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Biomedical subjects

P C Humblet

Publications and source records attributed to P C Humblet.

5 recordsLinked to original sources

Premature avoidable deaths by road traffic injuries in Belgium: trends and geographical disparities.

Road traffic injuries are a major public health problem. In this study, we chose Years of Potential Life Lost (YPLL) to analyse the trends during the period 1974-1994 and the relative impact of the traffic injuries death on total mortality and on total avoidable mortality in Belgium. We analysed the geographical trends over a 20-year period at the district level. The YPLL age-adjusted rates were analysed for four successive 5-year periods: 1974-1978, 1980-1984, 1985-1989, 1990-1994 and the ratios of YPLL rates were used to describe changes between 1974 and 1994 at district level. The YPLL rates decrease for 'all causes mortality', 'total avoidable causes' and 'road traffic injuries'. This trend can be observed during the four periods of 5 years. A slowing down of the decrease of the YPLL rates for road traffic injuries, both for men and women is observed: 11.7% between periods 2 and 1, and only 3% between periods 4 and 3 for men (16.2 and 7.5% for women). The geographical analysis shows marked differences between districts. Even though a favourable trend is observed for the traffic injuries deaths in Belgium it is important to highlight the important slowing down of this trend during the most recent years. It is also necessary to underline the importance of geographical disparities in the distribution of YPLL rates within the entire population.

Accidents, Traffic↗

Trends in Belgian premature avoidable deaths over a 20 year period.

STUDY OBJECTIVES: To analyse over a 20 year period the level and trends in the "EC avoidable death indicators". DESIGN: The Years of Potential Life Lost (YPLL) method applied to curative and preventive avoidable mortality indicators in Belgium for four successive five year periods, countrywide as well as by district, separately for women and men. Ratios of YPLL rates (age standardised) describe changes between 1974-78 and 1990-94. SETTING: Belgium for the periods 1974-78, 1980-84, 1985-89, 1990-94. PARTICIPANTS: All avoidable death cases aged 1-64. MAIN RESULTS: Ratio of YPLL rates indicated a more favourable development between 1974-78 and 1990-94 in the EC avoidable indicators than in all causes premature mortality. The EC avoidable mortality indicators have been assigned to two categories, curative indicators and preventive indicators. The best ratio of YPLL rates was found in curative indicators for men but the largest gains in YPLL rates over the periods come from the "preventive indicators" in men. For women, malignant neoplasm of the breast rose to the first ranked in 1985-1989 and 1990-1994, where it contributed to more years of YPLL loss than motor vehicle accidents, and malignant neoplasm of the trachea, bronchus and lung had risen to the fifth ranked since 1985-89. The order of the top causes for men did not change between 1974 and 1994, except for cirrhosis of liver, which rose from the fifth to the fourth rank. In the particular case of one "preventive indicator", malignant neoplasm of the trachea, bronchus and lung, the regional analysis of time trend between 1974-78 and 1990-94 showed more districts with a favourable development for both men and women in the Flemish region than in Wallonia. CONCLUSION: The YPLL method combined with the avoidable mortality indicators enabled us to compare the changes of curative and preventive EC avoidable indicators between 1974-78 and 1990-94. In the case of malignant neoplasm of the trachea, bronchus and lung, which is of major concern to the health promotion policies, changes over the periods have widened a "north/south" health contrast.

Accident Prevention↗

Health and social inequities in Belgium.

This paper presents two different yet complementary on-going studies related to the understanding of the mechanisms leading to social inequalities in health. The first part is devoted to a differential morbidity survey held in southern Belgium. It confirms that striking differences exist in the period around birth between social categories, and between the three districts under study. In a multivariate approach, differences remain between the social categories and between the district samples, which classically studied socio-demographical, behavioural and medical characteristics cannot fully explain. The role of cultural factors is analysed and discussed through the concept of 'health culture' and alternative hypotheses are reviewed in the light of the results. The second part reviews the studies conducted on the so-called avoidable mortality in the EEC and more specifically in Belgium. The concept of avoidable mortality is discussed, as well as its utility from the standpoint of the present concern on social inequalities. Differences between EEC countries are large, and even within Belgium there are important disparities between the districts. The role of health care supply has not been demonstrated yet in these two contexts. For Belgium, it appears that a major part of the unequally distributed mortality is constituted by causes of death considered as avoidable. Moreover, the most discriminating causes of death are overrepresented in socially deprived districts. The two perspectives are confronted in order to delineate perspectives for future research and operational outcomes for policy making and interventions.

Belgium↗

Organization of prenatal care in Belgium.

Prenatal care in Belgium is characterized by regional variations between the Flemish- and French-speaking communities. Generally, care in the former area is provided by a general practitioner or a gynecologist/obstetrician in private practice, and in the latter by a gynecologist/obstetrician on a private or public basis. The level of use of prenatal care observed is, on average, high, but variations do exist according to the socioeconomic and cultural characteristics of the families and the health care services which they frequent.

Belgium↗

[Avoidable mortality in Belgium].

The concept of avoidable mortality leads to an attempt at using specific mortality rates as output measures of health services. The analysis covered 43 Belgian districts between the years 1974 and 1978. Two Belgian areas were compared along a dimension defined by two axes of a correspondence factor analysis: Flanders which is associated with low SMR of avoidable mortality and Wallonia which has high rates. The persistence of high mortality in Wallonia was confirmed. Factorial scores for each district were used as indexes for geographical heterogeneity. Variations in these indices, including patient consultation rates and technical medical procedures, remained even after adjustment for socio-economic differences.

Adolescent↗