Changes in Mortality by Place of Residence in Lithuania Before and After the 2014 Health Strategy
O Mesceriakova, D Stumbrys, R Kalediene, S SauliuneAbstract
Introduction
This study aimed to evaluate mortality trends by sex and place of residence for all causes and major causes of death before (1990–2013) and after (2014–2024) the implementation of the Lithuanian National Health Strategy, which was designed to improve population health, increase life expectancy, and reduce health inequalities.
Methods
Age-standardized mortality rates were calculated for all-cause mortality and separately for deaths due to cardiovascular diseases (CVD), cancer, external causes, and diseases of the digestive system, stratified by sex and place of residence. Mortality trends were assessed using Joinpoint regression analysis.
Results
Between 1990 and 2013, mortality rates for all causes, CVD, and external causes significantly declined among both men and women in urban and rural areas, while cancer mortality also decreased in urban populations (P < 0.05). In contrast, mortality from diseases of the digestive system increased (P < 0.05). During 2014–2024, male mortality from all causes, cancer, and digestive system diseases in urban areas, as well as mortality from external causes in both urban and rural areas, showed significant decreases (P < 0.05). Among women, mortality from CVD and external causes in both urban and rural areas, and from cancer in urban areas, also declined (P < 0.05). The rate of mortality decline was faster during 2014–2024 compared with 1990–2013.
Conclusions
Following the implementation of the National Health Strategy, mortality of Lithuanian population decreased, reflecting improvements in population health. While causality cannot be definitively established, these trends indicate that the strategy may have contributed to accelerating the reduction of mortality.
Key messages
• Following the implementation of the Lithuanian Health Strategy, population mortality declined more rapidly.
• The implementation of the Health Strategy may have contributed to improvements in population health.