APH 1999, 57, 1-87:

Atlas of "avoidable mortality" in Belgium 1985-1989.

A. Levêque, P.C. Humblet, and R. Lagasse

Keywords: avoidable mortality, geographical epidemiology, Belgium, health indicator, health services research, SMR

The so-called 'Avoidable Death Indicators" method has been developed to monitor medical care and health systems. Avoidable death refers to premature mortality for causes amenable to medical care or to health promotion. This method has been mainly used to make geographic comparisons and is useful to detect higher levels of mortality which are regarded as a waming signal. The Atlas 1985-89 contains the maps and tables showing these indicators at the district level. The methods used are strictly comparable with those in the previous atlas for the years 1974-78 and 1980-84 in order to enable comparisons. For the period 1985-89, the tests of heterogeneity of the standardised mortality ratios (SMR) between the 43 districts are statistically significant for all avoidable causes of death except two: malignant neoplasm of cervix uteri and body of uterus (15-54 years) and infant mortality (female). Comparisons between the Belgian atlas for the years 1974-78, 1980~84 and 1985-89, have led to observe some large geographic areas with SMR significantly higher than 100 at each period. lt is particularly the case of areas situated in South-West of the country for "cirrhosis of the liver" (males, females, 15-64 years), and in the provinces of Limburg, Luxembourg and Namur for motor vehicle accidents (males, all ages). Since these unfavourable results are observed with continuity, they must be considered as warning signals which warrant further investigations on determinants of the geographic variations of the specific mortality.