Sunday, May 19, 2013

What are the top 10 Leading Causes of Mortality in the Philippines?

Burden of Noncommunicable Diseases in the Philippines | Cardiovascular Program in Cavite Province | Promoting Healthy Lifestyle in Bangued, Abra

This is one of the  most researched question about the Philippine health situation. Because of the limitations of the website, I changed the format from table to narrative. This post is valid at the time of publication. I'll try to make it easy for you to understand.

The source is from the Philippine Health Statistics. The DOH website data is also from the same report. If you go there armed with little knowledge, you'd be looking at a bunch of numbers and will probably scratch your head or avoid it altogether. The "Rate" number is the  mortality rate per 100,000 population. For example: there are 109.4 cases of death from Heart Disease (see below) per 100,000 of the Filipino population.

Top 1: Diseases of the Heart

2009: Number:100,908 Rate:109.4
5 year average (2004 to 2008): Number:82,290 Rate:94.5

The data, stretching as far back as 1990, shows Diseases of the Heart as the top cause of death in the Philippine population. If we compare United States and most other countries' mortality rates, diseases of the heart remain the top cause of death. The rising number of deaths could be attributed to the rise in the Philippine population but the mortality rate rise tells a different story. In 1983, the mortality rate was 62.6 per 100,000. Now it is 109.4 per 100,000 population!
This sudden increase in the mortality rate is the target of the DOH campaign: Healthy Lifestyle to the Max. Shown in the figure is the graphical representation of the data. Watch the video below to get an idea on how to advise our patients.

Top 2: Diseases of the Vascular System

2009: Number:65,489 Rate:71.0
5-year average (2004-2008): Number: 55,999 Rate: 64.3

Diseases of the Vascular System has been in the top 2 spot for the leading cause of death since 1993. The mortality rate has been linear and ranges from 55 to 70 for the past 30 years. The common cause of both top 1 and top 2 are arterial blockage or arteriosclerosis, smoking (also the most preventable), increase intake of fat and salty foods, and inactivity. Other secondary causes are due to coexisting morbidities like diabetes and obesity. The same campaign "Healthy Lifestyle to the Max" can address this situation.

Top 3: Malignant Neoplasms

2009: Number:47,732 Rate:51.8
5-year average (2004-2008): Number:42,185 Rate:49.6

Cancer has been in the top 3 spot ever since 1999. Prior to that year, it was at the number 4 spot. There is an increase in the mortality rate however the range and average of deaths for the past 5 years tells us that the statistics are stable. There is still a lot of room for improvement. Various Department of Health Programs do exist, such as an Anti-smoking and Cancer Awareness campaigns. However, due to societal influences, smoking remains the top preventable cause of cancer in all sexes and in all ages.

Top 4: Pneumonia

2009: Number:42,642 Rate:46.2
5-year average (2004-2008): Number:35,756 Rate:41.1

Historically, Pneumonia has been in the top 1 spot when most of the Philippines had basic to no access to health care. Most of the Philippines remain rural. But due to increase hospital access, and upgrading of existing health care facilities to accomodate difficult cases, pneumonial deaths are largely hampered. The mortality rate has been halved from 30 years ago.

Top 5: Accidents

2009: Number:35,990 Rate:39.0
5-year average (2004-2008): Number:34,704 Rate:39.9

Death from accidents are on the rise. The data is largely on the ages 10 to 24 age group which shows increase in traffic-accident-related deaths, a side-effect of urbanization. Other causes of death are drowning-related and occupational-related.

Healthy Lifestyle to the Max
Watch the DOH Infommercial

Top 6: Tuberculosis, all forms

2009: Number:25,470 Rate:27.6
5-year average (2004-2008): Number:25,376 Rate:29.2

The tuberculosis mortality rate has been on a decline for the past decade. This is largely in part to the intensive effort of the National Tuberculosis Program and various non-governmental organizations that are pushing to eradicate tuberculosis in the country. It is a monumental task but it has already been gaining ground in terms of mortality rate.

Top 7: Chronic lower respiratory disease

2009: Number:22,755 Rate:24.7
5-year average (2004-2008): Number:20,830 Rate:24.0

It's interesting to note that only in 1992 was this topnotcher added in the leading causes of mortality. It has enjoyed this spot ever-since. Chronic lower respiratory disease is largely preventable since the cause is a long term exposure to smoke or smog. Once the disease sets in however, patients gradually decline in lung function until death. The mortality rate has since increased by 75%.

Top 8: Diabetes Mellitus

2009: Number:22,345 Rate:24.2
5-year average (2004-2008): Number:19,805 Rate:22.7

Diabetes-related deaths has doubled in the past two decades. This is despite advances in diabetes control and treatment. The main problem is access to low cost insulin and PP-IV inhibitors. Also, another main factor is societal taboo or misinformation about the use of insulin. Another is the lack of symptoms at the detection of the disease. There is still room for improvement.

Top 9: Nephritis, nephrotic syndrome and nephrosis

2009: Number:13,799 Rate:15.0
5-year average (2004-2008): Number:11,612 Rate:13.4

Kidney disease could be due to diabetes, hypertension, and/or immune related. There are also other causes but end-stage renal disease is not easily detected. This is why aggressive treatment of diabetes and hypertension can lead to prevention of end-stage kidney disease. The push is always through prevention. The treatment, medical or surgical, for ESRD or chronic kidney disease is too costly especially for the average Filipino.

Top 10: Certain conditions originating in the perinatal period

2009: Number:11,514 Rate:12.5
5-year average (2004-2008): Number:12,590 Rate:14.5

These conditions include all mortality whether maternal or neonatal in the time surrounding birth. Another interesting note is its appearance only in the late 1999 health statistics. It debuted at the top 8 part and has decreased its ranking ever since. The decline could be due to various health programs by the department of health that pushes the mothers to have regular checkups with health specialists at hospitals or health centers.