Geographical Variation of Mortality in Thailand
Pinij Faramnuayphol MD, MPH*, Virasakdi Chongsuvivatwong MD, PhD**, Supasit Pannarunothai MD, PhD***
Affiliation : * Health Information System Development Office, Health Systems Research Institute, Nonthaburi ** Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla *** Centre for Health Equity Monitoring, Faculty of Medicine, Naresuan University, Phitsanulok
Objective : To examine geographical variation of mortality in Thailand.
Material and Method: Descriptive ecological study using the national vital registration data in 2000,
age-specific mortality rate and cause-specific standardized mortality ratio (SMR) were presented at district
geographic level.
Results : Overall mortality was highly concentrated in the middle part of the upper north, as well as mortality
of the working age. Clustering of cause-specific SMR in a single region was found for liver cancer (in the
upper northeast region) and chronic obstructive pulmonary disease (in the upper north region). Clustering in
multiple regions was found for renal failure (in the upper north and the upper northeast regions). Dispersed
pattern of mortality with no regional clustering was found for leukemia. The geographical pattern of cause-
specific mortality might be explained by distribution of incidence and related risk factors.
Conclusion : Geographical variation of mortality exists and should be used as a target for reducing mortality
gap across geographical areas.
Keywords : Geographical variation, Mortality
