Mortality profiles in a country facing epidemiological transition: An analysis of registered data

Luis Huicho · Miguel Trelles · Fernando Gonzales · Walter Mendoza · J. Jaime Miranda

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Insurance, Mortality, Demography, Risk Management Healthcare Systems and Public Health Global Health and Epidemiology

Abstract

BACKGROUND: Sub-national analyses of causes of death and time-trends help to define public health policy priorities. They are particularly important in countries undergoing epidemiological transition like Peru. There are no studies exploring Peruvian national and regional characteristics of such epidemiological transition. We aimed to describe Peru's national and regional mortality profiles between 1996 and 2000. METHODS: Registered mortality data for the study period were corrected for under-registration following standardized methods. Main causes of death by age group and by geographical region were determined. Departmental mortality profiles were constructed to evaluate mortality transition, using 1996 data as baseline. Annual cumulative slopes for the period 1996-2000 were estimated for each department and region. RESULTS: For the study period non-communicable diseases explained more than half of all causes of death, communicable diseases more than one third, and injuries 10.8% of all deaths. Lima accounted for 32% of total population and 20% of total deaths. The Andean region, with 38% of Peru's population, accounted for half of all country deaths. Departmental mortality predominance shifted from communicable diseases in 1996 towards non-communicable diseases and injuries in 2000. Maternal and perinatal conditions, and nutritional deficiencies and nutritional anaemia declined markedly in all departments and regions. Infectious diseases decreased in all regions except Lima. In all regions acute respiratory infections are a leading cause of death, but their proportion ranged from 9.3% in Lima and Callao to 15.3% in the Andean region. Tuberculosis and injuries ranked high in Lima and the Andean region. CONCLUSION: Peruvian mortality shows a double burden of communicable and non-communicable, with increasing importance of non-communicable diseases and injuries. This challenges national and sub-national health system performance and policy making.

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References

2005The Epidemiologic Transition: A Theory of the Epidemiology of Population Change 1971The Epidemiologic Transition: A Theory of the Epidemiology of Population Change 2006The World Health report 2006 1 : Working together for health 2 2005Counting the dead and what they died from: an assessment of the global status of cause of death data.2006Disease Control Priorities in Developing Countries (2nd Edition)2006Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States 1991Elements for a theory of the health transition.2007World Mortality 1950–2000: Divergence Replaces Convergence from the Late 1980s

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2009LA CARGA DE ENFERMEDAD Y LESIONES EN EL PERÚ Y LAS PRIORIDADES DEL PLAN ESENCIAL DE ASEGURAMIENTO UNIVERSAL 2014A community-based cluster randomized survey of noncommunicable disease and risk factors in a peri-urban shantytown in Lima, Peru 2022The shifting rural–urban gap in mortality over the life course in low- and middle-income countries

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