Changes in Mortality Trends and Patterns in The Pre-Covid-19 Period: Cause of Death Analysis of Life Expectancy and Lifespan Variation in Turkey

Abstract

This dissertation, which aims to analyse the recent pattern and trend in death rates in the pre-Covid period, consists of three articles. In the first essay quality of cause of death data for 2013-2019 were evaluated by focusing on garbage codes. By using WHO recommendations, garbage codes were determined and redistributed to target codes. Findings indicate that garbage cardiovascular diseases constituted the highest share of total garbage codes and increased between 2013 and 2019. The second essay evaluates the burden of communicable diseases by using Markov-chain modelling. Acccording to the results, communicable diseases increased significantly in 2013-2019 period and had higher impact on elderly. Findings also suggest that age at death distribution of males shifted towards older ages. Furthermore, the increase in communicable diseases points to a different pattern of mortality in Turkey's epidemiological transition.

The third essay aims to evaluate the age and cause contributions to life expectancy and lifespan variation between 2013 and 2019 by using decomposition method. Sex difference in life expectancy and lifespan variation were also analyzed with decomposition method. In this essay, the threshold age separating premature mortality from old-age mortality was also calculated. Findings of the essay disclose that males gained higher life expectancy than females due to the improvement in malignant neoplasms and unintentional injuries at ages below threshold age. Increasing life expectancy among females stem from the improvement in cardiovascular diseases at age above threshold ages. This study also indicates that increasing communicable diseases are an important barrier to the higher life expectancy. Sex gap in life expectancy shows the female advantage at all causes. Sex difference in lifespan variation indicates that females have higher variation at older ages and lower variation at young and adult ages than males.

To sum up, results of this dissertation highlight three important results. Firstly, garbage cardiovascular diseases is an important issue in cause of death data that needs to be addressed. Secondly, communicable diseases are becoming dangerous for elderly. Thirdly, females and males have different mortality patterns. While mortality improvement is seen at older ages among females (expansion of mortality), mortality improvement is seen at younger ages among males (compression of mortality).