Explaining regional disparities in mortality in Poland

We aim to explain regional disparities in mortality in Poland and their changes over the years 1991-2010 taking into account mortality from selected causes of death. The list of causes of death includes causes medically amenable and those dependent on behavioral factors (smoking-related, external causes and Ischemic Heart Disease), but also ill-defined causes. Regional inequalities in mortality are quantified with values of Mean Logarithmic Deviation estimated for regional life-expectancies and separately for gains in life-expectancies in the Polish regions resulting from elimination of selected causes of death. Changes in the value of these indeces are further decomposed to answer the question concerning the source of change in health inequality between Polish regions: changes in population composition and values of life-expectancy in selected regions of the country. Inequalities in life-expectancy between the regions are relatively small and stable over the study period, but the inequalities related to selected causes differ. With the exception of medically amenable causes, this effect is stronger among males. In general, the largest negative effect characterizes medically-amenable causes of death and mortality from IHD. Effect of smoking-related and ill-defined causes is relatively small for the inequality in mortality between Polish voivodships.

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