Excess mortality in working age males in Poland: general patterns.

Since the second World War, excess mortality of males has been steadily growing in Poland. The aim of this paper was to analyze the basic relationships between excess male mortality and some social and economic factors, with special reference to both age and place of residence. Data published in Demographic Yearbooks and included in reports produced by the Government Population Council were used in the analysis. The excess male mortality is expressed in terms of male/female mortality ratio, and also in terms of the difference between the average female and male life expectancy. In the early 1990s the general male mortality rate in Poland was by 23% higher than the general female mortality rate, whereas in males at younger working age (20-44 years) mortality was three times higher, and in the older age (45-64 years) groups 2.7 times higher than the female mortality. Compared with the majority of European countries, Poland is characterised by high rates of excess male mortality, which points to a deteriorated health status of the population. At present, excess mortality of the working age males is much higher than in the 1960s and 1970s. Our analysis of the 1960-1994 trends revealed that the highest excess male mortality occurs in the 20-24 age group. Although recently a falling trend has been observed in the infant, juvenile and post working age groups, a continuous increase is noted in the working age population of Poland. Causes of death were also included in our analysis. Among circulatory diseases, the highest excess mortality was due to acute myocardial infarction (the risk of death from this disease was 8 times higher for males than for females). Accidents, injuries and poisoning constitute another leading group of causes responsible for excess mortality (6/1 male/female death risk ratio). The excess male mortality rates are higher in the rural than in the urban areas. The excess male mortality was also reflected in the indices of average life expectancy. In 1995, the average life expectancy was 67.6 years for males and 76.4 years for females. Thus, in Poland males live 8.6 years shorter than females on average. Increased excess mortality among the working age males, a considerable difference between male and female average life expectancy, disturbed demographic male/female balance, these are at least some of the reasons why further in depth studies of excess male mortality in Poland should continue.

[Dynamics and spatial differentiation of premature mortality in the productive age group of the population--premise for in depth studies of causes and conditions of this phenomenon]. / Dynamika i zróznicowanie przestrzenne umieralnosci przedwczesnej populachji w wieku produkcyjnym--przeslanki dla poglebionych badan przyczyn i uwarunkowan tego zjawiska.

The increased mortality in Poland compared to that observed just after the war was mainly caused by the elevated frequency of premature deaths (under 65 years of age). The aim of the work was to assess: the premature mortality in the population of the productive age in Poland in comparison with other countries of Central and Eastern Europe, Scandinavian and Western European countries as well as with other developed countries in the world; the dynamics of premature mortality; the spatial differentiation of premature mortality in our country. Two age phases: I = 20 - 44 years, and II = 45 - 64 years were identified in premature mortality. A considerable increase in male premature mortality in phase II of the productive age which began in the second half of the sixties and had continued until 1991 doubled the mortality ratio in Poland when compared with the average ratio observed in all Scandinavian and Western European countries. The analysis of spatial differentiation of premature mortality indicates clearly the relationship between mortality and environmental conditions: the highest ratios are noted in highly urbanized and industrialized voivodships (provinces). It accounts for possible reasons of shortened by 7-8 years period of men's life in Poland as compared to Western countries or even by 10 year in comparison with Japan, for example. The situation among women is more favorable. These alarming data on premature mortality, especially among men in phase II of the productive age emphasize the urgent need for in-depth studies of causes, circumstances and factors contributing to deaths at the most active productive age.