Transcript Gender Specific Effects of Early
Причины смерти и методы их анализа
Н.С. Гаврилова
Causes of death and their classification
Established by the World Health Organization as International Classification of Diseases (ICD)
Has several revisions. The most recent revision is the 10 1990s th revision. Adopted by most countries in the mid
Classification of causes of death in Russia
Classification of causes of death used in the Soviet statistical forms was different from WHO classification.
Form #5 (later called form C51) had 185 causes of death. Main differences between WHO and Soviet classification are found in the groups of CVD and injuries
New classification of causes of death in Russia
After dissolution of the Soviet Union most FSU countries continued to use the old classification of causes of death In 1999 Russia adopted a new classification of causes of death corresponding to the 10 th ICD revision Still incompatible with the WHO classification
Major causes of death within the group of injuries. Men
Иванова и др., Demoscope Weekly, N181-182, 2004
Major causes of death within the group of injuries. Women
Иванова и др., Demoscope Weekly, N181-182, 2004
Degradation of mortality statistics in Russia
Pace of Growth of Age-Adjusted Mortality in 1989-2000 for Classes of Causes of Death 4 3 2 1 0 9 8 7 6 5 All causes Injuries Ill-Def.C.
Infections Males Females
Proportion of deaths from ill defined conditions is a measure of quality of mortality statistics Proportion higher than 5% indicates poor quality In developed countries most deaths from ill-defined conditions are diagnosed at older ages
Is this increase in mortality from ill-defined conditions related to more cases of deaths from senility?
200 150 100 50 0
0 2001 1991 20
Age Profile of Mortality from Ill-Defined Conditions in Russia
Males Females 160 140 120 100 80 60 40 20 0 0 40 Age 60 80 20 2001 1991 40 Age 60 80
Injuries Top Five Causes of Death for Young Adult Males (20-24)
1990 2001
Injuries Neoplasms Diseases of Circulatory System Symptoms, Signs and Ill Defined Conditions Diseases of Nervous System and Sens.Organs
Symptoms, Signs and Ill Defined Conditions Infectious Diseases Neoplasms Diseases of Respiratory System
Top Five Causes of Death for Young Adult Females (20-24)
1990 2001
Injuries Injuries Neoplasms Neoplasms Diseases of Circulatory System Diseases of Circulatory System Complications of Pregnancy and Childbearing Symptoms, Signs and Ill Defined Conditions Diseases of Nervous System and Sens.Organs
Infectious Diseases
What Causes of Death Are Hidden Behind the Ill-Defined Conditions?
We Used Individual Death Certificates With More Detailed Description of Circumstances of Death Collected by Kirov Department of Health Kirov is a Typical Russian Region with Lower than Average Mortality from Ill-Defined Conditions
Age-Adjusted Mortality from Injuries in 1996 for Russian Males Aged 0-64 years Data from the WebAtlas Project (http://sci.aha.ru/ATL)
Deaths from Ill-Defined Conditions in Kirov Region of Russia in 2003
Sudden infant death (R95) 3.3% Decomposition in water (river, well, pond) (R99) 13.0% Decomposition at home (R99) 53.5% Decomposition in garden, summer house (R99) 1.7% Decomposition in forest or field (R99) 6.0% Decomposition in nonresidential building, on the street (R99) 12.3% Decomposition in water pipe (R99) 0.7% Decomposition on the cemetery (R99) 0.3% Decomposition in bath, lavatory or barn (R99) 1.0% Decomposition in other place (R99) 5.5% unknown (R99) 2.3% senility (R54) 0.3%
Mortality in Moscow city
80 70 60 50 40 30 20 10 0 1996 1998
Ill-defined conditions injuries of undetermined intent
2000
Year
2002 2004 2006
Ill-defined conditions and external deaths of undetermined intent are two sides of the same coin It appears that both causes of death may be used for concealing criminal cases of violent death
Top Five Causes of External Mortality in Russia and Moscow in 2001 Russia
Suicide Undetermined Injury Homicide
Moscow
Accidental Falls Undetermined Injury All Other Accidental Causes Accidental Poisoning by Alcohol All Other Accidental Causes Homicide Suicide
Autopsies in Russia
Autopsies are used to verify cause of death Autopsy is mandatory for violent death, death of woman during pregnancy, labor or postpartum period, death of infant below 1 year, death from cancer not supported morphologically, death from any infectious disease
Situation with medical examiner services
Only 34-48% of jobs are filled by physicians
38-54% of jobs are filled by histologists
35% of workers reached retirement age
Средний ожидаемый возраст смерти по причинам, женщины России
Васин С., доклад в Киеве 2006
Вероятность для новорожденного умереть на протяжении жизни от семи групп причин смерти (на 100 родившихся), мужчины России
БСК и новообр. – правая ось Васин С., доклад в Киеве 2006
Сравнение структуры смертности мужчин России и Западных стран. 1965 год
Васин С., доклад в Киеве 2006
Сравнение структуры смертности мужчин России и Западных стран. 2004 год
Васин С., доклад в Киеве 2006
Decomposition of the U.S.-Russia gap in life expectancy by cause
USA – 1999; Russia – 2001. Source: Shkolnikov et a. Mortality reversal in Russia.
Decomposition of the U.S.-Russia gap in life expectancy by cause
USA – 1999; Russia – 2001. Source: Shkolnikov et a. Mortality reversal in Russia.
Contribution of different causes of death to changes in LE, men
Contribution of different causes of death to changes in LE, women
Age and cause components of LE increase due to anti-alcohol campaign: Men
Age and cause components of LE increase due to anti-alcohol campaign: Women
Contribution of causes of death to 40 e 20 (CA) 40 e 20 (Slav) Males (total difference = 2.90 years) 1.8
1.6
1.4
1.2
1.0
0.8
0.6
0.4
0.2
0.0
In fe ct io ns N eo pl as m s C V D R es pi ra to ry D is .
D ig es tiv e D is .
In ju ri es O th er c au se s
Contribution of causes of death to 40 e 20 (CA) 40 e 20 (Slav) Females (total difference = .28 years) 0.35
0.30
0.25
0.20
0.15
0.10
0.05
0.00
-0.05
In fe ct io ns -0.10
N eo pl as m s C V D R es pi ra to ry D is .
D ig es tiv e D is .
In ju ri es O th er c au se s