CCPR Seminar

"Probabilistic Cause-of-Death Assignment using Verbal Autopsies"

ABSTRACT

In areas without complete-coverage civil registration and vital statistics systems there is uncertainty about even the most basic demographic indicators.  In such areas the majority of deaths occur outside hospitals and are not recorded.  Worldwide, fewer than one-third of deaths are assigned a cause, with the least information available from the most impoverished nations.  In populations like this, verbal autopsy (VA) is a commonly used tool to assess cause of death and estimate cause-specific mortality rates and the distribution of deaths by cause.  VA uses an interview with caregivers of the decedent to elicit data describing the signs and symptoms leading up to the death.  This talk describes a new statistical method to classify cause of death using information acquired through VA.  Unlike current approaches, our method shares uncertainty between cause of death assignments for specific individuals and the distribution of deaths by cause across the population.  We demonstrate the effectiveness of our method using side-by-side comparisons with both observed and simulated data.

“Exposure to the United States and Healthy Eating Among U.S. Immigrants:
A Life Course Perspective on Immigrant Health”

ABSTRACT

The negative acculturation perspective predicts that immigrants’ health advantages erode with increasing exposure to the U.S. due to the adoption of the unhealthy default American lifestyle. Focusing on diet, we argue that this perspective underestimates immigrants’ abilities to maintain healthy eating patterns, especially among adult immigrant arrivals, and fails to account for how migration during childhood can disrupt important developmental processes. We advance an alternative “life course perspective on immigrant health” and present evidence for it by examining the associations of age at arrival and duration of residence with healthy eating among adult immigrants. Our results suggest that earlier age at arrival is negatively associated with healthy eating and that duration of residence has a weak but positive association with healthy eating, especially among those who arrived as adults. The results call into question notions that emphasize a steady erosion of healthy eating with time and acculturation. Instead, they support the life course perspective and point to the importance of early childhood exposures for understanding how living in the U.S. influences healthy eating among immigrants.

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