| Titre : | Patterns of mortality and their changes in France (1968-99) : insights into the structure of diseases leading to death and epidemiological transition in an industrialised country. (2006) |
| Auteurs : | J. Coste ; E. BERNARDIN ; JOUGLA (E.) : FRA. Inserm CépiDc. Le Vésinet. ; Université Paris Descartes. Ap-Hp. Hôpital Cochin. Faculté de Medecine. Paris. FRA |
| Type de document : | Article |
| Dans : | Journal of epidemiology and community health (vol. 60, n° 11, 2006) |
| Pagination : | 945-955 |
| Langues: | Anglais |
| Mots-clés : | Mortalité ; Epidémiologie ; Changement ; France ; Europe ; Pathologie ; Mort ; Facteur |
| Résumé : | [BDSP. Notice produite par INIST-CNRS 3gR0xY83. Diffusion soumise à autorisation]. Background : Epidemiological transition theory is based on a succession of specific "patterns" of causes of death in human societies. However, the reality and consistency of patterns of causes of death in a population at a given moment has never been formally and statistically evaluated. Methods : Correlation analyses and principal component analysis were used to explore the correlation between age and sex cause-specific death rates and to identify consistent patterns of mortality in France for two periods : 1968-79 and 1988-99. Results : Cause-specific death rates in France from 1988 to 1999 were found to be strongly and consistently correlated across space and time. The analysis outlines four specific patterns : mortality of 45-84-year olds, mostly by neoplasms, cardiovascular and digestive diseases ; mortality of the oldest old (>84 years) ; mortality of 25-64-year-old men, notably by HIV infection ; and mortality by injury and poisoning of 15-44-year olds. These patterns, which cover 96% of the total mortality during the period, differ from those for the period 1968-79 when respiratory diseases and conditions affecting children aged<1 year shaped mortality. They also differ substantially from those predicted by classical epidemiological transition theory. Conclusion : This study provides evidence for an evolutionary structure of patterns of mortality in contemporary France and therefore suggests using the concept of epidemiological transition in a less simplistic way than is commonly the case. It also shows much stronger interrelationships between diseases leading to death than is usually believed and suggests that current categorisations of cause-specific mortality in populations need reconsideration. |
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