Preventable mortality: indicator or target? Applications in developing countries

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Preventable mortality is a key indicator of health system performance and population well-being.
• Existing mortality metrics may not fully capture health disparities or progress.
• International comparisons are valuable for setting health goals and identifying areas for improvement.

Purpose of the Study:

• To analyze preventable mortality using multiple indicators, including standardized mortality ratio (SMR) and ratio of observed and expected years of potential life lost (RYPLL).
• To illustrate these methods using mortality data from Argentina and Mexico.
• To assess the utility of RYPLL in identifying health inequalities beyond traditional mortality measures.

Main Methods:

• Calculation of SMR for all ages and for deaths before age 65.
• Computation of RYPLL using country-specific past data (for progress assessment) and US data (for future goals).
• Analysis of all-cause and cause-specific mortality for comparisons.

Main Results:

• The RYPLL indicator was found to be most sensitive to differences between observed and expected deaths.
• RYPLL provides additional insights into health inequalities compared to crude, age-adjusted, and cause-specific proportional mortality rates.
• Comparisons with the past focused on all-cause mortality, while future-oriented assessments included cause-specific mortality.

Conclusions:

• RYPLL is a valuable tool for assessing current health status against past performance and future benchmarks.
• These analytical procedures can aid countries in health priority setting, surveillance, and health service evaluation.
• The methods offer a comprehensive approach to understanding and addressing preventable mortality and associated health inequalities.