Zoning and Identifying the Affecting Factors in Premature Death Registration
Authors: Iravani Ehsan , Mirmohamadkhani Majid , Gholami Elham , Soltani-Kermanshahi Mojtaba 
Published: April 2022

Background. Different types of death among people indicates both the extent to which people use different types of health care and the growth and development of a society. Premature mortality imposes a heavy burden on society in terms of health, economy, and mental issues. Given the preventability of these deaths, efforts are being made to reduce premature deaths by 25 percent ın hıgh level plans by 1404s. Methods. The purpose of this descriptive-analytical study, using death registration data, was to perform zoning of premature deaths in the cities supervised by Semnan University of Medical Sciences in Iran, it also investigated the factors affecting the premature deaths in order to reduce premature mortality especially among people at the age range of 30 to 69. Data were extracted based on the information of death certificates entered in the death registration system from 2013 to 2018. We, thus, studied 3619 registered deaths. The data were analyzed through SPSS software, using descriptive statistics (Relative Frequency, Mean, and Standard Deviation) and inferential tests (chi-square and independent t-test) according to the type of variables. The level of significance was set at 5 percent. Results. The mean and standard deviation of premature mortality was found to be 55.7 ± 10.6 and most of the deaths occurred in the seventh decade of their life. Premature mortality was more common among men, employed people, and urban residents. The major causes of premature mortality included cardiovascular diseases, cancer, and accidents. Conclusion. The results showed that accidents are the major cause of premature mortality at younger age, but they are gradually replaced by chronic and non-communicable diseases at the middle age. Therefore, in order to reduce the risk factors regarding premature mortality, collaboration of the related organizations is essential. Extended Abstract Background Different types of death among people indicates both the extent to which people use different types of health care and the growth and development of a society. Premature mortality also imposes a heavy burden on society in terms of health, economy, and mental issues. Given the preventability of premature mortality and the serious efforts to reduce premature mortality by 25 percent by 2025, we decided to conduct a study in this field under the title of ''Assessment of causes and Geographical distribution of early death in 30 to 69- year- old population covered by the Semnan University of Medical Science (SUMS) and its relation with Demographic characteristics: a 10 years cross-sectional study between 2009 to 2018''. Methods The population of this study included all cases of premature death in the population aged 30 to 69 years for whom a death certificate had been issued and registered in the death registration system under the supervision of the SUMS in Semnan Province. Semnan is one of the largest provinces of Iran including eight important cities. Six out of 8 cities including: 1-Garmsar, 2-Aradan, 3-Sorkhe, 4-Semnan, 5-Mahdishahr and 6-Damghan is supervised by the SUMS health network which was considered as population of this study from the year 2013 to 2018. Demographic information of the deceased was extracted and analyzed from the death registration system without using their personal information. This was a census study and the studied variables included causes of premature death (Cardiovascular diseases, malignant neoplasms, respiratory diseases, neurological diseases, accidents, traffic accidents, poisoning, kidney diseases, gastrointestinal diseases, infections, surgical complications and other causes) , age, gender(Male, Female), place of residence (urban and rural) and education. Descriptive statistics were used for the analysis and independent chi-square and t-tests were used to analyze the relationship between variables according to the type of variable at a significance level of 5percent with SPSS software. Results A total of 3619 premature deaths occurred between the ages of 30 and of 69 from 2009 to 2018. The mean ± standard deviation of premature mortality was 55.7 ± 10.6 years. The highest number of premature deaths in 2011 was 18percent and the lowest was related to 2010 with 15.3percent. Premature mortality was more common in men, employed people, medical centers, illiterate and urban residents and most of the deaths occurred in the seventh decade their life. 39.3 percent of premature deaths was recorded in Semnan district. The major causes of premature mortality include cardiovascular diseases, cancers, and accidents. The prime cause of premature death was found to be cardiovascular diseases, accounting for 31.1 percent of all deaths, often resulting from heart attacks and atherosclerosis of various arteries and high blood pressure. The rate of annual premature mortality between 2009 and 2018was not related to the year of collection (P = 0.086). Only the number of premature deaths due to car accidents and surgical complications is the same in different age groups (p> 0.05). Cardiovascular diseases seem to increase significantly with age (p<0.001). Conclusion The results show that accidents at a young age are the major cause of premature mortality, but they are gradually being replaced by chronic and non-communicable diseases in the middle age.This study recommends the cooperation of organizations involved in the control of premature mortality, such as the Ministry of Roads and Transportation, Ministry of Urban development, and the Ministry of Health. Practical Implications of Research In order to reduce premature deaths and increase life expectancy, we must try to prevent accidents and the underlying causes of internal diseases, in addition to creating a culture of changing the lifestyle of citizens to reduce risk factors as much as possible. Ethical Consideration This research has been supported by Semnan University of Medical Sciences and health Services grant IR.SEMUMS.REC.1398.114 and its information has been extracted from the health deputy system with the permission of the university. Conflict of InterestsThe Authors declare that there is no conflict of interest. Acknowledgement We would like to thank the Deputy Minister of Health at Semnan University of Medical Sciences for providing the necessary facilities for doing this research.