Concepts of Avoidable Mortality for Public Health Research in Germany

Einleitung:

Diverging concepts are use to explain avoidable mortality. One is premature mortality that is used to account for absolute or relative comparisions on population level. The major limitation of the premature mortality concept is the minor application for public health research and confined for adequate regional comparisons. For that reason an adopted approach of avoidable mortality was applied to define avoidable mortality as a selection of causes of death that should be either include amenable deaths to health care (amenable mortality) or avoidable deaths through primary prevention (preventable mortality). This approach preferably can be used to explain potential regional variation in avoidable mortality.

Methode:

A long-term trend analyses was computed with estimates of standardized death rates of preventable and amenable mortality for men and women and for three geographic super-regions – Northwestern, Southwestern and Eastern Germany – for the period of 1990 – 2014. For relative comparison rate ratios are used.

Ergebnisse:

The major outcome reveals that the 'traditional' East-West divide is still evident in men. The analyses provide also strong evidence for an establishing north-south divide in amenable mortality, particularly among women. This north-south gradient will potentially drive the future trends of avoidable mortality in Germany.

Diskussion:

Regional variations in preventable mortality can be explain with higher risk exposure affecting more men in the Northeast of Germany. Also there is an emerging regional gradient for high levels of amenable mortality for women in West Germany that is accounted with unfavorable timeliness and effectiveness of medical care regarding diagnosis and treatment.