Premature Mortality in Slovenia in Relation to Selected Biological, Socioeconomic, and Geographical Determinants

Aim To determine biological (sex and age), socioeconomic (marital status, edu­
cation, and mother tongue) and geographical (region) factors connected with causes of death and
lifespan (age at death, years-of-potential-life-lost, and mor­ tality rate) in Slovenia in the
1990s.

Methods In this population -based cross-sectional study, we analyzed all deaths in the 25-64 age
group (N = 14 816) in Slovenia in 1992, 1995, and 1998. Causes of death, classified into groups
according to the 10th revision oflnternational Classification of Diseases, were linked to the data
on the deceased from the 1991 Census. Stratified contingency-table analyses were performed .
Years-of-poten ­ tial-life-lost (YPLL) were calculated on the basis of population life-tables
strati­ fied by region and linearly modeled by the characteristics of the deceased . Pois­ son
regression was applied to test the differences in mortality rate.

Results Across all socioeconomic strata, men died at younger age than women (index of excess
mortality in men exceeded 200 for all studied years) and from different prevailing causes (injuries
in men aged <45 years; neoplasms in women aged >35 years). For men, higher education was associated
with fewer deaths from digestive and respiratory system diseases.The least educated women died
relatively often from circulatory diseases, but rarely from neoplasms . Single peo­ ple died from
neoplasms less often. Marriage in comparison with divorce reduced the mortality rate by 1.9-fold in
both men and women (P<0.001). Mortality rate in both men and women decreased with increasing
education level (P<0.001) . Mortality rate of ethnic Slovenians was half the mortality rate of
ethnic minor­ ity members and immigrants (P<0.001).Analysis ofYPLL revealed limited and nonlinear
impact of education level on premature mortality. The share of neo­ plasms was the highest in the
cluster of socioeconomically prosperous regions, whereas the share of circulatory diseases was
increased in poorer regions. Sig­ nificant differences were found between individual regions in age
at death and mortality rate, and the differences decreased over the studied period .

Conclusion These data may aid in understanding the nature, prevalence and consequences of mortality
as related to socioeconomic inequalities, and thus serve as a basis for setting health and social
policy goals and planning health
measures.