This document discusses a study on trends in county mortality rates and disparities in the United States. It summarizes the following key points:
- In the 1980s, a "reversal of fortunes" occurred where some vulnerable populations experienced stagnating or worsening life expectancy while the best off saw continued improvements.
- This was primarily due to slowing declines in cardiovascular mortality coupled with rises in other chronic diseases for both sexes, and HIV/AIDS and homicide for men.
- Income levels, sociodemographic factors, data accuracy, and cause of death coding may have influenced the disparities.
- A comprehensive intervention plan based on health behavior change theories like the Transtheoretical Model or Prec
National Institute on AgingNational Institutes of HealthU..docxvannagoforth
National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services
Global Health and Aging
2 Global Health and AgingPhoto credits front cover, left to right (Dreamstime.com): Djembe; Sergey Galushko; Laurin Rinder; Indianeye;
Magomed Magomedagaev; and Antonella865.
3
Preface
Overview
Humanity’s Aging
Living Longer
New Disease Patterns
Longer Lives and Disability
New Data on Aging and Health
Assessing the Cost of Aging and Health Care
Health and Work
Changing Role of the Family
Suggested Resources
Contents
Rose Maria Li
1
2
4
6
9
12
16
18
20
22
25
4 Global Health and Aging
5
Preface
The world is facing a situation without precedent: We soon will have more older people than
children and more people at extreme old age than ever before. As both the proportion of older
people and the length of life increase throughout the world, key questions arise. Will population
aging be accompanied by a longer period of good health, a sustained sense of well-being, and
extended periods of social engagement and productivity, or will it be associated with more illness,
disability, and dependency? How will aging affect health care and social costs? Are these futures
inevitable, or can we act to establish a physical and social infrastructure that might foster better
health and wellbeing in older age? How will population aging play out differently for low-income
countries that will age faster than their counterparts have, but before they become industrialized
and wealthy?
This brief report attempts to address some of these questions. Above all, it emphasizes the central
role that health will play moving forward. A better understanding of the changing relationship
between health with age is crucial if we are to create a future that takes full advantage of the
powerful resource inherent in older populations. To do so, nations must develop appropriate
data systems and research capacity to monitor and understand these patterns and relationships,
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well-being. And research needs to be better coordinated if we are to discover the most cost-effective
ways to maintain healthful life styles and everyday functioning in countries at different stages of
economic development and with varying resources. Global efforts are required to understand and
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existing knowledge about the prevention and treatment of heart disease, stroke, diabetes, and
cancer.
Managing population aging also requires building needed infrastructure and institutions as soon as
possible. The longer we delay, the more costly and less effective the solutions are likely to be.
Population aging is a powerful and transforming demographic force. We are only just beginning
to comprehend its impact ...
CDC Health Disparities and Inequalities Report — United StatMaximaSheffield592
CDC Health Disparities and Inequalities Report —
United States, 2013
Supplement / Vol. 62 / No. 3 November 22, 2013
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
Morbidity and Mortality Weekly Report
Supplement
The MMWR series of publications is published by the Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC),
U.S. Department of Health and Human Services, Atlanta, GA 30333.
Suggested Citation: Centers for Disease Control and Prevention. [Title]. MMWR 2013;62(Suppl 3):[inclusive page numbers].
Centers for Disease Control and Prevention
Thomas R. Frieden, MD, MPH, Director
Harold W. Jaffe, MD, MA, Associate Director for Science
Joanne Cono, MD, ScM, Acting Director, Office of Science Quality
Chesley L. Richards, MD, MPH, Deputy Director for Public Health Scientific Services
MMWR Editorial and Production Staff
Ronald L. Moolenaar, MD, MPH, Editor, MMWR Series
Christine G. Casey, MD, Deputy Editor, MMWR Series
Teresa F. Rutledge, Managing Editor, MMWR Series
David C. Johnson, Lead Technical Writer-Editor
Jeffrey D. Sokolow, MA, Catherine B. Lansdowne, MS,
Denise Williams, MBA, Project Editors
Martha F. Boyd, Lead Visual Information Specialist
Maureen A. Leahy, Julia C. Martinroe,
Stephen R. Spriggs, Terraye M. Starr
Visual Information Specialists
Quang M. Doan, MBA, Phyllis H. King
Information Technology Specialists
MMWR Editorial Board
William L. Roper, MD, MPH, Chapel Hill, NC, Chairman
Matthew L. Boulton, MD, MPH, Ann Arbor, MI
Virginia A. Caine, MD, Indianapolis, IN
Barbara A. Ellis, PhD, MS, Atlanta, GA
Jonathan E. Fielding, MD, MPH, MBA, Los Angeles, CA
David W. Fleming, MD, Seattle, WA
William E. Halperin, MD, DrPH, MPH, Newark, NJ
King K. Holmes, MD, PhD, Seattle, WA
Timothy F. Jones, MD, Nashville, TN
Rima F. Khabbaz, MD, Atlanta, GA
Dennis G. Maki, MD, Madison, WI
Patricia Quinlisk, MD, MPH, Des Moines, IA
Patrick L. Remington, MD, MPH, Madison, WI
William Schaffner, MD, Nashville, TN
Asthma Attacks Among Persons with Current Asthma —
United States, 2001–2010 .......................................................................... 93
Diabetes — United States, 2006 and 2010 ............................................ 99
Health-Related Quality of Life — United States, 2006 and 2010 .... 105
HIV Infection — United States, 2008 and 2010 .................................. 112
Obesity — United States, 1999–2010 .................................................... 120
Periodontitis Among Adults Aged ≥30 Years —
United States, 2009–2010 ........................................................................ 129
Preterm Births — United States, 2006 and 2010 ............................... 136
Potentially Preventable Hospitalizations — United States,
2001–2009 .................................................................................................... 139
Prevalence of Hypertension and Contr ...
INTRODUCTION
Elderly population is increasing in all countries of the world. This is due to several factors which include decline in fertility, improvement in public health and increase in life expectancy. Decline in fertility was brought about by more wide spread acceptability of family planning while increase in life expectancy is attributed to improved medical care brought about by technological advancement. According to a published U.S Bureau Bulletin of the Census and Database on Ageing in 1988, the world’s total population is growing at a rate of 1.7 percent per year.
REMOTEAREAMEDICALCan disparities be deadlyControv.docxaudeleypearl
REMOTE
AREA
MEDICAL
Can disparities be deadly?
Controversial research explores whether living in an
unequal society can make people sick
B y E m i l y U n d e r w o o d
W
hitehall street, just south of Tra
falgar Square in central London,
is the heartbeat of the British
government. Generations of
workers in the highly strati
fied British Civil Service have
marched to work each day in the govern
ment offices lining the road, with top
bureaucrats working and living in pala
tial brick mansions built for aristocrats.
Over the years, the denizens of Whitehall
have fallen prey to the ills of the modern
world: Their arteries have filled with fatty
plaque; their blood sugar has spiked from
diabetes; their lungs have been damaged
by emphysema. And with surprising and
troubling frequency, lower ranked workers
have died earlier from these ailments than
have their superiors.
To find out why, thousands of these civil
servants, from typists to top officials, have
gone to nearby medical clinics to have
blood drawn, fill out questionnaires about
how much they exercise and smoke, and
don scratchy paper gowns for physical ex
ams. Last year marked the 11th wave of
data from this ambitious study, which has
run for roughly 40 years and sparked an
entire research program on the contentious
question of whether being low-ranked can
make you sick.
Deaths by rank at Whitehall
Relative rate of death over 25 years
2.0
Top officials Executive Clerical Other
■ Adjusted for age ■ Adjusted for other
risk factors
Source: Marmot, 2000
HEALTHY AT THE TOP. In the long-running Whitehall
studies, civil servants at every occupational grade
live longer than their Inferiors.
All agree that compared with the wealthy,
poor people are less healthy. A child born in
Norway can expect to live roughly 30 years
longer than one born in Afghanistan. In
the United States, on average, people in the
highest income group can expect to outlive
those in the lowest income group by more
than 6 years. Preventable illnesses caused
by poor nutrition and lack of education
and care account for much of the dispar
ity. Investing in health care and making
it widely available can boost the health of
those at the bottom. Redistributing wealth
to the lower end of the curve helps, too. One
simulation by researchers at the University
of Otago, Wellington, for example, showed
that shifting New Zealanders’ incomes to
ward the mean income by 10% would save
about 1100 lives per year.
But epidemiologist Michael Marmot of
University College London (UCL), who
leads the Whitehall study, argues that
there’s more to health than money alone.
On the basis of his own and other studies,
Marmot argues that hierarchy itself is a
threat to health, with low-ranking individu
als getting sicker and dying younger than
higher-ups in part because of the sheer
stress of being low on the social ladder.
Some public health experts say their own
studies bear out ...
However, addictions are hard to treat and pain is hard to control, so those currently in midlife may be a “lost generation” (36) whose future is less bright than those who preceded them.
National Institute on AgingNational Institutes of HealthU..docxvannagoforth
National Institute on Aging
National Institutes of Health
U.S. Department of Health and Human Services
Global Health and Aging
2 Global Health and AgingPhoto credits front cover, left to right (Dreamstime.com): Djembe; Sergey Galushko; Laurin Rinder; Indianeye;
Magomed Magomedagaev; and Antonella865.
3
Preface
Overview
Humanity’s Aging
Living Longer
New Disease Patterns
Longer Lives and Disability
New Data on Aging and Health
Assessing the Cost of Aging and Health Care
Health and Work
Changing Role of the Family
Suggested Resources
Contents
Rose Maria Li
1
2
4
6
9
12
16
18
20
22
25
4 Global Health and Aging
5
Preface
The world is facing a situation without precedent: We soon will have more older people than
children and more people at extreme old age than ever before. As both the proportion of older
people and the length of life increase throughout the world, key questions arise. Will population
aging be accompanied by a longer period of good health, a sustained sense of well-being, and
extended periods of social engagement and productivity, or will it be associated with more illness,
disability, and dependency? How will aging affect health care and social costs? Are these futures
inevitable, or can we act to establish a physical and social infrastructure that might foster better
health and wellbeing in older age? How will population aging play out differently for low-income
countries that will age faster than their counterparts have, but before they become industrialized
and wealthy?
This brief report attempts to address some of these questions. Above all, it emphasizes the central
role that health will play moving forward. A better understanding of the changing relationship
between health with age is crucial if we are to create a future that takes full advantage of the
powerful resource inherent in older populations. To do so, nations must develop appropriate
data systems and research capacity to monitor and understand these patterns and relationships,
��������
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������
� ���������������
��������������������� ���� �������
�����������������
���
��
well-being. And research needs to be better coordinated if we are to discover the most cost-effective
ways to maintain healthful life styles and everyday functioning in countries at different stages of
economic development and with varying resources. Global efforts are required to understand and
�
�������������
����������
������������� ������������������ �����������
������ �
��
�������� ���
��
existing knowledge about the prevention and treatment of heart disease, stroke, diabetes, and
cancer.
Managing population aging also requires building needed infrastructure and institutions as soon as
possible. The longer we delay, the more costly and less effective the solutions are likely to be.
Population aging is a powerful and transforming demographic force. We are only just beginning
to comprehend its impact ...
CDC Health Disparities and Inequalities Report — United StatMaximaSheffield592
CDC Health Disparities and Inequalities Report —
United States, 2013
Supplement / Vol. 62 / No. 3 November 22, 2013
U.S. Department of Health and Human Services
Centers for Disease Control and Prevention
Morbidity and Mortality Weekly Report
Supplement
The MMWR series of publications is published by the Center for Surveillance, Epidemiology, and Laboratory Services, Centers for Disease Control and Prevention (CDC),
U.S. Department of Health and Human Services, Atlanta, GA 30333.
Suggested Citation: Centers for Disease Control and Prevention. [Title]. MMWR 2013;62(Suppl 3):[inclusive page numbers].
Centers for Disease Control and Prevention
Thomas R. Frieden, MD, MPH, Director
Harold W. Jaffe, MD, MA, Associate Director for Science
Joanne Cono, MD, ScM, Acting Director, Office of Science Quality
Chesley L. Richards, MD, MPH, Deputy Director for Public Health Scientific Services
MMWR Editorial and Production Staff
Ronald L. Moolenaar, MD, MPH, Editor, MMWR Series
Christine G. Casey, MD, Deputy Editor, MMWR Series
Teresa F. Rutledge, Managing Editor, MMWR Series
David C. Johnson, Lead Technical Writer-Editor
Jeffrey D. Sokolow, MA, Catherine B. Lansdowne, MS,
Denise Williams, MBA, Project Editors
Martha F. Boyd, Lead Visual Information Specialist
Maureen A. Leahy, Julia C. Martinroe,
Stephen R. Spriggs, Terraye M. Starr
Visual Information Specialists
Quang M. Doan, MBA, Phyllis H. King
Information Technology Specialists
MMWR Editorial Board
William L. Roper, MD, MPH, Chapel Hill, NC, Chairman
Matthew L. Boulton, MD, MPH, Ann Arbor, MI
Virginia A. Caine, MD, Indianapolis, IN
Barbara A. Ellis, PhD, MS, Atlanta, GA
Jonathan E. Fielding, MD, MPH, MBA, Los Angeles, CA
David W. Fleming, MD, Seattle, WA
William E. Halperin, MD, DrPH, MPH, Newark, NJ
King K. Holmes, MD, PhD, Seattle, WA
Timothy F. Jones, MD, Nashville, TN
Rima F. Khabbaz, MD, Atlanta, GA
Dennis G. Maki, MD, Madison, WI
Patricia Quinlisk, MD, MPH, Des Moines, IA
Patrick L. Remington, MD, MPH, Madison, WI
William Schaffner, MD, Nashville, TN
Asthma Attacks Among Persons with Current Asthma —
United States, 2001–2010 .......................................................................... 93
Diabetes — United States, 2006 and 2010 ............................................ 99
Health-Related Quality of Life — United States, 2006 and 2010 .... 105
HIV Infection — United States, 2008 and 2010 .................................. 112
Obesity — United States, 1999–2010 .................................................... 120
Periodontitis Among Adults Aged ≥30 Years —
United States, 2009–2010 ........................................................................ 129
Preterm Births — United States, 2006 and 2010 ............................... 136
Potentially Preventable Hospitalizations — United States,
2001–2009 .................................................................................................... 139
Prevalence of Hypertension and Contr ...
INTRODUCTION
Elderly population is increasing in all countries of the world. This is due to several factors which include decline in fertility, improvement in public health and increase in life expectancy. Decline in fertility was brought about by more wide spread acceptability of family planning while increase in life expectancy is attributed to improved medical care brought about by technological advancement. According to a published U.S Bureau Bulletin of the Census and Database on Ageing in 1988, the world’s total population is growing at a rate of 1.7 percent per year.
REMOTEAREAMEDICALCan disparities be deadlyControv.docxaudeleypearl
REMOTE
AREA
MEDICAL
Can disparities be deadly?
Controversial research explores whether living in an
unequal society can make people sick
B y E m i l y U n d e r w o o d
W
hitehall street, just south of Tra
falgar Square in central London,
is the heartbeat of the British
government. Generations of
workers in the highly strati
fied British Civil Service have
marched to work each day in the govern
ment offices lining the road, with top
bureaucrats working and living in pala
tial brick mansions built for aristocrats.
Over the years, the denizens of Whitehall
have fallen prey to the ills of the modern
world: Their arteries have filled with fatty
plaque; their blood sugar has spiked from
diabetes; their lungs have been damaged
by emphysema. And with surprising and
troubling frequency, lower ranked workers
have died earlier from these ailments than
have their superiors.
To find out why, thousands of these civil
servants, from typists to top officials, have
gone to nearby medical clinics to have
blood drawn, fill out questionnaires about
how much they exercise and smoke, and
don scratchy paper gowns for physical ex
ams. Last year marked the 11th wave of
data from this ambitious study, which has
run for roughly 40 years and sparked an
entire research program on the contentious
question of whether being low-ranked can
make you sick.
Deaths by rank at Whitehall
Relative rate of death over 25 years
2.0
Top officials Executive Clerical Other
■ Adjusted for age ■ Adjusted for other
risk factors
Source: Marmot, 2000
HEALTHY AT THE TOP. In the long-running Whitehall
studies, civil servants at every occupational grade
live longer than their Inferiors.
All agree that compared with the wealthy,
poor people are less healthy. A child born in
Norway can expect to live roughly 30 years
longer than one born in Afghanistan. In
the United States, on average, people in the
highest income group can expect to outlive
those in the lowest income group by more
than 6 years. Preventable illnesses caused
by poor nutrition and lack of education
and care account for much of the dispar
ity. Investing in health care and making
it widely available can boost the health of
those at the bottom. Redistributing wealth
to the lower end of the curve helps, too. One
simulation by researchers at the University
of Otago, Wellington, for example, showed
that shifting New Zealanders’ incomes to
ward the mean income by 10% would save
about 1100 lives per year.
But epidemiologist Michael Marmot of
University College London (UCL), who
leads the Whitehall study, argues that
there’s more to health than money alone.
On the basis of his own and other studies,
Marmot argues that hierarchy itself is a
threat to health, with low-ranking individu
als getting sicker and dying younger than
higher-ups in part because of the sheer
stress of being low on the social ladder.
Some public health experts say their own
studies bear out ...
However, addictions are hard to treat and pain is hard to control, so those currently in midlife may be a “lost generation” (36) whose future is less bright than those who preceded them.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Ethnobotany and Ethnopharmacology:
Ethnobotany in herbal drug evaluation,
Impact of Ethnobotany in traditional medicine,
New development in herbals,
Bio-prospecting tools for drug discovery,
Role of Ethnopharmacology in drug evaluation,
Reverse Pharmacology.
How to Split Bills in the Odoo 17 POS ModuleCeline George
Bills have a main role in point of sale procedure. It will help to track sales, handling payments and giving receipts to customers. Bill splitting also has an important role in POS. For example, If some friends come together for dinner and if they want to divide the bill then it is possible by POS bill splitting. This slide will show how to split bills in odoo 17 POS.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
How to Create Map Views in the Odoo 17 ERPCeline George
The map views are useful for providing a geographical representation of data. They allow users to visualize and analyze the data in a more intuitive manner.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
1. DISCUSSION BOARD forum 3
Discussion Board Forum 3 Read “The Reversal of Fortunes” by Ezzati, et al., located in the
Reading & Study folder for this module/week. Discuss the following points in your thread.
Review the Discussion Board Instructions before posting your thread.In general public
health measures appear to be working. Not only has US life expectancy increased over the
past half century, but mortality rates of major lifestyle-related diseases—particularly heart
disease and stroke—have decreased in both men and women. In the 1980s, however, a
disconcerting “reversal of fortunes” began to occur in some vulnerable populations in some
regions of the US. Describe what happened and give the proximal (immediate) influences
for this backward trend.What do you think are the distal (ultimate) influences for the
“reversal of fortunes” described in the article? Suggest a comprehensive intervention plan
to reverse this reversal. Upon which theoretical framework or model would it be based?
Why?Replies needed as well:Jeffrey Perkins DB Forum 3: The Reversal of Fortunes Article
ReviewCOLLAPSEBased on the article review, the reversal of fortunes there appears to be
an increase in mortality rates amongst counties. The U.S. Census and vital statistics data
were used to consider poverty impacts amongst gender and race groups. U.S. Census data is
self-reported and may not provide most accurate information. However, mortality data is
more accurate since vital records provide death certification. Consider data is analyzed over
four decades and mortality rates were well documented over a time span to provide
statistical review. Once it was determined trends do not reflect similar patterns amoungs
mostly ethic and gender groups issues of reverse fortune occur, “Between 1961 and 1999,
average life expectancy in the United States increased from 66.9 to 74.1 y for men and from
73.5 to 79.6 y for women.” [1] Give credit to the researchers ability to withdraw inferences
where data did not reflect actual reality. Income is a key indicator which helps determine
poverty between groups. Once you compare the income “ Between 1961 and 1983, counties
with life expectancy improvement above and below the national average had relatively
similar income levels”[1] Since health, poverty, and income are closely related as social
determinants of public health. A closer look at ethnicity and gender profile is a requirement
to consider, “Black women formed a larger proportion of the population in counties with
above-average life expectancy improvement than in those counties with below-average life
expectancy change; the pattern was reversed for men. After 1983, gain in life expectancy
was positively associated with county income.”[1] The increase to life expectancy related to
county income is a key parameter to realize how greatly income affects a persons individual
function and behavioral outcomes. The reverse of fortune was not beneficial to all because
2. life expectancy gains were not applicable to all groups. The adverse mortality rates impact
the population groups labeled disadvantaged due to existing inequalities. The increase to
other disease factors did not help considering “Higher HIV/AIDS and homicide deaths also
contributed substantially to life expectancy decline for men, but not for women. Alternative
specifications of the effects of migration showed that the rise in cross-county life expectancy
SD was unlikely to be caused by migration.The increase in communicable diseases women
.”[1]The idea of ruling of migration as a factor in life expectancy provides more reason to
focus on the segment of population categorized as disadvantaged. The distal influence was
income since wages impact quality of life. In any environment poverty can impact health
outcomes. In the counties impacts may spread to even larger community scope, “ Poverty
contributes to epidemic disease and epidemic disease contributes to poverty:causation is
bi-directional and occurs through many different pathways. For example,loss of labour from
a farming system may result in failure to maintain infrastructure such as terracing, leading
to soil erosion, and decreasing agricultural productivity.”[2] There appears to be some
change built on more recent research mentions improvement in children poverty rates in
the U.S. compared to historical data, “Turning to an analysis of age-specific mortality rates,
we show that among adults age 50 and over, mortality has declined more quickly in richer
areas than in poorer ones, resulting in increased inequality in mortality. This finding is
consistent with previous research on the subject.”[3]Faith in progress continuously
provides a best outcomes Ephesians 4:13-14 Till we all come in the unity of the faith, and of
the knowledge of the Son of God, unto a perfect man, unto the measure of the stature of the
fulness of Christ: That we henceforth be no more children, tossed to and fro, and carried
about with every wind of doctrine, by the sleight of men, and cunning craftiness, whereby
they lie in wait to deceive. To understand that change is constantly happening “We also
show that there have been stunning declines in mortality rates for African Americans
between 1990 and 2010, especially for black men. The fact that inequality in mortality has
been moving in opposite directions for the young and the old, as well as for some segments
of the African-American and non-African-American populations, argues against a single
driver of trends in mortality inequality, such as rising income inequality.”[3] Implementing
a community intervention program health belief model could help improve information and
access to ways to supplement poverty related outcomes.Ezzati M, Friedman AB, Kulkarni SC,
Murray CJL. Correction: The Reversal of Fortunes: Trends in County Mortality and Cross-
County Mortality Disparities in the United States. PLoS Medicine. 2008: 5(4): e66.
https://journals.plos.org/plosmedicine/article?id=…Barnett, T., & Whiteside, A.2002;
poverty and HIV/AIDS: impact, coping and mitigation policy. In G. AIDS, Public Policy and
Child Well-Being.https://www.unicef-irc.org/research/ESP/aids/chapter11.pdfCurrie,
Janet, and Hannes Schwandt. 2016; Mortality inequality: the good news from a county-level
approach. Journal of Economic Perspectives .30(2): 29–
52.https://www.aeaweb.org/articles?id=10.1257/jep.30.2.29Holy BibleSecond
reply:Jordan Williams DBIn the 1980’s a disconcerting “reversal of fortunes” began to occur
in some vulnerable populations in some regions of the US. For example, the difference
between life expectancies of the countries that make up the 2.5 % of the US populations
with the lowest and highest mortality each year rose from 9.0 years in 1983 and to 11.0
3. years in 1999 for men, and from 6.7 years to 7.5 years for women.1 This was caused by
stagnating improvements in life expectancy among the worst off, while the best off
experienced consistent mortality decline.1 The stagnation of mortality among the worst off
was primarily caused by a slowdown or halt of the earlier decline of cardiovascular
mortality, coupled with a moderate rise in number of other chronic diseases for both sexes
as well as HIV/AIDS and homicide for men.After 1983 the decline in female life expectancy
was caused by a rise in mortality from lung cancer, COPD, diabetes, and a range of other
non-communicable diseases in the older ages. Mortality from diabetes, cancers and COPD in
the older ages also worsened in men but these continued to be countered by relatively large
reductions in male cardiovascular mortality. 1 In the article, there were several different
factors that influence the “reversal of fortunes” which include income levels and
sociodemographic factors, data that was unaccounted for, cause of death coding, and
statistical uncertainty in death rates.This week’s reading included discussion on two stage
theories that predominate in health promotion research and practice: the Trans theoretical
Model of Change (TMC) and the Precaution Adoption Process Model (PAPM).2 Both of these
theories have been used to successfully change a diverse array of health behaviors, either
facilitating the elimination of health risk behaviors or the adoption of health protective
behaviors.ReferencesEzzati M, Friedman AB, Kulkarni SC, Murray CJL. The Reversal of
Fortunes: Trends in County Mortality and Cross-County Mortality Disparities in the United
States. PLoS Medicine. 2008;DiClemente RJ, Salazar LF, Crosby RA. Health Behavior Theory
for Public Health. Burlington, MA: Jones & Bartlett Learning; 2013
![DISCUSSION BOARD forum 3
Discussion Board Forum 3 Read “The Reversal of Fortunes” by Ezzati, et al., located in the
Reading & Study folder for this module/week. Discuss the following points in your thread.
Review the Discussion Board Instructions before posting your thread.In general public
health measures appear to be working. Not only has US life expectancy increased over the
past half century, but mortality rates of major lifestyle-related diseases—particularly heart
disease and stroke—have decreased in both men and women. In the 1980s, however, a
disconcerting “reversal of fortunes” began to occur in some vulnerable populations in some
regions of the US. Describe what happened and give the proximal (immediate) influences
for this backward trend.What do you think are the distal (ultimate) influences for the
“reversal of fortunes” described in the article? Suggest a comprehensive intervention plan
to reverse this reversal. Upon which theoretical framework or model would it be based?
Why?Replies needed as well:Jeffrey Perkins DB Forum 3: The Reversal of Fortunes Article
ReviewCOLLAPSEBased on the article review, the reversal of fortunes there appears to be
an increase in mortality rates amongst counties. The U.S. Census and vital statistics data
were used to consider poverty impacts amongst gender and race groups. U.S. Census data is
self-reported and may not provide most accurate information. However, mortality data is
more accurate since vital records provide death certification. Consider data is analyzed over
four decades and mortality rates were well documented over a time span to provide
statistical review. Once it was determined trends do not reflect similar patterns amoungs
mostly ethic and gender groups issues of reverse fortune occur, “Between 1961 and 1999,
average life expectancy in the United States increased from 66.9 to 74.1 y for men and from
73.5 to 79.6 y for women.” [1] Give credit to the researchers ability to withdraw inferences
where data did not reflect actual reality. Income is a key indicator which helps determine
poverty between groups. Once you compare the income “ Between 1961 and 1983, counties
with life expectancy improvement above and below the national average had relatively
similar income levels”[1] Since health, poverty, and income are closely related as social
determinants of public health. A closer look at ethnicity and gender profile is a requirement
to consider, “Black women formed a larger proportion of the population in counties with
above-average life expectancy improvement than in those counties with below-average life
expectancy change; the pattern was reversed for men. After 1983, gain in life expectancy
was positively associated with county income.”[1] The increase to life expectancy related to
county income is a key parameter to realize how greatly income affects a persons individual
function and behavioral outcomes. The reverse of fortune was not beneficial to all because](https://image.slidesharecdn.com/discussionboardforum3-230602105729-6fc00e88/85/DISCUSSION-BOARD-forum-3-docx-1-320.jpg)
![life expectancy gains were not applicable to all groups. The adverse mortality rates impact
the population groups labeled disadvantaged due to existing inequalities. The increase to
other disease factors did not help considering “Higher HIV/AIDS and homicide deaths also
contributed substantially to life expectancy decline for men, but not for women. Alternative
specifications of the effects of migration showed that the rise in cross-county life expectancy
SD was unlikely to be caused by migration.The increase in communicable diseases women
.”[1]The idea of ruling of migration as a factor in life expectancy provides more reason to
focus on the segment of population categorized as disadvantaged. The distal influence was
income since wages impact quality of life. In any environment poverty can impact health
outcomes. In the counties impacts may spread to even larger community scope, “ Poverty
contributes to epidemic disease and epidemic disease contributes to poverty:causation is
bi-directional and occurs through many different pathways. For example,loss of labour from
a farming system may result in failure to maintain infrastructure such as terracing, leading
to soil erosion, and decreasing agricultural productivity.”[2] There appears to be some
change built on more recent research mentions improvement in children poverty rates in
the U.S. compared to historical data, “Turning to an analysis of age-specific mortality rates,
we show that among adults age 50 and over, mortality has declined more quickly in richer
areas than in poorer ones, resulting in increased inequality in mortality. This finding is
consistent with previous research on the subject.”[3]Faith in progress continuously
provides a best outcomes Ephesians 4:13-14 Till we all come in the unity of the faith, and of
the knowledge of the Son of God, unto a perfect man, unto the measure of the stature of the
fulness of Christ: That we henceforth be no more children, tossed to and fro, and carried
about with every wind of doctrine, by the sleight of men, and cunning craftiness, whereby
they lie in wait to deceive. To understand that change is constantly happening “We also
show that there have been stunning declines in mortality rates for African Americans
between 1990 and 2010, especially for black men. The fact that inequality in mortality has
been moving in opposite directions for the young and the old, as well as for some segments
of the African-American and non-African-American populations, argues against a single
driver of trends in mortality inequality, such as rising income inequality.”[3] Implementing
a community intervention program health belief model could help improve information and
access to ways to supplement poverty related outcomes.Ezzati M, Friedman AB, Kulkarni SC,
Murray CJL. Correction: The Reversal of Fortunes: Trends in County Mortality and Cross-
County Mortality Disparities in the United States. PLoS Medicine. 2008: 5(4): e66.
https://journals.plos.org/plosmedicine/article?id=…Barnett, T., & Whiteside, A.2002;
poverty and HIV/AIDS: impact, coping and mitigation policy. In G. AIDS, Public Policy and
Child Well-Being.https://www.unicef-irc.org/research/ESP/aids/chapter11.pdfCurrie,
Janet, and Hannes Schwandt. 2016; Mortality inequality: the good news from a county-level
approach. Journal of Economic Perspectives .30(2): 29–
52.https://www.aeaweb.org/articles?id=10.1257/jep.30.2.29Holy BibleSecond
reply:Jordan Williams DBIn the 1980’s a disconcerting “reversal of fortunes” began to occur
in some vulnerable populations in some regions of the US. For example, the difference
between life expectancies of the countries that make up the 2.5 % of the US populations
with the lowest and highest mortality each year rose from 9.0 years in 1983 and to 11.0](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)