Comprehensive studies on death in rural areas.
10.2185/jjrm.38.1073
- VernacularTitle:農村における死亡の実証的研究
- Author:
Isamu EBIHARA
- Publication Type:Journal Article
- From:Journal of the Japanese Association of Rural Medicine
1990;38(6):1073-1083
- CountryJapan
- Language:Japanese
-
Abstract:
The corrected death rate is by far higher among those engaged in agriculture and fishery than those engaged in other occupations.
The purpose of this study is to provide data useful for the public health service and medical care in the future. For this purpose, investigation was made into the ways of life the deceased had led while alive and medical treatment they had received. Furthermore, the causes of death were examined in light of social as well as medical factors.
1. Our survey at hospitals showed that the largest number of deaths was caused by malignant neoplasm. This was followed by cerebrovascular disorder, heart disease and others, in that order.
According to a comparative study conducted by a group of researchers at Hiroshima General Hospital on the causes of death between urban and rural communities, the ratios of cerebrovascular disease, accidents, trauma and suicide to the total are higher in rural areas than in urban areas, respectively. Malignant neoplasm and myocardial infarction were associated with urban lifestyle. As for neoplasm, lung cancer more frequently attacks urbanites, while cancer of the colon occurs in rural inhabitants.
2. Pattern of Death
A close look at death notices does not always reveal a clearcut pattern of death in rural areas. It varies greatly depending on economic, industrial and other factors of regions.
However, a general picture of what takes the lives of people can be drawn. The most frequent causes of death among those at 50 or below are accidents, neoplasm, and suicide.
A study of the suicide cases in Shimane Prefecture over the past eight years shows that there is a upward tendency for men aged 65 years or above in urban areas and younger than 65 in rural areas to commit suicide. As for women, suicide cases are on the rise among those younger than 65 years old in both urban and rural areas. As the causes of self-killing, suffering from illness stands out from any other, with mental disturbance, household economy, family trouble, pressure of work and love affairs trailing behind.
3. Start of Medical Examination
Of the dead, the majority had visited hospitals or clinics before their death, complaining about displeasure. About 30% of those who had suffered from mental disease, attempted suicide or had some other reasons had seen doctors. Unexpectedly, however only a small number of them consulted physicians after undergoing a regular mass health screening.
Within a month from the onset of subjective symptoms, 80% received medical examination and most of them visited hospitals or clinics early in the morning. Nevertheless, many met their death in a relatively short period of time. That was a surprising finding.
To be more specific. In one month after the onset of their disease, 30% of them died; in 6 months, about 60%; and one year, 70%. In the cases of neoplasm, about 50% survived for more than one year. A very few, who had their malady detected early in a screening, remained alive for more than five years. This fact proved that the screening for early detection of diseases is important.
4. Risk Factors The correlations between the major causes of death and the ways of living were examined to ponder over risk factors for diseases. However, it was difficult to link the causes of death and lifestyles. Various research institutes study this subject in different ways. The biological process from birth to death is interlocked with various social factors and environmental influences.
Based on the findings of a case control study on lung cancer, we obtained the odds ratios by occupation. The ratio was low among those engaged in agriculture, forestry and fishery, and significantly high among those working in wood and metal processing plants. Moreover, it was made clear that cigarette smoking and exposure to mineral particulates multiply risks of developing lung cancer.
