Abstract
Objective: To describe the incidence of avoidable mortality for causes amenable to medical care among occupation groups in Canada.
Method: A cohort study over an 11-year period among a representative 15% sample of the non-institutionalized population of Canada aged 30–69 at cohort inception. Age-standardized mortality rates for causes amenable to medical care and all other causes of death were calculated for occupationally-active men and women in five categories of skill level and 80 specific occupational groups as well as for persons not occupationally active.
Results: Age-standardized mortality rates per 100,000 person-years at risk for causes amenable to medical care and for all other causes were 132.3 and 218.6, respectively, for occupationally-active women, and 216.6 and 449.3 for occupationally-active men. For causes amenable to medical care and for all other causes, for both sexes, there was a gradient in mortality relative to the five-level ranking by occupational skill level, but the gradient was less strong for women than for men. Across the 80 occupation minor groups, for both men and women, there was a linear relationship between the rates for causes amenable to medical care and the rates for all other causes.
Conclusions: For occupationally-active adults, this study found similar gradients in mortality for causes amenable to medical care and for all other causes of mortality over the period 1991–2001. Avoidable mortality is a valuable indicator of population health, providing information on outcomes pertinent to the organization and delivery of health care services.
Key words: Occupations, cause of death, health services research
Résumé
Objectif: Décrire l’incidence de la mortalité évitable dont les causes sont traitables par des soins médicaux au sein de groupes de professions au Canada.
Méthode: Étude de cohortes menée sur une période de 11 ans auprès d’un échantillon représentatif de 15 % de la population hors-établissement du Canada âgée de 30 à 69 ans lors de la première cohorte. Nous avons calculé les taux de mortalité normalisés selon l’âge pour les causes traitables par des soins médicaux et pour toute autre cause de décès chez les hommes et les femmes ayant une activité professionnelle dans cinq catégories de compétences et 80 groupes professionnels particuliers, ainsi que chez les personnes inactives sur le plan professionnel.
Résultats: Chez les femmes actives, les taux de mortalité normalisés selon l’âge pour 100 000 personnes à risque/année étaient de 132,3 pour les causes traitables par des soins médicaux et de 218,6 pour toute autre cause. Chez les hommes actifs, ces taux étaient de 216,6 et de 449,3, respectivement. Les décès de causes traitables par des soins médicaux et de toute autre cause, chez les deux sexes, présentaient un gradient selon les cinq niveaux de compétences professionnelles, mais ce gradient était moins prononcé chez les femmes que chez les hommes. Dans les 80 groupes professionnels mineurs, tant chez les hommes que chez les femmes, nous avons observé une relation linéaire entre les taux pour les causes traitables par des soins médicaux et les taux pour toute autre cause.
Conclusion: Chez les adultes ayant une activité professionnelle, notre étude a constaté des gradients semblables dans la mortalité pour des causes traitables par des soins médicaux et pour toutes les autres causes de mortalité entre 1991 et 2001. La mortalité évitable est un bon indicateur de santé des populations, car elle donne de l’information sur les résultats de santé pertinents pour l’organisation et la prestation des services de santé.
Mots clés: professions, cause de décès, recherche sur les services de santé
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