3.-6.9.1997, Münster, International Epidemiological Association (IEA) – European Regional Meeting: The health of populations in a changing Europe
International Epidemiological Association (IEA) – European Regional Meeting; organized by Institute für Epidemiologie und Sozialmedizin, U Münster; Akademie für öffentliche Gesundheit; in cooperation with IEA European Epidemiological Group and Deutsche Arbeitsgemeinschaft für Epidemiologie
- Venue: University of Münster, Zentralklinikum, Lehrgebäude of the Medical School
- Scientific Secretariat: U. Keil, H.-W. Hense
- Satellite Symposium (3.9.1997): Cancer Registration in Europe (U. Keil, E. Grundmann)
Flyer
Own contribution: R. Fehr, Surveillance approaches for “Agenda 21”: Regional mortality predictors in Germany. Beitrag 199, Oral presentation, Session “Surveillance and Monitoring I” [96-40].
Abstract (Program book, p.63):
- Purpose: To improve the basis for Environmental Health policy-making and for establishing a regional or local “Agenda 21“, as demanded by international agreement at the UN Conference on Environment and Development in 1992.
- Methods: All-cause mortality is taken as a useful, complex indicator of overall population health. Age-standardized mortality rates were computed for 416 cities and counties in Germany, 1994. After appropriate transformations, the association of geographic location and population density with all-cause mortality was examined by multiple regression. Outlier analysis (1st and higher degrees) was used to characterize individual regions.
- Results: Regional mortality was found to be associated significantly with geographic latitude (positive, p<.0001), population density (negative, p<.0001), and location in former East vs. West Germany (higher in the East, p<.0001). The model predicted 65% of the mortality variance. The negative relationship between population density and mortality was confirmed in all federal states of Germany except for one. – Accounting for basic regional characteristics, the model provides “expected” mortality rates that can be compared to current rates, and used for rating purposes in the process of regional policy-making for “Agenda 21″. For regions with higher-than-expected mortality rates, the expected rates can serve as “target lines”. “Outlier” regions may warrant special investigations into causative or protective factors, respectively.
- Conclusions: Surveillance based on readily available data can be useful for regions striving to establish “baselines” and “targets” and to define regional characteristics. – Next steps refer to the inclusion of additional environmental and socio-economic data and to the examination of temporal trends.
