Determinants of premature mortality in a city population: an eight-year observational study concerning subjects aged 18-64.
BACKGROUND
Premature deaths constitute 31.1% of all deaths in Łódź. Analysis of the causes of premature deaths may be helpful in the evaluation of health risk factors. Moreover, findings of this study may enhance prophylactic measures.


METHODS
In 2001, 1857 randomly selected citizens, aged 18-64, were included in the Countrywide Integrated Noncommunicable Diseases Intervention (CINDI) Programme. In 2009, a follow-up study was conducted and information on the subjects of the study was collected concerning their health status and if they continued to live in Łódź. The Cox proportional hazards model was used for evaluation of hazard coefficients. We adjusted our calculations for age and sex. The analysis revealed statistically significant associations between the number of premature deaths of the citizens of Łódź and the following variables: a negative self-evaluation of health - HR = 3.096 (95% CI: 1.729-5.543), poor financial situation - HR = 2.811 (95% CI: 1.183-6.672), occurring in the year preceding the study: coronary pain - HR = 2.754 (95% CI: 1.167-6.494), depression - HR = 2.001 (95% CI: 1.222-3.277) and insomnia - HR = 1.660 (95% CI: 1.029-2.678). Our research study also found a negative influence of smoking on the health status - HR = 2.782 (95% CI: 1.581-4.891). Moreover, we conducted survival analyses according to sex and age with Kaplan-Meier curves.


CONCLUSIONS
The risk factors leading to premature deaths were found to be highly significant but possible to reduce by modifying lifestyle-related health behaviours. The confirmed determinants of premature mortality indicate a need to spread and intensify prophylactic activities in Poland, which is a post-communist country, in particular, in the field of cardiovascular diseases.
Epidemiology and Biostatistics Department, Medical University of Lodz, Łódź, Poland, irena.maniecka-bryla@umed.lodz.pl.
Irena
I
Maniecka-Bryła
Elżbieta
E
Dziankowska-Zaborszczyk
Marek
M
Bryła
Wojciech
W
Drygas
D000293:Adolescent; D000328:Adult; D002637:Chest Pain / Q000401:mortality; D003863:Depression / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D053208:Kaplan-Meier Estimate; D008019:Life Style; D008297:Male; D008875:Middle Aged; D061213:Mortality, Premature; D011044:Poland / Q000453:epidemiology; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000401:mortality; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D014505:Urban Population; D055815:Young Adult