Leading Causes of Death And Mortality Rates - carpha

THE CARIBBEAN EPIDEMIOLOGY CENTRE (CAREC) PAHO/WHO EPIDEMIOLOGY DIVISION STATISTICS UNIT

LEADING CAUSES OF DEATH AND MORTALITY RATES (COUNTS AND RATES) IN CARIBBEAN EPIDEMIOLOGY CENTRE MEMBER COUNTRIES (CMCS) 1985

1990

1995

2000

Leading Causes of Death And Mortality Rates (Counts and Rates) in Caribbean Epidemiology Centre Member Countries (CMCs): 1985 1990 1995 2000 ISBN 976-8114-24-4

The Caribbean Epidemiology Centre (CAREC) welcomes requests for permission to reproduce or translate its publications, in part or in full. Applications and enquiries should be addressed to CAREC, which will be glad to provide the latest information on any changes made on the text, plans for new editions, reprints and translations already available.

First Edition 2005

Caribbean Epidemiology Centre (CAREC) – 2005 Pan American Health Organization/World Health Organization (PAHO/WHO)

Publications of the Caribbean Epidemiology Centre (CAREC) enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights are reserved.

The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the CAREC concerning the legal status of any country, territory, city or area of its authorities, or concerning the delimitation of its frontiers or boundaries.

ACKNOWLEDGEMENTS CAREC MEMBER COUNTRIES Anguilla

Ms. Ezra Connor

Grenada

Ms. Angella Joseph, Dr. Allister Antoine

Antigua and Barbuda

Mr. Statchel Edwards

Guyana

Ms. Cheryl Peters, Dr. Navindra Persaud

Aruba

Ms. Maribelle Tromp

Jamaica

Dr. Affette McCaw-Binns, Dr. Deanna Ashley

Bahamas

Ms. Kathleen Wilson

Montserrat

Ms. Grethlyn West

Barbados

Ms. Ingrid Layne

Saint Lucia

Ms. Milva Edmunds-Jerome, Dr. Alina Jamie

Belize

Mr. Engelbert Emmanuel

St. Vincent & the Grenadines

Ms. Sandra Grant, Ms. Marjorie Browne

Bermuda

Ms. Brenda Vanderpool

St. Kitts & Nevis

Ms. Sandra Cotton, Ms. Gail Cranstoun

British Virgin Islands

Ms. Adeline Vanterpool

Suriname

Dr. Widya Punwasi

Cayman Islands

Dr. Alla Kumar

Trinidad & Tobago

Ms. Cheryl Rickson-Pinder

Curaçao and the Netherlands Antilles

Ms. Norediz Lourents, Dr. Izzy Gerstenbluth

Turks and Caicos Islands

Medical Records Department, Ministry of Health

Dominica

Ms. Lidy Warrington

CARIBBEAN EPIDEMIOLOGY CENTRE (CAREC) Dr. Eldonna Boisson, Manager Dr. George Legall, Senior Biostatistician Ms. Marsha Ivey, Biostatistician Mrs. Angela Hinds, Computer Systems Analyst/Programmer Ms. Esther Bissessarsingh, Statistical Information Officer Ms. Stacey Grant, Statistical Information Officer Mr. Nigel Grant, Statistical Information Officer Mr. Michael Dolabaille, Office/Printing Assistant

CONTENTS Foreword

i

List of Abbreviations

ii

Notes to Tables

iii

Table 1.

Selected Mortality Rates: CAREC Member Countries – 1985 1990 1995 2000

1

Table 2.

Age-specific Crude Mortality Rates by Gender: CAREC Member Countries – 1985 1990 1995 2000

1

Table 3a.

Ten Leading Causes of Death: All Genders – CAREC Member Countries – 1985 1990 1995 2000

2

Table 3b.

Ten Leading Causes of Death: Males – CAREC Member Countries – 1985 1990 1995 2000

3

Table 3c.

Ten Leading Causes of Death: Females – CAREC Member Countries – 1985 1990 1995 2000

4

Table 4a.

Ten Leading Causes of Death by Age Group: CAREC Member Countries – 1985

5

Table 4b.


6

Table 4c.


7

Table 4d.


8

Table 5.

Deaths and Crude Mortality Rates (Per 100,000 Population) by Age Group and Gender for Selected Diseases: CAREC Member Countries – 1985 1990 1995 2000

9

Table 6.

Potential Years of Life Lost (PYLL) and PYLL Rate (Per 100,000) by Age Group and Gender for Selected Diseases: CAREC Member Countries – 1985 1990 1995 2000

12

Table 7a.

Causes of Death Due to Communicable Diseases: CAREC Member Countries – 1985 1990 1995 2000

16

Table 7b.

Causes of Death Due to Neoplasms: CAREC Member Countries – 1985 1990 1995 2000

17

Table 7bi.

Causes of Death Due to Neoplasms – Males: CAREC Member Countries – 1985 1990 1995 2000

18

Table 7bii.

Causes of Death Due to Neoplasms – Females: CAREC Member Countries – 1985 1990 1995 2000

19

Table 7c.

Causes of Death Due to Diseases of The Circulatory System: CAREC Member Countries – 1985 1990 1995 2000

20

Table 7d.

Causes of Death Due to Conditions Originating In The Perinatal Period: CAREC Member Countries – 1985 1990 1995 2000

21

Table 7e.

Causes of Death Due to External Conditions: CAREC Member Countries – 1985 1990 1995 2000

22

Table 7f.

Causes of Death Due to All Other Diseases: CAREC Member Countries – 1985 1990 1995 2000

23

Table 8a.

Potential Years of Lost Life (PYLL) and PYLL Rate by Age Group: Communicable Diseases; Neoplasms; Circulatory Disorders: CAREC Member Countries – 1985 1990 1995 2000

25

Table 8b.

Potential Years of Lost Life (PYLL) and PYLL Rate by Age Group: Perinatal Conditions; External Causes; Other Diseases: CAREC Member Countries – 1985 1990 1995 2000

26

Table 9a.

Standardised Mortality Rates by Age Group: CAREC Member Countries – 1985

27

Table 9b.


30

Table 9c.


33

Table 9d.


36

Figure 1.

Crude Mortality Rates for Select Diseases by Year: CAREC Member Countries

39

Figure 2.

Potential Years of Life Lost by Six Major Cause of Death Groups: CAREC Member Countries – 1985 1990 1995 2000

40

Figure 3.

Potential Years of Life Lost by Six Major Cause of Death Groups for Selected Diseases: CAREC Member Countries – 2000

41

Appendix A

Population Distribution by Age Group and Gender: CAREC Member Countries – 1985 1990 1995 2000

42

Appendix B

Formulas Used

43

Appendix C

CAREC Ranking List

44

Appendix D

Mortality Tabulation ICD9/ICD10 Merger Listing

45

FOREWORD Most CAREC member countries (CMCs) have experienced a health transition, with fertility and mortality rates decreasing and disease patterns changing, such that the greatest morbidity and mortality burdens are due to chronic non-communicable diseases (NCDs), AIDS and injuries, paralleled and sometimes driven by social and behavioural changes that affect health. In the Caribbean, CMCs have also been experiencing another phase of the health transition described as a re-emergence of ‘old’ communicable diseases (e.g. tuberculosis) and the emergence of new communicable diseases (e.g. AIDS), together with the increasing prominence of NCDs (e.g. heart disease, cancers and diabetes). A descriptive study of mortality data from all CMCs was conducted for four point years; 1985, 1990, 1995 and 2000. This publication provides the summary, as well as age and sex specific tables for the leading causes of death for these four years. Analyses showed that during 1985-2000, there was an overall 5% decrease in age-adjusted mortality rates in the CMCs and male mortality exceeded female mortality. Overall, as well as among males and females, heart disease was the leading cause of death, with cancers, cerebrovascular diseases, diabetes mellitus and hypertensive disease also in the top five causes in most years. Among cancers, prostate cancer was the leading cause of death among men and among women cancer of the uterus and breast. HIV disease (AIDS) featured in the ten leading causes of death for the first time in 1990 and was the 5th leading cause in 2000. In 2000, AIDS was the largest contributor to premature death (contributing 14% of the total person years of life lost that year); followed by heart disease (7% PYLL), assault/homicide (6% PYLL), diabetes (4% PYLL), cerebrovascular diseases (3% PYLL) and hypertensive disease (2% PYLL). During the period 1985-2000, CMCs observed an increase in mortality due to NCDs diseases, AIDS and assaults (homicides), the latter two causes occurring particularly in the 15-44 year age group. Member states of the Caribbean Community participate in the Caribbean Cooperation in Health, an initiative aimed at improving and sustaining the health of the people of the Caribbean. Phase II of this initiative includes NCDs and AIDS as priority areas, but not intentional injures and violence. The latter two areas must also be considered as priority areas in phase III of this initiative. Non-communicable diseases, AIDS, injuries and violence are often considered to be a manifestation of lifestyle choices, though it must be recognized that choices are greatly affected by social, cultural and economic factors. The determinants of these conditions are influenced by many sectors other than health. Thus, a multi-sectoral, long-term approach is necessary to reverse the increasing mortality due to these conditions. This publication will be useful for public health and medical practitioners, policy makers and researchers, both regionally and internationally. I thank the many persons in our 21 CMCs who have contributed to collecting data for this publication – medical and public health practitioners, mortality data coders, statisticians, epidemiologists, researchers, etc. I also thank the CAREC staff and collaborating partners who have produced this publication.

Dr. C. James Hospedales Director, CAREC Page i

LIST OF ABBREVIATIONS

AIDS

Acquired Immunodeficiency Syndrome

CAREC

Caribbean Epidemiology Centre

CCHD

Caribbean Commission on Health and Development

CDC

Centre For Disease Control and Prevention

CMCs

CAREC Member Countries

CTC

CAREC Assigned Tabulation Code

HIV

Human Immunodeficiency Virus

NCD

Non-Communicable Diseases

PAHO

Pan American Health Organization

PYLL

Potential Years of Life Lost

WYLL

Working Years of Life Lost

ICD

International Classification of Disease

Page ii

NOTES TO TABLES

1.

Data Source: Data submitted to CAREC by Government institutions from the following 21 CAREC member countries: Anguilla; Antigua and Barbuda; Aruba; Bahamas; Barbados; Belize; Bermuda; British Virgin Islands; Cayman islands; Dominica; Grenada; Guyana; Jamaica; Montserrat; Netherland Antilles (Curaçao); St Kitts and Nevis; St Lucia; St Vincent and the Grenadines; Suriname; Trinidad and Tobago; Turks and Caicos Islands

2.

Tables 3A-4D, 7A-7F and 9A-9D are a mixture of ICD 9 and ICD 10 PAHO Mortality Tabulation Listing. Please refer to Appendix C and/or Appendix D for guidance when interpreting.

3.

Tables 3A-4D were ranked using the CAREC Ranking List in Appendix C.

4.

Table 9A - 9D are ordered using the CAREC Assigned Tabulation Code (CTC) in Appendix D

5.

Rates calculated using population figures for CMCs and expressed per 100,000 (see Appendix A and Appendix B)

6.

The ‘Total’ columns and/or rows for the ‘All Genders’ tables are inclusive of ‘unknown’ categories and as such, may not agree with the sum ‘Total’ columns for the Age and Gender specific tables.

7.

Mortality data are not included for the following countries: Aruba for 1985, Bahamas for 1990, Curaçao for 1995 and 2000, Montserrat for 1985 and Grenada for 1995 and 2000.

8.

Mortality data substitutions were made for the following countries: Bermuda - 1994 for 1995; Curaçao - 1987 for 1985; Jamaica - 1996 for 1995 and 1998 for 2000.

9.

Population substitutions were made for following countries: Belize - 1986 for 1985; Grenada 1984 for 1985; and Guyana 1984 for 1985.

Page iii

TABLE 1. SELECTED MORTALITY RATES: CAREC MEMBER COUNTRIES 1985 1990 1995 2000 1985

1990

1995

2000

Crude Death Rate per 100,000

634.9

625.2

683.6

652.0

Under 5 Mortality Rate per 100,000

559.8

469.2

488.7

425.9

Potential Years of Life Lost –