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Population Mortality and Morbidity in Ireland. April 2001. Irish Population Mortality 1962-1996. Mortality Improvement by Age Group. Mortality rates by cause for 15-34 year olds. Mortality Rates from Road Traffic Accidents 1962 - 1996. Mortality Rates from Suicide 1962 - 1996.
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Population Mortality and Morbidity in Ireland • April 2001
International Experience Comparisons Source – Calculated from WHO Statistical Information System Mortality Data. Countries: Ireland, Scotland, Denmark, Germany, US, England & Wales, Australia, France, Greece, Sweden, Japan. 1996 for all except Australia 1995.
International Experience Comparisons Source – Calculated from WHO Statistical Information System Mortality Data. Countries: Ireland, Scotland, Denmark, Germany, US, England & Wales, Australia, France, Greece, Sweden, Japan. 1996 for all except Australia 1995.
Assessing impact of diseases on population health • Cause of death analysis • Years’ lost analysis • Disability years’ lost analysis
Part 2 • Impact of particular causes and lifestyle on Mortality
Agenda • Causes • Cardiovascular conditions • Cancer • Road Traffic Accidents • Suicide • AIDS • Risk factors • Smoking • Diet & Lifestyle
Cardiovascular diseases • 43% of all deaths are due to such conditions • Covers many illness types such as heart failure, diseases of the arteries, stroke and hypertension related diseases • Mortality varies significantly by age and gender • Certain types of these disease are affected by geographic area of residence • Main cause of death for those over 65 years of age • Trend in EU is downwards in relation in to incidence of such diseases • Though need to consider each individual cause separately
Cardiovascular - Heart disease • For heart disease, trend is downwards for both males and females • Mirrors international experience, though fall is at a faster rate than EU average • However, is still higher than EU average
Cardiovascular - Stroke • Trend is downwards for incidence of death due to a stroke for both males and females • Fall again is at a faster rate than EU average • So, much so that there is no statistical difference between Ireland and EU average experience
Cancer • Like cardiovascular conditions many different forms of cancer (Over 200 known) • Not all cancers cause death • Second largest cause of death in Ireland • Incidence rate varies significantly between males and females • Also, within geographic areas depending upon the form of cancer • In international terms, Ireland’s cancer mortality rates are higher than the average
Cancer – Breast cancer • Ireland has one of the highest rates of breast cancer in the EU • Trend for incidence at younger ages is downwards • For older lives, trends appears to be upward • Could be explained by differences in screening programmes • Western world has significantly higher incidence of breast cancer than developing world
Road Traffic Accidents • Road Safety performance over last 30 years has shown considerable improvement • However: • Still one of main cause of deaths within 15-34 age group • By international standards relatively high • At all ages, higher incidence among males than females • By number of deaths largest number within 15-24, 25-34 and 65+ age groups
Suicide • Rate of suicide has risen sharply over the last 20 years • Possible reasons for the increase include: • Underlying rate has increased significantly • Reporting may have increased • Coding may be more accurate • One of main cause of deaths within 15-34 age group • Significantly higher incidence among males than females • Particularly high incidence rate among young males
Suicide • Significant differences between countries • These differences also are by age group • Unable to find any conclusive reason to explain this variation though climate is a possibilty
AIDS Pattern for AIDS: • Low number of cases and deaths in 1980’s followed by a rapid increase in mid-1990’s • Appears to have been dramatic fall since late 1990’s
AIDS • Same picture reflected internationally
AIDS • However, the AIDS pattern is not reflected in HIV rates • Upwards trend since mid-1990’s
AIDS • Could be explained by a change in the development times between onset of HIV, onset of full-blown AIDS and death due to AIDS • Working Party believes significant health issue around increase in HIV levels • However, caution needed in predicting doom as theory that death is only deferred is open to debate • If people are living longer then heretofore increased cost of treatment of AIDS needs to be considered
Smoking • Lifestyle factor with most widely known impact on health • Peto has completed extensive research on smoking patterns between countries • SOA study on Irish Assured Lives has found that mortality for smokers was appproximately twice that for non-smokers • Experience from Peto suggests it is could be as high as three times that of non-smokers
Smoking • 6,000 people die each year as a result of causes attributed to smoking • Certain causes affected more than others from smoking e.g. lung disease, heart disease • By international standards, Irish smoking rates comparatively low for males but high for females • Continued innovative ‘no-smoking’ campaigns are to be encouraged
Diet & Nutrition • No data for working party to consider effects of diet explicity • Long term relationship between health status and diet • International studies have found that there is a change in mortality depending upon the in-take of certain food groups
The good news is mortality will, we believe, improve over the immediate future
Reasons for this Continuation of past trends
Reasons for this Continuation of past trends Cohort Effect
Reasons for this Continuation of past trends Cohort Effect Increasing Wealth
Reasons for this Continuation of past trends Cohort Effect Increasing Wealth Screening
Reasons for this Continuation of past trends Cohort Effect Increasing Wealth Screening Smoking behaviour
The Even Better News The scope for improvement is considerable