[The structure of causes of death of the adult population of the Moscow region in 2019 and 2023].

Objective: To compare the structure of causes of death among men and women of different age groups in 2019 and 2023 (using the Moscow Region as an example).

Material and methods: Anonymized personalized data from medical death certificates (MDC) of the database of the Main Civil Registry Office in the Moscow Region. A total of 87.555 MDCs in 2019 and 92.182 in 2023 of persons aged 18 years and older. The absolute number of deaths (total and in ten-year age groups), the contribution of disease classes according to ICD-10 were determined, a comparison of unstandardized mortality rates (UR) and the structure of causes of death was carried out.

Results: The mortality rate for men (18 years and older) was 1499 per 100.000 men in 2019 and 1434 in 2023; for women - 1367 and 1344, respectively. The UR of men is higher than that of women up to the age of 80, with the greatest differences at the age of 18-39 years. An increase in the number of deaths, UR and contribution to the mortality structure in men and women was noted for 5 ICD classes (E, J, K, N and S-T in men); a decrease was found for class F, for women - for 2 classes (G and R). The most significant differences in the UR and structure of causes of death in men and women are associated with four classes (S-T, J, E and G). The smallest changes were recorded for the class of neoplasms (about 15% of deaths in both men and women in 2019 and in 2023). A high proportion of poorly defined codes was noted (for example, more than 80% in the class of nervous diseases are accounted for by 3 codes G31.1, G93.0 and G93.4). The differences and changes identified in the structure of causes of death in 10-year age groups of men and women are likely largely due to controversial issues regarding the determination of the underlying cause of death.

Conclusion: Mortality reduction strategies should take into account age-sex characteristics of causes of death. Significant changes in UR from individual causes and a sharp increase in the proportion of deaths with codes that have no clinical analogues in old age require improvement of approaches to indicating and coding causes of death.