Meščeriakova Olga, Kalėdienė Ramunė, Sauliūnė Skirmantė, Kaselienė Snieguolė, Ronto Rimantė, Jasilionis Domantas
Department of Health Management, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.
BMC Public Health. 2025 Sep 24;25(1):3092. doi: 10.1186/s12889-025-24255-1.
Worldwide, health inequalities have emerged as a big issue of public health. Lithuania, along with other European Union countries, pays great attention to the reduction of health inequalities. However, studies on inequalities in mortality and life expectancy (LE) by marital status over the long term have not been investigated in Lithuania. The aim of this study was to analyze changes in the inequalities of mortality from major causes and LE by marital status in Lithuania during 2001-2014.
The study included Lithuanian residents aged over 30 who died from cardiovascular diseases (CVDs), cancer, external causes, and gastrointestinal diseases during 2001-2014. Age-standardized mortality rates were calculated by marital status per 100,000 person-years. LE was calculated using life tables. Inequalities in mortality and LE by marital status were assessed using rate differences and rate ratios.
The highest mortality rates among married and unmarried Lithuanian population were from CVDs in 2001 and 2014. In the married population, mortality from CVDs, cancer, and external causes decreased, while in the unmarried population, mortality decreased from external causes and from CVDs (only among women) during 2001-2014 (P < 0.01). The rate ratios of mortality from CVDs and cancer increased throughout the study period, as well as from external causes among men and from gastrointestinal diseases among women (P < 0.05). During 2001-2014, LE was significantly higher in the married population than in the unmarried population (P < 0.05). Differences in LE between married and unmarried population increased, but the increase was faster among women (by 4.49% per year, P < 0.001) than among men (by 1.87% per year, P = 0.005).
Inequalities in age-standardized mortality rates (except for gastrointestinal diseases for men and for external causes for women) from major causes of death and in LE by marital status were increasing in Lithuania during 2001-2014. This knowledge provides a better understanding of the impact of sociodemographic factors on mortality and inequality trends in Lithuania, and can also contribute to the development of more effective health policies and strategies.
在全球范围内，健康不平等已成为公共卫生领域的一个重大问题。立陶宛与其他欧盟国家一样，高度重视减少健康不平等。然而，立陶宛尚未对婚姻状况导致的长期死亡率和预期寿命不平等进行研究。本研究的目的是分析2001年至2014年期间立陶宛主要死因死亡率和预期寿命因婚姻状况产生的不平等变化。
该研究纳入了2001年至2014年期间30岁以上因心血管疾病（CVD）、癌症、外部原因和胃肠道疾病死亡的立陶宛居民。按婚姻状况计算每10万人年的年龄标准化死亡率。使用生命表计算预期寿命。通过率差和率比评估婚姻状况导致的死亡率和预期寿命不平等。
2001年和2014年，立陶宛已婚和未婚人群中死亡率最高的是心血管疾病。在已婚人群中，心血管疾病、癌症和外部原因导致的死亡率下降，而在未婚人群中，2001年至2014年期间外部原因和心血管疾病（仅女性）导致的死亡率下降（P<0.01）。在整个研究期间，心血管疾病和癌症的死亡率率比增加，男性外部原因导致的死亡率率比以及女性胃肠道疾病导致的死亡率率比也增加（P<0.05）。2001年至2014年期间，已婚人群的预期寿命显著高于未婚人群（P<0.05）。已婚和未婚人群之间的预期寿命差异增加，但女性的增加速度（每年4.49%，P<0.001）比男性（每年1.87%，P=0.005）更快。
2001年至2014年期间，立陶宛主要死因的年龄标准化死亡率不平等（男性胃肠道疾病和女性外部原因除外）以及预期寿命因婚姻状况产生的不平等在增加。这些知识有助于更好地理解社会人口因素对立陶宛死亡率和不平等趋势的影响，也有助于制定更有效的卫生政策和战略。
