Beyond the underlying cause of death: an algorithm to study multi-morbidity at death
Grippo, Francesco (Istituto Nazionale di Statistica (ISTAT))
Frova, Luisa (Istituto Nazionale di Statistica (ISTAT))
Pappagallo, Marilena (Istituto Nazionale di Statistica (ISTAT))
Barbieri, Magali (Institut National d'Etudes Demographiques (INED))
Trias-Llimós, Sergi (Centre d'Estudis Demogràfics)
Egidi, Viviana (University of Rome)
Meslé, France (Institut National d'Etudes Demographiques (INED))
Désesquelles, Aline (Institut National d'Etudes Demographiques (INED))
Centre d'Estudis Demogràfics

Data:	2024
Resum:	Background: In countries with high life expectancy, a growing share of the population is living with several diseases, a situation referred to as multi-morbidity. In addition to health data, cause-of-death data, based on the information reported on death certificates, can help monitor and characterize this situation. This requires going beyond the underlying cause of death and accounting for all causes on the death certificates which may have played various roles in the morbid process, depending on how they relate to each other. Methods: Apart from the underlying cause, the cause-of death data available in vital registration systems do not differentiate all other causes. We developed an algorithm based on the WHO rules that assigns a "role" to each entry on the death certificate. We distinguish between the following roles: originating (o), when the condition has initiated a sequence of events leading directly to death; precipitating (p), when it was caused by an originating condition or one of its consequences; associated (a), when it contributed to death but was not part of the direct sequence leading to death; ill-defined (i), i. e. , conditions such as symptoms or signs or poorly informative causes. We applied this algorithm to all death records in four countries (Italy, France, Spain and the US) in 2017. Results: The average number of originating causes is similar in the four countries. The proportion of death certificates with more than one originating cause-a situation typical of multi-morbidity-ranges from 10% in the US to 18% in Spain. All ages combined, the proportion of deaths with at least one associated cause is higher in Italy (41%) and in the US (42%) than in France (29%) and in Spain (27%). It is especially high in the US at all adult ages. Variations in the average number of causes between the four countries are mainly due to precipitating and ill-defined causes. Conclusions: The output of our algorithm sheds light on cross-country differences in the average number of causes on death certificates. It also opens the door for improvements in the methods used for multiple cause-of-death analysis.
Ajuts:	Agencia Estatal de Investigación RYC2021-033123-I
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Mortality ; Causes of death ; Aging ; Multi-morbidity
Publicat a:	Population Health Metrics, Vol. 22 (December 2024) , ISSN 1478-7954

DOI: 10.1186/s12963-024-00356-8
PMID: 39696432

16 p, 1.1 MB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències socials i jurídiques > Centre d’Estudis Demogràfics (CED-CERCA)
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