The National Center for Health Statistics, CDC, has produced an Atlas of United States Mortality which includes maps of rates for the leading causes of death in the United States for the period 1988–1992. As part of this project, many aspects of statistical mapping have been re‐examined to maximize the atlas's effectiveness in conveying accurate mortality patterns to epidemiologists and public health practitioners. Because recent cognitive research demonstrated that no one map style is optimal for answering many different map questions, maps and graphs of several different mortality statistics are included for each cause of death. New mixed effects models were developed to provide predicted rates and improved variance estimates. Results from these models were smoothed using a weighted head‐banging algorithm to produce maps of general spatial trends free of background noise. Maps of White female lung cancer rates from the new atlas are presented here to illustrate how this innovative combination of maps and graphs permits greater exploration of the underlying mortality data than is possible from previous single‐map atlas designs. Published in 1999 by John Wiley & Sons, Ltd. This article is a U.S. Government work and is in the public domain in the United States.
Weight gain advice showed a notable shift for white married mothers during the 1980s, with a large decline in reported advice of less than 22 pounds concomitant with a substantial increase in reported advice of 28 pounds or more. For black married mothers, there was little change in reported advice, except in the proportion of mothers who said they were advised to gain at least 35 pounds, which increased from 2 to 11%. It should be noted that it is not possible to corroborate the information on weight gain advice reported by mothers in 1980 or 1988 because of the lack of similar information from the providers of prenatal care. However, for the 1996 NMIHS, the feasibility of collecting such information from prenatal care providers will be examined. In view of the strong, positive relationship between maternal weight gain and birth weight, optimum weight gain advice for white and black mothers is critical. A recent nationwide survey of practicing dieticians found that 26% of the pregnant mothers they counseled believed that one shouldn't gain more than 20 pounds during pregnancy and that obese women didn't need to gain any weight at all. These beliefs were often culturally transmitted. Although only 12% of white mothers reported advice that did not meet the minimum standard in effect in 1988 and 19% reported advice that did not meet the minimum 1990 IOM guideline for their weight and height, a significantly higher proportion of black mothers reported advice of less than 22 pounds (33%) or the IOM minimum (34%). The far more frequent inappropriate advice reported by black than white mothers cannot be explained by differences in body mass index, age, education, parity, marital status, or site of care. Nevertheless, compliance with advice was almost the same for black and white mothers: More than 70% gained at least 22 pounds when this was the reported weight gain advice. It is thus entirely feasible that more appropriate advice for black women will result in significantly higher weight gains and improvement in infant birth weight and health.
This paper describes a program written in the SAS language which allows constructing a simulation with a subset of the GPSS language. A discrete event model is encoded and then run in the SAS environment. The advantage of this approach is the ability to use the statistical and graphics procedures in SAS for monitoring of the simulation during the run and/or for post-simulation analysis. Examples of the interaction of the GPSS blocks and the SAS pro cedures are provided.
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