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2017, European journal of epidemiology
Sweden has a long tradition of recording cause of death data. The Swedish cause of death register is a high quality virtually complete register of all deaths in Sweden since 1952. Although originally created for official statistics, it is a highly important data source for medical research since it can be linked to many other national registers, which contain data on social and health factors in the Swedish population. For the appropriate use of this register, it is fundamental to understand its origins and composition. In this paper we describe the origins and composition of the Swedish cause of death register, set out the key strengths and weaknesses of the register, and present the main causes of death across age groups and over time in Sweden. This paper provides a guide and reference to individuals and organisations interested in data from the Swedish cause of death register.
Scandinavian Journal of Public Health, 2003
Aims: Life expectancy in Sweden is among the highest in the world, and the province of Halland has the highest life expectancy in Sweden today. In an earlier paper the authors reported that life expectancy in the province of Halland in the south-west of the country was approx. 3.5 years above the national average between 1911 and 1950. The aim of this study was to explore the influence of different causes of death on life expectancy in Sweden and the distribution of these causes of death in Halland compared with Sweden as a whole during the same period of time. Method: Causes of death between 1911 and 1950 in the whole of Sweden and in Halland were obtained from the archives of Statistics Sweden. A trend analysis was performed on the impact of the various causes of death on life expectancy in Sweden. Calendar year, age, and sex were controlled for in a Poisson model. The distribution and incidence of the most frequent causes of death were compared between Halland and Sweden as a who...
The European Journal of Public Health, 2001
Background: Trends in external causes of deaths in the Baltic States-Estonia, Latvia and Lithuania-were analysed against the background of turbulent political, social and economic changes. The reliability of mortality statistics concerning external causes of death in these countries is considered to be good. Method: This study is based on data published by the statistical offices of the three Baltic States and on data obtained through interviews with personnel employed at the national statistical offices. The study period was divided, by socio-political and economic factors, into a period of stagnation (1970-1984) and a period of reforms (1985-1997). Results: During 1970-1984 a stable slightly upward trend of external causes of death rates was observed. The curve became S-shaped in the reform period: between 1984 and 1988 a marked decrease occurred followed by a rapid increase of rates until 1994, and then by 1997 a fall to the approximate level of 1984. The male to female ratio of external causes of death was between 3.4:1 and 4.2:1. External deaths accounted for 10% to 14% of all deaths before 1984. During the period 1984-1988 the proportion of external deaths was under 10% and peaked in 1994 at 16%. Fluctuations in the trends of external death were more pronounced among males than females in all Baltic countries. Conclusion: Trends in external causes of death were similar in Baltic States. High proportions of violent death decreased life-expectancy for both sexes, but markedly for males. Social stresses and alcohol consumption could be considered as factors influencing the mortality rates and specific fluctuations in trends of external death, especially among males.
Journal of Clinical Epidemiology, 2009
Objective: Mortality statistics are important for epidemiological research. We examine if discrepancies between death certificate (DC) and hospital discharge condition (HDC) indicate certification errors.
Social Science & Medicine. Part C: Medical Economics, 1981
Ahshucr-In view of the epidemiological responsibility that, according to the new Swedish health legislation. will be laid upon the local county councils. there will be increasing demands to identify and monitor the health status of the local population, e.g. the commune. As part of a large scale collaborative project between a central Swedish health planning institute, a local county council and a research department. this paper focuses on the availability and usefulness of the official statistics. The process of community diagnosis is discussed and illustrated by means of a regional mortality display. It is argued that regional epidemiological data will be of major importance for the future planning of preventive programmes where also non-medical solutions are mandatory.
BMC public health, 2016
National mortality statistics should be comparable between countries that use the World Health Organization's International Classification of Diseases. Distinguishing between manners of death, especially suicides and accidents, is a challenge. Knowledge about accidents is important in prevention of both accidents and suicides. The aim of the present study was to assess the reliability of classifying deaths as accidents and undetermined manner of deaths in the three Scandinavian countries and to compare cross-national differences. The cause of death registers in Norway, Sweden and Denmark provided data from 2008 for samples of 600 deaths from each country, of which 200 were registered as suicides, 200 as accidents or undetermined manner of deaths and 200 as natural deaths. The information given to the eight experts was identical to the information used by the Cause of Death Register. This included death certificates, and if available external post-mortem examinations, forensic au...
International journal of epidemiology, 2015
Background: Immigration to the Nordic countries has increased in the last decades and foreign-born inhabitants now constitute a considerable part of the region's population. Several studies suggest poorer self-reported health among foreign-born compared to natives, while results on mortality and life expectancy are inconclusive. To date, few studies have summarized knowledge on mortality differentials by country of birth. This article aims to systematically review previous results on all-cause and cause-specific mortality by country of birth in the Nordic countries. Methods: The methodology was conducted and documented systematically and transparently using a narrative approach. We identified 43 relevant studies out of 6059 potentially relevant studies in August 2016, 35 of which used Swedish data, 8 Danish and 1 Norwegian.
Epidemiology: Open Access
Introduction: Migration is an important factor that could influence the distribution of disease and death in a population. The majority of studies on migration and health relate to external migration i.e. between different countries and cultures and has been thoroughly investigated in various settings. Studies of health effects related to internal migration, i.e. within the borders of a country however, are much rarer. Aim: The aim of the current study was therefore to examine, from a socio-epidemiological perspective, the impact of internal migration on the risk of death from different diseases among individuals born in a province in south-west Sweden, living in the province itself or in other parts of the country. The study comprised the whole population of both Sweden and the province of Halland and had a historical, prospective design which made it possible to follow individuals from 1980 to 1990. The participants were aged between 25 and 55 years in 1980 when the individual background variables were collected for the first of three times by repeated Swedish national questionnaires i.e. the Population and housing census (FoB). All deaths listed in the international classification of diseases (ICD) during the 10-year period from 1980-1990 were included. Statistical methods: The risk of death was estimated by Poisson regression as a function of age, marital status, educational level and socio-economic classification (SEI) for Sweden as a whole. The expected number of deaths was calculated by taking all of the abovementioned variables into account. For the hazard rate (HR), 95% confidence intervals were calculated. Comparisons between the observed and expected number of deaths were performed by means of Poisson distribution. Results: Men born in Halland and still living there had a lower risk of death than other male residents of the province who were born elsewhere (HR 0.89 CI 0.80-0.99). Women showed a similar, although non-significant tendency. The results also revealed that those natives of Halland who had moved to another part of the country retained their advantage compared to Swedes born outside the province and living in other parts of Sweden. This difference was statistically significant among men (HR 0.90 CI 0.81-0.99) while a non-significant tendency in the same direction was seen in women. All these comparisons were adjusted for the background variables as age, marital status, educational level and SEI.
International Journal of Epidemiology, 1996
Background. 'Avoidable' mortality is commonly studied as an indicator of the outcome of health care. In this study socioeconomic differences in avoidable mortality in Sweden from 1986 to 1990 are analysed and related methodological issues discussed. Methods. The 1985 Swedish Population and Housing Census was linked to the National Cause of Death Register 1986-1990. Mortality from potentially 'avoidable' causes of death was analysed for the age group 21-64 years. Analyses were performed for different socioeconomic groups, blue-collar workers, white-collar workers and the self-employed as well as for individuals outside the labour market Standardized Mortality Ratios were calculated using standardization by age and sex. Results. For all indicators studied, the death rates for those not in work were higher than for people at work. The largest differences were found for chronic bronchitis, diabetes, bacterial meningitis, ulcer of the stomach and duodenum, chronic rheumatic heart disease, asthma and hypertensive and cerebrovascular disease. For these causes of death the risk of dying was between 3.1 and 7.5 times greater in the non-working population than in the workforce. The differences in avoidable mortality between blue-collar workers and white-collar workers and the self-employed were, however, much smaller. For most of the indicators no significant differences were found. For ulcers of the stomach and duodenum, however, the death rate for blue-collar workers was 2.8 times higher than for other categories In work. Conclusions. The small difference in mortality outcome for different socioeconomic groups within the workforce indicates an equal quality of care for these groups. The greatly increased risk among the non-working population, however, is a warning sign. These results may be due to a 'healthy worker" effect. The measurement of socioeconomic differences in mortality may be dependent on the time-period chosen between occupational exposure and mortality outcome.
European Journal of Public Health, 2005
Background: Mortality in a population is regarded as an accurate and valid measure of the population's health. There are a few international studies, predominantly cross-sectional, of mortality among all foreign-born compared with an indigenous population, and the results have varied. No Swedish longitudinal study describing and analysing mortality data was found in a literature review. Methods: This study describes and analyses the differences in mortality between foreign-born persons and native Swedes during the period 1970-1999, based on data from Statistics Sweden and the National Board of Health and Welfare. The database consisted of 723 948 persons, 361 974 foreign-born living in Sweden in 1970, aged $16 years, and 361 974 Swedish controls matched for age, sex, occupation and type of employment, living in the same county in 1970. Results: The results showed increased mortality for foreign-born persons compared with the Swedish controls [odds ratio (OR) 1.08; 95% confidence interval (CI) 1.07-1.08]. Persons who had migrated 'late' (1941-1970) to Sweden were 2.5 years younger at time of death than controls. In relation to country of birth, the highest risk odds were for men born in Finland (OR 1.21), Denmark (OR 1.11) and Norway/Iceland (OR 1.074). Age cohorts of foreign-born persons born between 1901 and 1920 had higher mortality at age 55-69 years than cohorts born between 1921 and 1944. Conclusions: Migrants had higher mortality than the native population, and migration may be a risk factor for health; therefore, this seems to be an important factor to consider when studying mortality and health.
Journal of Patient Safety and Risk Management, 2021
Objectives In this paper, we explore and compare types and longitudinal trends of hospital adverse events in Norway and Sweden in the years 2013–2018 with special reference to AEs that contributed to death. Design Acute care hospitals in both countries performed medical record reviews on randomly selected medical records from all eligible admissions. Analysis: Comparison between Norway and Sweden of linear trends from 2013–2018, and percentage rates of admissions with at least one AE according to types and severities. Setting Norway and Sweden have similar socio-economic and demographic characteristics, which constitutes a relevant context for cooperation, comparison and mutual learning. This setting has promoted the use of GTT to monitor national rates of AEs in hospital care in the two countries. Participants 53 367 medical records in Norway and 88 637 medical records in Sweden were reviewed. Results 13.2% of hospital admissions in Norway and 13.1% in Sweden were associated with a...
Scandinavian Journal of Public Health, 2018
Aims: The standardized mortality ratio (SMR) is a widely used measure. A recent methodological study provided an accurate approximate relationship between an SMR and difference in lifetime expectancies. This study examines the usefulness of the theoretical relationship, when comparing historic mortality data in four Scandinavian populations. Methods: For Denmark, Finland, Norway and Sweden, data on mortality every fifth year in the period 1950 to 2010 were obtained. Using 1980 as the reference year, SMRs and difference in life expectancy were calculated. The assumptions behind the theoretical relationship were examined graphically. The theoretical relationship predicts a linear association with a slope, [Formula: see text], between log(SMR) and difference in life expectancies, and the theoretical prediction and calculated differences in lifetime expectancies were compared. We examined the linear association both for life expectancy at birth and at age 30. All analyses were done for ...
BMC Public Health, 2022
Background: Reliable statistics on the underlying cause of death are essential for monitoring the health in a population. When there is insufficient information to identify the true underlying cause of death, the death will be classified using less informative codes, garbage codes. If many deaths are assigned a garbage code, the information value of the cause-of-death statistics is reduced. The aim of this study was to analyse the use of garbage codes in the Norwegian Cause of Death Registry (NCoDR). Methods: Data from NCoDR on all deaths among Norwegian residents in the years 1996-2019 were used to describe the occurrence of garbage codes. We used logistic regression analyses to identify determinants for the use of garbage codes. Possible explanatory factors were year of death, sex, age of death, place of death and whether an autopsy was performed. Results: A total of 29.0% (290,469/1,000,128) of the deaths were coded with a garbage code; 14.1% (140,804/1,000,128) with a major and 15.0% (149,665/1,000,128) with a minor garbage code. The five most common major garbage codes overall were ICD-10 codes I50 (heart failure), R96 (sudden death), R54 (senility), X59 (exposure to unspecified factor), and A41 (other sepsis). The most prevalent minor garbage codes were I64 (unspecified stroke), J18 (unspecified pneumonia), C80 (malignant neoplasm with unknown primary site), E14 (unspecified diabetes mellitus), and I69 (sequelae of cerebrovascular disease). The most important determinants for the use of garbage codes were the age of the deceased (OR 17.4 for age ≥ 90 vs age < 1) and death outside hospital (OR 2.08 for unknown place of death vs hospital). Conclusion: Over a 24-year period, garbage codes were used in 29.0% of all deaths. The most important determinants of a death to be assigned a garbage code were advanced age and place of death outside hospital. Knowledge of the national epidemiological situation, as well as the rules and guidelines for mortality coding, is essential for understanding the prevalence and distribution of garbage codes, in order to rely on vital statistics.
Acta paediatrica (Oslo, Norway : 1992), 2018
Countries that conduct systematic child death reviews report a high proportion of modifiable characteristics among deaths from external causes, and this study examined the trends in Sweden. We analysed individual-level data on external, ill-defined and unknown causes from the Swedish cause of death register from 2000 to 2014, and mortality rates were estimated for children under the age of one and for those aged 1-14 and 15-17 years. Child deaths from all causes were 7914, and 2006 (25%) were from external, ill-defined and unknown causes: 610 (30%) were infants, 692 (34%) were 1-14 and 704 (35%) were 15-17. The annual average was 134 cases (range 99-156) during the study period. Mortality rates from external, ill-defined and unknown causes in children under 18 fell 19%, from 7.4 to 6.0 per 100 000 population. A sizeable number of infant deaths (8.0%) were registered without a death certificate during the study period, but these counts were lower in children aged 1-14 (1.3%) and 15-1...
… Journal of Primary …, 1988
The aim of this study was to examine whether observed high mortality from ischaemic heart disease (IHD) among males in the municipality of Hofors, Sweden, is accurate, or the result of some artefact. The validity of death certificates from Hofors municipality and from a control area (Gavle) were ascertained by comparing them with medical records from hospitals and district physician'offices, and reports from clinical or medicolegal autopsies. The results indicate that the observed high mortality from IHD among Hofors males cannot be explained by deficiencies in establishing the cause of death. Results from other validity studies indicate, however, that there is a risk of local variation when reporting c a w of death. In many instances this motivates checking the validity of data before they are incorporated into official statistics and used as a basis for planning.
Continuity and Change, 1997
On November 11–14 1993, Indiana University hosted a conference on the ‘History of Registration of Causes of Death’, with funding from the US National Institute on Aging and the National Institute of Child Health and Human Development. The conference brought together historians of medicine and historically-oriented demographers and epidemiologists to discuss the origins of the recording of causes of death and the possible uses of these documents in demographic and epidemiological research. Demographers and epidemiologists would like to use long-run series of causes of death to examine the effects of social and economic conditions, the availability of health care, and specific risk factors on mortality. Many important questions (such as the effects of early health experiences on old-age morbidity and mortality) are best studied with data on changes over long periods of time. However, it is very difficult to construct a consistent series of deaths by cause over time because advances in...
Scandinavian Journal of Public Health, 2006
Accident Analysis & Prevention, 2005
Objective: To survey unnatural deaths among teenagers in northern Sweden and to suggest preventive measures. Setting: The four northernmost counties (908,000 inhabitants, 1991), forming 55% of the area of Sweden. Material and methods: All unnatural teenager deaths from 1981 through 2000 were identified in the databases of the Department of Forensic Medicine in Umeå, National Board of Forensic Medicine. Police reports and autopsy findings were always studied, social and hospital records if present. Results: Three hundred and fifty-five deaths were found, of which 267 (75%) were males and 88 (25%) females. Ninety out of 327 (28%) tested positive for alcohol. Two hundred and forty-eight (70%) were unintentional and 102 (30%) were intentional deaths, and five (1%) were categorized as undetermined manner of death. Unintentional deaths decreased while the incidence of intentional deaths remained unaffected by time.
Journal of Immigrant and Minority Health, 2006
In a previous Swedish longitudinal study of mortality among 723,948 foreign born and native-born Swedes, 1970-1999, increased mortality was found among foreign-born persons. This study describes and analyses the differences in mortality between 361,974 foreign-born persons and 361,974 native Swedes during the period 1970-1999, based on data from Statistics Sweden and the National Board of Health and Welfare. The mortality pattern showed dissimilarities; with a significantly higher number of deaths among foreign-born persons in six diagnose groups and a significantly lower mean age at time of death. A high number of deaths were found for migrants from Denmark in Neoplasm, for migrants from Finland and Poland in Diseases of the circulatory system and for migrants from Yugoslavia in Symptoms, signs and ill-defined conditions. There is a tendency to a more similar pattern between foreign-and Swedish-born persons over time. Migration may be a risk factor for health, and therefore seems to be an important factor to consider when studying morbidity and health and when planning preventive work.
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