Avoidable mortality across Canada from 1975 to 1999.
BACKGROUND
The concept of 'avoidable' mortality (AM) has been proposed as a performance measure of health care systems. In this study we examined mortality in five geographic regions of Canada from 1975 to 1999 for previously defined avoidable disease groups that are amenable to medical care and public health. These trends were compared to mortality from other causes.


METHODS
National and regional age-standardized mortality rates for ages less than 65 years were estimated for avoidable and other causes of death for consecutive periods (1975-1979, 1980-1985, 1985-1989, 1990-1994, and 1995-1999). The proportion of all-cause mortality attributable to avoidable causes was also determined.


RESULTS
From 1975-1979 to 1995-1999, the AM decrease (46.9%) was more pronounced compared to mortality from other causes (24.9%). There were persistent regional AM differences, with consistently lower AM in Ontario and British Columbia compared to the Atlantic, Quebec, and Prairies regions. This trend was not apparent when mortality from other causes was examined. Injuries, ischaemic heart disease, and lung cancer strongly influenced the overall AM trends.


CONCLUSIONS
The regional differences in mortality for ages less than 65 years was attributable to causes of death amenable to medical care and public health, especially from causes responsive to public health.
James
Paul D
PD
Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue, Toronto, Canada. paul.james@utoronto.ca
Manuel
Doug G
DG
Mao
Yang
Y
D000293:Adolescent; D000328:Adult; D002170:Canada / Q000453:epidemiology; D002423:Cause of Death / Q000639:trends; D002648:Child; D002675:Child, Preschool; D005260:Female; D005843:Geography; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008175:Lung Neoplasms / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D017202:Myocardial Ischemia / Q000401:mortality; D009313:National Health Programs / Q000592:standards* / Q000639:trends; D016012:Poisson Distribution; D014947:Wounds and Injuries / Q000401:mortality