title: Regional variation in mortality from ischaemic heart disease in Poland, 2006-2010.
abstract: BACKGROUND
  Spatial differences in mortality in Poland are large and remain unexplained to a large extent. Ischaemic heart disease (IHD) is a good candidate for explaining regional inequalities in mortality in Poland due to the high level of mortality from this cause and the large spatial differences.
  
  
  OBJECTIVE
  We describe the contribution of IHD to all-cause mortality in Poland in 2006-2010 on a powiat (Polish district) level and explain the differences in mortality by selected socio-economic factors.
  
  
  METHODS
  We use mortality data from the population registry at the NUTS-4 level for 2006-2010. We map age-standardised all-cause and IHD mortality rates. The contribution of IHD mortality to all-cause mortality was also assessed through variance decomposition. Correlation coefficients between age-standardised mortality rates and selected socio-economic variables were estimated for all powiats and for a group excluding large cities.
  
  
  RESULTS
  We demonstrated that regional differences between powiats in IHD mortality do not constitute a major factor behind regional mortality disparities in Poland. However, the spatial patterns for all-cause and IHD mortality in Polish powiats were both related to the level of urbanisation, with group of powiats characterised by the lowest IHD mortality comprising only large cities. The negative effect of large cities on the level of all-cause and IHD mortality was confirmed by the significant correlation between the socio-economic contextual variables, standing for the level of urbanisation, and IHD mortality.
  
  
  CONCLUSIONS
  Ease of access to medical care in large cities and in particular to cardiology units is an important factor behind the levels of all-cause and IHD mortality in Poland.
authors: Insitute of Statistics and Demography, Warsaw School of Economics, Warsaw, Poland. mmuszyns@sgh.waw.pl.
authors: Magdalena M
authors: MM
authors: Muszyńska
authors: Urszula
authors: U
authors: Sulkowska
authors: Witold A
authors: WA
authors: Zatoński
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000401:mortality*; D011044:Poland / Q000453:epidemiology; D012959:Socioeconomic Factors; D062206:Spatial Analysis