National mortality tendencies of population in ukraine and the kharkiv region

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Kharkiv National Medical University

National mortality tendencies of population in ukraine and the kharkiv region

Mishchenko M. M.

Національні тенденції смертності населення України та Харківської області

Міщенко М. М.

Резюме

Мета дослідження: визначити національні тенденції смертності в Україні та Харківській області.

Матеріали і методи: використано дані офіційних джерел статистичної інформації України, проведено систематичний аналіз та узагальнення отриманих даних та розраховано тенденції смертності в Україні та Харківській області.

Результати та висновки. Дослідження відзначило зростання трендів смертності населення України у 2010-2019 рр. (на 100 тис. населення) за кількома групами захворювань: новоутворення (тенденції +3,0 %: чоловіки +3,4 %, жінки +2,2 %) та захворювання органів травлення (відповідно +3,9 %: +1,1 % та 8,3 %). Харківська область лідирує серед регіонів у 2019 році в таких класах: загальний показник - 3 місце (40611 випадків), хвороби системи кровообігу - 2 (28079), ішемічна хвороба серця - 2 (21154), захворювання органів травлення - 2 (1624), зовнішні причини смерті - 2 (2225), новоутворення - 3 (5714), цереброваскулярні захворювання - 4 (5009), захворювання дихальної системи - 4 (810), захворювання сечостатевої системи - 4 (196) і вроджені вади розвитку, деформації та хромосомні аномалії - 4 (69). У Харківській області протягом 2018-2019 рр. виявлено значне зростання трендів як в абсолютних показниках, так і в розрахунку на 100 тис.: ускладнення вагітності, пологів і післяпологового періоду (+300,0 та +293,8 %), певні стани, що виникають у перинатальному періоді (+14,3 та +24,3 %), інші причини (+13,8 та +14,5 %) та сечокам'яна хвороба (+12,0 та +12,9 %) з визначеними найбільшими структурними характеристиками смертності при хворобах системи кровообігу (69,09 %), новоутвореннях (14,04 %), а також нещасних випадках та травмах (5,26 %). Отримані результати загальної динаміки трендів зниження смертності від основних захворювань та їх зростання за окремими нозологіями та структурними характеристиками основних причин смертності в Україні повністю збігаються з даними інших світових досліджень.

Ключові слова: неінфекційні захворювання, смертність, тенденції, Харківська область.

The purpose of the study was to determine national tendencies of mortality in Ukraine and the Kharkiv region.

Materials and methods. Data from official sources of statistical information of Ukraine were used and systematic analysis and generalization of the obtained data was performed and tendencies of mortality in Ukraine were calculated.

Results and discussion. According to the dynamics of mortality rates of the population of Ukraine in 2010-2019, there was a decrease in almost all nosological forms of disease. For some groups of diseases there was a tendency of increasing mortality per 100 thousand population with tendencies for the general population +3.0% and +3.9%, for men +3.4% and +1.1% and women +2.2% and 8.3%.

Obtained results on the overall dynamics of declining tendencies in mortality due to major diseases in recent years and their growth due to some nosologies and structural characteristics of the main causes of mortality are in complete agreement with other studies.

The study noted an increase in tendencies of mortality of population of Ukraine in 2010-2019 (per 100 thousand population) in several disease groups: neoplasms (tendency +3.0%: males +3.4 %, females +2.2%) and diseases of digestive system (respectively +3.9%: +1.1% and +8.3%). The Kharkiv region leads among other regions in 2019 in such classes: overall - 3rd place (40,611 cases), diseases of the circulatory system - 2nd (28,079), coronary heart disease - 2nd (21,154), diseases of the digestive system - 2nd (1,624), external causes of death - 2nd (2,225), neoplasms - 3rd (5,714), cerebrovascular disease - 4th (5,009), diseases of the respiratory system - 4th (810), diseases of the genitourinary system - 4th (196) and congenital malformations, deformities and chromosomal abnormalities - 4th (69). Significant increase in tendencies found in the Kharkiv region during 2018-2019 both in absolute counts and per 100 thousand: complications of pregnancy, childbirth and postpartum period (+300.0 and +293.8%), certain conditions that occur in the perinatal period (+14.3 and +24.3%), other causes (+13.8 and +14.5%) and urolithiasis (+12.0 and +12.9%) with defined structural characteristics of mortality in diseases of the circulatory system (69.09%), neoplasms (14.04%) and accidents and trauma (5.26%).

Conclusion. The obtained results of the general dynamics of decreasing mortality tendencies due to major diseases and their growth due to some nosologies and structural characteristics of the main causes of mortality in Ukraine completely coincide with the data of other studies.

Keywords: non-infectious diseases, mortality, tendencies, the Kharkiv region.

Connection of the study with scientific programs, plans, topics. The work was carried out according to the plan of scientific research work of the Department of Public Health and Health Care Management of the Kharkiv National Medical University of the Ministry of Health of Ukraine “Medical and social aspects of the quality of life of young people with excess weight and obesity”.

Introduction. The registration and analysis of the causes and medical and epidemiological characteristics of mortality is widely used to prioritize investment and track progress towards global health goals [1], especially in view of the abrupt changes in its structure that require constant and dynamic adjustment of global economic and social orientations, strategic decisions and updating global assessments [2-4].

It is determined that the characteristics of mortality vary significantly depending on geographical, medical, demographic, temporal and other characteristics [4].

Thus, studies of recent years show an abrupt increase (by 15.9%) in the age mortality indices during 2019-2020 (from 715.2 to 828.7 deaths per 100 thousand population) [5].

The results of a study by Roth G. A. et al. [6] identify tendencies in the dynamics of the main characteristics of global mortality for 2007-2017. Quantitative population growth has contributed to the increase in overall mortality due to 20 leading causes, among which noncommunicable diseases (NCDs) remain the leading cause of death worldwide and their burden is constantly increasing. Thus, the main causes of death in 2017 were NCDs, which accounted for 73.4% (95.0% confidence interval (CI) 72.5-74.1), while the percentage of other causes (infectious, maternal, neonatal and related to nutrition) amounted to 18.6% (95.0% CI 17.9-19.6) and 8.0% - injuries (95.0% CI 7.7-8.2). The total number of deaths from NCDs in 2007-2017 increased by 22.7% (95.0% CI 21.5-23.9), which is a quantitative increase in deaths by 7.61 million (95.0% CI 7.20-8.01), and in general, global mortality due to NCDs decreased by 7.9% (95.0% CI 7.0-8.8). The number of deaths due to other (infectious, maternal, neonatal and food-related) causes decreased by 22.2% (95.0% CI 20.0-24.0), and global mortality - by 31.8% (95.0% CI 30.1-33.3). The total number of deaths due to injuries increased by 2.3% (95.0% CI 0.5-4.0), and mortality decreased by 13.7% (95.0% CI 12.2-15.1).

Among the main NCDs, the largest number of deaths is due to cardiovascular diseases (17.8 million [95.0% CI 17.5-18.0] deaths), neoplasms (Neo) (9.56 million [95.0% CI 9.40-9.69] deaths) and chronic respiratory diseases (3.91 million [95.0% CI 3.79-4.04] deaths).

The importance of careful study and analysis of the main characteristics of mortality is confirmed by Foreman K. J. et al. [7], who noted that for most countries, prioritizing NCDs and preventing risk factors for their development in health care planning and investment decisions can significantly reduce overall premature mortality rates by 2040. It is projected that by 2040 (compared to 2016) NCDs will take the largest part of years of life lost (YLL) in almost all regions of the world (67.3% of global YLL [95.0% CI 61.9-72.3]). Also, a significant percentage of the world's countries (especially low-income ones) by 2040 will have high levels of other (infectious, maternal, neonatal and nutrition-related) diseases, which will account for a significant proportion of YLL (53.5%) in 2040 [95.0% CI 48.3-58.5] in Sub-Saharan Africa).

The purpose of the study was to determine national tendencies of mortality in Ukraine and the Kharkiv region.

Materials and methods. Data from official sources of statistical information of Ukraine (State Institution “Center for Medical Statistics of the Ministry of Health of Ukraine”) were used to determine national tendencies of mortality in Ukraine. A systematic analysis and generalization of the obtained data was performed and tendencies of mortality in Ukraine were calculated.

Research results. Mortality tendencies in Ukraine and the Kharkiv region for 2010-2019 were determined for some infectious and parasitic diseases (SIPD), Neo, blood and hematopoietic organs diseases (BHOD), endocrine system diseases and eating and metabolic disorders (ESDEMD), mental and behavioral disorders (MBD), diseases of the nervous system (DNS), diseases of the eye and appendix (DEA), diseases of the ear and mammary process (DEMP), diseases of the circulatory system (DCS), hypertension (HTN), coronary heart disease (CHD), cerebrovascular disease (CVD), diseases of the respiratory system (DRS), diseases of the digestive system (DDS), diseases of the skin and subcutaneous tissue (DSST), diseases of the musculoskeletal system (DMSS), diseases of the genitourinary system (DGUS), complications of pregnancy, childbirth and postpartum period (CPCPP), certain conditions that occur in the perinatal period (CPP), congenital malformations, deformities and chromosomal abnormalities (CMDCA), trauma, poisoning and some other consequences of external causes (TPEX), symptoms, signs and abnormalities found in clinical and laboratory studies, not classified in other headings (NC) and external causes of death (ECD).

According to the dynamics of mortality rates of the population of Ukraine in 2010-2019, there was a decrease in almost all nosological forms of disease (SIPD, DCS, DRS and ECD). For some groups of diseases (Neo and DDS) there was a tendency of increasing mortality per 100 thousand population with tendencies for the general population +3.0% and +3.9%, for men +3.4% and +1.1% and women +2.2% and 8.3% (Table 1).

By regions of Ukraine, the highest mortality rates (in absolute numbers) were observed in the Dnipropetrovsk (50,929 cases), Donetsk (41,087) and Kharkiv (40,611) regions and the city of Kyiv (33,137) (Table 2). In terms of 100 thousand population, the highest mortality in 2019 was noted in the Chernihiv (1,861.2 percent), Kirovohrad (1,644.9), Poltava (1,644.2) and Cherkasy (1,642.9) regions (Table 3).

The Kharkiv region, among all regions of Ukraine, had significant mortality rates due to major diseases, both in absolute terms and per 100,000 population (Tables 2 and 3). Thus, in 2019, in absolute terms, the mortality rate in the Kharkiv region due to major diseases in total amounted to 40,611 cases, which is why it ranked third among all regions. Mortality due to SIPD was 348 cases (8th place), Neo - 5,714 (3rd), ESDEMD - 94 (8th), MBD - 23 (16th), DNS - 122 (17th), DCS - 28,079 (2nd), CHD - 21,154 (2nd), cause mortality among the middle-aged population (25-64 years) and a decrease due to infectious and parasitic diseases, tumors, diseases of the musculoskeletal system and connective tissue. Sidney S. et al. [12] showed in recent decades a halt in the decline in age-adjusted mortality rates due to heart disease and a significant percentage reduction in cancer rates.

mortality population national

Table 1 - Mortality of Ukraine population during 2010-2019 according to main classes of causes of death and gender with exclusion of temporary occupied territory of the Autonomous Republic of Crimea, Donetsk and Lugansk regions (no., per 100 thousand population) [8]

Table 2 - Regional mortality in Ukraine in 2019 according to main classes of causes of death with exclusion of temporary occupied territory of the Autonomous Republic of Crimea, Donetsk and Lugansk regions (no.) [8]

Table 3 - Mortality of the population of Ukraine by regions in 2019 by main classes of causes of death without taking into account the temporarily occupied territory of the Autonomous Republic of Crimea and Donetsk and Luhansk regions (per 100 thousand population) [8]

Table 4 - Mortality of the Kharkiv region population during 2018-2019 according to main classes of causes of death

(no., per 100 thousand population) [9]

Notes: * - per all female population, ** - per female population of fertile age, *** - per 1,000 livebirths

Figure 1 - Structural characteristics of mortality in the Kharkiv region in 2019 according to main mortality classes (%)

Conclusion

The study noted an increase in tendencies of mortality of population of Ukraine in 20102019 (per 100 thousand population) in several disease groups: Neo (tendency +3.0%: males +3.4%, females -2.2%) and diseases of digestive system (respectively +3.9%: +1.1% and 8.3%). The Kharkiv region leads among other regions in 2019 in such classes: overall - 3rd place (40,611 cases), DCS - 2nd (28,079),

CHD - 2nd (21,154), DDS - 2nd (1,624), ECD - 2nd (2,225), Neo - 3rd (5,714), CVD - 4th (5,009), DRS - 4th (810), DGUS - 4th (196) and CMDCA - 4th (69).

Significant increase in tendencies found in the Kharkiv region during 2018-2019 both in absolute counts and per 100 thousand: CPCPP (+300.0% and +293.8%), CPP (+14.3 and +24.3%), other causes (+13.8 and +14.5%) and urolithiasis (+12.0 and +12.9%) with defined structural characteristics of mortality in DCS (69.09%), Neo (14.04%) and accidents and trauma (5.26%).

Perspectives of further research. In further studies, it is planned to determine the tendencies of morbidity, disability and mortality from cerebrovascular disease in the Kharkiv region.

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