Widening regional inequality in premature mortality rates in Manitoba.
OBJECTIVE
To describe regional trends in premature mortality in Manitoba.


METHODS
Comparison of all-cause and cause-specific mortality of persons less than age 75 in 11 Regional Health Authority populations over two time periods: 1985-89 and 1990-94.


RESULTS
The provincial premature mortality rate declined over the two time periods (4.00/1,000 to 3.72/1,000). Declines were also observed in 9 of 11 regional populations. Premature mortality increased, however, in the 2 regional populations with the highest mortality rates in the first observation period.


CONCLUSIONS
Declining premature mortality in low mortality populations and rising premature mortality in high mortality populations has resulted in a widening of regional mortality rates in Manitoba. Recent policy initiatives in many provinces, including the devolution of authority for the management and delivery of health services and the implementation of population need-based funding formulas to share health care resources among regional health authorities, if implemented, have the potential to partially mitigate the processes producing these widening regional health inequalities.
Mustard
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CA
Faculty of Medicine, University of Manitoba. cmustard@iwh.on.ca
Derksen
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Black
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D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002423:Cause of Death / Q000639:trends*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D020380:Needs Assessment / Q000458:organization & administration; D011159:Population Surveillance; D012041:Regional Medical Programs / Q000458:organization & administration; D017678:Sex Distribution