TOTAL AND CANCER MORTALITY PATTERNS IN THE WEST BANK REGIONS

Introduction Since the year 2000, the West Bank has been divided into small areas separated by check points and by the separation wall. These segregation measures have affected peoples mobility and accessibility to health services. The epidemiological situation in the occupied Palestinian territory is similar to that in the developing countries. The burden of the communicable diseases is decreasing compared to the increasing burden of the non-communicable diseases. Cardiovascular diseases are the leading cause of death followed by cancer (Palestinian Authority Ministry of Health). Objective To study whether total mortality and cancer specific mortality rates vary in the different Regions of the West Bank and over a ten years period. Methods Causes of death data were obtained from the Palestinian Health Management Information Centre (HMIC) – Palestinian Ministry of Health (MoH) for the years 1999-2009. Standardized Mortality Ratios (SMR) have been calculated (reference West-Bank). Results A total of 34,628 deaths were reported during the period between 1999 and 2009. The highest SMR for all causes mortality was found in the north-western governorates of the West Bank and the southern governorates and the lowest SMR was found in the eastern. There was difference in SMR between males and females in Ramallah governorate with higher SMR among males. The cancer SMR had similar pattern as all cause SMR. Bethlehem and Nablus have the highest SMR for males and females. Low SMR was found for Jerusalem governorates. This does not reflect the real situation in Jerusalem as these numbers are collected only for Palestinians living Jerusalem area that is under the Palestinian Authority control. Conclusions The regional variation in SMRs among Palestinian regions in the West Bank indicates specific risk factors and determinants that cluster in certain areas. These variations might also reflect inaccessibility of health services that has to be further investigated