Socio-economic transition and inequalities in mortality from diseases of the digestive system: Lithuanian experience

Abstract

Continuance and rise of inequalities in health is one of the major challenges in Lithuania. However, inequalities research is mainly concentrated at several major causes of death, while diseases of the digestive tract are not well analysed in terms of inequalities. Aims To evaluate inequalities in mortality from diseases of digestive system in Lithuania by the level of education and marital status during the period socio-economic transition for planning and implementing strategies to achieve better equity in health. Methods Analysis was based on routine mortality from diseases of the digestive system statistics and census data for 1989 and 2001 for the Lithuanian population >30 years. The Relative Index of Inequality and the Slope Index of Inequality were calculated. Results Lithuanian population with primary and lower education level, and unmarried had higher mortality rates due to all diseases of the digestive system, including liver cirrhosis and gastric, duodenal and peptic ulcers than married and those with university education. In 2000–02, as compared with 1988–90, inequalities in mortality from all diseases of the digestive system and liver cirrhosis increased due to growing mortality in primary and lower educational groups and unmarried, and due to decreasing mortality in higher education group and married. Inequalities in mortality from all diseases of the digestive system, liver cirrhosis and gastric, duodenal and peptic ulcers in men of different marital status were higher than those in women. Conclusions The study highlighted the relevance of inequalities in population mortality from diseases of the digestive system in Lithuania. In planning prevention and control measures of diseases of the digestive system, special attention should be given to inhabitants at highest risk for these diseases, i.e. unmarried and those with the lowest education level.