Recent advances in informatics technology has made it possible to integrate, manipulate, and analyze variables from a wide range of scientific disciplines allowing for the examination of complex social problems such as health disparities. This study used 589 county-level variables to identify and compare geographical variation of high and low preterm birth rates. Data were collected from a number of publically available sources, bringing together natality outcomes with attributes of the natural, built, social, and policy environments. Singleton early premature county birth rate, in counties with population size over 100,000 persons provided the dependent variable. Graph theoretical techniques were used to identify a wide range of predictor variables from various domains, including black proportion, obesity and diabetes, sexually transmitted infection rates, mother’s age, income, marriage rates, pollution and temperature among others. Dense subgraphs (paracliques) representing groups of highly correlated variables were resolved into latent factors, which were then used to build a regression model explaining prematurity (R-squared = 76.7%). Two lists of counties with large positive and large negative residuals, indicating unusual prematurity rates given their circumstances, may serve as a starting point for ways to intervene and reduce health disparities for preterm births.

Objectives: Previous studies have shown increased rates of death and dementia in older people in specific serious mental illnesses (SMI) such as bipolar disorder or depression. We examined the rates of death and dementia in older people referred into a secondary care psychiatric service across a range of SMIs.Methods: We used an anonymised dataset across 6 consecutive years with 28,340 patients aged 65 years and older from a single secondary care psychiatric trust in the United Kingdom.We identified deaths and incident dementia in patients with bipolar disorder/mania, schizophrenia, recurrent depression and anxiety disorders. We compared mortality and dementia rates between these diagnostic groups and in different treatment settings. We also examined mortality rates and dementia rates compared with general population rates.Results: Patients with schizophrenia showed the highest hazard rate for death compared to other groups with SMIs (hazard ratio, 1.58; 95% confidence interval (CI), 1.18–2.1, with anxiety group the reference). Survival was reduced in patients referred to liaison psychiatry services. There were no significant differences between the SMI groups in terms of rates of dementia. However, risks of death and dementia were significantly increased compared to the general population (standardized mortality rates with 95% CI, 2.6(2.0–3.3), 3.5(2.6–4.5), 2.5(2.0–3.0) and 1.8 (1.4–2.2) and standardized dementia incidence rates with 95% CI, 2.7(1.5–4.1), 2.9(1.5–4.7), 3.8(2.6–5.2) and 4.3 (3.0–5.7) for bipolar disorder/mania, schizophrenia, recurrent depression and anxiety disorders respectively.Conclusions: Older adults referred into an old age psychiatry service show higher rates of dementia and death than those reported for the general population.

Background: Previous studies have shown reduced survival in Lewy body dementia (LBD) compared to Alzheimer’s disease (AD), but the reasons for this are not known. We identified cause of death categories accounting for the reduced survival in LBD.Methods: We linked cohorts of patients with dementia with Lewy bodies (DLB), Parkinson’s disease dementia (PDD) and AD, with proximal cause of death data. We examined mortality by dementia group and hazard ratios for each death category by dementia group in males and females separately. In a specific focus on the dementia group with the highest mortality rate versus reference, we examined cumulative incidence to identify the main causes of death accounting for the excess deaths.Results: Hazard ratios for death were higher in PDD and DLB compared to AD, for both males and females. PDD males had the highest hazard ratio for death across the dementia comparison groups (HR 2.7, 95% CI 2.2–3.3). Compared with AD, hazard ratios for “nervous system” causes of death were significantly elevated in all LBD groups. Additional significant cause‐of‐death categories included aspiration pneumonia, genitourinary causes, other respiratory causes, circulatory and a “symptoms and signs” category in PDD males; other respiratory causes in DLB males; mental disorders in PDD females; and aspiration pneumonia, genitourinary and other respiratory causes in DLB females.Conclusion: Further research and cohort development is required to investigate differences by age group, to extend cohort follow‐up to the whole population and to investigate the risk‐balance of interventions which may differ by dementia group.

Socioeconomic inequality in child mortality highlights opportunities for policies to reduce child deaths. We used singleton birth, death and maternity records from Scotland, 1981–2011, to examine mortality rate differences by age across deprivation quintiles over time. We measured the difference between the most and least deprived quintiles (Q5–Q1) and the slope index of inequality (SII) across all quintiles—measures of the absolute deprivation gap, providing an indication of the public health impact. Q5–Q1 remained relatively constant from 1990 onwards for early neonates, widened in the mid-2000s for late neonates, increased in the 1990 s then decreased in the 2000 s in the post-neonates and declined over time in early childhood. The trend over time in SII showed no significant change for early neonates (P = 0.440), significant decrease for post-neonates (P = 0.010) and early childhood (P = 0.043), and significant increase for late neonates (P = 0.011). Over three decades, the absolute deprivation gap in mortality widened in late neonates but stabilized or declined at other ages. This may reflect improved survival beyond the early neonatal period of babies with conditions related to socioeconomic inequality such as prematurity. Monitoring birth cohort data could enhance understanding of this vulnerable group.