Regional mortality differentials in Greece by selected causes of death: 2006-2008

Deaths due to neoplasms and diseases of the circulatory and the respiratory system represent 80% of all deaths in Greece. In the context of dearth of statistical analysis of spatial patterns of cause-specific mortality in Greece, this paper aims at studying the distribution and structure of appropriate mortality measures for the above mentioned causes of death at prefecture level. To achieve this, official statistics on deaths (2006-2008) and population (2007) are employed and Standardized Mortality Ratios (SMRs) by gender and cause of death are estimated using as 'standard' mortality schedule the national age-sex and cause-specific death rates. Estimation of Moran's I statistic revealed the existence of significant positive spatial autocorrelation for neoplasms and circulatory diseases. Empirical Bayes procedures were employed to adjust SMR values which, although show less dispersion, were close to the original estimates. The thematic maps depict regions with relatively high ( SMR s > 100) or low ( SMR s > 100) mortality and their significance levels, indicating that spatial patterns exhibit many similarities between sexes for each cause of death. SMRs for neoplasms and circulatory diseases show a roughly similar tendency; lower mortality compared to the country's average in southern and western Greece and the islands, and higher mortality in northern Greece, especially in the Region of East Macedonia and Thrace. Patterns due to respiratory diseases, on the other hand, differ somewhat but the corresponding relative risks are not as significant. Thorough observation and analysis of the conditions prevailing in northern Greece is needed to identify factors exacerbating ill health.