Health inequalities among rural and urban inhabitants of Lodz Province, Poland

Introduction and objective. The aim of the study was to compare the state of health of the inhabitants of the countryside and city dwellers in the Lodz province, measured with the real and standardized death rate and years of life lost, as well as the analysis of causes of deaths distinguishing these two populations. Materials and methods. The study material included a database containing information gathered from 313,144 death certificates of the inhabitants of Lodz province who died between 1999-2008. Real and standardized death rates were determined. The standardization was carried out by a direct method. The Standard Expected Years of Life Lost (SEYLL method) was used to compute years of life lost. Analysis of time trends of death rates and life span in the Lodz province was conducted with jointpoint models. The intensity of mortality computed with standardized death rates in the province was higher in the countryside than in the city. Results. In 2008, the standardized death rate in the countryside was 904.5 per 100,000 inhabitants, and in the city - 903.4 per 100,000 inhabitants. Inhabitants of the countryside more often died of cardiovascular diseases (SDR=418.7 vs. 367.9) and from external causes (SDR=90.2 vs. 63); those from the city and towns died from malignant neoplasms (SDR=204.5 vs. 195.6) and diseases of the alimentary tract (SDR=55.6 vs. 34.6). In 2008, SEYLL calculation for 1,000 people was 204 years for the inhabitants of the city and towns and 190 years for the inhabitants of the countryside. Conclusion. It is necessary to introduce more effective prophylactic and health promoting activities in order to lessen the differences in the state of health state in the Lodz province and the rest of the country.