Health risk factors and mortality in Pécs City, Hungary in the 1990s.

In the period of 1990-1994 an increase of all causes mortality for 35-74 years old males was observed both in Pécs and in all Hungary. From 1994 to 1997 the mortality decreased. Similar changes, but of smaller dimension, were observed in the female population. The increasing mortality of the early 1990s is attributed primarily to the extra psycho-social stress of this period. The data of the population survey at Pécs in 1995-96 were compared to the data of earlier surveys. The mean blood total cholesterol levels and the prevalence of smoking decreased from 1990 to 1996. The prevalence of hypertension and male obesity increased. Physical inactivity, unhealthy diet and lack of improvement of diet still represent significant health problems. High prevalence of increased gamma-glutamyl transferase indicate high prevalence of excess alcohol consumption. The risk factor profile of 18-25 year old males is very unfavourable. Smoking prevalence in females aged 26-35 years exceeds that of males of the same age group. Preventive efforts should be focused to young males and females.

Socioeconomic inequalities in mortality among women and among men: an international study.

OBJECTIVES: This study compared differences in total and cause-specific mortality by educational level among women with those among men in 7 countries: the United States, Finland, Norway, Italy, the Czech Republic, Hungary, and Estonia. METHODS: National data were obtained for the period ca. 1980 to ca. 1990. Age-adjusted rate ratios comparing a broad lower-educational group with a broad upper-educational group were calculated with Poisson regression analysis. RESULTS: Total mortality rate ratios among women ranged from 1.09 in the Czech Republic to 1.31 in the United States and Estonia. Higher mortality rates among lower-educated women were found for most causes of death, but not for neoplasms. Relative inequalities in total mortality tended to be smaller among women than among men. In the United States and Western Europe, but not in Central and Eastern Europe, this sex difference was largely due to differences between women and men in cause-of-death pattern. For specific causes of death, inequalities are usually larger among men. CONCLUSIONS: Further study of the interaction between socioeconomic factors, sex, and mortality may provide important clues to the explanation of inequalities in health.

[Epidemiologic crisis in Hungary]. / Epidemiologiai valsag Magyarorszagon a kilencvenes evekben.

PIP: An analysis of the mortality crisis that is developing in Hungary is presented. The author examines mortality trends over the past ten years, including differences by sex and age and in infant mortality, as well as changes over time in the causes of death. The crisis is shown to have its most serious effect on adult males; and the socioeconomic factors associated with this trend are identified. (SUMMARY IN ENG AND RUS)^ieng

Mortality from causes amenable and non-amenable to medical care: the experience of eastern Europe.

OBJECTIVE: To investigate comparative national trends in mortality from conditions amenable to timely, appropriate medical care and from those considered not to be amenable to such care. DESIGN: Analysis of trends in direct age standardised mortality from the 1950s to 1987. SETTING: Four eastern European nations (Hungary, Czechoslovakia, Poland, the German Democratic Republic) and two western European (the Federal Republic of Germany and England and Wales) and two North American nations (United States and Canada). SUBJECTS: The total populations of the relevant countries during the period examined. MAIN OUTCOME MEASURES: Proportional changes over time in age standardised mortality. Mortality from amenable and non-amenable causes was restricted to the age group 0-64. RESULTS: A divergence in the trends for all cause mortality between eastern Europe and the western nations occurred in about 1970, when the rates in western countries steadily declined but those in eastern Europe remained fairly static. In the age group 0-64 mortality from causes considered amenable to medical care fell less quickly in eastern Europe than in the West, particularly after 1970. In the same age group, mortality from non-amenable causes rose in eastern European countries from the late 1960s compared with substantial declines in such mortality in the West. CONCLUSIONS: Non-amenable causes of death seem to be the principal, but not exclusive, reason for lack of improvement in trends in all cause mortality in eastern Europe from 1970. The agenda for action in eastern Europe should give priority to a healthier lifestyle and improvement of the environment though not neglect enhancements in the quality and efficiency of direct health services.

The epidemiological future.

Forecasting the epidemiological future of industrialized countries for about thirty or maybe fifty years has been attempted. This will be determined by the future condition of relevant factors of the physical-biological, socio-economic and cultural environment of the population in question and by the socio-demographic structures of the population itself. It is highly probable that substantial development in prevention and curing of diseases, and in a few cases even breakthroughs will occur in the next three decades or so. Also public awareness with respect to health promotion can be expected to rise substantially in the future. Under these circumstances health conscious behaviour and sophisticated medical technology will have a much more serious impact on the health of the population in the future than at present. The aging of the population will become faster as fertility is expected to remain constant at very low levels and mortality will become the major cause of aging. Consequently general mortality will eventually increase, yet infant mortality will further decrease and will be as low as 6.0 per thousand live births by the 2020's. Lifespan prolongation by selective dietary restrictions would become a feasible human option. If some chronic degenerative diseases will be eliminated or will be put at least under control then life expectancy at birth can be as high as 84.3 years. However, it has been suggested that delaying the progression of chronic diseases is more realistic than eliminating them. Consequently the prevalence of chronic disease in the population will increase, along with the associated costs of treatment and care. Yet another school of thinking forecasts the 'compression of morbidity'. It is an open question whether inequalities in health will increase or decrease. AIDS infection will spread dramatically, but mainly in the third world and prevention strategies will use general information, education and counselling in order to increase public awareness with respect to the chances of avoiding infection.

Health in Eastern Europe.

To assess trends in health in Eastern Europe, age-standardised mortality rates since 1950 in four Eastern European countries (German Democratic Republic, Poland, Czechoslovakia, and Hungary) were compared with those in two Western European countries (Federal Republic of Germany and England and Wales). In the Eastern European countries mortality rates had increased or were virtually unchanged since the mid-1960s, especially in middle aged and elderly men. Death rates in males in Poland, Czechoslovakia, and Hungary in the mid to late 1980s were as high as those in the two Western European countries in the early 1950s. There was a shorter time lag for females. This poor health record in Eastern Europe will need to be addressed by the policy makers in the new democracies.