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Logo of jepicomhJournal of Epidemiology and Community HealthVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
 
J Epidemiol Community Health. 2007 November; 61(11): 1016.
PMCID: PMC2465609

Hygieia

Sexual structure of a population

While it is recognised that the structure of sexual networks has a central role in transmission dynamics of sexually transmitted infections (STIs), it is difficult to obtain reliable data on sexual contacts between individuals. However, the venues where people recruit sexual partners may provide valuable information on sexual networks. As such, these are an increasingly important focus of STI surveillance and prevention. The observation that individuals may congregate at particular venues (for example, commercial sex workers in red light districts, men who have sex with men in gay bars and clubs) is the rationale for time‐location sampling to obtain a representative sample of individuals from hidden populations. Information on these venues or “sexual affiliations” provides valuable data on the structure, especially of larger sexual networks, and tends to be more robust to biases in the sampling process than other forms of network data. Mathematical and statistical models of sexual affiliations are needed to help in the interpretation of such data. (Sex Transm Infect 2007;83(Suppl I):i37–i42)

Head injuries in older Australians

Rates of head injuries necessitating hospitalisation among people aged 60 and older are increasing in Australia, a study has found. Data on head injuries were obtained from the Australian Institute of Health and Welfare Hospital Morbidity Database from 1998–9 to 2004–5. Rates of head injuries necessitating hospitalisation among older people increased 1.4‐fold between 1998–9 (582.8 per 100 000 population) and 2004–5 (844.3 per 100 000 population). Those aged 85+ had 10.8 times the rate of their 60–64‐year‐old counterparts; men had 1.1 times the rate of women; and those living in rural/remote areas had 3.1 times the rate of their town‐dwelling counterparts. Individuals identifying themselves as Indigenous had 1.7 times the rate of non‐Indigenous individuals. The most prevalent injuries were open wounds of the head (38%), followed by superficial injuries (24.7%) and intracranial trauma (18.3%). Over 80% of hospital admissions for head injury were due to falls. Given the increasing numbers of older people in western societies and the cost of treating head injuries necessitating hospitalisation, the ability to reduce risk of such injuries in this age group is of critical public heath importance. (Inj Prev 2007;13:243–7)

Glenys Hughes ghughes@btinternet.com

Disease and injury burden in Spain

Injury prevention has become increasingly important worldwide, not only because of related mortality but also because of its associated morbidity, short‐term and long‐term impairment, impact on quality of life and cost. Few studies have either measured the burden of non‐fatal injuries or measured it against that of other health conditions. In a Spanish study, data on the adult population were taken from the 2001 Spanish National Health Interview (a household telephone survey of the Spanish population) and then compared with six measures of burden for 11 conditions (cardiovascular, injuries, endocrinological, respiratory, rheumatological, digestive, psychiatric, neurological, genitourinary, ophthalmological and dermatological) by age and sex. The study found that injuries contribute 11–23% of the total health burden of the adult Spanish population. They rank first and second out of the 11 conditions with regard to emergency visits and hospital admission, respectively; they rank third to sixth when other measures are chosen (reduction in leisure activities, reduction in main activities, consulting a doctor, bedridden for half a day). Rheumatological, cardiovascular and respiratory conditions are the only other conditions with a burden of comparable magnitude. This sort of comparison may raise the profile of injuries among health professionals and policy makers. (Inj Prev 2007;13:254–7)

Air pollution and mortality in Great Britain

Surveys have indicated short‐term associations between ambient air pollution and mortality, but long‐term effects on mortality are less well understood although potentially more important for public health. A small area study was performed across electoral wards in Great Britain of mean annual black smoke and sulphur dioxide concentrations (from 1966) and subsequent all‐cause and cause‐specific mortality, adjusted for social deprivation and urban/rural classification. Significant associations were found between black smoke and sulphur dioxide concentrations and mortality. The effects were stronger for respiratory illness than other causes of mortality for the most recent exposure periods (shorter latency time) and most recent mortality period (lower pollution concentrations). In pooled analysis across four sequential 4 year mortality periods (1982–98), adjusted excess relative risk for respiratory mortality was 3.6% per 10 μg/m3 black smoke and 13.2% per 10 parts per billion sulphur dioxide, and in the most recent period (1994–8) it was 19.3% and 21.7%, respectively. These findings add to the evidence that air pollution has long term effects on mortality and point to continuing public health risks even at the relatively lower levels of black smoke and sulphur dioxide that now occur. (Thorax published online 31 July 2007; doi: 10.1136/thx.2006.076851)

Coronary heart disease trends in England and Wales

Mortality rates from coronary heart disease (CHD) have declined steadily since the late 1960s with improvements in population risk factors and in medical treatment for patients with CHD contributing substantially to the declines seen between 1981 and 2000. However, CHD remains the leading cause of death and exacts a heavy social and economic toll. A study to examine recent trends in age‐specific mortality rates from CHD, particularly trends among younger adults, was carried out by examining mortality data from 1984 to 2004 in British adults aged >35. Overall, the age adjusted mortality rate decreased by 54.7% in men and by 48.3% in women. However, among men aged 35–44 years, CHD mortality rates in 2002 increased for the first time in over two decades; furthermore, the recent decreases in CHD mortality rates appears to be slowing in both men and women aged 45–54. The mortality rates in older adults, however, continued to decrease steadily. These unfavourable trends in CHD in young adults may be explained by increases in obesity and diabetes, compounded by high cholesterol levels and a smoking prevalence persisting above 25%. (Heart published online 19 July 2007; doi: 10.1136/hrt.2007.118323)


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