Socio-economic transition and mortality from drowning in Lithuania: critical points in time and place

Abstract

The aim of the study was to analyse trends in mortality from drowning and to detect demographic and urban/rural differences in cut points over two decades of socio-economic transition in Lithuania. Methods Information on deaths from drowning for the 1988–2009 period was obtained from Lithuanian Department of Statistics. Mortality rates were analyzed according to urban/rural residence and sex. The Jointpoint analysis was used to identify the best-fitting points, wherever a statistically significant change in mortality occurred. Results Throughout the period under investigation, mortality from drowning of Lithuanian population decreased statistically significantly both in males and females, nevertheless, considerable fluctuations have occurred in different periods. The year 1994 was found to be the cut point in mortality both in urban and rural areas, when the increasing trend reversed to the declining one. Drowning mortality rates in rural areas exceeded those of the urban by 1.6–2.5 times. Throughout the period of the study, mortality from drowning in rural areas was declining by 1.8%, and in urban areas - by 1.5% annually (p < 0.05). The most positive period in terms of mortality decline in urban areas was the period of 1994–2004 for females and 1994–1997 for males. In rural areas, most positive changes in mortality of females occurred in 1994–2003 (average annual decline was 6.6%, p < 0.05), while for rural males there were no significant changes in mortality observed. Mortality from drowning among males was 4.5 - 3.5 times higher than that of females. Decline in mortality was more considerable in females, compare to males, particularly in 1994–2004 both in urban and rural areas. Conclusion Drowning is an important but neglected public health issue in Lithuania. Despite the general decline [...]