Background. Public health research characterising the course of life through the middle age in developing societies is scarce. The aim of this study is to explore patterns of adult (15-64 years) mortality in an Ethiopian population over time, by gender, urban or rural lifestyle, causes of death and in relation to household economic status and decision-making. Methods. The study was conducted in Butajira Demographic Surveillance Site (DSS) in south-central Ethiopia among adults 15-64 years old. Cohort analysis of surveillance data was conducted for the years 1987-2004 complemented by a prospective case-referent (case control) study over two years. Rate ratios were computed to assess the relationships between mortality and background variables using a Poisson regression model. In the case-referent component, odds ratios (95% confidence intervals) were used to assess the effect of certain risk factors that were not included in the surveillance system. Results. A total of 367 940 person years were observed in a period of 18 years, in which 2 860 deaths occurred. One hundred sixty two cases and 486 matched for age, sex and place of residence controls were included in the case referent (case control) study. Only a modest downward trend in adult mortality was seen over the 18 year period. Rural lifestyle carried a significant survival disadvantage [mortality rate ratio 1.62 (95% CI 1.44 to 1.82), adjusted for gender, period and age group], while the overall effects of gender were negligible. Communicable disease mortality was appreciably higher in rural areas [rate ratio 2.05 (95% CI 1.73 to 2.44), adjusted for gender, age group and period]. Higher mortality was associated with a lack of literacy in a household, poor economic status and lack of women's decision making. Conclusion. A complex pattern of adult mortality prevails, still influenced by war, famine and communicable diseases. Individual factors such as a lack of education, low economic status and social disadvantage all contribute to increased risks of mortality. © 2008 Fantahun et al; licensee BioMed Central Ltd.
CITATION STYLE
Fantahun, M., Berhane, Y., Högberg, U., Wall, S., & Byass, P. (2008). Young adult and middle age mortality in Butajira demographic surveillance site, Ethiopia: Lifestyle, gender and household economy. BMC Public Health, 8. https://doi.org/10.1186/1471-2458-8-268
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