Declining Amenable Mortality: Time Trend (2000-2013) and Geographic Area Analysis.

Abstract

To update amenable mortality in 32 OECD countries at 2013 (or last available year), to describe the time trends during 2000-2013, and to evaluate the association of these trends with various geographic areas. Secondary data from 32 countries during 2000-2013, gathered from the World Health Organization Mortality Database. Time trend analysis. Using Nolte and McKee's list, age-standardized amenable mortality rates (SDRs) were calculated as the annual number of deaths over the population aged 0-74years per 100,000 inhabitants. We performed a mixed-effects polynomial regression analysis on the annual SDRs to determine whether specific geographic areas were associated with different SDR trajectories over time. The OECD average annual decrease was 3.6/100,000 (p<.001), but slowed over time (coefficient for the quadratic term=0.11, p<.001). Eastern and Atlantic European countries had the steepest decline (-6.1 and -4.7, respectively), while Latin American countries had the lowest slope (-1.7). The OECD average annual decline during the 14-year period was -0.5 (p<.001) for cancers and -2.5 (p<.001) for cardiovascular diseases, with significant differences among countries. Declining trend of amenable SDRs was continuing to 2013 but with steepness change compared with previous periods and with a slowdown.