[波兰死亡率最高地区劳动年龄人口男性超额死亡率趋势]

[Trends in excess male mortality in the working age population in a region with the highest mortality rates in Poland].

作者信息

Ciabiada-Bryła Beata, Pikala Małgorzata, Burzyńska Monika, Drygas Wojciech, Maniecka-Bryla Irena

机构信息

Uniwersytet Medyczny w Łodzi / Medical University of Lodz, Łódź, Poland (Wydział Nauk o Zdrowiu, Katedra Medycyny Społecznej i Zapobiegawczej, Zakład Medycyny Zapobiegawczej / Faculty of Health Sciences, Chair of Social and Preventive Medicine, Department of Preventive Medicine).

Uniwersytet Medyczny w Łodzi / Medical University of Lodz, Łódź, Poland (Wydział Nauk o Zdrowiu, Katedra Medycyny Społecznej i Zapobiegawczej, Zakład Epidemiologii i Biostatystyki / Faculty of Health Sciences, Chair of Social and Preventive Medicine, Department of Epidemiology and Biostatistics).

出版信息

Med Pr. 2020 May 15;71(3):325-335. doi: 10.13075/mp.5893.00932. Epub 2020 Apr 2.

DOI:10.13075/mp.5893.00932

PMID:32242879

Abstract

BACKGROUND

The intensity of premature deaths in the Łódź region in 2014 amounted to 40 per 10 000, and was the highest in the country (the average rate for Poland was 32). Excess mortality of men aged <65 continues to be a major medical and social problem. The aim of the study is to analyze time trends of excess male mortality in the working age population in the Łódź region, both in general and due to the most important causes of deaths.

MATERIAL AND METHODS

The research material consists of information on 144 589 deaths of the Łódź region inhabitants aged 20-64 in 1999-2014. Crude and standardized mortality rates were calculated, as well as excess male mortality rates both in general and by cause of death. Standardization was carried out using the direct method according to the standard European population. A study of time trends was performed with the use of the joinpoint regression analysis. Average annual percentage rates of changes were estimated.

RESULTS

The excess mortality rate of men at the productive age decreased from 2.9 to 2.8 in the Łódź region in 1999-2014. The most important causes of death among men aged 20-64 in 2014 were (rates per 10 000): cardiovascular diseases (19.1), malignant neoplasms (16.6) and external causes of death (12.3). Among women, the most significant were malignant neoplasms (11.1), cardiovascular diseases (5.1) and diseases of the digestive system (2.1). The excess mortality rate of men aged 20-64 in the analyzed period reached the highest values due to external causes of death (5.1-7.3) and cardiovascular diseases (3.0-3.7). The highest rate of the decline in excess male mortality in 1999-2014 was recorded due to malignant neoplasms, on average 1.4% per year (p < 0.05). Meanwhile, the fastest growth concerned external causes of death, on average 1.0% per year (p < 0.05).

CONCLUSIONS

Despite the decline in the mortality rates among both sexes, excess male mortality due to external causes of death and cardiovascular diseases increased. Med Pr. 2020;71(3):325-35.

摘要

背景

2014年罗兹地区过早死亡强度为每万人40例，是全国最高的（波兰平均水平为32例）。65岁以下男性的超额死亡率仍然是一个主要的医学和社会问题。本研究的目的是分析罗兹地区劳动年龄人口中男性超额死亡率的时间趋势，包括总体情况以及最重要的死亡原因。

材料与方法

研究材料包括1999 - 2014年罗兹地区20 - 64岁居民144589例死亡的信息。计算了粗死亡率和标准化死亡率，以及总体和按死因分类的男性超额死亡率。根据欧洲标准人口，采用直接法进行标准化。使用连接点回归分析对时间趋势进行研究。估计了平均年变化率。

结果

1999 - 2014年罗兹地区生产年龄男性的超额死亡率从2.9降至2.8。2014年20 - 64岁男性中最重要的死亡原因（每万人死亡率）为：心血管疾病（19.1）、恶性肿瘤（16.6）和外部死因（12.3）。女性中，最重要的是恶性肿瘤（11.1）、心血管疾病（5.1）和消化系统疾病（2.1）。在分析期内，20 - 64岁男性的超额死亡率因外部死因（5.1 - 7.3）和心血管疾病（3.0 - 3.7）达到最高值。1999 - 2014年男性超额死亡率下降最快的是恶性肿瘤，平均每年1.4%（p < 0.05）。同时，增长最快的是外部死因，平均每年1.0%（p < 0.05）。