International Journal of Epidemiology 2000;29:193
© International Epidemiological Association 2000
Book Review |
Atlas of Leading and ‘Avoidable’ Cause of Death in Countries of Central and Eastern Europe.
Péter Józan, Remigijus Prokhorskas (eds). Budapest: Hungarian CSO Publishing House, 1999, DM40, pp.323, ISBN 963 215 146 1.
This atlas presents mortality from ‘avoidable’ and leading causes of death in 14 countries of Central and Eastern European Countries (CCEE) in the late 1980s. This was just before the major political and socio-economic changes that preceded deterioration of health in many countries of the CCEE. The WHO European Region and the Hungarian Statistical Office funded the production of the atlas.
Mortality data are perhaps the most accurate and intentionally comparable health-related information. ‘Avoidable’ mortality is now widely used as a measure of the availability and quality of medical care, since with appropriate medical care premature deaths from these causes should be largely avoidable.
The atlas's approach follows closely the one adopted for an earlier atlas of ‘avoidable’ mortality in the European Community, which is a strength since this facilitates comparisons with the West. In addition the authors added leading causes of death and life expectancies to give an overview of mortality in the CCEE. The atlas covers nearly all of the CCEE (Moldova is omitted) and consists of maps, data tables, and a short description of the methods used. Interpretation is left to the user. There are three sets of maps: 1) whole country maps for leading causes of death for the WHO European Region using direct age-standardization; 2) small region maps for leading and avoidable causes of death for the whole CCEE Region standardized to the whole CCEE Region and; 3) maps for individual countries in the CCEE Region, with small region death rates standardized to the individual country's death rates. Trends in leading causes of death are shown for individual countries. The tables provide data on population, observed numbers of deaths, and age-standardized mortality ratios using own-country and CCEE standards.
The atlas is well presented with attractive and clear maps, slightly marred by printing errors that necessitated an erratum slip. It is a pity that where there are separate maps for males and females they were not presented on facing pages. In following the format of the EC atlas it facilitates comparisons with comparable information for Western European countries. Although the data are by now somewhat out of date, they do provide a useful baseline for interpreting more recent data. A computer version of the atlas giving even more data is available from the WHO European Regional Office, and can be downloaded from the WHO European web site (www.who.dk, see Country Information page).
The atlas will be a useful source of reference material for researchers and others requiring information of health status and health services. The results of the research on which the atlas was based revealed very wide variations which should be useful for formulating hypotheses that may lead to improvements in health care. Publication of mortality data in the form of maps adds considerably to the interpretability and usefulness of the data.
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