TY  - JOUR
PY  - 2020//
TI  - Partial contributions and temporal trends of leading causes of death during the last four decades in Spain
JO  - Public health
A1  - Cirera, L.
A1  - Ballesta, M.
A1  - Márquez-Calderón, S.
A1  - Chirlaque, M.-d.
A1  - Sáez, M.
A1  - Salmerón, D.
A1  - Mortality working group of the Spanish Epidemiological Association, 
SP  - 81
EP  - 90
VL  - 189
IS  - 
N2  - 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>
LA  - en
SN  - 0033-3506
UR  - http://dx.doi.org/10.1016/j.puhe.2020.08.023
ID  - ref1
ER  -