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The contribution of smoking to regional mortality differences in the Netherlands

Author

Listed:
  • Fanny Janssen

    (Nederlands Interdisciplinair Demografisch Instituut (NIDI))

  • Alette Spriensma

    (VU Medisch Centrum)

Abstract

Background: Smoking is an important preventable determinant of morbidity and mortality. Knowledge about its role in regional mortality differences can help us to identify relevant policy areas, and to explain national mortality differences. Objective: We explored the extent to which the regional differences in all-cause mortality in the Netherlands could be due to smoking, by examining its link with regional differences in smoking-attributable mortality. Methods: All-cause mortality, lung cancer mortality, and population numbers were obtained from Statistics Netherlands for the period 2004-2008, by 40 NUTS-3 regions, age, and sex. Smoking-attributable mortality was estimated using an adapted indirect Peto-Lopez method. We mapped regional differences in age-standardised all-cause mortality, smoking-attributable mortality fractions, and smoking- and non-smoking-related mortality rates. We assessed spatial clustering, calculated correlations, and compared and decomposed regional variance. Results: Significant regional differences in all-cause mortality, exhibiting a random pattern, were found. Smoking-attributable mortality fractions, which ranged from 22% to 30% among males and 7% to 14% among females, correlated significantly with all-cause mortality, especially among males. Smoking-attributable mortality varied far more than all-cause mortality, while non-smoking-attributable mortality varied less than all-cause mortality. The variance in smoking-attributable mortality contributed 39% to the regional variance in all-cause mortality among males, and 30% among females. Conclusions: Smoking-attributable mortality thus clearly contributed to the regional differences in all-cause mortality, especially among males. This finding can be linked to past regional differences in smoking behaviour and underlying regional differences in socio-economic variables.

Suggested Citation

  • Fanny Janssen & Alette Spriensma, 2012. "The contribution of smoking to regional mortality differences in the Netherlands," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 27(9), pages 233-260.
    • Handle: RePEc:dem:demres:v:27:y:2012:i:9
    DOI: 10.4054/DemRes.2012.27.9
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    References listed on IDEAS

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    1. Fabian Tetzlaff & Jelena Epping & Heiko Golpon & Juliane Tetzlaff, 2020. "Compression, expansion, or maybe both? Growing inequalities in lung cancer in Germany," PLOS ONE, Public Library of Science, vol. 15(11), pages 1-15, November.
    2. Paulien Hagedoorn & Hadewijch Vandenheede & Didier Willaert & Katrien Vanthomme & Sylvie Gadeyne, 2016. "Regional Inequalities in Lung Cancer Mortality in Belgium at the Beginning of the 21st Century: The Contribution of Individual and Area-Level Socioeconomic Status and Industrial Exposure," PLOS ONE, Public Library of Science, vol. 11(1), pages 1-18, January.
    3. Fanny Janssen & Anthe van den Hende & Joop de Beer & Leo van Wissen, 2016. "Sigma and beta convergence in regional mortality: A case study of the Netherlands," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 35(4), pages 81-116.

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    More about this item

    Keywords

    Netherlands; smoking; socioeconomic status; all-cause mortality; regional differences; smoking-related mortality;
    All these keywords.

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • Z0 - Other Special Topics - - General

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