Sex disparities in premature adult mortality in Estonia 1995-2016: a national register-based study.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
16 07 2019
Historique:
entrez: 19 7 2019
pubmed: 19 7 2019
medline: 7 7 2020
Statut: epublish

Résumé

To quantify sex disparities in cause-specific premature adult mortality in Estonia, to determine the causes of death with the largest differences, to provide insight into related behaviours and to offer some guidance to public health policy-makers based on the results of the study. A national register-based study. Estonia. Individual records of deaths at ages 20-69 years in 1995-2016 from the Estonian causes of death register; data on tobacco smoking and alcohol consumption in the adult population in 1996-2016 from the biennial postal survey of health behaviour. Overall and cause-specific age-standardised mortality rates, average annual percentage changes in mortality, and cause-specific men-to-women mortality rate ratios were calculated. In addition, the age-standardised prevalence proportions of tobacco smoking and alcohol consumption and men-to-women prevalence rate ratios were determined. Overall premature adult mortality decreased considerably during 1995-2016, but no reduction was observed with respect to the large relative sex disparities. In circulatory disease mortality, the disparities widened significantly over time. Extremely high mortality rate ratios were observed for cancer of the upper aerodigestive tract and for lung cancer. There was a stable, more than fivefold male excess mortality from external causes. A fourfold male disadvantage was evident for alcohol poisoning, mental disorders due to alcohol and alcohol-related degeneration of the nervous system as a group. The prevalence of tobacco smoking and harmful alcohol consumption among men exceeded that among women by factors of two and six, respectively. Even though premature adult mortality has markedly decreased over time, there has been no success in diminishing the large sex differences in the mortality patterns, mostly associated with smoking and excessive alcohol consumption, both more prevalent among men. Estonia needs a comprehensive and consistent alcohol policy while maintaining and further developing antitobacco measures.

Identifiants

pubmed: 31315857
pii: bmjopen-2018-026210
doi: 10.1136/bmjopen-2018-026210
pmc: PMC6661706
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e026210

Informations de copyright

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Kaja Rahu (K)

Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.

Mati Rahu (M)

Department of Epidemiology and Biostatistics, National Institute for Health Development, Tallinn, Estonia.

Hajo Zeeb (H)

Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology, Bremen, Germany.
Health Sciences Bremen, University of Bremen, Bremen, Germany.

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