Cuban Application of Two Methods for Analyzing Multiple Causes of Death

Area of Science:

• Public Health
• Epidemiology
• Biostatistics

Background:

• Single cause of death analysis is often insufficient for understanding complex mortality patterns.
• Multiple cause of death (MCOD) approaches offer a more comprehensive view but are underutilized in Cuba.
• Existing MCOD methods in Cuba are limited, necessitating critical assessment and implementation of recognized international approaches.

Purpose of the Study:

• To critically assess and implement two recognized multiple cause of death analysis approaches using Cuban data.
• To explore the connections between underlying and associated causes of death, using diabetes mellitus as a case study.
• To identify trends in MCOD in Cuba for the years 2005, 2010, and 2015.

Main Methods:

• Utilized death records from Cuba's National Medical Records and Health Statistics Bureau for 2005, 2010, and 2015.
• Applied two MCOD approaches: the simple method and the cause-of-death association indicator.
• Analyzed trends overall, by age group, and by sex, focusing on diabetes mellitus as the underlying cause.

Main Results:

• Identified key trends in MCOD in Cuba across the studied years.
• Observed an increasing trend in the mean number of causes of death per death certificate between 2005 and 2015.
• Diseases of the arteries, arterioles, and capillaries were most frequently associated with diabetes mellitus as the underlying cause.

Conclusions:

• The MCOD approach enhances understanding of disease patterns, comorbidity, and mortality in the Cuban population.
• The simple method highlights the full spectrum of a cause's contribution to mortality.
• The cause-of-death association indicator facilitates the exploration of inter-cause relationships, offering insights beyond the simple method.