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[Comparison between several standard populations for age-adjusting].

J Llorca Díaz1, D Prieto Salceda, T Dierssen Sotos

  • 1Cátedra de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Cantabria, Santander. llorcaj@medi.unican.es

Revista Espanola De Salud Publica
|October 14, 2000
PubMed
Summary

The choice of reference population significantly impacts age-adjusted mortality rate differences, but ratios and annual changes remain consistent for most causes. Careful analysis of age-specific rates is crucial for accurate comparisons.

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Area of Science:

  • Demography
  • Epidemiology
  • Public Health

Background:

  • Age-adjusted mortality rates are essential for comparing population health over time and across regions.
  • The selection of a reference population for age adjustment can influence the interpretation of mortality indicators.
  • Understanding these effects is critical for accurate epidemiological analysis.

Purpose of the Study:

  • To analyze the impact of different reference populations on various indicators derived from age-adjusted mortality rates.
  • To compare the results obtained using Spanish, European, and world standard populations for mortality data from Spain (1971-1992).

Main Methods:

  • Mortality rates for various causes of death in Spain (1971-1992) were age-adjusted using four reference populations: Spanish (1971, 1992), Standard European, and Standard World.

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  • Three indicators were compared: difference in rates (1992 vs. 1971), ratio of rates (1992 vs. 1971), and annual percentage change (1971-1992).

    • Main Results:

    • For most causes (total mortality, ischemic heart disease, tumors), rate ratios and annual changes were similar across reference populations, while rate differences varied significantly.
    • For infectious diseases and testis cancer, rate differences were consistent, but rate ratios varied with the reference population.
    • Mortality from pneumonia, Parkinson's disease, and encephalic cancer showed changes across all three indicators depending on the reference population.

    Conclusions:

    • Prior analysis of age-specific rates is necessary before age adjustment to ensure correctness.
    • This preliminary analysis helps determine the most appropriate indicator (difference, ratio, or percentage change) for valid comparisons between populations or time periods.