Assessing premature mortality: an indicator selection analysis using data from Republic of Moldova, Czechia, and Switzerland

Abstract

Premature mortality is a highly intricate concept, and despite its extensive exploration in specialized literature, a universally agreed-upon definition remains elusive. This study seeks to compare two distinct models of premature mortality analysis in order to determine the more appropriate approach within the national context. The relevance of this study is underscored by the observed mortality rates in Moldova, particularly the concern surrounding adult male mortality. To achieve this objective, a comparison was conducted involving the following indicators: the proportion of deaths before a specific age threshold, Potential Years of Life Lost (PYLL), disparity in lifespans, and age thresholds derived from lifespan disparity. The analysis primarily adopts a comparative approach, and as such, data from Czechia and Sweden were employed for this purpose. In the context of Moldova, identifying a universally accepted set of indicators to effectively monitor premature mortality proves to be a complex task. Conventional indicators are susceptible to variations caused by age and population structure. The application of standardization methods can mitigate the impact of these factors. Alternatively, the "dynamic" approach indicators are less influenced by age and population structure, yet their methodology is more intricate, posing challenges for interpretation. Nonetheless, the establishment and promotion of such an indicator set are undeniably imperative. It is noteworthy that the selection of indicators for monitoring premature mortality is influenced by prevailing scientific or actuarial interests, as well as the specific goals outlined for the analysis.