Determinants of premature mortality in a city population: An eight-year observational study concerning subjects aged 18–64

Abstract

Background: Premature deaths constitute 31.1% of all deaths in Łódź. Analysis of the causes of premature deaths may be helpful in the evaluation of health risk factors. Moreover, findings of this study may enhance prophylactic measures. Material and Methods: In 2001, 1857 randomly selected citizens, aged 18-64, were included in the Countrywide Integrated Noncommunicable Diseases Intervention (CINDI) Programme. In 2009, a follow-up study was conducted and information on the subjects of the study was collected concerning their health status and if they continued to live in Łódź. The Cox proportional hazards model was used for evaluation of hazard coefficients. We adjusted our calculations for age and sex. The analysis revealed statistically significant associations between the number of premature deaths of the citizens of Łódź and the following variables: a negative self-evaluation of health -HR = 3.096 (95% CI: 1.729-5.543), poor financial situation -HR = 2.811 (95% CI: 1.183-6.672), occurring in the year preceding the study: coronary pain -HR = 2.754 (95% CI: 1.167-6.494), depression -HR = 2.001 (95% CI: 1.222-3.277) and insomnia -HR = 1.660 (95% CI: 1.029-2.678). Our research study also found a negative influence of smoking on the health status -HR = 2.782 (95% CI: 1.581-4.891). Moreover, we conducted survival analyses according to sex and age with Kaplan-Meier curves. Conclusions: The risk factors leading to premature deaths were found to be highly significant but possible to reduce by modifying lifestyle-related health behaviours. The confirmed determinants of premature mortality indicate a need to spread and intensify prophylactic activities in Poland, which is a post-communist country, in particular, in the field of cardiovascular diseases. Attempts to find reasons of deaths in the first decade of the 21st century may lead to a detailed and long-term research which would focus on determining a wide spectrum of factors contributing to the mortality of Łódź citizens. This in turn, may lead to implementation of a multidimensional prophylaxis which would contribute to improving the state of health of the inhabitants of Łódź as well as other cities and industrial populations, where the population of Łódź may act as a representative. THE AIM OF THE STUDYThe study aimed at listing factors which determine premature mortality of the citizens of Łódź, basing on the results of empirical data the sources of which are multidirectional epidemiological studies. Researchers attempt to identify factors influencing the phenomenon of premature deaths.

The association of insomnia and depressive symptoms with all‐cause mortality among middle‐aged and old adults

“…Major depressive disorder and depressive symptoms have been associated with premature risk of death and mortality. 19,20 Over a 12-year follow-up of community dwelling old adults, men with depression, for example, had a 1.9 times higher death rate than men without depression. 21 One explanation for this finding may be the high suicide completion rate among depressed men, and in particular non-Hispanic White men.…”

“…23 Similarly, symptoms of insomnia have been associated with higher odds of mortality and premature risk of death, though the effect size is more modest than that associated with depression. 4,20 In a communitybased sample of middle-aged adults in Norway followed for 13 to 15 years, models adjusting for demographic characteristics, lifestyle behaviors, mental health, and health variables found insomnia to be associated with a 3-fold increase in mortality. When models were run with a continuous measure of insomnia symptoms, for each increasing score value (from zero to 16), the mortality rate increased by 10%.…”

Years of Life Lost Due to External Causes of Death in the Lodz Province, Poland

“…External causes of death are the third most common cause for both inhabitants of Poland and the Lodz region. The most common causes of death are cardiovascular diseases followed by malignant neoplasms [2][3][4][5][6][7][8][9][10]. An analysis of mortality in particular age groups confirms that external causes most often affect people aged 15-39 and they contribute to 45% of all deaths, which results in the greatest number of lost years [11].…”

Years of Life Lost due to Premature Mortality in a Province with the Shortest Life Expectancy in Poland

“…The economic transformation which occurred in Poland after 1989 substantially influenced lifestyle and health behaviours of Polish society (1)(2)(3)(4). The development of new medical technologies and modern diagnostic methods have improved many aspects of health: for example, a decrease in the death rate led to an increase in average life expectancy.…”