The European Journal of Public Health Advance Access originally published online on April 2, 2007
The European Journal of Public Health 2007 17(6):593-599; doi:10.1093/eurpub/ckm022
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Mortality and Life Expectancy |
Estimating mortality and causes of death in Turkey: methods, results and policy implications
Seval Akgün1, Chalapati Rao2, Nazan Yardim3, Berrak Bora Basara3, Ozlem Ayd
n1,
Salih Mollahaliloglu3 and
Alan D. Lopez2
1 Baskent University School of Medicine, Ankara, Turkey
2 School of Population Health, University of Queensland, Queensland, Australia
3 School of Public Health, Ministry of Health, Turkey
Correspondence: Prof. Alan D. Lopez, PhD, FAFPHM, School of Population Health, University of Queensland, Herston Road, Herston, Queensland 4006, tel: +617 3346 4623, fax: +617 3365 5442, e-mail: a.lopez{at}sph.uq.edu.au
Received August 21, 2006 , accepted February 12, 2007
Background: Cause-specific mortality statistics are primary evidence for health policy formulation, programme evaluation, and epidemiological research. In Turkey, a partially functioning vital registration system in urban areas yields fragmentary evidence on levels and causes of mortality. This article discusses the application of innovative methods to develop national mortality estimates in Turkey, and their implications for national health development policies. Methods: Child mortality levels from the Demography and Health Survey (DHS) were applied to model life tables to estimate age-specific death rates. Reported causes of death from urban areas were adjusted using re-distribution algorithms from the Global Burden of Disease (GBD) Study. Rural cause structure was estimated from epidemiological models. Local epidemiological data was used to adjust model-based estimates. Results: Life expectancy at birth in 2000 was estimated to be 67.7 years (males) and 71.9 years (females), about 8–10 years lower than in Western Europe. Leading causes of death include major vascular diseases (ischaemic heart disease, stroke) causing 35–38% of deaths, chronic obstructive lung disease and lung cancer in men, but also perinatal causes, lower respiratory infections and diarrhoeal diseases. Injuries cause about 6–8% of deaths, although this may be an underestimate. Conclusions: Mortality estimates are uncertain in Turkey, given the poor quality of death registration systems. Application of burden of disease methods suggests that there has been progress along the epidemiological transition. Key health development strategies for Turkey include improved access to communicable disease control technologies, and urgent attention to the development of a reliable, nationally representative health information system.
Keywords: causes of death, health policy, mortality, Turkey, vital registration
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