Regional differences in mortality: a comparison between Austria, Hungary and Switzerland.

BACKGROUND

Important differences in mortality rates exist even between neighbouring countries. This should facilitate the identification of the lifestyle parameters underlying these differences. The mortality rates obtained in Hungary, Austria and Switzerland were compared.

METHODS

The mortality rates for all-cause, total cardiovascular, total cancer and stroke mortality were obtained from a special tape from WHO. Nutritional data were obtained from FAO food balance sheets and from dietary surveys. Gompertz and polynomial equations were calculated from the age-specific mortality rates.

FINDINGS

Great differences in mortality exist between the three countries. In the period from 1950 until 1995 mortality decreased in Austria and Switzerland, but increased in Hungary. In men, total cancer and total cardiovascular mortality also increased markedly in Hungary during the last 20 years. Hungary has a lower dietary P/S ratio, a higher level of animal/vegetal fat and a lower consumption of fruit than Austria and Switzerland, combined with a high level of salt consumption. The level of cigarette smoking is similar in Hungary and Switzerland. The increase in mortality rate in Hungary is less pronounced in women than in men.

INTERPRETATION

The major differences in lifestyle between the three countries concern socio-economic and nutritional patterns. Epidemiological evidence favours nutrition as the most important determinant of the differences in mortality rates between the three countries.