Excess winter deaths in Europe: a multi-country descriptive analysis
Excess winter deaths in Europe: a multi-country descriptive analysis
复制标题
DOI：
10.1093/eurpub/cku073
复制
发表时间：
2015-04-01
影响因子：
4.4
通讯作者：
Murray, Virginia
中科院分区：
文献类型：
--
作者：
Fowler, Tom;Southgate, Rosamund J.;Murray, Virginia
背景：冬季死亡是许多国家已知的卫生和社会保健挑战。先前的一项国际比较显示，20世纪90年代整个欧洲冬季超额死亡率存在显著差异，北方国家的冬季超额死亡率低于南欧国家。研究方法：冬季死亡指数（EWDI）是冬季（12月至次年3月）死亡人数与非冬季死亡人数的比率。欧盟统计局数据库和国家登记处的数据被用来计算欧洲31个国家2002/2003年至2010/2011年期间的EWDI。结果如下：国家EWDI值显示出异质性，从北方到南欧EWDI值增加，冬季平均温度增加（r（2）= 0.50，P > 0.0001）。马耳他、葡萄牙、西班牙、塞浦路斯和比利时的EWDI在统计上都显著高于其他30个欧洲国家的平均EWDI。国家一级的EWDI和欧洲冬季温度的年际变化水平之间没有明显的联系。讨论：本文展示了欧洲国家之间存在的EWDI差异，对研究和政策都有影响。许多死亡是可以避免的，因为已知环境、社会和个人因素会导致冬季死亡。我们现在需要努力更好地理解国家间差异的原因。
Background: Winter deaths are a known health and social care challenge for many countries. A previous international comparison showed significant differences in excess winter deaths across Europe in the 1990s, with the northern countries having lower excess winter mortality than those in southern Europe. Methods: The Excess Winter Deaths Index (EWDI) is the ratio of deaths in the winter period (December to March) compared with deaths in the non-winter period. Data from the Eurostat database and national registries were used to calculate the EWDI for 31 countries in Europe across the time period 2002/2003 to 2010/2011. Results: National EWDI values show heterogeneity, with a broad pattern of increasing EWDI values from northern to southern Europe and increasing mean winter temperature (r(2) = 0.50, P > 0.0001). Malta, Portugal, Spain, Cyprus and Belgium all had an EWDI that was statistically significantly higher than the average EWDI for the other 30 European countries. There was no clear association between country-level EWDI and the level of inter-annual variability in winter temperature across Europe. Discussion: This article demonstrates the differences in EWDI that exist between European countries with implications for both research and policy. Many deaths may be avoidable as environmental, social and personal factors are known to contribute to winter mortality. We now need to work to better understand the causes of inter-country differences.