Avoidable Mortality Differences between Rural and Urban Residents During 2004-2011: A Case Study in Iran

Area of Science:

• Public Health
• Health Services Research
• Epidemiology

Background:

• Avoidable mortality is a key indicator for evaluating health system performance.
• Previous research has focused on this indicator for a long time.
• This study compares health system performance in rural and urban settings using avoidable mortality data.

Purpose of the Study:

• To compare health system performance between rural and urban areas in Bushehr province, Iran.
• To analyze trends in avoidable mortality rates in these regions.
• To identify specific causes of death that contribute to avoidable mortality.

Main Methods:

• A retrospective analysis of 29,916 deaths in Bushehr province from 2004-2011.
• Utilized Nolte and McKee's avoidable deaths model to classify deaths.
• Employed Poisson Regression and age-standardized death rates using STATA software.

Main Results:

• Avoidable mortality rates declined by 3.33% annually in both urban and rural areas.
• Ischemic Heart Disease (IHD) and preventable deaths showed significant declines.
• Rural areas saw greater decreases in preventable deaths (7%) compared to urban areas (5%).
• No statistically significant decline was observed in treatable mortality in either area.

Conclusions:

• Annual declines in avoidable mortality are evident, but further reductions are possible.
• Policy initiatives focusing on screening and inter-sectoral measures are recommended.
• Targeting specific causes like cancers, hypertension, and traffic accidents can further decrease avoidable deaths.