Dossier n. 156/2007 [Abstract] Atlas of mortality in Emilia-Romagna Region. 1998-2004

The aim of this volume is to analyze mortality phenomenon in Emilia-Romagna through appropriate and different synthesis tools. The analysis of mortality is since long time a fundamental aspect of epidemiological research and a global health indicator. It allows to study the distribution of the most lethal pathologies in populations and to make causality hypotheses between risk factor and pathology.

The volume is mainly descriptive, but it can nonetheless suggest questions on the reasons of particular geographical, temporal, sex and age death distributions; it can also support decision-makers to identify appropriate health policies and interventions.

Mortality is stratified by cause according to ICD IX international classification, both by general population and by sex. Results are aggregated by year, by time period, by Municipality and by Health Unit of residence.

The volume is divided in two sections:

• the first is dedicated to general mortality and cancers,
• the second is dedicated to other death causes.

The first section describes in particular the following death causes:

• general mortality
• all cancers
• malignant cancer of stomach
• malignant cancer of colon, rectum, sigmoid flexure, anus
• malignant cancer of trachea, bronchuses, lungs
• malignant breast cancer in women
• malignant cancer of uterus
• other cancers

The second section presents other death causes:

• diabetes mellitus
• AIDS
• cardiovascular disease
• acute myocardial infarction
• other heart diseases
• vascular diseases of the encephalon
• respiratory diseases
• bronchitis and asthma
• digestive system diseases
• traumas and poisonings
• car and other vehicles accidents
• suicides and self inflicted injuries
• involutive/degenerative brain diseases

In the various chapters the following data are detailed: regional (1986-2004) and national (1986-2002) trends; mortality rates standardized by region; regional 2004 mortality data, divided by Health Unit, sex and cause; total number of deaths, raw and standardized rates with confidence intervals (1998-2004) aggregated by residence; geographical maps of relative risk by Municipality; for some causes average years of potential life lost.

In the CD mortality data from the regional database since its creation in 1995 are presented. In particular, absolute figures and specific rates by 10-year-age-class, cause, Health Unit and year in the period 1995-2004 are available through an aggregate dataset.

At a first glance, considering standardized mortality rates by all causes, in 2002 Emilia-Romagna was below the national datum for both sexes. The analysis of regional standardized mortality rates (1986-2004) shows for cancers a decreasing trend but still markedly above the national datum for women and slightly above for men. Only the datum on lung cancer differs from this trend, being above the national datum and increasing. Women’s breast and uterus cancers are slowly decreasing with a trend similar to the national one.

As far as the other death causes, the Emilia-Romagna trend is nearly always below the national datum and decreasing. Some exceptions are represented by infarction - the standardized rate is the same as the national one - and other heart ischemic diseases - that do not present relevant variation in the period considered. AIDS shows a bell trend with the peak appearing in 1995-1196; the regional datum is superior to the national one. The regional datum for traumas and poisonings (included suicides, self inflicted injuries and car accidents) is above the national one; involutive/degenerative brain diseases in elderly people present a strongly increasing trend, with the regional datum always superior to the national one.

The analysis on geographical sub-areas shows a certain homogeneity of general mortality; some statistically significant mortality excesses are however recorded in the provinces of Piacenza and Ferrara and in the Appennines of Parma and Bologna, while the Romagna datum is below the regional one. Such distribution is confirmed also for the main deadly pathologies (over all cardiovascular diseases); others are characterized by specific geographical distributions that demonstrate the presence of particular patterns of risk factors: lung cancers (in particular provinces of Ferrara and Piacenza), stomach cancers (Romagna, in particular the Appennines), liver cancer (high risk in the provinces of Piacenza and Parma) and car accidents (mainly along the Adriatic coast).