@article{ref1,
title="Partial contributions and temporal trends of leading causes of death during the last four decades in Spain",
journal="Public health",
year="2020",
author="Cirera, L. and Ballesta, M. and Márquez-Calderón, S. and Chirlaque, M.-d. and Sáez, M. and Salmerón, D. and Mortality working group of the Spanish Epidemiological Association, ",
volume="189",
number="",
pages="81-90",
abstract="OBJECTIVES: The study was conducted to assess time trend shifts of leading causes of death and their partial contributions over the years 1975-2016 in Spain.   STUDY DESIGN: A longitudinal ecological epidemiologic design was conducted to analyse linear trend period shifts using joinpoint regression as the annual percentage of change (APC) in the period 1975-2016. The partial contributions were illustrated as the rate ratio of a singular-cause to their major-cause shift periods.   RESULTS: HIV/AIDS shaped the increasing trend period of infectious diseases in 1989-1995 (APC = 25.3, P < 0.05) and the decreasing trend in 1995-1999 and 1999-2016. Lung cancer fell gradually from 1994 in men (-0.4, P < 0.05); however, in women, the condition continued increasing from 1990 (P < 0.05). Dementia types influenced mental and neurological disease drifts. The recent trend for circulatory periods (1980-2016) was mainly modulated by cardiac ischaemia, with increased partial contributions (25%, 32% and 30%). Traffic accidents defined the descending tendency of external causes.   CONCLUSIONS: Spain showed a Western pattern in descended rates, including non-decreasing trends in mental and neurological diseases, pancreatic cancer, drug abuse and suicide. Trend shifts and partial contributions illustrated targets for further mortality reduction.<p /> <p>Language: en</p>",
language="en",
issn="0033-3506",
doi="10.1016/j.puhe.2020.08.023",
url="http://dx.doi.org/10.1016/j.puhe.2020.08.023"
}