[Trends in adult mortality in the city of Medellín, Colombia, 1994-2003].
BACKGROUND
The death of an adult affects the family as well as the adults role in its labor and social environment. In developing countries, the load of diseases and associated trauma continues to increase and place increasing demands for the intervention by public health authorities.


OBJECTIVE
Trends of mortality were determined for adults of 20 to 64 years in Medellín, Colombia, between 1994 and 2003 according to sex.


METHODS
A retrospective, longitudinal study was undertaken that analyzed trends in mortality rates. A secondary data source consisted of death certificates recorded at the Departamento Administrativo Nacional de Estadísticas (National Department of Statistics) during the decade 1994-2003.


RESULTS
The rate average of mortality for the decade was 497 deaths per 1000 habitants. Men displayed a risk of dying of 3.5 (95%CI: 2.0-6.0) times that of women. Approximately 59% of the deaths had external causes (i.e., not related to illness or old age). Twenty-nine percent of the female deaths were due to tumors; this trend was positive throughout the decade. The 5 most important causes of mortality were as follows: aggressive behaviors, heart disease, traffic accidents, malignant tumors and pulmonary disease. The trend in deaths due to by external causes was negative, but positive for the deaths due to acute myocardial infarctions (mainly in the 45 to 64 year population) and HIV in young adults. An increasing trend in malignant breast cancer was observed in young adult women, but remained constant in the 45 to 64 year-old female population.


CONCLUSIONS
Mortality in the adult population differs by sex and age. The younger male population is more at risk than women as a consequence of environmental factors in early life. In later life, women are more strongly affected by increasing incidence of cardiovascular disease and malignant tumors. The increased levels of mortality at all age levels represent a problem that generates a high human and economic cost.
Cardona
Doris
D
Grupo de Investigación Demografía y Salud, Universidad de Antioquia, Medellín, Colombia. doriscar@guajiros.udea.edu.co
Agudelo
Héctor Byron
HB
D000293:Adolescent; D000328:Adult; D003105:Colombia; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D012189:Retrospective Studies; D012307:Risk Factors; D012931:Social Environment