Background
Methods
Cause of death | ICD-9 codes | ICD-10 codes | Age groups | Maps | |
---|---|---|---|---|---|
Men | Women | ||||
ALL CAUSES | All premature (1-74) | Figure 1a | Figure 1b | ||
40-59 |
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3
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5
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60-74 |
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4
|
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6
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Cardiovascular diseases | 390-398, 410-429, 440-459 | I01-I09, I20-I52, I70-I99 | All premature (1-74) | Figure 2 |
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7
|
Cerebrovascular diseases & HTA | 401-405,430-438 | I10-I15,I60-I69 | All premature (1-74) |
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8
|
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9
|
Lung cancer | 162 | C34 | All premature (1-74) | Figure 3a | Figure 3b |
40-59 |
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10
|
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12
| |||
60-74 |
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11
|
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13
| |||
Lip, Oral cavity, Pharynx, Larynx and Oesophageal cancer | 140-149, 150, 161 | C00-C14, C15, C32 | All premature (1-74) | Figure 4 | - |
Colorectal cancer | 153-154.0,154.1 | C18-C20 | All premature (1-74) |
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14
|
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15
|
Breast cancer | 174 | C50 | All premature (1-74) | - |
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16
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17
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18
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Diabetes mellitus (anal.in multiple causes) | 250 (No multiple causes analysis) | E10-E14 | All premature (1-74) | Figure 5 |
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19
|
Mental and neurological Diseases excluding alcohol-related deaths | 290-319, 320-389 (except 291) | F and G , except F10,G312,G621 | All premature (1-74) |
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20
|
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21
|
COPD | 490-492, 496 | J40-J44 | All premature (1-74) |
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22
|
-
|
Alcohol-related death (an.in mult.causes) | 291, 303, 860, 305.0, 425.5, 535.3, 5710:571.3,571.5 (No multiple causes analysis) | F10, G312, G621, I426, K292, K860, K852, K70, K73, K74 (exc. K74.3 K74.4 K74.5), X45 | All premature (1-74) | Figure 6 |
Additional file
23
|
Road accidents | 810-829 | V00-V89 (except V81, V82) | All premature (1-74) | Figure 7 | - |
Non-transport accidents | 850-869, 880-915 | W00-X59 | All premature (1-74) |
Additional file
24
| - |
Suicide | 950-959 | X60-X84 | All premature (1-74) |
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25
| - |
Construction of the maps
Dispersion measures
-
The variation coefficient, as the standard error of the adjusted rates divided by the average adjusted rate for a specific condition and by sex.
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The decile ratio (p90/p10) of the adjusted rates of deceased people. Decile ratios [24] stress the gap between the top and the bottom of a distribution. It is calculated as the number of deaths observed in the lowest 10% of the population (after having ranked the districts according to their mortality rates) divided by the number of deaths observed in the upper 10% of the population [25]. The ratios were presented with their confidence interval. The evolution of the decile ratios over time was measured and tested with a z test according to Altman’s method [26].
Results
Maps
All causes mortality
Cause-specific premature mortality
Natural causes
Cardiovascular diseases premature mortality
Cerebrovascular and hypertensive diseases premature mortality
Lung cancer premature mortality
Lip, oral cavity, pharynx,larynx and oesophagus cancers premature mortality in men
Colorectal cancer premature mortality
Breast cancer premature mortality in women
Diabetes mellitus premature mortality
Mental and neurological diseases premature mortality
Alcohol-related premature mortality
External causes
Road accident premature mortality in men
Non-transport accident premature mortality in men
Suicide premature mortality in men
Dispersion measures
Sex = males | ||||||||
---|---|---|---|---|---|---|---|---|
Cause of death
|
Mean rate 1993-1997
|
Mean rate 2003-2009
|
Coeff.Var. 1993-1997
|
Coeff.Var. 2003-2009
|
Decile ratio [CI] 1993-1997
|
Decile ratio [CI] 2003-2009
|
Change dec.ratio
|
p value
|
ALL CAUSES | 663.6 | 515.7 | 15% | 18% | 1.56 [1.5; 1.6] | 1.71 [1.7; 1.7] | 9.7% | <0.001 |
Lip, Oral cav., Pharybx, Larynx & Oesoph. Ca | 22.1 | 18.2 | 34% | 27% | 3.19 [2.8; 3.7] | 2.56 [2.3; 2.9] | −19.8% | <0.05 |
Lung Ca | 95.6 | 67.0 | 13% | 12% | 1.46 [1.4; 1.5] | 1.47 [1.4; 1.6] | 0.2% | ns. |
Diabetes Mel,multiple causes | . | 28.4 | . | 41% | 3.41 [3.1; 3.8] | . | ||
Diabetes Mel. (underl.cause) | 7.6 | 7.5 | 36% | 50% | 3.19 [2.5; 4.0] | 3.78 [3.1; 4.6] | 18.5% | ns. |
Mental & Neurol. DIS | 20.7 | 23.1 | 24% | 34% | 2.07 [1.8; 2.3] | 2.67 [2.4; 3.0] | 29.5% | <0.01 |
Cerebrov. dis. & HTA | 35.5 | 24.1 | 16% | 22% | 1.56 [1.4; 1.7] | 1.91 [1.7; 2.1] | 22.1% | <0.01 |
Cardio-Vasc. Dis | 155.4 | 101.5 | 14% | 14% | 1.52 [1.5; 1.6] | 1.56 [1.5; 1.6] | 2.8% | ns. |
Chron. Obs. Pulm. Dis. | 35.7 | 23.5 | 29% | 28% | 2.20 [2.0; 2.4] | 2.34 [2.1; 2.6] | 6.1% | ns. |
Alcohol-rel_dt (Mult.causes) | . | 40.6 | . | 46% | 5.60 [5.1; 6.2] | . | ||
Alcohol-rel dt (underl.cause) | 21.0 | 19.8 | 49% | 48% | 7.52 [6.2; 9.1] | 5.64 [4.9; 6.5] | −25.0% | <0.05 |
EXTERNAL CAUSES | 83.1 | 72.0 | 25% | 26% | 1.93 [1.8; 2.1] | 2.00 [1.9; 2.1] | 4.1% | ns. |
Road accident | 29.1 | 20.9 | 35% | 38% | 2.70 [2.4; 3.0] | 3.42 [3.0; 3.9] | 27.0% | <0.01 |
Non transp.acc. (Pois/fall/envir.) | 15.3 | 17.0 | 30% | 32% | 2.60 [2.2; 3.0] | 2.45 [2.2; 2.8] | −5.5% | ns. |
Suicide | 31.9 | 29.8 | 25% | 24% | 2.14 [1.9; 2.4] | 1.83 [1.7; 2.0] | −14.8% | <0.05 |
Sex = females
| ||||||||
Cause of death
|
Mean rate 1993-1997
|
Mean rate 2003-2009
|
Coeff.Var. 1993-1997
|
Coeff.Var. 2003-2009
|
Decile ratio [CI] 1993-1997
|
Decile ratio [CI] 2003-2009
|
Change dec.ratio
|
p value
|
ALL CAUSES | 315.7 | 261.1 | 11% | 14% | 1.40 [1.4; 1.4] | 1.54 [1.5; 1.6] | 9.8% | <0.001 |
Lip, Oral cav., Pharybx, Larynx & Oesoph. Ca | 3.6 | 3.8 | 46% | 33% | 4.74 [3.2; 6.9] | 2.54 [2.0; 3.3] | −46.3% | <0.01 |
Lung Ca | 12.4 | 16.8 | 33% | 28% | 2.69 [2.3; 3.2] | 2.52 [2.2; 2.8] | −6.3% | ns. |
Breast Ca | 34.2 | 26.1 | 14% | 13% | 1.48 [1.3; 1.6] | 1.45 [1.3; 1.6] | −1.8% | ns. |
Diabetes Mel, multiple causes | . | 15.8 | . | 35% | 2.55 [2.3; 2.9] | . | ||
Diabetes Mel. (underl.cause) | 6.6 | 4.4 | 33% | 38% | 2.41 [1.9; 3.1] | 2.93 [2.3; 3.7] | 21.2% | ns. |
Mental & Neurol. DIS | 13.6 | 14.5 | 23% | 31% | 1.99 [1.7; 2.3] | 2.16 [1.9; 2.4] | 8.5% | ns. |
Cerebrov. dis. & HTA | 23.2 | 15.7 | 18% | 18% | 1.72 [1.5; 1.9] | 1.72 [1.5; 1.9] | 0.5% | ns. |
Cardio-Vasc. Dis | 60.9 | 39.2 | 15% | 18% | 1.54 [1.4; 1.7] | 1.79 [1.7; 1.9] | 15.9% | <0.01 |
Chron. Obs. Pulm. Dis. | 7.2 | 7.9 | 39% | 49% | 3.23 [2.6; 4.1] | 4.00 [3.4; 4.8] | 23.9% | ns. |
Alcohol-rel_dt (Mult.causes) | . | 15.2 | . | 49% | 6.06 [5.1; 7.2] | . | ||
Alcohol-rel dt (underl.cause) | 9.4 | 8.5 | 58% | 53% | 7.24 [5.6; 9.4] | 7.39 [5.8; 9.4] | 2.2% | ns. |
EXTERNAL CAUSES | 30.8 | 25.4 | 21% | 22% | 1.86 [1.7; 2.1] | 1.91 [1.7; 2.1] | 2.5% | ns. |
Road accident | 9.3 | 6.0 | 38% | 45% | 2.68 [2.2; 3.3] | 3.65 [2.9; 4.6] | 36.0% | ns. |
Non transp.acc. (Pois/fall/envir.) | 6.7 | 7.0 | 28% | 40% | 2.59 [2.0; 3.3] | 3.25 [2.7; 3.9] | 25.5% | ns. |
Suicide | 11.1 | 10.1 | 25% | 22% | 2.06 [1.7; 2.4] | 2.02 [1.7; 2.3] | −1.9% | ns. |
Discussion
Coding and quality of data issues
Summary and interpretation of the main findings
All cause premature mortality
Interpretation of the cause-specific premature mortality patterns
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Cardiovascular diseases in both sexes
-
Cerebrovascular diseases in men.
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Diabetes in both sexes
-
Mental and neurological Diseases in both sexes
-
Chronic Obstructive Pulmonary Diseases in men (not mapped for women because of a too low number of cases)
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Alcohol-related deaths (excluding cancer-related and external causes) in men (not mapped for women).
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Non-Transport accident in men (not mapped for women)
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Head and Neck, Oesophagus and Liver Cancers (in men)
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Suicide (in men)
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Breast Cancer in women: slightly higher rates are observed in the Western part of the country.
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Lung cancer in men: for all ages (1–74), the disparity is moderate and shows lower-than-average rates in a central northern zone. However, a North–south gradient is observed in men aged 40–59.
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Lung Cancer in women: higher rates are observed in the Eastern part of the country and Brussels
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Colorectal Cancer in men: medium rates in the centrum, some hot spots in a few districts of West Flanders and Hainaut, and lower than average rates in the external districts.
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Road accidents: highest rates in the South of Hainaut, Namur and Luxemburg; rather high rates along the French and German borders.