Population Mortality and Morbidity in Ireland

Transcription

1 Population Mortality and Morbidity in Ireland

2 Agenda Mostly good news But some bad news Cohort analysis Years lost analysis Lessons from study

3 Part 1 The good news

4 Irish Population Mortality Age Standardised Mortality Rates - Ireland Population m f Deaths per 100,000 Year

5 Mortality Improvement by Age Group Males Females Age-band % Reduction % Reduction % 77% % 73% % 37% % 47% % 57% % 52% % 42% % 36% % 32% % 23%

6 Cardiovascular diseases 43% of all deaths are due to such conditions

7 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 Trend in mortality rates from heart disease - males 1962 to % 120% 100% 80% 60% 40% and over 20% 0% year

8 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 Trend in mortality rates from stroke - females 1962 to % 180% 160% 140% 120% 100% 80% 60% 40% and over 20% 0% year

9 Part 2 The bad news

10 International Experience Comparisons Irish male age standardised mortality rates expressed as percentage of average sample country rates Homicid e Suicid e RTAs External causes Liver Diseases Digestive Diseases Bronchitis/asthma Respiratory Diseases Cerebro-vascular disease Heart d iseases Circulatory Diseases Prostate Cancer Breast Cancer Lung Cancer Stomach Cancer Infectious and parasitic diseases Malignant neoplasms -80% -60% -40% -20% 0% 20% 40% 60% 80% Source Calculated from WHO Statistical Information System Mortality Data. Countries: Ireland, Scotland, Denmark, Germany, US, England & Wales, Australia, France, Greece, Sweden, Japan for all except Australia 1995.

11 International Experience Comparisons Irish female age standardised rates expressed as a percentage of average sample country rates Ho micid e Suicid e RTAs External causes Liver Dis eas es Digestive Diseases Bro nchitis/as thma Respiratory Diseases Cerebro-vascular disease Heart diseases Circulatory Diseases Prostate Cancer Breast Cancer Lung Cancer Stomach Cancer Infectious and parasitic diseases Malignant neoplasms -80% -30% 20% 70% 120% Source Calculated from WHO Statistical Information System Mortality Data. Countries: Ireland, Scotland, Denmark, Germany, US, England & Wales, Australia, France, Greece, Sweden, Japan for all except Australia 1995.

12 Mortality rates by cause for year olds Males Males Females Females Cause Infectious and Parasitic 2% 1% 7% 1% Diseases Malignant Neoplasms 7% 9% 10% 23% All Circulatory Diseases 3% 7% 11% 10% Injury and Poisoning 75% 66% 44% 40% Road Traffic Accidents 33% 24% 16% 18% Suicide 25% 26% 15% 12% Homicide 1% 1% 0% 3% Other 16% 15% 12% 7% All Other Diseases 13% 19% 28% 26%

13 Mortality Rates from Road Traffic Accidents Trend in mortality rates from rtas - males 1968 to % 210% 180% 150% 120% 90% 60% % 0% year

14 Mortality Rates from Suicide Trend in mortality rates from suicide - males 1976 to % 350% 300% 250% 200% 150% 100% % 0% year

15 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 age group Significantly higher incidence among males than females Particularly high incidence rate among young males

16 Cancer Second largest cause of death in Ireland

17 Mortality Rates from Lung Cancer Trend in mortality rates from lung cancer - females 1962 to % 800% 600% 400% 200% and over 0% year

18 Mortality Rates from Lung Cancer Trend in mortality rates from lung cancer - males 1962 to % 800% 600% 400% 200% and over 0% year

19 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 Trend in mortality rates from breast cancer - females 1962 to % 270% 240% 210% 180% 150% 120% 90% 60% and over 30% 0% year

20 Part 3 Cohort analysis

21 Male mortality improvements by decade & age group Male mortality improvements Ireland Population split by decade & age group annual rate of mortality improvement age group decade

22 Female mortality improvements by decade & age group Female mortality improvements - Ireland population split by decade & age group annual rate of mortality improvement age group decade

23 Part 4 Assessing impact of diseases on population health

24 Males Cause of Death versus Years Lost Infectious and Parasitic Diseases Breast Cervical Lung Digestive Male age standardised rate split by cause Ireland population 1996 Other Stroke Other circulatory Pneumonia. Bronchitis Asthma Nephrosis. All Injury/Po isoning Road Traffic Accidents Suicide Ho micid e Other Injury All Other Diseases All Malignant Neoplasm Heart Disease All Diseases of Circulatory System Deaths per 100,000 Infectious and Parasitic Diseases Breast Cervical Lung Digestive Stroke Other circulato ry Pneumonia. Bronchitis Asthma Nephrosis. Homicide Male years lost split by cause Ireland population deaths 1996 Other Injury Other Road Traffic Accidents S uic ide Heart Disease All M a lignant Neoplasm All Other Diseases All Injury/P oiso ning All Diseases of Circulatory System 0 10,000 20,000 30,000 40,000 50,000 Years Lost

25 Females Cause of Death versus Years Lost Infectious and Parasitic Diseases Lung Digestive Breast Cervical Female age standardised rate split by cause Ireland population 1996 Other Stroke Other circulatory Pneumonia. Bronchitis Asthma Nephrosis. All Injury/Poisoning Road Traffic Accidents Suicid e Ho micid e Other Injury Heart Disease All Other Diseases All Malignant Neoplasm All Diseases of Circulatory System Deaths per 100,000 Infectious and P arasitic Diseases Lung Digestive Breast Cervical Female years lost split by cause Population deaths 1996 Other Heart Disease Stroke Other circulato ry Pneumonia. Bro nchitis As thma Nephrosis. All Injury/P o is o ning Road Traffic Accidents S uic ide Homicide Other Injury All Other Diseases All Malignant Neoplasm All Diseases of Circulatory System 0 10,000 20,000 30,000 40,000 50,000 Years Lost

26 Part 5: Lessons from study 1. Media attention 2. Years lost concept 3. Importance of non-illness mortality 4. Complexity 5. Can we fix it Yes we can!