Description
Background
The proportional mortality rate of cardiovascular diseases (CVD) (34%), cancer (14%), diabetes mellitus (DM) (9%), and chronic respiratory disease (CRD) (8%) account for 65% of all deaths in the country (WHO, 2018). According to the Annual Health Bulletin Sri Lanka, in 2019, 51% of deaths in government hospitals were due to noncommunicable diseases (NCDs. The high mortality burden due to noncommunicable diseases (NCDs) warrants further exploration. An initial assessment of disparities by sex can highlight the need for targeted interventions to promote gender equality and improve overall NCD related morbidity and mortality outcomes. This analysis can also reflect differences by gender which is based on societal roles of males and females in Sri Lanka.
Objective
The objective of this project is to identify gender disparities in relation to morbidity and mortality due to cardiovascular diseases (CVDs), selected chronic respiratory diseases (CRD), diabetes mellitus (DM), and selected carcinomas where biological sex is not a major risk factor (CA) in Sri Lanka in 2019 using data from the civil registration system and inpatient admissions.
Methods
We analyzed the morbidity and mortality data obtained from Registrar Generals (RG) and the Indoor Morbidity and Mortality Register (IMMR) for the year 20191. The selected diseases for analysis were CVDs, CRD, DM, and certain types of CAs. For the current analysis we selected the prevalent cancers in Sri Lanka, namely, cancers of the lip, oral cavity and pharynx, oesophagus, colon, rectosigmoid junction, rectum, anus and anal canal. A total of 146,397 deaths from RG and 14,955,720 admissions from the IMMR were available for analysis. Life expectancy data by age and gender was obtained using life tables published for Sri Lanka.
Results
Considering proportional mortality rates (PMR), CVDs contributed to a higher number of deaths compared to the other selected NCDs. Comparable to global findings, men had a higher PMR from CVDs, which was nearly 2% higher than that of women. Considering DM, females had higher PMR compared to men. Considering admission patterns of the four selected diseases, hospital admissions were somewhat similar. There was a slightly higher percentage of admissions for CRDs for males compared to females (3.4% versus 2.8%) and morbidity rates for CVDs were more or less similar for both groups (4.3% vs. 4.1%). Considering DM, a slightly higher female morbidity rate was observed compared to men. Of the selected diseases, CVD was the leading cause of death and morbidity in Sri Lanka in 2019. Although morbidity rates were more or less comparable, proportional mortality rates were different between the two sexes. Considering DM, both morbidity and proportional mortality were higher among females than males. The differences observed in hospital admissions and mortality for the selected NCDs between the two sexes were significant (p<0.05).
Conclusion
Since gender disparity in NCD morbidity, and mortality can be observed, it is crucial to address these potential gender disparities by implementing gender-sensitive NCD prevention and management strategies. The reasons behind these observed disparities should be explored.
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