Determinants of Mortality at Older Ages: The Role of Biological Markers of Chronic Disease

Researchers have had a longstanding interest in understanding the determinants of mortality. This article examines the impact of a broad array of biological markers, together with self‐reports of physical and mental health status, on the probability of dying for older adults. The estimates are derived from logistic regression models based on data from a national survey in Taiwan. The analysis confirms previous studies demonstrating the effects of clinical measures related to metabolic syndrome on mortality and identifies detrimental effects of neuroendocrine and immune‐system markers. The results reveal that biomarkers provide independent explanatory power in the presence of self‐reported health measures. The associations between biomarkers and mortality found here provide new avenues for projecting future mortality and elucidating differences in longevity across populations.     

Vero-Cytotoxigenic Escherichia coli O157 in Pasteurized Milk Containers at the Point of Retail: A Qualitative Approach to Exposure Assessment

Dairies within the United Kingdom are classified into two groups, namely, off-farm and on-farm dairies (the latter often being small scale). We propose a model for the probability of milk sold as pasteurized reaching the point of retail contaminated with Vero-cytotoxigenic Escherichia coli (VTEC) O157 from each of these two pathways. We evaluate qualitatively the exposures inherent in each, and compare and contrast the two situations. The model framework is generic, in that it can in principle be used, with the relevant data modifications, to provide a qualitative assessment of the likely exposure from milk sold as pasteurized to any potentially milk-borne pathogenic organism. Furthermore, the methodological approaches presented are widely applicable in the microbial risk assessment field. The specific example presented will be of particular interest to the UK dairy and public health communities: we conclude that the exposure potential per liter consumed from milk processed in off-farm dairies is negligible, whereas the exposure potential per liter consumed from milk processed on-farm is low, but not sufficiently small to be regarded as negligible. We also identify areas of data sparsity, which need to be addressed for quantitative risk assessment to proceed, and highlight the critical points in the pasteurized milk production chain, which, in the event of a breakdown, have the potential to increase the risk to the consumer.     

The Best Predictors of Survival: Do They Vary by Age,Sex, and Race?

We consider a broad set of variables used by social scientists and clinicians to identify the leading predictors of five‐year survival among American adults. We address a question not considered in earlier research: Do the strongest predictors of survival vary by age, sex or race/ethnicity? The analysis uses hazard models with 30 well‐established predictors to examine five‐year survival in the National Health and Nutrition Examination Survey. We find that the simple measure of self‐assessed health and self‐reported measures of functional ability and disability are the strongest predictors in all demographic groups, and are generally ranked considerably higher than biomarkers. Among the biomarkers, serum albumin is highly ranked in most demographic groups, whereas clinical measures of cardiovascular and metabolic function are consistently among the weakest predictors. Despite these similarities, there is substantial variation in the leading predictors across demographic groups, most notably by race and ethnicity     

Beyond Self‐Reports: Changes in Biomarkers as Predictors of Mortality

The proliferation of biosocial surveys has increased the importance of weighing the costs and benefits of adding biomarker collection to population‐based surveys. A crucial question is whether biomarkers offer incremental value beyond self‐reported measures, which are easier to collect and impose less respondent burden. We use longitudinal data from a nationally representative sample of older Taiwanese (aged 54+ in 2000, examined in 2000 and 2006 with mortality follow‐up through 2011) to address that question with respect to predicting all‐cause mortality. A summary measure of biomarkers improves mortality prediction (as measured by the area under the receiver operating characteristic curve) compared with self‐reports alone, but individual biomarkers perform better than the summary score. We find that incorporating change in biomarkers over a six‐year period yields a small improvement in mortality prediction compared with one‐time measurement. But, is the incremental value worth the costs?     

Quare Eire

In this position piece we will briefly introduce The(e)ories: Advanced Seminars for Queer Research, which we founded and have convened at University College Dublin, Ireland, since January 2003. We will do this in an effort to illustrate how the aims and development of The(e)ories have mirrored, but also deviated from the US/UK-centric model of Queer Theory which (although largely a myth) continues to dominate discussions of sexuality. In this, we endeavor here to show how Queer Theory and Lesbian Studies, while not interchangeable, intersect with each other in important ways in our praxis in Ireland and thus, are not reducible to the 'collision model' (Doan, this volume) forwarded by proponents and critics alike.     

Heterogeneous Effects of Child Development Accounts on Savings for Children’s Education

We examine effects of Child Development Accounts on savings for postsecondary education in a statewide experiment (N = 2,677), which automatically opened state-owned college savings accounts for treatment-group children, and encouraged their caregivers to open and save in participant-owned college savings accounts. The experiment achieves universal participation for children in the treatment group; almost all treatment-group children hold an account with more than $1,000 in college assets. Treatment participants we expect would hold their own participant-owned accounts without the intervention have $395 more in savings than their counterparts in the control group; those who are motivated by the intervention to hold a participant-owned account have mean deposits of $888. Those who are motivated by the intervention to save have mean deposits of $1,826. The intervention reduces the socioeconomic disparity in asset accumulation for children. The program has the potential to promote asset building for children’s education.     

Program Knowledge and Racial Disparities in Savings Outcomes in a Child Development Account Experiment

This study investigated whether participants’ program knowledge was associated with savings outcomes in Child Development Accounts and whether differences in program knowledge explained racial and ethnic disparities in savings outcomes. We used data collected from White, Black, American Indian, and Hispanic treatment participants in the SEED for Oklahoma Kids (SEED OK) experiment (N?=?1126). Analysis results indicated that knowledge of SEED OK program features was low, especially among members of minority groups. Logit and Tobit regressions showed that program knowledge was positively related to the likelihood of holding a SEED OK account and to individual savings amounts. Gaps in program knowledge were associated with racial disparities in savings outcomes. If Whites and minorities had the same levels of program knowledge, gaps in savings outcomes would have significantly narrowed. The findings call for the development of policy designs and communication tools to enhance knowledge of program features among households with Child Development Accounts, especially racial- and ethnic-minority households.     

A new look at entropy and the life table

The mathematical derivations described in this paper offer a new look at the entropy of the life table, denoted by H. Contrary to previous claims, it is theoretically possible, and has been observed empirically, for life tables to have entropy values greater than unity. A re-expression of H as a weighted average of life expectancy at different ages relative to life expectancy at birth demonstrates clearly the conditions under which reductions in mortality by a fixed amount at all ages can result in even greater gains in life expectancy.     

Prenatal and delivery care and childhood immunization in guatemala: Do family and community matter?*

In this paper we investigate family choices about pregnancy-related care and the use of childhood immunization. Estimates obtained from a multilevel logistic model indicate that use of formal (or “modern ”) health services differs substantially by ethnicity, by social and economic factors, and by availability of health services. The results also show that family and community membership are very important determinants of the use of health care, even in the presence of controls for a large number of observed characteristics of individuals, families, and communities.