OBJECTIVE
To compare the structure of causes of death among men and women of different age groups in 2019 and 2023 (using the Moscow Region as an example).
MATERIAL AND METHODS
Anonymized personalized data from medical death certificates (MDC) of the database of the Main Civil Registry Office in the Moscow Region. A total of 87.555 MDCs in 2019 and 92.182 in 2023 of persons aged 18 years and older. The absolute number of deaths (total and in ten-year age groups), the contribution of disease classes according to ICD-10 were determined, a comparison of unstandardized mortality rates (UR) and the structure of causes of death was carried out.
RESULTS
The mortality rate for men (18 years and older) was 1499 per 100.000 men in 2019 and 1434 in 2023; for women — 1367 and 1344, respectively. The UR of men is higher than that of women up to the age of 80, with the greatest differences at the age of 18—39 years. An increase in the number of deaths, UR and contribution to the mortality structure in men and women was noted for 5 ICD classes (E, J, K, N and S-T in men); a decrease was found for class F, for women — for 2 classes (G and R). The most significant differences in the UR and structure of causes of death in men and women are associated with four classes (S-T, J, E and G). The smallest changes were recorded for the class of neoplasms (about 15% of deaths in both men and women in 2019 and in 2023). A high proportion of poorly defined codes was noted (for example, more than 80% in the class of nervous diseases are accounted for by 3 codes G31.1, G93.0 and G93.4). The differences and changes identified in the structure of causes of death in 10-year age groups of men and women are likely largely due to controversial issues regarding the determination of the underlying cause of death.
CONCLUSION
Mortality reduction strategies should take into account age-sex characteristics of causes of death. Significant changes in UR from individual causes and a sharp increase in the proportion of deaths with codes that have no clinical analogues in old age require improvement of approaches to indicating and coding causes of death.
