Citation

Radovanovic Z. Eur. J. Epidemiol. 1994; 10(6): 733-736.

Affiliation

Behavioral Sciences, Faculty of Medicine, Safat, Kuwait.

Copyright

(Copyright © 1994, Holtzbrinck Springer Nature Publishing Group)

DOI

unavailable

PMID

7672055

Abstract

Two main features of the mortality pattern in Kuwait are very low crude death rates, not exceeding 2.3 per 1,000, and a high frequency of traffic accidents, ranking as the second leading cause of death. In quantitative terms, mortality statistics in Kuwait have reached their objectives in that coverage approaches 100%. However, quality of data still suffers from apparent shortcomings, as exemplified by senility (without mention of psychosis) as the sixth leading cause of death. Huge oscillations in the frequency of some conditions from one year to the next one are even more indicative of the dubious reliability of the information on the death certificate. These variations occur across the board and do not characterize only a pre-war/post-war comparison. Coding inconsistencies are not restricted to the same group of diseases (e.g., cardiovascular disorders) but appear to comprise shifts in coding between different groups of diseases (e.g., pneumonia and disorders related to short gestation). Socially undesirable causes of death are, in particular, an area where reliability of data may be easily challenged on logical grounds. If raw mortality data were taken for granted, they could be very misleading. Providing for a cautious interpretation, however, these data may still be fairly informative.This study examines the mortality patterns of Kuwaitis and non-Kuwaitis during 1987-92. Population in Kuwait declined from about 2 million in the late 1980s, of which about 28% were nationals, to 1.4 million in June 1992. The war in 1990-91 contributed to the departures of both Kuwaitis and non-Kuwaitis. Crude mortality rates, with the exception of the war years, are estimated to be 2.2 and 2.3 per 1000, and 2.5 for males and 2.0 for females. Standardized rates are three times higher (7 per 1000 for both Kuwaitis and non-Kuwaitis). Differences in causes of death are apparent between nationals and others. Three patterns are considered characteristic for Kuwait: 1) crude death rates are low; 2) the leading causes of death are ranked peculiarly; 3) the number of certified causes of death in a very short time period shows major changes. Kuwait has very high fertility and a very young population. Non-Kuwaitis are described as being healthy due to pre-employment requirements, having a high turnover of expatriates, and not having any retired expatriates. Traffic accidents are given as the second leading cause of death. External causes, which include traffic accidents, constitute 16% of all causes in 1986 and 18% in 1992. Cardiovascular diseases are 31-35% of total deaths, and malignant neoplasms are 10-12% of deaths. The high number of traffic accidents is attributed to the lack of technical experience of motorists and the dense network of highways. Death certificates and recorded causes of death are considered unreliable. The example is given of the high frequency of senility as an underlying cause. Frequency changes can be considerable from one year to the next. For example, acute myocardial infarction rates declined by almost half during 1988-92. Ischemic heart disease by 1992 became a leading cause of death from a fourth-ranked position in 1988. Coding consistencies appear to be within the same group of illnesses. Unlikely patterns are also evident for diabetes mellitus rates. The ratio of male/female cause-specific mortality rates is 7:1.

Language: en