Morbidity, Mortality, and Associated Costs
Based on the some of the financial analysis techniques learned about this week, suggest a cost-effective plan that might use this information to track women’s morbidity and mortality trends in your home state.
The IWHS is a longitudinal study of mortality and cancer occurrence in older women.3,4 The state of Iowa was chosen as the site of this study because of the availability of cancer incidence and mortality data from the State Health Registry of Iowa.
This registry is a participant in the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program. The sample was selected from a January 1985 current drivers list obtained from the Iowa Department of Transportation. The list contained the names of 195,294 women aged 55 to 69 and represented approximately 94% of the women in the state of Iowa in this age range.
In December 1985, a 50% random sample of the eligible women was selected, yielding 99,826 women with Iowa mailing addresses. A 16-page health history questionnaire was mailed on January 16, 1986, followed by a reminder postcard one week later and a follow-up letter four weeks later; a total of 41,837 women responded. Information was collected about basic demographics, medical history, reproductive history, personal and family history of cancer, usual dietary intake, smoking and exercise habits, and medication use.
A paper tape measure also was provided along with detailed instructions for the subject to record selected body measurements: height, weight, and circumferences of the waist and hips.
Determine whether distribution of body fat centrally (i.e., around the waist) rather than peripherally (i.e., on the hips) is associated with increased risk of cancer.
The occurrence of cancer was determined by record linkage with the State Health Registry. A computer program was used to match new cancer cases in the registry with study participants on name, ZIP code, birth date, and Social Security number.
