Hierarchical spatio-temporal mapping of premature mortality due to alcoholic liver disease in Hungary, 2005-2010.
BACKGROUND
Excess alcohol consumption is a major public health issue in Hungary, with high mortality rates from alcohol disease. In addition, excess alcohol consumption has been found to differ by socioeconomic and environmental factors.


METHODS
The spatial pattern of mortality from alcoholic liver disease across Hungary for the period 2005 and 2010, at municipality level, was investigated by sex using Bayesian modelling. The changes in mortality over this 6-year period were analysed using hierarchical spatio-temporal disease mapping. The association between the spatial distribution of mortality from alcoholic liver disease and cirrhosis and deprivation (by sex) was also assessed using a Hungarian-specific deprivation index.


RESULTS
A statistically significant association was found between mortality and deprivation status in males. Areas of significantly highest age-adjusted relative risks were found, for males, in the south-western part, and at the eastern border of the country. A number of areas showed area-specific trends that were significantly steeper than the national average mortality trend.


CONCLUSIONS
Using our findings, population groups with increasing mortality trends were identified, which may help decision makers fund effective health promotion programmes to reduce mortality rates in the working-age population.
1 Public Health Administration Service of Government Office of Capital City Budapest, Budapest, Hungary nagy.csilla@kmr.antsz.hu.
Csilla
C
Nagy
1 Public Health Administration Service of Government Office of Capital City Budapest, Budapest, Hungary.
Attila
A
Juhász
2 Public Health Administration Service of Government Office of Heves County, Eger, Hungary.
Zoltán
Z
Papp
3 Small Area Health Statistics Unit, MRC Centre for Environment and Health, Imperial College London, UK.
Linda
L
Beale
D000328:Adult; D001499:Bayes Theorem; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D008108:Liver Diseases, Alcoholic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D061213:Mortality, Premature; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D062211:Spatio-Temporal Analysis