Age

In the field_options table, where field_name = 'opt_age_group':

While any age grouping is somewhat arbitrary, from a US perspective, the designation of adulthood starting at 16 (rather than 18) and senior citizenship starting at 50 instead of, say, 65, seems awkward. Also, a small inconsistency: the Infant and Child categories share the value of “1”, but other categories don't share boundary ages.

If the purpose of the grouping is for charting age trends, where uniform age range “buckets” are desirable, then 5-year buckets (0-4, 5-9, etc.) or 10-year buckets (0-9, 10-19) are common, e.g., [1]. There are sometimes modifications, e.g., breaking out the “under 1 year” category and capping at “85 years and over”, e.g. [2]. If using 10-year buckets, capping at “90 years and over” [0] or “100 years and over” [6] are common.

Another approach is to avoid groupings in favor of a stated aged, understanding that in some cases that is an estimate (as it may be for group categorization as well). Most straightforward is to just do age in years. Under 1 year can be represented by “0”, or spelled out, e.g., “< 1”. As to how to treat the upper bound, one could choose a very high bound (e.g., “120”), or as lesser bound with a plus, e.g., “100+”, as recommended [6] as part of a new WHO world population standard.

In the US, adulthood legally begins at 18, but some restrictions remain until age 21, and some medical procedures delivered to under-18 patients can be done without parental consent and/or notification. Retirement is traditionally at age 65, but sometimes as early as 62, and in recent years has been slowly raised to 66 or 67.

One example [3] of incorporating this is

The Office of Device Evaluation of the Food and Drug Administration (FDA), in its guidance to pediatric advisory panels [4], suggests

and notes that including adolescents up to the age of 21 is consistent with definitions found in three recent pediatric textbooks. (More about this below.) Another FDA office used the same subpopulations except only up to the age of 16 [5].

The US Census reports in a number of different ways [0], presumably in response to frequent requests. One hierarchy (with increasing granularity from left to right) is:

Another grouping from the same source provides lower bounds at important milestones (but not restating ones that were reported elsewhere, namely 65 and over, 85 and over, and 90 and over):

Also, in Hispanic culture, 15 may be a more notable milestone than 16.

We take the ungrouped approach:

The “display_order” column is an LPF customization that may eventually be propagated to Sahana.

TriagePic, as an input source to LPF, indicates whether a disaster victim should be seen by a “pediatric” specialist or not. If this designation needs to be mapped to an age range, what should it be?

The age range covered by pediatric medical practitioners can vary by country and over time. Prior to World War II in the US, “although some pediatricians … were seeing early adolescents, many chose to discontinue care for patients who were approximately 12 years of age. The age cutoff for admission to hospital pediatric services was 14 years.” [7] An influential 1972 statement by the American Academy of Pediatrics [8] posited a range that “may begin during pregnancy and usually terminates by 21 years of age”. The effort to extend the range was to provide more work for pediatricians servicing a shrinking post-baby-boom demographic and better transitional coverage to teenagers (who even by the end of the 20th century were under-represented in physician visits). A 1981-2 regional survey of pediatricians showed a range of policies, with peak cutoffs for new patients being at their 16th (26%) and 18th (23%) birthdays (and 8% later), and for existing patients at their 16th (13%) and 18th (36%) birthdays (and 13% later) [9].

It would seem in general that the age cutoff varies nationwide. Recent advice from a columnist [10]:

Q: At what age do you consider transferring a child from a pediatrician to a family practitioner? My son is 16 and is beginning to be uncomfortable going to a “baby” doctor.

A: There is not an exact age that is appropriate for changing to an “adult” doctor. […Pediatricians] are well trained specialists in the care of newborns, children, and adolescents, often until they finish college. Some pediatricians even take care of young adults with chronic diseases with whom they have long established relationships….

Particular hospitals may impose particular cutoff policies. For instance, Nationwide Children's Hospital has a cutoff at the 22nd birthday, except for adults of any age with congenital conditions [11].

[0] “United States - QT-P1. Age Groups and Sex: 2000”, US Census Bureau, http://factfinder.census.gov/servlet/QTTable?_bm=y&-geo_id=01000US&-qr_name=DEC_2000_SF1_U_QTP1&-ds_name=DEC_2000_SF1_U

[1] “Population Projections: United States by State, Age and Sex, for the years 2004 - 2030”, Centers for Disease Control and Prevention, http://wonder.cdc.gov/WONDER/help/PopulationProjections.HTML.

[2] “Death rates for twelve age groups from all causes”, www.disastercenter.com/cdc/allcause.html.

[3] “J. Brownstein, K. Kleinman, K. Mandl, “Identifying pediatric age groups for influenza vaccination using a regional surveillance system”, Am. J. Epidemiol., 2005 Oct 1; v 162(7), pp 686-93.

[4] Office of Device Evaluation, FDA, “Guidance for Industry and FDA Staff, Pediatric Expertise for Advisory Panels, Jne 3, 2003, Center for Devices and Radiological Health, FDA.

[5] W. Rodriguez, M.D. “CDER's Experience: What we have learned from the Pediatric Initiative”, www.fda.gov/cder/pediatric/presentation/ped_init-rodriguez/tsld001.htm

[6] O. Ahmad, C. Boschi-Pinto, A. Lopez, C. Murray, R. Lozano, M. Inoue, “Age Standardization of Rates: A New WHO Standard”, GPE Discussion Paper Series: No. 31, EIP/GPE/EBD/WHO.

[7] I. Litt, “Commentary on 'Age Limits of Pediatrics'”, Pediatrics 1998 v 102, pp 249-50. DOI: 10.1542/peds.102.1.S1.249

[8] Council on Child Health/American Academy of Pediatrics, “Age Limits of Pediatrics”, Pediatrics, 1972, v 49, p. 463.

[9] M. Resnick, “Use of Age Cutoff Policies for Adolescents in Pediatric Practice: Report from the Upper Midwest Regional Physician Survey”, Pediatrics 1983 v 72, pp 420-27.

[10] H. Bernstein, M.D., “Age Cut-Off for Visiting a Pediatrician”, http://life.familyeducation.com/teen/medical-care/40530.html

[11] www.nationwidechildrens.org/GD/Templates/pages/medpros/ProfessionalPublications/….