RESUMEN

The aim of our study is to test the theories of compression or expansion of morbidity on the basis of data on the elderly population of Austria. Our data come from four microcensus surveys for the years 1978, 1983, 1991, and 1998. We use self-perceived health ratings to calculate healthy-life expectancy for the elderly population aged 60-89. Because our data are based on four cross-sectional surveys, we devote the first part of the paper to the consequences of possible sampling and non-sampling errors in our analysis of time trends. We come to the conclusion that, although the absolute number of years lived in good health may be overestimated, the time trend in healthy-life expectancy over the 20 years most probably is unbiased. The second part of the paper describes trends in healthy-life expectancy for the Austrian population. Our results suggest that both healthy-life expectancy and the ratio of healthy years to life expectancy increased between 1978 and 1998. Thus, in Austria ill health seems to be more and more compressed into the later years of life. Contrary to Fries's hypothesis, however, life expectancy does not seem to be approaching a maximum average life span in Austria, as mortality rates at older ages have been continuously decreasing over the last 20 years.

Asunto(s)

RESUMEN

With the decline of the former main causes of death in early childhood--infections and starvation--sudden infant death syndrome (SIDS) has emerged as the most important single cause of postneonatal infant mortality. It has adopted the role of a major indicator for the standard of public health care. Despite extensive input into research, its pathophysiology has remained rather obscure. The resulting helplessness of scientists and health care professionals have lead to adherence to unconfirmed pathophysiological hypotheses and to pursuit of preventive strategies of doubtful efficacy. In this overview, the medical and technical background of five major hypotheses is being presented. A lot can be learnt from the history of their development, efforts to refute them, and the reasons for unreflected adherence to them. (1) Due to its illustrative nature, the so-called 'status thymico-lymphaticus', the theory of asphixation by an enlarged thymus, could not be eradicated although well-reknowned physicians--including the Austrian pathologist Paltauf--have repeatedly attempted to do so. (2) Assumed familiarity, an aspect which attracted the attention of pediatricians to SIDS initially has been excluded, but an increased risk of SIDS for the siblings of affected babies is still common belief. (3) The sleep-apnea-hypothesis has turned out a complete error with serious consequences, but home apnea monitors are still being widely recommended. (4) The rise of SIDS in the 80ies and its subsequent decline in the 90ies has been interpreted as the advent and successful control of an epidemic although significant numbers of cot death have been reported long before the turn of the century, and the apparent increase which paralleled the introduction of the 9th edition of the ICD code is most likely due to improved registration. (5) Finally, SIDS is still being considered a random event--ignoring all evidence of an obvious role of socioeconomical factors.

Asunto(s)

RESUMEN

The purpose of this study is to describe socioeconomic differences in the health status and mortality of the Austrian population. Socioeconomic differentials in disability and self-perceived health are studied on the basis of educational groups. The data are drawn from the 1991 Austrian micro-census on health and from linked death and census records for the years 1981/82. The maximum number of years lived between ages 30 and 75 is divided into years lost, years lived in disability or poor health and years lived without disability or in good health. Our findings clearly indicate a correlation between higher education and higher life expectancy and lower morbidity. Comparing the two indicators, more years are lived in poor health than in severe functional disability. The two concepts of health lead to different conclusions when results for men and women are compared: women live more years in disability than men but fewer years in poor health. Differences between educational groups are lower when the concept of self-perceived health is applied.

Asunto(s)

RESUMEN

PIP: After summarizing Austrian population trends from 1961 to 1995, the authors describe three main scenarios for Austria's future population developments to the year 2021 based on various assumptions about internal and international migration, mortality, and fertility. Their results show that total population size will increase slightly, and that demographic aging will take place. Regional differences will be apparent, however, with the western areas showing demographic growth while the population of the southern regions decreases. Future demographic trends in the labor force are also summarized; unemployment is expected to remain relatively high. This article was based on a more detailed report produced for an Austrian conference on spatial management; projection results are available in machine-readable form from the Osterreichische Raumordnungskonferenz, Hohenstaufengasse 3, 1010 Vienna, Austria.^ieng

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

In late 1990 a screening program for the early detection of neuroblastoma in infants was introduced in Austria. The program is performed on a voluntary basis in collaboration with general pediatricians and practitioners. Filter strips for urine collection are distributed to parents of infants aged seven to nine months on the occasion of a routine check up. The samples are sent to the laboratory by parents and analysed for vanillylmandelic acid (VMA) and homovanillic acid (HVA). Between January 1991 and December 1995 125,201 infants were screened. The compliance rate was 26.8% for Austria, but great differences were seen for different regions (65% in Carinthia, 10% in Vorarlberg). 30 children were admitted to hospital for investigation of repeatedly elevated urine catecholamines. A neuroblastoma was identified in 16 cases. In 12 of these cases at least one unfavorable prognostic factor was present (stage > or = 3, elevated LDH, unfavorable histology, N-myc amplification, di- or tetraploidy). Neuroblastoma screening of infants aged more than six months seems to detect predominantly those tumors which are unlikely to regress spontaneously. The observation of one false negative case, however, demonstrates that neuroblastomas which become clinically manifest at a later date may remain undetected by early screening. Possible advantages of shifting screening to a later age and repeated screening are discussed.

Asunto(s)

RESUMEN

After the rise in incidence of the sudden infant death syndrome (SIDS) in the 1980s to a peak of 1.7/1000 live births in Austria in 1988, the SIDS rate more than halved to 0.79/1000 live births in 1994. This trend can be regarded as typical of the epidemiology of SIDS in most Western countries. It is commonly interpreted as a result of preventive measures. However, the decline in incidence of SIDS started several years before systematic preventive activities were undertaken in Austria. Graphical presentation shows that the dynamics of SIDS does not affect the almost linear decline in postneonatal mortality over the past 25 years, as would be expected from the fact that SIDS is the most important cause of death in the postneonatal period. A comparative analysis of trends of postneonatal SIDS and non-SIDS mortality reveals that in Austria the increase of SIDS was accompanied by a rapid fall of non-SIDS mortality, whereas, on the contrary, the decline of SIDS went along with relative increase of non-SIDS mortality. Changing awareness of coroners and forensic pathologists of SIDS, with the resultant changes in frequency and performance of postmortem examinations, and changes in coding practices of causes of death should be taken into consideration as determinants of SIDS incidence before interpreting trends as resulting from public health interventions.

Asunto(s)

RESUMEN

"First an overview is given of the secular decline of infant mortality in Austria between 1820 and 1950.... Second the study analyses the historical regional differences of infant mortality in Austria comparing data for all 99 political districts (Politische Bezirke) for the period 1900 to 1950. The most important results are: At the turn of the 19th century infant mortality rates were generally lower in Alpine than in non-Alpine regions and lower in cities than in their surrounding areas. This geographical pattern which remained constant until the 1950s was solely determined by differences in post-neonatal mortality rates. Plausible explanations for these regional differences are discussed." (SUMMARY IN FRE)

Asunto(s)

RESUMEN

"The present analysis offers a projection of life expectancy at advanced ages in Austria for the year 2010. To estimate the gains in life expectancy the Simultaneous Multiple Cause-Delay (SIMCAD) method is used. This model takes into account the epidemiological concept of an additional delay in the onset of particular chronic-degenerative diseases. While the results of the SIMCAD method vary only slightly on the whole from the official projection of life expectancy at age 60, the similarity between the two projections decreases steadily with increasing age. The SIMCAD model predicts higher gains in life expectancy for the oldest age-groups of the population than do the official statistics." (SUMMARY IN FRE)

Asunto(s)

RESUMEN

The sudden infant death syndrome (SIDS) is the most frequent cause of death during the postneonatal period (2-12 months) in Austria. A retrospective analysis of the SIDS cases registered between 1988 und 1992, however, shows marked differences between the provinces with regard to the relative proportion of SIDS against total infant mortality figures. The use of different definitions for SIDS seems to be responsible for local differences. Thus, a standardized investigation for all sudden unexpected deaths is required (autopsy, histological investigations, death scene investigation). Furthermore, a uniform classification for sudden unexpected infant death should be applied.

Asunto(s)

RESUMEN

PIP: "The Austrian population is presently in the middle of its age structure transition which started with World War I and will continue until the 40s of the next century. Within this time period the number of people aged 60 years or over will increase from about half a million to 2.8 million (1995: 1.6 million) and the share of the elderly will mount from about 9 percent to more than 35 percent (1995: 20 percent). The present article points out the demographic causes for population aging asking whether high fertility and/or high numbers of migrants can stop the aging process. Different measurements of demographic aging in Austria (share of various age groups, mean age and median age, dependency ratios, several aging indices) are calculated for the time period 1869 to 2050. Special attention is paid to regional differences within Austria and to changes of the sex ratio at older ages over time." (EXCERPT)^ieng

Asunto(s)

RESUMEN

PIP: "Projections show that Austria's population will increase slightly in the next decades. The seemingly constant development, however, conceals far-reaching age structure shifts on the one hand, and great regional differences concerning the future population development on the other. While urban agglomerations will grow, the population of the peripheral regions of the eastern parts of Austria and even more so of its southern parts is expected to decrease markedly.... In the western parts of Austria and in suburban communities the number of the elderly will grow in greater measure than in its eastern parts and peripheral regions [but] the share of the young is decreasing much less in Austria's western regions and the suburban communities." (EXCERPT)^ieng

Asunto(s)

RESUMEN

PIP: "This present analysis is looking into the epidemiologic causes of the above-average infant mortality in Vienna using a population-based cohort study (birth cohorts 1984-93).... The estimation of crude and adjusted relative risks as well as of 95%-confidence intervals demonstrates that Vienna's higher infant mortality rate is statistically significant, that socio-demographic risk groups are not responsible whereas the higher rate of premature births is; it furthermore shows that infant mortality is above-average in other big provincial capitals as well. From the health policy point of view this means that all measures taken to lower infant mortality should be aimed at the period before birth, i.e. improving antenatal care." (EXCERPT)^ieng

Asunto(s)

RESUMEN

Stairs are among the most hazardous features of the everyday environment, yet stairway falls have received little research attention. A stratified random sample of Austrian residents was surveyed in person in 1989. Of over 55,000 respondents, 147 reported a stairway injury in the previous year that limited activity for at least one day. Thirty-seven percent of these injuries resulted in hospitalization. Extrapolating to the entire country of 8 million people, each year some 20,000 Austrians sustain serious stairway injuries resulting in over 7,500 hospitalizations. The incidence of stairway injury increases monotonically with age, and females are more at risk than males. The stereotypical stairway injury victim is an elderly woman, not highly educated, who is unmarried and living alone.

Asunto(s)

RESUMEN

"This analysis provides an outline of the changes in family formation behaviour in Austria in the years 1950 to 1990. Using vital statistical data and retrospective data of the 1981 census all women with their first confinement in the years 1950 to 1990 were classified into three distinct groups according to their form of family formation behaviour: 1. Mother is unmarried at date of birth...,2. mother marries during pregnancy, 3. mother is married at time of conception. Changes in family formation behaviour over time are discussed in detail, focussing on different age groups and on regional differences." (SUMMARY IN ENG)

Asunto(s)

RESUMEN

"The present study is (1) an attempt to outline the reasons for and the course of the ageing transition in Austria, and (2) to predict what might be the social consequences of this process."

Asunto(s)

RESUMEN

"In 1989/90 the world's population was approximately 5.2 billions. According to U.N.-projections (medium variant) every 10 to 11 years this figure will grow by one billion, corresponding to an increase of 100 [million] people per year.... This article discusses the causes for the population growth and the impact on the settlement system, the food-situation, the ecological system, and the development process in the Third World." (SUMMARY IN ENG)

Asunto(s)

RESUMEN

This paper analyzes the birth and death certificate data of infants who died from the Sudden Infant Death Syndrome (SIDS) before their first birthday. It investigates possible causes of differences in regional mortality and of the significant increase in the number of cases between 1980 and 1987. Moreover, the authors try to assess whether the number of SIDS cases registered by the Austrian Central Statistical Office is plausible. Between 1980 and 1987 the number of SIDS cases increased from 38 (= 2.9% of all infant mortality cases) to 141 (= 16.6%). Moreover, there are significant regional differences in SIDS mortality, varying between 0.3 per thousand in Upper Austria and 2.2 per thousand in Salzburg. Possible causes for these mortality differences are discussed (misclassifications, regional differences in the level of infant mortality). Finally, the authors look at the reliability of the official Austrian SIDS statistics and conclude that the officially announced number of SIDS cases may not give an accurate picture of the situation but is still the best estimate available.

Asunto(s)

RESUMEN

This paper investigates SIDS cases in the first year of life between 1980 and 1987 in Austria regarding age at death, seasonal distribution and influence of birth weight, APGAR-Score and socio-demographic risk factors. SIDS mortality is highest between the 10th and 12th week of life. The median life span of SIDS cases is 103 days. The seasonal distribution indicates an influence of acute respiratory diseases. 37% of all cases happened from October to December. Although--because of competing risks--SIDS has primary importance for infants with a birth-weight of more than 2500 g, low birth-weight is an important risk factor. Age of mother, illegitimate birth and low educational level of the mother are important socio-demographic risk factors.

Asunto(s)