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Temporal Mortality Trends Attributable to Stroke in South Asia: An Age-Period-Cohort Analysis
Ruhai Bai1,2, Minmin Li3, Ashok Bhurtyal4
1School of Public Affairs, Nanjing University of Science and Technology, Nanjing 210094, China.
Healthcare (Basel, Switzerland)
|September 28, 2024
Summary
Stroke mortality in South Asia decreased over 30 years, but concerning trends emerged in Nepal and Pakistan. Continued public health efforts are crucial to sustain these improvements in stroke death rates.
Area of Science:
- Epidemiology
- Public Health
- Cardiovascular Disease Research
Background:
- South Asia bears the highest global burden of stroke mortality.
- Understanding long-term stroke mortality trends is vital for targeted interventions.
Purpose of the Study:
- To analyze long-term stroke mortality trends in four South Asian countries (India, Pakistan, Bangladesh, Nepal).
- To investigate the associations of these trends with age, period, and birth cohort effects.
Main Methods:
- Utilized data from 1990 to 2019 for stroke mortality analysis.
- Calculated age-standardized mortality rates (ASMR) to compare trends across countries and demographic groups.
- Employed age-period-cohort modeling to identify specific contributing factors.
Main Results:
- In 2019, South Asia recorded nearly one million stroke deaths with an ASMR of 80.2 per 100,000.
- India showed the most significant ASMR decrease (-35.8%), while Pakistan had the smallest (-7.6%).
- Pakistan and Nepal exhibited concerning increases in ASMR for specific age groups and recent periods, respectively, despite overall decreases in most countries.
Conclusions:
- Stroke mortality has declined in South Asia over three decades.
- Emerging unfavorable period and cohort effects in Pakistan and Nepal necessitate focused public health strategies.
- Sustained governmental and societal initiatives are essential to maintain the downward trend in stroke mortality.
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