The effect of avoidable mortality on life expectancy in Serbia, 2010-2019

Abstract

Avoidable mortality is defined as death that could have been avoided by adequate and timely healthcare and public health and prevention measures. The method measures the efficiency of the health system by quantifying premature deaths (0-74) from certain causes. The analysis of avoidable mortality in Serbia, including both amenable and preventable mortality, covers the period from 2010 to 2019. The results for Serbia have shown that the contribution of specific mortality rates by age is mostly positive and that in the second decade of the 21st century, we can see a trend of increasing life expectancy (LE). The decomposition of life expectancy by age groups, sex, and cause of death showed that most positive contributions relate to the reduction of avoidable mortality (about 70%). Observed by gender, the reduction in avoidable mortality rates is higher in men, especially in middle-aged people, where gains in LE are over 80%. In women, the share of avoidable mortality by age in changes in LE is usually around 70%. Avoidable mortality rates in Serbia remain relatively high compared to the rest of Europe, but there is a positive shift. The fact that the probability of avoidable mortality in the male population at birth in Serbia is about 30% (18% for women) shows that there is much room for improvement. With the hypothetical elimination of avoidable mortality, the increase in LE in men could be 6.3 years, and in women 3.9. Amenable and preventable mortality rates are always higher in the male population, but the reduction in standardised values is more intense in men in Serbia. Standardised preventable mortality rates have been declining faster than standardised amenable mortality rates in Serbia. Since the male population is significantly more burdened with preventable causes of death, the possibility of reduction is higher. Diseases and conditions that can be amenable by adequate healthcare showed a steady decrease in mortality rates by sex in the observed period, while the main difference observed in avoidable mortality is the result of a greater shift in preventable mortality in men. The most significant positive trend in the reduction of avoidable mortality is in cardiovascular diseases and violent deaths. At the beginning of the observed period, cardiovascular diseases had a higher share than cancer, but 10 years later the situation changed, and cancer became the most significant cause of avoidable mortality in Serbia, with an increasing trend. Malignant neoplasm of the trachea, bronchi, and lungs is the most common disease that can be avoided, while ischemic heart disease is in second place. Data from the 10-year period (2010 to 2019) show that respiratory diseases, infectious and contagious diseases, and addiction have a clear growth trend, as does cancer. The most significant positive trend in the reduction of avoidable mortality is in cardiovascular diseases and violent death. Diseases that can be treated and prevented by lifestyle changes and regular check-ups can significantly extend life expectancy in Serbia. Investing in the healthcare system pays off many times over because the costs of treating an individual are reduced in the long run, and that person can potentially contribute more to the community in good health over the years.