Résumé :
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[BDSP. Notice produite par INIST R0xjzEX5. Diffusion soumise à autorisation]. Objectives. Because geographic differences in heath care have been found for many diseases, including those affecting children, there are probably geographic differences in the health care of young children with sickle cell disease. Consequently, survival of young children with sickle cell disease might differ among geographic areas. This study's objective was to identify areas in the United States where young children with sickle cell disease are at especially high and low risk of dying. Methods. Using U.S. death certificate data from 1968 through 1992, the authors calculated the mortality rates of I - through 4-year-old black children with sickle cell disease for states, counties, and cities. Deaths from trauma, congenital anomalies, and perinatal conditions were excluded. Results. From 1968 through 1980 and from 1981 through 1992,1-through 4-year-old black children with sickle cell disease in Florida had a markedly higher risk of dying, and those in Pennsylvania had a markedly lower risk of dying, than the average I-through 4-year-old black child with the disease in the United States. From 1981 through 1992,1 through 4-year-old black children with sickle cell disease in Maryland had the lowest mortality rate in the nation. During the same time period, I - through 4-year-old black children with sickle cell disease in five counties in Florida were at especially high risk while in Baltimore no young black children with the disease died. (...)
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