Spatial patterns of mortality among the able-bodied population in the Republic of Bashkortostan

Abstract

BACKGROUND: Regional differentiation adds complexity to the issue of high mortality among the working-age population. The identified regional patterns of mortality causes are typically not confined to specific areas, but rather influenced by spatial factors.
 AIM: To study temporal trends in spatial patterns of mortality of the working-age population mortality from the main causes of death in the Republic of Bashkortostan. In addition, we identified territorial factors associated with the mortality patterns and trends.
 METHODS: Mortality data on 6 main causes of death from 54 municipal districts, 20 urban districts and urban settlements were collected for the period from 2002 through 2020. The analysis included estimation of the Moran's index and the spatial panel data modeling.
 RESULTS: Spatial mortality patterns were evident for mortality from diseases of the circulatory system, infectious and parasitic diseases, and external causes. The impact of crime levels in a specific region (male: p=0.046; female: p=0.019) negatively affected mortality rates from circulatory diseases among working-age men and women. Additionally, for men, the volume of gross municipal product (GMP) had an additional effect (p=0.046). Factors that contribute to a decrease in mortality from external causes among able-bodied men and women included the growth of GMP (male: p=0.010; female: p=0.003 — for women), an increase in the number of doctors per 10,000 people in the population (male: p=0.001; female: p=0.037), and the availability of nursing staff (male: p=0.026; female: p=0.005). Furthermore, crime rates had a significant impact on mortality from external causes for men (p=0.028), while the availability of hospital beds played a crucial role for women (p=0.030).
 CONCLUSION: The study provides the evidence on the presence of spatial autocorrelation in the context of causes of death, as well as common and differing factors influencing male and female mortality in Bashkortostan. The findings provide a solid foundation for further analysis of spatially determined factors contributing to mortality among working-age population.