Age-gender mortality study on alcohol-induced deaths in Slovakia

OBJECTIVE

Alcohol use is one of the ten most common risk factors threatening global health that is avoidable (ranked fifth after smoking). It is involved in high rates of liver cirrhosis, epilepsy, hypertension, cerebrovascular and mental illness. Negative consequences of family and social drinking are also very significant. The aim of the study is to quantify the gender and age-differentiated disparities in alcohol-related mortality in the population over 16 years between the years 1996-2017 in Slovakia.

METHODS

We used data from mortality reports within 1996-2017 provided by the National Health Information Centre in the Slovak Republic. We applied two-dimensional correspondence analysis where dimensions are age and chosen causes of deaths induced by use of alcohol and classified by the International Classification of Diseases.

RESULTS

In case of males, we found that K74 - Fibrosis and cirrhosis of liver diagnosis almost perfectly corresponds to age 66-75 years, and we documented strong correspondence between K70 - Alcoholic liver disease and age 46-55 years. For females, the most robust finding is that K70 - Alcoholic liver disease corresponds relatively similarly with age groups 26-35, 36-45, 46-55. The results of the analysis allow us to obtain a detailed overview of the development of mortality in individual alcohol diagnoses and their intervention in individual age groups by gender. Mortality for some diagnoses affects the young female as well as male population. We observed that there are systematic differences in alcohol-induced mortality between males and females.

CONCLUSIONS

In such development of the alcohol-related mortality structure, the priority remains the permanent provision of primary, secondary and tertiary prevention at the individual and population level. The results of our analysis represent a valuable platform for health and social policymakers to develop quality national and regional health strategies aimed at eliminating the consequences of alcohol use. Lessons learned from our analysis will be supported by our other geographically oriented analytical lines to link identified and quantified regional disparities in the mortality of alcohol diagnoses to the availability of health care to treat these diseases.

Spatial analysis of alcohol-related mortality in Slovakia

OBJECTIVE

The aim of our study was to investigate the relationship between alcohol-related mortality in Slovak regions, as represented by Nomenclature of Territorial Units for Statistics (NUTS) III level.

METHODS

We used data from mortality reports spanning 1996-2017 in the Slovak Republic. Data was provided by the National Health Information Centre in Slovakia. We applied two-dimensional correspondence analysis where the dimensions are regions and selected alcohol-related deaths diagnoses are classified by the International Classification of Diseases.

RESULTS

Analysis revealed a relationship between the Prešov region and diagnoses I42 - Cardiomyopathy and K29 - Alcoholic gastritis. Furthermore, the Banská Bystrica and Žilina regions correspond to G31 - Degeneration of nervous system due to alcohol and K86 - Alcohol-induced chronic pancreatitis. In the case of K70 - Alcoholic liver disease - the Banská Bystrica, Trenčín and Nitra regions are identified as regions which have an intermediate relationship with this diagnosis. The Trnava region corresponds to F10 - Acute alcohol intoxication. The Trenčín and Nitra regions correspond closely to G62 - Alcoholic polyneuropathy. Perfect correspondence can be seen between the Košice region and K73 - Chronic hepatitis, not elsewhere classified. K74 - Fibrosis and cirrhosis of liver diagnosis also corresponds with the Košice region.

CONCLUSIONS

The results of this analysis provide valuable insights for national and regional health policymakers in the process of preparing high-quality health regional plans, as well as retrospectively assessing the success of existing health policies and interventions in this area. Facts presented in the study justify the need for specialised health care, which is part of the process of building an Integrated Health Care Centre in Slovakia.

Impact of Selected Socio-demographic Factors on the Development of Mortality due to Circulatory System Diseases in the Slovak Republic

AIM

We mapped the situation within a group of diseases of the circulatory system (I00-I99) in the Slovak Republic during 1996-2014. We focused mainly on spatiotemporal differences in mortality while controlling for age and sex.

METHODS

We performed binary logistic regression aiming to reveal socio-demographic factors that influence the odds of dying due to diseases of the circulatory system (I00-I99). In our analysis, the dependent variable was death diagnosis and the independent variables were age, region, gender, and marital status.

RESULTS

Our findings suggest that odds of dying due to diseases of the circulatory system (I00-I99) increased for every year of age by 5.4%. Within the period from 1996 to 2014, the risk of dying from diseases of the circulatory system decreased by 2% every year. We also documented the fact that being female raised the odds of dying due to diseases of the circulatory system (I00-I99) by 12.9% compared to males. Furthermore, it could be argued that serious differences in terms of regional distribution of deaths caused by diseases of the circulatory system (I00-I99) exist in the Slovak Republic.

CONCLUSIONS

We present the development of diseases of the circulatory system (I00-I99) in the Slovak Republic. Differences in spatial distribution of deaths are documented as well as related gender differences. Our study can serve as a tool for policy makers and benchmark for professionals.

Risk of Dying from Cancer by Socio-demographic Indicators in the Slovak Republic

AIM

Cancer mortality distribution was investigated by detailed neoplasms groups, age, sex, marital status of deceased, and regions in the Slovak Republic, and examined how these determinants influence the odds of dying due to cancer.

METHODS

A retrospective analysis of cancer mortality statistics registered in the Slovak Republic during the years 1996-2014. For this time period, data was available only on the underlying subgroups of cancer deaths, place of death, age, year, sex, and marital status. Binary logistic regression was applied for odds of dying calculation influenced by these socio-demographic factors.

RESULTS

The most common are deaths from malignant neoplasms of digestive organs in males as well as females. The biggest difference among both genders is recognized in malignant neoplasms of lip, oral cavity and pharynx, where deaths among males are on average 7.9 times higher in comparison to females. As for place of death the Bratislava region reports the highest level of cancer mortality stated at 25.22% of all deaths, on the contrary the Banská Bystrica region reports only 21.40% of all deaths. Age has a negative influence on odds of dying due to neoplasms compared to all other causes of death by 1.7%. In all regions compared to the reference Bratislava region, the odds of dying from neoplasms are lower. Being female diminishes the odds of dying due to neoplasms by 25.7% compared to males. Yearly the relative ratio of dying from neoplasms increases with respect to all other causes of death. When single people are set as the reference category, the relation of the probability of death from cancer to the probability of death due to other causes of death is higher for married, divorced and widowed persons.

CONCLUSIONS

The results should be taken into account when comparing risk of dying due to cancer among people with the mentioned sociodemographic characteristics. Health policy makers should consider place of death and cancer types while planning hospital care units.

Time Trend, Age and Sex Distribution of Deceased from Diabetes Mellitus at the Regional Level in the Slovak Republic

AIM

To describe the time trends, age and sex distribution of death from diabetes mellitus (E10-E14) as a significant part of endocrine, nutritional and metabolic diseases (E00-E90), during 1996-2014 in the Slovak regions, and to estimate the influence of social characteristics on mortality.

METHODS

Secondary data on deaths during 1996-2014 were gathered from the National Health Information Center in the Slovak Republic. The total crude death rate per 100,000 of the standard Slovak population and age-standardized death rate per 100,000 of the standard European population were calculated by direct standardization. Multilevel logistic regression analysis was performed.

RESULTS

Deaths from diabetes mellitus account for 91.6% of deaths registered in the endocrine, nutritional and metabolic diseases Chapter. The age-standardized death rate per 100,000 of inhabitants decreased from 19.2 in 1996 to 15.3 in 2014 in the Slovak Republic, although a massive increase of up to 32.5 was reported in 1999. The highest age-standardized death rates per 100,000 inhabitants were typical for the Košice, Nitra and Trenčín regions. On the other hand, the lowest counts were recorded in the Bratislava region. Mortality from diabetes mellitus starts to be evident in the 45-49 year age-group in both sexes. The median age of death for women is lower in the 75-79 year age-group in comparison to men although the total crude death rate for men in lower age groups is higher. After age 80 the situation is reversed. The odds of dying due to endocrine, nutritional and metabolic diseases decreases by 0.4% each year. The odds of dying are lower by 17% and 12.3%, respectively, in the Žilina and Prešov regions compared to Bratislava region. Women have a higher probability of dying by 38% in contrast to men, and married couples by 16.7% than singles. Age is proved to be an insignificant factor.

CONCLUSIONS

In spite of the declining trend of mortality from diabetes mellitus, it is necessary to reduce the risk of its incidence by healthier food consumption and physical activity.

On the Structure of Mortality among the Regions in the Slovak Republic

AIM

The Slovak Republic consists of eight regions which may dispose a different structure of cause-specific mortality. The aim of this study is to reveal the regions with higher risk of dying from the main categories of diseases selected according to the chapters of the International Classification of Diseases (ICD-10).

METHODS

Data were obtained from mortality reports throughout 1996-2014. We applied multinomial logistic regression analysis, where the dependent variable is death categories and the explanatory variables are regions, age, year and gender. The Bratislava region and Diseases of the circulatory system are set as the reference level.

RESULTS

We propose a spatiotemporal analysis of the relative risk ratio of dying in the Slovak Republic for every significant group of diseases from the International Statistical Classification of Diseases and Related Health Problems maintained by the World Health Organization. Moreover, we propose gender and age analysis.

CONCLUSIONS

These results could be useful for setting active prevention programs, as well as a hospital network specialising in high risk diagnoses in Slovakian regions.