Poster session on Health, mortality and longevity (1)

Avoidable mortality in Russia was 526.2 per 100000 among men and 175.1 among women in 2010. Its level varied by 4.2 times (between Moscow and Tuva Republic - from 256.2 to 1097.7 for males and from 113.7 to 473.8 for females). We aimed characterize the factors influencing regional variations. Mortality of population aged 5-64 years from 38 preventable causes of death for 80 regions were analyzed together with economic indexes. The biggest consolidated expenditure on protection of public health is in the regions with high level of economic development, but they do not stimulate the reduction of mortality from preventable causes. Mortality decreased more intensively in regions where the levels of spending on health, physical education and sports are small. In all regions the leading causes of deaths depend on the living conditions and behavioral risk factors among population. In regions with higher spending on health such mortality is significantly higher than in regions with low costs. There are no regional differences in the proportion of avoidable deaths, which depends on timeliness of diagnostics. Mortality, which depends on quality of health care, is determined by socio-political situation in the country in a great extend then by regional health care expenses.

Russia is among ten countries with the largest number of diabetic patients and with one of the lowest recorded levels of mortality. The hypothesis tested that unreported deaths from diabetes is the result of the underestimation of the importance of diabetes for the population’s health. The next factors were analyzed: the completeness of recorded diabetes in patients with in-hospital mortality, the share of records about diabetes as a concomitant disease in death certificates, the frequency of use of the code E14 (unspecified diabetes) for registration of death as well as codes that can not be the primary cause of death, and to be replaced by diabetes. The result shows that a vicious circle is formed by the serious misperception of diabetes mellitus being a danger to population’s health. The significance of diabetes being underestimated leads to the exclusion of diabetes on the medical death certificates which lead to the underestimation of mortality from diabetes. This leads to a lack of attention of health authorities to the problems of prevention and quality of medical care for patients with diabetes, and this leads to a lower estimate for the importance of diabetes mellitus in population health by health professionals on practice level.

This research describes and analyses the trend in life expectancy evolution in various European Union countries, from the early 1960s until today. It is during this period that gender-based differences begin reaching significant convergence between male and female life expectancy rates with the greatest convergence occurring in 2011, even though women still reach higher average life expectancy.
In order to interpret this inequality trend regarding European life expectancy, a conceptual framework of the epidemiological transition theory has been used and applied at a micro level in Spain. The Instituto Nacional de Estadística and the Institut d’Estadistica de Catalunya provide death statistics by cause as well as life tables from which our data has been extracted. The epidemiological study has been carried out by grouping large causes of deaths while the methodology used is indirect standardisation, which allows comparing the 1960-2011 province mortality cause pattern to that of Spain for the same period.
This country has defined and characterized the final stages of the epidemiological transition. The increasing life expectancy rate and this impact on health disparities have an effect on the vulnerability of survival of the current elderly population, where women continue to break the epidemiological patterns.

Objectives:
The specific objectives of the study are:-
1. To study the level of mortality on the first day, first week and first month in, Bangladesh, India, Nepal and Pakistan at two different points, i.e. in 1990s and 2006-2007.
2. To study the differential in mortality on First day, First week and First month of birth by demographic and socio-economic characteristics.
3. To study the relative role of maternal health care, birth characteristics and socio-economic characteristics of mother in determining mortality on the First day, First week and First month of birth.
Methods: All data used in this study are taken from Demographic and Health Survey, India DHS (1992-93, 2005-06), Bangladesh DHS (1993-94, 2007), Nepal DHS (1996, 2006), Pakistan DHS (1990-91, 2006-07). A Binary Logistic Regression analysis has been used to identify the characteristics- Socio-economic variables, Demographic variables and Maternal Health care- having statistically significant effect on Very early neonatal mortality, Early neonatal mortality and Neonatal mortality.

Bangladesh achieved remarkable success in issue of third and fourth agenda of Millennium Development Goals- empowering women and to reduce child mortality rates; though an infant mortality of 52 deaths per 1000 live births indicate still we have to work to do in this sector. Under-five mortality may be reduced through the combined effect of improvement in standards of living between environment and personal hygiene, existence of maternal and child welfare scheme, as well as prevention and treatment of disease in infancy. Empowering women on her way to achieve freedom on own and child health care improve the quality of health related outcome of whole family; hopefully can decline under-five mortality in Bangladesh. In this paper, impact of women’s household decision-making autonomy on under-five survival had been determined without any intermediate terms. Using the proportional hazards model on BDHS-2007 data, the household decision-making autonomy is found to be a significant differential of under-five survival even after controlling for high risk factors of child mortality along with duration of breastfeeding, maternal health care seeking behavior and socioeconomic status. This implies; empowering women can effectively make a rapid enhancement in child and mothers health strategies, along with decline in under-five mortality.

The urbanization process in developing countries develops two sectors within urban areas. One is engaged in organized sector is highly rewarded and consumes most of the urban resources and live unhealthy lifestyle that increases chronic degenerative diseases. Other one is in unorganized sector and marginalized. They are poor and live in crowded slum areas where Infectious diseases thrive and outbreak. In these circumstances accessibility to public health system is crucial which is severely restricted in India because of inadequacy of the public health delivery system. Social exclusion, lack of awareness and inadequate economic resources further restrict their accessibility to the available public and private health facilities. This makes the urban poor more vulnerable and worse off than their rural counterparts as they are living in paltry slum conditions. Hence the urban health issue needs immediate attention to meet the challenges of future urban growth.
The paper attempts to understand these phenomena in Jaipur Metropolitan, an emerging mega city. Data for the study is obtained through primary and secondary sources. The study will use different statistical techniques and spatial analysis to know the extent of inequality in availability and accessibility of health service facilities among different socioeconomic groups.