Analysis of mortality in the Czech Republic using the newly constructed

socio-economic deprivation index

Šplíchalová Anna Šlachtová HanaTomášková HanaPolaufová Pavla

Institute of Public Health Ostrava

This study was realized within the Project NR 8480-3 funded by the Czech Ministry of Health

NRL for GI S in Public HealthNRL for GI S in Public Health

Progressive increase of mortality by the level of deprivation is a serious social health problem in many countries

Objective:

Aim:

The aim of the study was the analysis of total and specific mortality in the Czech Republic using by authors newly constructed socio-economic deprivation indices

Material and methods:

Index 1 Index 2

Two census (2001) based indices (Index1, Index2) and two sub-indices (Index2soc, Index2mat) for social and material deprivation were constructed to indicate the level of deprivation in all 77 Czech districts

The correlation of the both indices r = 0.96

Material and methods:

Newly constructed indices were used for the correlation analysis between districts' deprivation level and level of total and specific mortality from the routinely collected health statistics sources (DPS UZIS 2001)

Relationship between SMR (total and selected specific SMR) and indices (INDEX1, INDEX2, INDEX2mat and INDEX2soc) was evaluated by correlation analysis

SMR differences according to degree of district deprivation were evaluated by comparison with average SMR in the Czech Republic

Results:

INDEX1 INDEX2 Mortality Men Women Men Women Total 0.60 0.53 0.60 0.52 Cancer 0.47 0.44 0.48 0.44 Lung 0.55 0.54 Breast 0.02 0.03 Cardiovascular diseases 0.32 0.37 0.30 0.36 Gastrointestinal diseases 0.53 0.41 0.52 0.40 Respiratory diseases 0.31 0.14 0.31 0.14

Correlation between indices (INDEX 1, INDEX 2) and mortality

Both in men and women positive association was confirmed between the level of deprivation (INDEX1 and INDEX2) and total mortality, cancer mortality, mortality for gastrointestinal diseases and mortality for lung cancer in men

These associations were stronger in men than in women

Results:Relationship between degree of deprivation

and SMR for gastrointestinal diseases

women

men

Increased SMR was associated with the highest degrees of deprivation (7 – 10th degree)

The highest increase was found for gastrointestinal diseases mortality in women (up to 53 %), in men (up to 37 %)

Correlation between sub-indices (INDEX2soc and INDEX2mat) and mortality

Results:

Further results of detail analysis using INDEX2soc and INDEX2mat also showed that the investigated total and specific mortality in men and women was more strongly correlated with factors

of social deprivation than material deprivation

Relationship between degree of deprivation and total mortality in men

Results:

Total SMR more strongly correlated with factors of social deprivation than material deprivation

The highest degree of deprivation (7-10) was found in 15.6 % of districts with the total population of 1,681 thousands

inhabitants

Results:Counts of districts/population by degrees

of deprivation (INDEX1) in CR

Conclusions:

Both in men and women positive association was confirmed between the level of deprivation (INDEX1 and INDEX2) and total mortality, cancer mortality, mortality for gastrointestinal diseases and mortality for lung cancer in men

These associations were stronger in men than in women

Further results of detail analysis using INDEX2soc and INDEX2mat also showed that the investigated total and specific mortality in men and women was more strongly correlated with factors of social deprivation than material deprivation

This study was realized within the Project NR 8480-3 funded by the Czech Ministry of Health - Construction of Socio-economic Deprivation Index for Analysis of Routinely Collected data on Health Status of Population with the Use the GIS

Acknowledgement: