The impact of competing risks of death on gains and losses in life expectancy in Turkey

Dilek Torun, Hacettepe University

Mortality measures used for analyzing the mortality level of a population fail to quantify the effects of premature deaths. For this reason, alternative measures are developed to explain the mortality trends of a population. Years of potential life lost (YPLL) and potential gains in life expectancy (PGLE) are two measures for analyzing the effect of premature deaths. These measures enable to examine the premature mortality patterns of a population in terms of causes of death. The main objective of this study is to calculate the YPLL and PGLE indicators for Turkey according to the major groups of causes of death for the years 2000-2008. For applying cause specific mortality analyses, single and multiple decrement life tables and then further associated single decrement life tables are constructed. The life tables are constructed by using the infant mortality rates derived from the results of Turkish Demographic and Health Survey 1998, 2003 and 2008. The results of the PGLE analyses are represented by complete and partial elimination of causes of death. YPLL results are estimated as lifetime YPLL and YPLL up to age 65 for each group of cause of death. The findings suggest that the overall effect of premature mortality shows a decreasing trend during the period 2000 – 2008 in Turkey. Cardiovascular diseases and cancers are the leading causes of death affecting premature mortality. It is observed that the impact of cancers and injuries on premature mortality are greater for the younger age groups in Turkey. The results of this study represent useful information for effective allocation of public health resources and improvement of research programs as well as setting up health goals.