Disease pattern in Greenland: studies on morbidity in Upernavik 1979-1980 and mortality in Greenland 1968-1985.

The disease pattern is described for the population of Upernavik, which is the administrative centre of a very large, sparsely populated municipality in North Western Greenland. The number of medical contacts per person was by and large similar in Upernavik and Denmark despite different health care systems, but the distribution of diagnoses was different. Persons with poor socioeconomic status (housing conditions and social group) were admitted to hospital more often than those with high status. Mortality in Greenland was studied using a computerized register of causes of death covering all deaths in residents of Greenland during 1968-1985. Age standardized mortality rate was twice as high in Inuit of Greenland as in the population of Denmark but five times higher in children. Mortality due to infectious diseases, ischaemic heart disease and certain accidents decreased during the period studied while mortality due to lung cancer, suicide and homicide increased. Regional differences in mortality were pronounced with high infant mortality and high mortality from acute infections and accidents in the socioeconomically poor settlements and remote districts. The suicide and homicide rates were highest in the capital and in the remote East Greenland. Compared with Denmark, mortality rates were higher in Greenland from most causes with ischaemic heart disease as an exception, being significantly less common in Greenland in both males and females. A comprehensive literature review describes the disease pattern in Greenland with special emphasis on the period after 1970. It is concluded that epidemiology can contribute to future health planning in Greenland and that research and development must be given high priority. Some major health problems facing the Greenlandic community are the high mortality from suicides and homicides, the prevalence of violence often triggered by alcohol, the many accidents, the high infant and child mortality and the high mortality from preventable cancers (lung and cervix).