Bryan L. Sykes

The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013

Background The Global Burden of Diseases (GBD), Injuries, and Risk Factors study used the disability-adjusted life year (DALY) to quantify the burden of diseases, injuries, and risk factors. This paper provides an overview of injury estimates from the 2013 update of GBD, with detailed information on incidence, mortality, DALYs and rates of change from 1990 to 2013 for 26 causes of injury, globally, by region and by country. Methods Injury mortality was estimated using the extensive GBD mortality database, corrections for ill-defined cause of death and the cause of death ensemble modelling tool. Morbidity estimation was based on inpatient and outpatient data sets, 26 cause-of-injury and 47 nature-of-injury categories, and seven follow-up studies with patient-reported long-term outcome measures. Results In 2013, 973 million (uncertainty interval (UI) 942 to 993) people sustained injuries that warranted some type of healthcare and 4.8 million (UI 4.5 to 5.1) people died from injuries. Between 1990 and 2013 the global age-standardised injury DALY rate decreased by 31% (UI 26% to 35%). The rate of decline in DALY rates was significant for 22 cause-of-injury categories, including all the major injuries. Conclusions Injuries continue to be an important cause of morbidity and mortality in the developed and developing world. The decline in rates for almost all injuries is so prominent that it warrants a general statement that the world is becoming a safer place to live in. However, the patterns vary widely by cause, age, sex, region and time and there are still large improvements that need to be made.

Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory tract infections in 195 countries: a systematic analysis for the Global Burden of Disease Study 2015

Summary Background The Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2015 provides an up-to-date analysis of the burden of lower respiratory tract infections (LRIs) in 195 countries. This study assesses cases, deaths, and aetiologies spanning the past 25 years and shows how the burden of LRI has changed in people of all ages. Methods We estimated LRI mortality by age, sex, geography, and year using a modelling platform shared across most causes of death in the GBD 2015 study called the Cause of Death Ensemble model. We modelled LRI morbidity, including incidence and prevalence, using a meta-regression platform called DisMod-MR. We estimated aetiologies for LRI using two different counterfactual approaches, the first for viral pathogens, which incorporates the aetiology-specific risk of LRI and the prevalence of the aetiology in LRI episodes, and the second for bacterial pathogens, which uses a vaccine-probe approach. We used the Socio-demographic Index, which is a summary indicator derived from measures of income per capita, educational attainment, and fertility, to assess trends in LRI-related mortality. The two leading risk factors for LRI disability-adjusted life-years (DALYs), childhood undernutrition and air pollution, were used in a decomposition analysis to establish the relative contribution of changes in LRI DALYs. Findings In 2015, we estimated that LRIs caused 2·74 million deaths (95% uncertainty interval [UI] 2·50 million to 2·86 million) and 103·0 million DALYs (95% UI 96·1 million to 109·1 million). LRIs have a disproportionate effect on children younger than 5 years, responsible for 704 000 deaths (95% UI 651 000–763 000) and 60.6 million DALYs (95ÙI 56·0–65·6). Between 2005 and 2015, the number of deaths due to LRI decreased by 36·9% (95% UI 31·6 to 42·0) in children younger than 5 years, and by 3·2% (95% UI −0·4 to 6·9) in all ages. Pneumococcal pneumonia caused 55·4% of LRI deaths in all ages, totalling 1 517 388 deaths (95% UI 857 940–2 183 791). Between 2005 and 2015, improvements in air pollution exposure were responsible for a 4·3% reduction in LRI DALYs and improvements in childhood undernutrition were responsible for an 8·9% reduction. Interpretation LRIs are the leading infectious cause of death and the fifth-leading cause of death overall; they are the second-leading cause of DALYs. At the global level, the burden of LRIs has decreased dramatically in the last 10 years in children younger than 5 years, although the burden in people older than 70 years has increased in many regions. LRI remains a largely preventable disease and cause of death, and continued efforts to decrease indoor and ambient air pollution, improve childhood nutrition, and scale up the use of the pneumococcal conjugate vaccine in children and adults will be essential in reducing the global burden of LRI. Funding Bill & Melinda Gates Foundation.

Mass Incarceration, Family Complexity, and the Reproduction of Childhood Disadvantage

In this article we examine the link between family complexity—measured by noncustodial parenthood and multiple-partner fertility—and incarceration. In 2012, close to 2.6 million children, or roughly one in twenty-five minors, had a parent in jail or prison. The risk of having a parent currently or ever incarcerated is disproportionately concentrated among black children and children of high school dropouts, many of whom are noncustodial parents. Variation in question wording, differences in length of exposure to parental incarceration, and the measurement of residential parenthood in household-based sample surveys converge to produce different estimates of race and class inequality in having a parent currently or ever incarcerated, when compared to similar estimates of parental incarceration from inmate surveys. Drawing on data from multiple sources and the development of a new method for the estimation of multiple-partner fertility among inmates, we consider how race and class inequality in parental incarceration may contribute to family complexity and the reproduction of childhood disadvantage.

Structuring and Re-Creating Inequality: Health Testing Policies, Race, and the Criminal Justice System:

Research shows that prison inmates have a higher risk of contracting HIV than the general population, which prompts measures aimed at diagnosis, quarantine, and treatment. Research has also linked released inmates to an increase in the HIV incidence rate of communities. The authors explore the disjuncture between institutional policies and potential community outcomes by evaluating health assessments of inmates before and during prison admission. The authors argue that the penal institution is an active agent in structuring and re-creating health inequalities within prisons, thereby exacerbating existing community health inequities when inmates are released. Using data from the 2002 Survey of Inmates in Local Jails and the 2004 Survey of Inmates in State and Federal Prisons, the authors find significant racial, educational, and marital inequalities in health testing and test results. These inequalities vary across types of institutional testing policies and inmate cohorts, with later admission cohorts being less likely to receive HIV tests and future release cohorts having a higher likelihood of being HIV-positive.

Mentoring Marginality The Role of Informal Mentors in the Lives of Socially Disadvantaged Adolescents

Educational attainment is a key predictor of potential contact with the criminal justice system. A growing body of literature implicates social background and parental incarceration as factors that affect the educational, emotional, and behavioral development of children. Wilson argues that the social isolation of the underclass in urban cities prevents youth from being exposed to mainstream individuals who serve as positive role models, thereby solidifying inequality among the socially disadvantaged. This article draws upon a new, nationally representative data set to assess racial differences in informal mentorship among adolescents. We investigate how mentoring affects academic engagement and self-control among disadvantaged youth who have experienced parental incarceration. Using propensity score-matching methods, findings indicate persistent racial differences in the likelihood of having an informal mentor after controlling for measures of neighborhood disorder, social institutions, and social cohesion. Results show that informal mentoring is associated with increased self-control for non-White children who have never had a parent incarcerated but not for Latino youth who have had a parent behind bars. However, informal mentoring has no measurable effect on the academic engagement of adolescents exposed and unexposed to parental incarceration.

The Problem of “Cameo Appearances” in Mixed-methods Research: Implications for Twenty-first-century Ethnography

Amid ongoing controversies in ethnography concerning representation, reproducibility, and generalizability, social scientific scholarship has increasingly taken a mixed-methods turn. While studies that blend qualitative and quantitative data promise to enhance the validity of representations of social worlds under analysis, they cannot escape contending with foundational dilemmas of scientific translation, integration, and commensurability across methodological paradigms. Recent debates have ignited a new line of inquiry about the integration of multiple methods in ethnography. In this paper, we argue that “cameo appearances”—the summoning of either qualitative or quantitative analyses in separate, purely mono-method studies—amounts to a form of methodological tokenism under the guise of methodological pluralism. We articulate sampling design, enhanced training, and curriculum development as crucial for arbitrating these debates as mixed-methods research emerges as a distinct innovation in twenty-first-century ethnography.

Aligning sampling and case selection in quantitative-qualitative research designs: Establishing generalizability limits in mixed-method studies

Quantitative researchers increasingly draw on ethnographic research that may not be generalizable to inform and interpret results from statistical analyses; at the same time, while generalizability is not always an ethnographic research goal, the integration of quantitative data by ethnographic researchers to buttress findings on processes and mechanisms has also become common. Despite the burgeoning use of dual designs in research, there has been little empirical assessment of whether the themes, narratives, and ideal types derived from qualitative fieldwork are broadly generalizable in a manner consistent with estimates obtained from quantitative analyses. We draw on simulated and real-world data to assess the bias associated with failing to align samples across qualitative and quantitative methodologies. Our findings demonstrate that significant bias exists in mixed-methods studies when sampling is incongruent within research designs. We propose three solutions to limit bias in mixed-methods research.

Code of the Classroom? Social Disadvantage and Bullying Among American Adolescents, U.S. 2011-2012

Little research has explored whether social policies aimed at lessening economic hardship affect the prevalence of bullying, particularly after the Great Recession. This article investigates how the strains of neighborhood and cumulative disadvantage are associated with racial differences in bullying, and we consider whether social program participation—enlistment in needs-based social programs to attenuate poverty and disadvantage—upends race-based differences in bullying. Using probit, negative binomial, and propensity score matching methods, we show that adolescents who experience any markers of disadvantage are more likely to bully others, with Black and Hispanic adolescents being more likely to engage in bullying than Whites. Importantly, matched estimates reveal that participation in needs-based social programs eliminates racial differences in bullying.