Mortalità per malattie respiratorie in Italia (1990-2010). Parte II: Tassi standardizzati, confronto con l'Europa e conclusioni.

The purpose of this study is to evaluate mortality rates of MAR, particularly chronic respiratory diseases (MRC), in the 90s and in the first decade of the new millennium. The results are presented into two separate reports. In the first report (Part I), it was evidenced a progressive increase in deaths due to MAR and MRC, and the crude mortality rates for MAR and MRC showed a moderate increment in the new millennium. In the current report (Part II), after standardization for age, there is a decline of mortality for both MAR and MRC in all Italian geographical areas, in both sexes and in all age groups. The apparent contradiction between the increase of deaths and decreased mortality can be explained by the increase in the index of population aging (the elderly/young ratio raised from 90% in 1990 to 144% in 2010). The decline in mortality is more evident in the Southern Italy and in the Islands than in the Central-Northern Italy, as well as in males and in subjects aged 65-74 years. With regard to mortality for MAR, between 41 European countries, Italy ranks 31th for males and 33th for females. With regard to mortality for MRC, between 34 European countries, corresponding rankings are 19 and 21. The decline in mortality is particularly high in males and may be due in part to the decrease in smoking habit. Over the period 1957-1990, the prevalence of male smokers decreased from 63 to 38%, and the percent difference of smoker between men and women fell from 60 to 13%. Among males, residents in the Southern Italy and Islands have standardized mortality rates higher than the national average in all the twenty years considered. Among the females, this happens until 2000, and thereafter, the women living in the North tend to have higher values.