Decomposition of basic mortality indicators in Serbia 1990-2021

Abstract

The research of thirty-year changes in the mortality of the population of Serbia (1990-2021) is given through two basic indicators of mortality. Using the decompose method to calculated the effect of population aging on the difference between crude mortality rates, as well as the contributions of specific mortality rates and leading causes of death in the changes in life expectancy. The crude death rate shows that the intensity of dying in Serbia is very high. The pandemic contributed to record values in the last two years. Overall, in the period 1990-2019, the negative contribution of the age structure is twice as intense as the positive effect of age-specific mortality rates. Aging is more intense in the female population, which explains the greater increase in the crude death rate in women. The data show that the importance of demographic aging has always been more pronounced. The main characteristic in the observed time interval is that mortality decreases at all ages and that all age groups had a positive effect on life expectancy, as well as that men and women in Serbia have a different pattern of decreasing mortality by age. The most significant effect on life expectancy was the reduction of infant mortality (a fifth of the total contribution), a common feature of the male and female populations. In other age groups, men have more pronounced contributions up to the age of 50, and women in older cohorts. Due to higher mortality rates, the space for improving mortality is greater in young and middle-aged men than in women, so the positive effects are more pronounced at these ages. The largest number of leading causes of death burdens the population of Serbia less now than three decades earlier. Cardiovascular diseases, as the leading cause of death, contributed the most to positive changes in mortality. The biggest effect of life expectancy is the reduction of mortality rates due to diseases of the circulatory system in the 65-79 year old population. Observed by gender, the effect is greater in the female population, where cardiovascular diseases contribute to the extension of life expectancy by as much as 67% or by 2.4 years, while in the male population the importance of cardiovascular diseases in the extension of life expectancy is lower and amounts to 42% or by 1.9 years. Tumors, as the second most common cause of death in Serbia, contribute negatively to those aged 50 and over and positively to younger age groups. The overall effect on life expectancy is positive, and mortality rates in men decline until the age of 60. In women, rates increase from age 50 or older, and of all causes of death, only tumors have an overall negative effect on life expectancy growth. Among the other causes, the importance of violent deaths and their positive effect should be singled out, due to the reduction of mortality rates at all ages, especially among the younger population. Positive changes in the age of 15-49 years in the male population contribute to an increase in life expectancy of even 1 year. In the female population, a positive contribution is also present at all ages, but the effect is significantly lower. The COVID-19 pandemic brought the highest increase in mortality in Serbia in the last 70 years. Mortality increased by 14% in the first year of the pandemic, and by 34% in the second, compared to the 2017-2019 average. The crude death rate has increased tremendously and for men in 2020 it is 18.0‰, and in 2021 it will show a maximum value of 21 deaths per 1,000 persons. For women, this mortality rate is 15.9‰ and 19.0‰ (in 2020 and 2021, respectively). Changes compared to the values from 2019, for both sexes, are solely the result of the increase in mortality by age, while changes in the distribution of the population by age had a negligible effect in this period. The last analyzed year (2021) brings a drop in life expectancy for men of as much as 3.4 years compared to the period before the pandemic. Women in Serbia have a slightly smaller decline in life expectancy in this period of 2.9 years.