TÜRKİYE’DE ÖLÜM NEDENLERİ: BULAŞICI HASTALIK YÜKÜNDEKİ ARTIŞ CİNSİYETE VE YAŞA GÖRE NASIL DEĞİŞMEKTEDİR?

Öz

Ölüm nedeni istatistikleri, halk sağlığı için çok önemli araçlardır, ancak Türkiye ölüm nedenleri ve eğilimlerine ilişkin yapılan çalışmalarda geride kalmaktadır. Bu çalışma, bulaşıcı hastalıklardaki (BH’lerdeki) artışa özel bir vurgu yaparak, 2013-2019 döneminde Türkiye'deki ölüm nedenlerini ve eğilimlerini değerlendirmektedir. Çalışma, ulusal nüfus ve ölüm nedeni kayıt sistemlerine dayalı temsili araştırma tasarımına sahiptir. Uluslararası Hastalık Sınıflandırması Onuncu Revizyon (UHS-10) kodlarına sahip tüm ölüm nedenleri gruplandırılmış ve çöp kodlar belirlenerek ölüm nedenleri içinde yeniden dağıtılmıştır. BH yükündeki artışın cinsiyete ve yaşa göre nasıl değiştiğini anlamak için ayrık Markov zinciri modellemesi kullanılmış ve en fazla ölümün meydana geldiği yaş, üç ana ölüm nedenine göre yaşa özel ölüm oranları, ölüm olasılıkları ve kaybedilen yaşam yılları hesaplanmıştır. Çalışmanın sonuçlarına göre, erkek nüfusta en fazla ölümün meydana geldiği yaş daha ileri yaşlara kaymış; her iki cinsiyette de 2013-2019 yılları arasında- COVID-19 pandemisinin başlamasından hemen önce- solunum yolu enfeksiyon hastalıkları ile diğer bulaşıcı ve parazit hastalıkların payı hızla artmıştır. Genel olarak, sonuçlarımız her iki cinsiyet için de BH yükünün arttığını ve yaşlı erkek nüfusunun en çok etkilenen grup arasında olduğunu göstermektedir. Bulaşıcı olmayan hastalıklar hala önde gelen ölüm nedenleri olduğundan, artan BH oranları sağlık sistemi üzerinde fazladan bir yük oluşturabilir.

Anahtar Kelimeler

• Ölüm nedenleri
• bulaşıcı hastalıklar
• Markov zinciri
• ölümdeki mod yaş
• Türkiye

CAUSES OF DEATH IN TURKEY: HOW THE INCREASE IN THE BURDEN OF COMMUNICABLE DISEASES VARY BY SEX AND AGE?

Öz

Causes of death statistics are essential tools for public health, but Turkey lags in the number of studies on causes and trends of death. This study measures causes and trends of death in Turkey for the 2013-2019 period, with special emphasis on the increase in communicable diseases (CDs). This study has a representative research design based on the national population and cause of death registration systems. Causes of death with International Classification of Diseases, Tenth Revision (ICD-10) codes were grouped and garbage codes were determined and redistributed. To understand how the increase in the burden of CDs vary by sex and age, modal age at death, age-specific death rates, probability of eventual death, years of life lost (YLL) due to three main causes of death were calculated by using discrete absorbing Markov chain model. According to results, modal age at death among male population shifted to older ages, the share of respiratory infectious diseases and other infectious and parasitic diseases increased rapidly between 2013 and 2019, just before the onset of COVID-19 pandemic. Overall, our results suggest that burden of CDs increased for both sexes, and elderly male population was among the most effected group. Since non-communicable diseases were still the leading causes of death, increasing rate of CDs may create an extra burden on health system.

Anahtar Kelimeler

• Causes of death
• communicable diseases
• Markov chain
• modal age at death
• Turkey

Kaynakça

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