The impact of avoidable mortality on life expectancy at birth in Spain: changes between three periods, from 1987 to 2001.
OBJECTIVE
To evaluate the impact of avoidable mortality on the changes in life expectancy at birth in Spain.


METHODS
Standard life table techniques and the Arriaga method were used to calculate and to decompose life expectancy (LE) changes by age, effects and groups of causes of avoidable mortality among three periods (1987-91, 1992-6 and 1997-2001). A list of causes of avoidable mortality reached by consensus and previously published in Spain was used.


RESULTS
Life expectancy increased in all ages and both sexes. The main contribution to the increase of LE at birth was due to people over 50. Mortality in young adults produced a reduction in LE between the first two periods, but there was an important increase in LE between the last two periods; in both cases, this was the result of factors amenable to health policy interventions. The highest improvement in LE was due to non-avoidable causes, but avoidable mortality through health service interventions showed improvements in LE in those younger than 1 year and in those aged 45-75 years.


CONCLUSIONS
Making a distinction between several groups of causes of avoidable mortality and using decomposition by causes, ages and effects allowed us to better explain the impact of avoidable mortality on the LE of the whole population and gave a new dimension to this indicator that could be very useful in public health.
Gispert
R
R
Servei d'Informació i Estudis, Departament de Salut, Travessera de les Corts 131-159, 08028 Barcelona, Spain. rosa.gispert@gencat.net
Serra
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I
Barés
M A
MA
Puig
X
X
Puigdefàbregas
A
A
Freitas
A
A
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006304:Health Status; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008017:Life Expectancy / Q000639:trends*; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D019984:Quality Indicators, Health Care; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology