Peer reviewed : mortality patterns in the West Bank, Palestinian Territories, 1999-2003

Abdullatif,Husseini:Community and Public Health Rita,Giacaman:Community and Public HealthIntroduction The West Bank in the Palestinian Territories is undergoing an epidemiologic transition. We provide a general description of mortality from all causes, focusing on chronic disease mortality in adults. Methods Mortality data analyzed for our study were obtained from the Palestinian Ministry of Health in the West Bank for 1999 through 2003. Individual information was obtained from death notification forms. Results A total of 27,065 deaths were reported for 1999 through 2003 in the West Bank, Palestinian Territories. Circulatory diseases were the main cause of death (45%), followed by cancer (10%) and unintentional injuries (7%). Among men, the highest age-standardized mortality rates (ASMRs) were due to diseases of the circulatory system, cancer, and unintentional injuries. Among women, the highest ASMRs were due to circulatory disease, cancer, and diabetes mellitus. Of the circulatory diseases, the highest ASMRs for men were due to acute myocardial infarction and cerebrovascular disease. ASMRs attributable to circulatory system diseases were similar for women. Lung cancer was the largest cause of cancer mortality for men; breast cancer was the largest cause for women. Conclusions Because of the high mortality rates, the risk factors associated with chronic diseases in the Palestinian Territories must be ascertained. Medical and public health policies and interventions need to be reassessed, giving due attention to this rise in modern-day diseases in this area. Introduction The West Bank, Palestinian Territories, is undergoing a transition characterized by rapid urbanization (1) and changing lifestyles. According to the Palestinian Central Bureau of Statistics, approximately 40% of West Bank residents lived in rural areas in 2006 (1,2), compared with 62% in the early 1990s (3). At the same time, the Palestinian Territories have been undergoing an epidemiologic transition characterized by a persistent burden of infectious diseases typical of developing countries and a rise in noncommunicable (chronic) diseases such as cardiovascular disease, hypertension, diabetes mellitus, and cancer. High prevalences of type 2 diabetes and obesity were observed in urban and rural Palestinian areas beginning in the late 1990s, and the rates are rising (4,5). In 2001, the West Bank had a population of approximately 2.1 million (6). Since 2000, the Palestinian population has endured intense conflict characterized by severe restrictions on the movement of Palestinian people and goods, difficulties of access to health services, and spiraling poverty, which negatively affect living conditions and health status (7,8