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Cirera L, Bañón RM, Maeso S, Molina P, Ballesta M, Chirlaque MD, Salmerón D. Territorial gaps on quality of causes of death statistics over the last forty years in Spain. BMC Public Health 2024; 24:361. [PMID: 38310211 PMCID: PMC10837971 DOI: 10.1186/s12889-023-17616-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/29/2023] [Indexed: 02/05/2024] Open
Abstract
BACKGROUND The quality of the statistics on causes of death (CoD) does not present consolidated indicators in literature further than the coding group of ill-defined conditions of the International Classification of Diseases. Our objective was to assess the territorial quality of CoD by reliability of the official mortality statistics in Spain over the years 1980-2019. METHODS A descriptive epidemiological design of four decades (1980-, 1990-, 2000-, and 2010-2019) by region (18) and sex was implemented. The CoD cases, age-adjusted rates and ratios (to all-cause) were assigned by reliability to unspecific and ill-defined quality categories. The regional mortality rates were contrasted to the Spanish median by decade and sex by the Comparative Mortality Ratio (CMR) in a Bayesian perspective. Statistical significance was considered when the CMR did not contain the value 1 in the 95% credible intervals. RESULTS Unspecific, ill-defined, and all-cause rates by region and sex decreased over 1980-2019, although they scored higher in men than in women. The ratio of ill-defined CoD decreased in both sexes over these decades, but was still prominent in 4 regions. CMR of ill-defined CoD in both sexes exceeded the Spanish median in 3 regions in all decades. In the last decade, women's CMR significantly exceeded in 5 regions for ill-defined and in 6 regions for unspecific CoD, while men's CMR exceeded in 4 and 2 of the 18 regions, respectively on quality categories. CONCLUSIONS The quality of mortality statistics of causes of death has increased over the 40 years in Spain in both sexes. Quality gaps still remain mostly in Southern regions. Authorities involved might consider to take action and upgrading regional and national death statistics, and developing a systematic medical post-grade training on death certification.
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Affiliation(s)
- Lluís Cirera
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca. Ronda de Levante 11, 30008, Murcia, Spain
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Calle de Melchor Fernández Almagro, 3, 28029, Madrid, Spain
- Department of Health and Social Sciences, University of Murcia, IMIB-Arrixaca, 32. 30120, Buenavista, Spain
| | - Rafael-María Bañón
- Medico-Legal Advisor. Ministry of Justice. Calle San Bernardo, 21. 28071, Madrid, Spain
| | - Sergio Maeso
- National Centre for Epidemiology, Carlos III Institute of Health (ISCIII), Avenida Monforte de Lemos 5, 28029, Madrid, Spain
| | - Puri Molina
- SGAIPE. Departament de Salut, Generalitat de Catalunya. Travessera de Les Corts, 131. 08028, Barcelona, Spain
| | - Mónica Ballesta
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca. Ronda de Levante 11, 30008, Murcia, Spain
- Department of Health and Social Sciences, University of Murcia, IMIB-Arrixaca, 32. 30120, Buenavista, Spain
| | - María-Dolores Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB-Arrixaca. Ronda de Levante 11, 30008, Murcia, Spain
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Calle de Melchor Fernández Almagro, 3, 28029, Madrid, Spain
- Department of Health and Social Sciences, University of Murcia, IMIB-Arrixaca, 32. 30120, Buenavista, Spain
| | - Diego Salmerón
- Spanish Consortium for Research On Epidemiology and Public Health (CIBERESP), Calle de Melchor Fernández Almagro, 3, 28029, Madrid, Spain.
- Department of Health and Social Sciences, University of Murcia, IMIB-Arrixaca, 32. 30120, Buenavista, Spain.
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Redondo-Sánchez D, Fernández-Navarro P, Rodríguez-Barranco M, Nuñez O, Petrova D, García-Torrecillas JM, Jiménez-Moleón JJ, Sánchez MJ. Socio-economic inequalities in lung cancer mortality in Spain: a nation-wide study using area-based deprivation. Int J Equity Health 2023; 22:145. [PMID: 37533035 PMCID: PMC10399030 DOI: 10.1186/s12939-023-01970-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 07/19/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Lung cancer is the main cause of cancer mortality worldwide and in Spain. Several previous studies have documented socio-economic inequalities in lung cancer mortality but these have focused on specific provinces or cities. The goal of this study was to describe lung cancer mortality in Spain by sex as a function of socio-economic deprivation. METHODS We analysed all registered deaths from lung cancer during the period 2011-2017 in Spain. Mortality data was obtained from the National Institute of Statistics, and socio-economic level was measured with the small-area deprivation index developed by the Spanish Society of Epidemiology, with the census tract of residence at the time of death as the unit of analysis. We computed crude and age-standardized rates per 100,000 inhabitants by sex, deprivation quintile, and type of municipality (rural, semi-rural, urban) considering the 2013 European standard population (ASR-E). We further calculated ASR-E ratios between the most deprived (Q5) and the least deprived (Q1) areas and mapped census tract smoothed standardized lung cancer mortality ratios by sex. RESULTS We observed 148,425 lung cancer deaths (80.7% in men), with 73.5 deaths per 100,000 men and 17.1 deaths per 100,000 women. Deaths from lung cancer in men were five times more frequent than in women (ASR-E ratio = 5.3). Women residing in the least deprived areas had higher mortality from lung cancer (ASR-E = 22.2), compared to women residing in the most deprived areas (ASR-E = 13.2), with a clear gradient among the quintiles of deprivation. For men, this pattern was reversed, with the highest mortality occurring in areas of lower socio-economic level (ASR-E = 99.0 in Q5 vs. ASR-E = 86.6 in Q1). These socio-economic inequalities remained fairly stable over time and across urban and rural areas. CONCLUSIONS Socio-economic status is strongly related to lung cancer mortality, showing opposite patterns in men and women, such that mortality is highest in women residing in the least deprived areas and men residing in the most deprived areas. Systematic surveillance of lung cancer mortality by socio-economic status may facilitate the assessment of public health interventions aimed at mitigating cancer inequalities in Spain.
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Grants
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- PROYE20023SÁNC High Resolution Study of Social Inequalities in Cancer (HiReSIC), Asociación Española Contra el Cáncer (AECC)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- Not applicable Subprograma de Vigilancia Epidemiológica del Cáncer (VICA), del CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII)
- PI18/01593 EU/FEDER Instituto de Salud Carlos III
- PI18/01593 EU/FEDER Instituto de Salud Carlos III
- PI18/01593 EU/FEDER Instituto de Salud Carlos III
- Not applicable Acciones de Movilidad CIBERESP, 2022
- JC2019-039691-I Juan de la Cierva Fellowship from the Ministry of Science and the National Research Agency of Spain
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Affiliation(s)
- Daniel Redondo-Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain.
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain.
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain.
| | - Pablo Fernández-Navarro
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, 28029, Spain
| | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain
| | - Olivier Nuñez
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, 28029, Spain
| | - Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain
| | - Juan Manuel García-Torrecillas
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Emergency and Research Unit, Torrecárdenas University Hospital, Almería, 04009, Spain
| | - Jose Juan Jiménez-Moleón
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, 18071, Spain
| | - María-José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, 18012, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, 28029, Spain
- Escuela Andaluza de Salud Pública, Granada, 18080, Spain
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Radnic B, Bogdanovic M, Durmic T, Popovic V, Mihailovic Z, Soldatovic I, Atanasijevic T. Can blood alcohol concentration have a role in choosing high lethality method of suicide? AUST J FORENSIC SCI 2020. [DOI: 10.1080/00450618.2020.1757759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Bojana Radnic
- Institute of Forensic Medicine ‘Milovan Milovanovic’, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milenko Bogdanovic
- Institute of Forensic Medicine ‘Milovan Milovanovic’, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Tijana Durmic
- Institute of Forensic Medicine ‘Milovan Milovanovic’, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Vesna Popovic
- Institute of Forensic Medicine ‘Milovan Milovanovic’, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Zoran Mihailovic
- Institute of Forensic Medicine ‘Milovan Milovanovic’, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Ivan Soldatovic
- Institute for Medical Statistics and Informatics, School of Medicine, University of Belgrade, Belgrade, Serbia
| | - Tatjana Atanasijevic
- Institute of Forensic Medicine ‘Milovan Milovanovic’, School of Medicine, University of Belgrade, Belgrade, Serbia
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Artac Ozdal M, Behlul S. Causes of Deaths in Northern Cyprus: Implications for Accurate Recording and Prevention of Deaths. ACTA ACUST UNITED AC 2020. [DOI: 10.2174/1874944502013010014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Reporting the causes of deaths completely and correctly is important to develop interventions for reducing death rates in populations.
Objective:
This study aimed to evaluate the death rates, major causes of deaths and accuracy of recording of death causes in Northern Cyprus between 2007 and 2016.
Methods:
Data on death rates and causes of deaths between 2007 and 2016 were collected. The data were analyzed using SPSS 23 vs to determine the trends in death rates and to evaluate the ranking of causes of deaths.
Results:
There was an overall decrease in crude death rates between 2007 and 2016. The proportion of deaths in Northern Cyprus varied in terms of gender and age between 2007 and 2016, with death rates greater in males compared to females (1.89 times greater in 2007) and with higher death rates in people of older ages compared to younger people. The most common cause of death was ischemic heart diseases in all years, except in 2008, where senility was reported as the most common cause of death.
Conclusion:
There were decreasing trends in mortality rates in Northern Cyprus, with ischemic heart diseases reported as the top cause of deaths in the population. Accurate and complete reporting must be ensured for effective health policies and reduction of health expenditures.
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