, and non-Hispanic white adults in the United States. Using the 1989-2006 National Health Interview Survey Linked Mortality Files and 2010 U.S. National Vital Statistics System, I contribute to the understanding of racial/ethnic survival disparities through three empirical studies: The first chapter affirms that Hispanic mortality rate and life expectancy estimates are favorable relative to blacks and whites, particularly for foreign-born Hispanics and from smoking-related causes. The second chapter shows that, in addition to their higher mean age at death, Hispanics exhibit less variability around that mean relative to non-Hispanic whites. Non-Hispanic blacks, on the other hand, have greater variability and lower life expectancy than the other two racial/ethnic groups. The lower variability among Hispanics relative to whites is largely attributable to lower incidence in cancer, suicide, and other external cause mortality, whereas the greater variability among blacks relative to whites is mainly due to greater dispersion in age at death from heart disease and the residual cause grouping. The third chapter finds that smoking initiation in childhood or adolescence contributes additional mortality risk for current heavy and light smokers relative to never smokers. Lower smoking prevalence and later initiation among foreign-born and U.S-born Hispanics account for much of their lower mortality risk relative to whites.Item The relationship between adult mortality and educational attainment in Argentina(2014-08) Manzelli, Hernan Martin; Hummer, Robert A.The study of the relationship between socioeconomic characteristics and mortality patterns has been a traditional research focus in demography, representing one of the core areas of the discipline. In Latin America, there is an important set of studies that show a significant inverse relationship between socioeconomic status and mortality rates. However, mainly due to limitations in the available data, we know very little about the specific relation between educational attainment and adult mortality. This inverse relationship between educational attainment and mortality rates provides just the tip of the iceberg for a large set of questions: How wide are educational differences in overall adult mortality in Argentina? Does the association between educational attainment and adult mortality vary by age group, gender and region? Are there unique adult mortality patterns by education among specific causes of death? Has the adult mortality differential by education attainment widened or narrowed as education attainment increased between 1991 and 2010? The main objective of this research was to describe and analyze the relationship between educational attainment and adult mortality patterns during the 1991-2010 period in Argentina. The data used in this study come from the Argentinian Mortality Files for the period 1991-2010 and from the 1991, 2001 and 2010 Argentinian Censuses. Results show a clear gradient in the specific mortality rates according to educational groups, for both sexes and for all age groups. The existence and direction of this relationship was as expected; however, the magnitude of educational differences was much higher than what has been found in other countries. The data also exhibited a clear declining trend in mortality inequalities by education as age increased. Educational differences in overall adult mortality did not display an increasing pattern over time. The year 2001, which was characterized by serious economic and social crisis in the country, displayed the highest educational inequalities in mortality in comparison to either 1991 or 2010. The findings of this dissertation are relevant to policy questions about health care and social inequalities in death.Item The social consequences of the fall of Communism : a sociological analysis of the health crisis in Eastern Europe(2013-05) Minagawa, Yuka; Hummer, Robert A.Sociological interest in the relationship between the social structure and health began with the classic work of Durkheim, who first identified socially constructed patterns of suicide rates in Western European countries. Drawing on this structural tradition, a large literature has investigated how health is influenced and shaped by societal factors. Despite a great deal of research on the social causation of health, however, the potentially adverse effects of social structures have been rarely studied. If people's health is linked to broader social conditions, then it follows that health is also subject to societal disruption, especially in the wake of the breakdown or failure of the existing social structure. This dissertation advances our understanding of the relationship between the social structure and health at the population level, focusing on post-communist Eastern Europe as a case study. There are three interrelated goals in this dissertation: first, to elucidate differences in health and mortality outcomes between East Central Europe and the former Soviet Union; second, to numerically substantiate the association between drastic social change and the risk of death due to suicide; and third, to reveal the structural factors related to overall population health status in Eastern Europe. Using aggregate-level data for Eastern European countries for the post-communist period, I find that (1) there are growing inequalities in life expectancy and infant mortality between East Central Europe and the former Soviet Union, and mechanisms associated with disparities vary by gender and age; (2) consistent with Durkheim's theory of suicide, drastic structural change is related to increased suicide death rates for the period immediately after the collapse of communism; and (3) the malfunctioning of the social structure is inversely associated with the health status of populations. Taken together, fully understanding the health consequences of communism's fall in Eastern Europe requires research that looks beyond individual-level risk factors to incorporate the broader characteristics of the social structure in which populations are embedded.Item The over-winter ecology of lesser prairie-chickens (Tympanuchus pallidicinctus) in the northeast Texas Panhandle(2010-12) Kukal, Curtis A.; Ballard, Warren B.; Wallace, Mark C.; Butler, Matthew J.; Gipson, Philip S.; Whitlaw, Heather A.; Fish, Ernest B.Since the 1800s, lesser prairie-chicken (Tympanuchus pallidicinctus; LPC) populations have exhibited range-wide declines. Most aspects of the LPC?s over-winter ecology are poorly understood across the species? range, but especially in the northeast Texas Panhandle. We investigated space-use, habitat selection, and survival patterns for over-wintering LPCs between 1 September 2008 and 28 February 2010. We captured and monitored 41 LPCs (34 males and 7 hens) from 8 leks during the course of the study. We collected 1,229 locations from 19 LPCs during the over-winter of 2008?2009, and 1,984 locations from 29 LPCs during the over-winter of 2009?2010. We observed that ?98% of LPC locations were within 5.0 km of their leks-of-capture and ?98% were within 2.4 km of a known lek. We did not observe LPCs utilizing agricultural fields, possibly because most agriculture near leks was dominated by wheat (Triticum aestivum). Both genders consistently selected grassland landcover over shrubland landcover types. Our results underscore the need to conserve grassland landcover for over-wintering LPCs. We agree with previous management recommendations that rangelands within 5.0 km should be managed for over-wintering LPCs, but we further recommend prioritizing rangeland within 2.4 km of all the leks in an area. We found that cause-specific mortality rates were equally attributable to mammalian (M = 0.133, SE = 0.056) and avian (M = 0.198, SE = 0.063) predators. We evaluated 22 competing survival models using the second-order Akaike?s Information Criterion (AICc). Model selection indicated that mean patch size of shinnery oak (Quercus havardii) rangelands best explained over-winter survival. However, limited sample size likely contributed to uncertainty in our models. Our results suggested that managing for large, contiguous patches of shinnery oak could be counter-productive for LPC over-winter survival.Item Will our final years be golden? Mortality by Alzheimer's disease in the United States(Texas A&M University, 2007-09-17) Davis, Mary AnnAlzheimer'????????s disease (AD) is the fifth leading cause of death among the elderly. This study uses National Center for Health Statistics (NCHS) Multiple Cause of Death data for the United States for the years 1998 to 2002, examining the 9.5 million death records of all decedents of age 60 and over, and determines their incidence of AD. Seven independent variables are used: age, sex, race, ethnicity, marital status, education level and whether or not they lived in a metropolitan area. This study uses logistic regression, modeling five nested models, to determine the likelihood of mortality by AD and the direction of the relationship between AD and each of the variables. A Bayesian analysis, used to determine the best fit model, found that the full model was the best fit. The major findings of the study are that the incidence of AD increases significantly with increasing age in decedents aged 60-90. However, this peaks for decedents aged 85-89. Those who survive past age 90 begin to have a lesser likelihood of mortality by AD. With the exceptions of marital status and education, the hypotheses were supported. Females are more likely to die of AD than males. NonHispanic Whites are more likely to die of AD than Hispanics and NonHispanic Blacks. There is an increased risk of dying in a nursing home if one dies of AD. Future research as outlined above is needed to learn further about this fifth leading cause of mortality of those over age 60.