All newly diagnosed cases of Hirschsprung's Disease among children born in Baltimore City and County, Maryland and diagnosed within the Baltimore Standard Metropolitan Area during 1969 through 1977 were identified. Using hospital records and death certificates, 33 cases were ascertained. An overall incidence rate of 18.6 per 100 000 livebirths was found, similar to that reported by others. A high male to female ratio (4.32:1) was found; the ratio for non-whites to whites was 1.67:1. Non-white males had the highest rate, 37.6 per 100 000 livebirths. These findings plus the fact that 9% of these children were also diagnosed as having Down's Syndrome, were evidence that the aetiology of Hirschsprung's Disease may be partially genetic. Among environmental factors studied, there was no time trend and no relationship with socioeconomic status found. Among whites, there was a larger percentage of children who were the first births of mothers aged 30 and above, a result previously reported for children with neural tube defects. Very little is known about micro-environmental factors in relation to Hirschsprung's Disease and this would seem to be the area for future emphasis in research.
Few studies have examined whether risk factors for depressive symptomatology differ in bereaved and nonbereaved individuals or whether risk factors differ in bereaved individuals over time. Between 1979 and 1983 in Washington County, Maryland, the associations between various health and social network variables and depressive symptomatology were evaluated prior to bereavement and at 1 and 12 months after bereavement in 136 widows and 409 married controls. Prior Center for Epidemiologic Studies Depression Scale scores were generally a good predictor of subsequent scores; however, shortly after bereavement prior scores proved relatively uninformative as most widows experienced a marked increase in depressive symptomatology. Poor health and limitations in physical activity at baseline were consistently associated with higher levels of symptomatology. Although having more friends was also consistently associated with lower levels of symptomatology, the effect of family size appeared to be time and circumstance specific. These results suggest that women at risk of prolonged depression after the death of their husbands can be identified prior to or at the time of bereavement and that widows have risk factors similar to those of women at risk of depression in the general community.
The objective was to provide additional background information for a refinement of life events methodolgy. Data about life events for a one year period were gathered from a representative sample of the population in Kansas City, Missouri, and Washington County, Maryland, between 1971-1974. Using binary variable multiple regression, the relationships between individual events, overall scores and demographic variables were examined for 2780 subjects. Age, education, marital status, location and race were shown to be significantly related to scores of one or more on the life events scale. Individual items were also related to these and other demographic variables. Fifteen individual events were shown to be moderately related to one another, so that when one event occurred the other was likely to occur also. Because different subgroups of the population experience different frequencies of total life events and of particular individual events, life events scores can vary considerably from group to group, depending on demographic composition and the appropriateness of the life events list for each demographic subgroup. Such relationships, if not adjusted for, could lead to coincidental associations between life events and health-related outcomes.
A total of 1,144 white married women aged 65-75 years living in Washington County, Maryland were interviewed during February-August 1979 as part of a larger study. This cross-sectional analysis was undertaken to investigate the question of whether or not selected demographic, social network, and social support characteristics of these women were related to their level of depressive symptoms. Women at the low end of the socioeconomic scale were found more likely to have a high level of depressive symptoms than were women at the high end. Two structural characteristics, size and homogeneity of the social network, were also found to be related to symptoms of depression, although only homogeneity of the social network reached statistical significance. There was a larger percentage of women with a high level of depressive symptoms among those with small networks and among those with heterogeneous networks. Those women with good quality networks, which offer the opportunity for social support, were much less likely to have a high level of depressive symptoms than others. Cross-sectionally, social network factors were related to level of depressive symptoms; this relationship now needs to be demonstrated prospectively.
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