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Context: Russian life expectancy has fallen sharply in the 1990s, but the impact of the major causes of death on that decline has not been measured.Objective: To assess the contribution of selected causes of death to the dramatic decline in life expectancy in Russia in the years following the breakup of the Soviet Union.Design: Mortality and natality data from the vital statistics systems of Russia and the United States.Setting: Russia, 1990-1994.Population: Entire population of Russia.Main Outcome Variables: Mortality rates, life expectancy, and contribution to change in life expectancy.Methods: Application of standard life-table methods to calculate life expectancy by year, and a partitioning method to assess the contribution of specific causes of death and age groups to the overall decline in life expectancy. United States data presented for comparative purposes.Results: Age-adjusted mortality in Russia rose by almost 33% between 1990 and 1994. During that period, life expectancy for Russian men and women declined dramatically from 63.8 and 74.4 years to 57.7 and 71.2 years, respectively, while in the United States, life expectancy increased for both men and women from 71.8 and 78.8 years to 72.4 and 79.0 years, respectively. More than 75% of the decline in life expectancy was due to increased mortality rates for ages 25 to 64 years. Overall, cardiovascular diseases (heart disease and stroke) and injuries accounted for 65% of the decline in life expectancy while infectious diseases, including pneumonia and influenza, accounted for 5.8%, chronic liver diseases and cirrhosis for 2.4%, other alcohol-related causes for 9.6%, and cancer for 0.7%. Increases in cardiovascular mortality accounted for 41.6% of the decline in life expectancy for women and 33.4% for men, while increases in mortality from injuries (eg, falls, occupational injuries, motor vehicle crashes, suicides, and homicides) accounted for 32.8% of the decline in life expectancy for men and 21.8% for women.Conclusion: The striking rise in Russian mortality is beyond the peacetime experience of industrialized countries, with a 5-year decline in life expectancy in 4 years' time. Many factors appear to be operating simultaneously, including economic and social instability, high rates of tobacco and alcohol consumption, poor nutrition, depression, and deterioration of the health care system. Problems in data quality and reporting appear unable to account for these findings. These results clearly demonstrate that major declines in health and life expectancy can take place rapidly. [ABSTRACT FROM AUTHOR]

Presents a study which investigated levels and trends between 1975 and 1986 in the rates of cesarean section and of operative vaginal delivery in several countries. Review of related literature; Cesarian rates by selected maternal and infant characteristics; Comparison of perinatal mortality ratios with cesarian section and with operative vaginal rates.

In this study birthweight distributions for Mexican Americans and Mexico City were compared. Sharp differences in the two distributions were nearly eliminated by controlling for altitude. The small remaining excess in low birthweight in Mexico City appears to be due to a slight overrepresentation of tertiary hospital deliveries, and possibly to a greater prevalence of pathological conditions. The results are consistent with the favorable low birthweight rate reported for Mexican Americans and illustrate the need to adjust for altitude in studies of low birthweight. [ABSTRACT FROM AUTHOR]

To date the US has experienced the greatest number of cases and deaths due to COVID-19 in the world, but the impact has been even greater for American Indians and Alaska Natives (AIAN). Despite numerous disadvantages related to poor socioeconomic status and preexisting health conditions, Tribal sovereignty, community strength and resiliency have been important factors in limiting the burden of disease on Indigenous Americans. AIAN Tribes have repeatedly chosen to protect lives over Tribal income, choosing to close businesses that are the economic lifeblood of the reservations. [ABSTRACT FROM AUTHOR]

The International Group for Indigenous Health Measurement (IGIHM) is a 4-country group established to promote improvements in the collection, analysis, interpretation and dissemination of Indigenous health data, including the impact of COVID-19. This overview provides data on cases and deaths for the total population as well as the Indigenous populations of each country. Brief summaries of the impact are provided for Canada and New Zealand. The Overview is followed by separate articles in this edition with more detailed discussion of the COVID-19 experience in Australia and the US. [ABSTRACT FROM AUTHOR]

This article presents the fourth installment on a series called "Who Counts?" which looks at the barriers to getting citizen statistics in developing nations. The lack of citizen registration greatly hampers the measurement of medical intervention effectiveness in poor countries. The global community has failed to provide the technical and economic support needed to create reporting systems in these countries. The authors admit there is no one system that will work for every country but says there are things that can be done to start the systems and generate better vital statistics than are available in 2007.

This article presents the second is a series called "Who Counts?" which looks at the huge number of unregistered people around the world and how that impacts medical interventions, financial allotments and human rights. Vital statistics such as recording births and deaths are useful if they are of good quality. In this article, the authors propose a framework for the assessment of the quality of vital statistics and look at the gathering of information in developing countries in 2007. The authors argue that vital statistics should be considered public goods and are a key element for measuring health improvement.

Objectives: To compare maternal characteristics and birth outcomes of Mexico-born and native-born mothers in the United States and those of North African mothers living in France and Belgium to French and Belgian nationals. Methods: We examined information from single live birth certificates for 285,371 Mexico-born and 3,131,632 U.S.-born mothers (including 2,537,264 U.S.-born White mothers) in the United States, 4,623 North African and 103,345 Belgian mothers in Belgium, and a French national random sample consisting of 632 North African and 11,185 French mothers. The outcomes were mean birthweight, low birthweight, and preterm births. Differences between native/nationals and foreign-born mothers in each country were assessed in bivariate and multivariate analyses controlling for maternal risk factors. Results: The adjusted odds for low birthweight were lower for immigrants than native/nationals by 32% in the United States, by 32% in Belgium, and by 30% in France. The adjusted odds for preterm births were lower for immigrants compared with native/nationals by 11% in the United States and by 23% in Belgium. In France, the odds for preterm births were comparable for immigrants and naturalized mothers. Infants of immigrant mothers also had higher mean birthweights in all three countries. Conclusion: Despite their disadvantaged status, Mexico-born and North African-born women residing in the United States, France, and Belgium show good birth outcomes. These cannot be explained solely by traditional risk factors. Protective factors and selective migration may offer further clues. [ABSTRACT FROM AUTHOR]

Studies changes in indications for cesarean deliveries in the United States, for 1985 and 1994. Leading indications for cesarean delivery; Changes in the performance of cesareans attributable to dystocia, breech presentation and fetal distress; Strategies to lower cesarean rates.