Analysis of health and socio-economic characteristics of district level
Transcription
Analysis of health and socio-economic characteristics of district level
Biennial Collaborative Agreement between the Minister of Health of Poland and the Regional Office for Europe of the World Health Organization 2010-2011 Analysis of health and socio-economic characteristics of district level populations in Poland Agnieszka Chłoń-Domińczak, Michal Marek, Daniel Rabczenko, Jakub Stokwiszewski, Bogdan Wojtyniak Warsaw, February 2011 1 Content 1. POLISH DISTRICTS ..................................................................................................................... 18 1.1. Development of territorial units in Poland ..................................................................................................... 18 1.2. Demographic, economic and technical characteristics of Polish districts ...................................................... 23 1.3. Macro-level factors affecting district development ........................................................................................ 27 1.3.1. Social capital .......................................................................................................................................... 28 1.3.2. Polish metropolises................................................................................................................................. 29 1.3.3. Foreign investments ............................................................................................................................... 30 1.3.4. Public governance .................................................................................................................................. 32 1.3.5. European Union ...................................................................................................................................... 33 Summary ............................................................................................................................................................... 35 Annex 1.1. Lists .................................................................................................................................................... 37 Annex 1.2. Tables ................................................................................................................................................. 39 Annex 1.3. Figures ................................................................................................................................................ 44 2. SOCIAL AND ECONOMIC CHARACTERISTICS OF DISTRICTS IN POLAND .............. 48 2.1. Selection of variables ..................................................................................................................................... 48 2.2. Time and space characteristics of selected variables...................................................................................... 55 2.2.1. Demographic indicators.......................................................................................................................... 55 2.2.2. Economic and labour market indicators ................................................................................................. 60 2.2.3. Social cohesion indicators ...................................................................................................................... 66 2.2.4. Health care access indicators .................................................................................................................. 72 2.2.5. Educational indicators ............................................................................................................................ 75 2.3. Relations between selected variables ............................................................................................................. 83 References ............................................................................................................................................................. 92 ANNEX 2. VALUES OF SELECTED INDICATORS BY DISTRICT ............................................... 93 (TERYT: NATIONAL OFFICIAL REGISTER OF TERRITORIAL DIVISION OF THE COUNTRY) 117 3. DIFFERENCES IN HEALTH STATUS OF THE POPULATION ACROSS DISTRICTS IN POLAND ............................................................................................................................................ 118 Introduction ......................................................................................................................................................... 118 3.1. Overall mortality .......................................................................................................................................... 120 3.1.1. Total population ................................................................................................................................... 120 3.1.2. Population below 65 years of age ......................................................................................................... 124 3.1.3. Population aged 65 years and over ....................................................................................................... 128 3.2. Mortality from cancer .................................................................................................................................. 132 3.2.1. Total population ................................................................................................................................... 132 3.2.2. Population below 65 years of age ......................................................................................................... 136 3.2.3. Population aged 65 years and over ....................................................................................................... 140 2 3.3. Mortality from circulatory system diseases.................................................................................................. 144 3.3.1. Total population ................................................................................................................................... 144 3.3.2. Population below 65 years of age ......................................................................................................... 148 3.3.3. Population aged 65 years and over ....................................................................................................... 152 3.4. Mortality from diseases of the respiratory system ....................................................................................... 156 3.4.1. Total population ................................................................................................................................... 156 3.4.2. Population below 65 years of age ......................................................................................................... 160 3.4.3. Population aged 65 years and over ....................................................................................................... 164 3.5. Mortality from diseases of the digestive system .......................................................................................... 168 3.5.1. Total population ................................................................................................................................... 168 3.5.2. Population below 65 years of age ......................................................................................................... 172 3.5.3. Population aged 65 years and over ....................................................................................................... 176 3.6. Mortality from ill-defined causes (symptoms, signs and abnormal clinical and laboratory findings) ......... 180 3.7. Mortality from external causes ..................................................................................................................... 183 3.7.1. Total population ................................................................................................................................... 183 3.7.2. Population below 65 years of age ......................................................................................................... 187 3.7.3. Population aged 65 years and over ....................................................................................................... 191 3.8. Infant mortality ............................................................................................................................................ 195 3.9. Life expectancy ............................................................................................................................................ 198 Summary ............................................................................................................................................................. 202 ANNEX 3 ............................................................................................................................................ 204 4. ASSOCIATION OF HEALTH STATUS OF DISTRICTS POPULATION WITH SOCIOECONOMIC CHARACTERISTIC OF DISTRICTS.................................................................... 284 4.1. Overall mortality .......................................................................................................................................... 285 4.2. Mortality from cancer .................................................................................................................................. 287 4.3. Mortality from circulatory system diseases.................................................................................................. 288 4.4. Mortality from respiratory system diseases.................................................................................................. 289 4.5. Mortality from digestive system diseases .................................................................................................... 290 4.6. Mortality from ill-defined causes (symptoms, signs and abnormal clinical and laboratory findings) ......... 291 4.7. Mortality from the external causes of death ................................................................................................. 292 4.8. Infant mortality ............................................................................................................................................ 293 4.9. Life expectancy at birth ................................................................................................................................ 294 Summary ............................................................................................................................................................. 295 Annex 4 ............................................................................................................................................................... 299 3 Tables Table 1. Characteristics of administrative regions (2010.06.30) ............................................. 18 Table 2. Extreme differences between districts (2002) ........................................................... 21 Table 3. Extreme differences between municipal districts (2002) ........................................... 21 Table 4. Budgetary revenues of municipal districts per capita in 2005 ................................... 21 Table 5. Number of districts and local communities in Poland (1999 –2010)......................... 22 Table 6. Quality of life in district municipalities (1999).......................................................... 23 Table 7. Development of rural district technical infrastructure measured with an index ........ 26 Table 8. Increase of budgetary revenues of municipal districts in year 2005 and 2003 .......... 27 Table 9. Share of people trusting other people (18 years of age and above) ........................... 28 Table 10. Total amount of foreign investments in Visegrad Group countries (billions of USD) .................................................................................................................................................. 30 Table 11. New jobs created by foreign investments (2008) ..................................................... 30 Table 12. Number of employees working for firms with foreign capital (until 2008) ............ 31 Table 13. Countries with the lowest and the highest level of corruption ................................. 33 Table 14. Characteristics of the most underdeveloped regions (2008) .................................... 39 Table 15. Differences among districts (2002) .......................................................................... 39 Table 16. Rural district populations. Average values of three groups of districts ................... 41 Table 17. Economic development of rural districts. Average values of five groups of districts .................................................................................................................................................. 41 Table 18. Rural districts with the best and the worst developed technical infrastructure ....... 42 Table 19 Characteristics of Polish metropolises ...................................................................... 43 Table 20. Indicators for district-level analysis of socio-economic determinants of health in Poland ....................................................................................................................................... 51 Table 21. Descriptive statistics of feminization rate .............................................................. 57 Table 22. Descriptive statistics of old-age dempgraphic dependency ratio ............................. 58 Table 23. Descriptive statistics of population density.............................................................. 59 Table 24. Descriptive statistics of own revenue of local budgets per capita ........................... 62 Table 25. Descriptive statistics of unemployment rate ............................................................ 63 Table 26. Descriptive statistics of share of employment in agriculture ................................... 64 Table 27. Descriptive statistics of share of employment in hazardous conditions .................. 65 Table 28. Descriptive statistics of pre-school participation rate of children aged 3-5 ............. 68 Table 29. Descriptive statistics of library members per 1000 inhabitants ............................... 69 Table 30. Descriptive statistics of the share of households equipped with a bathroom ........... 70 Table 31. Descriptive statistics of local government elections turnout.................................... 71 Table 32. Descriptive statistics of the number of inhabitants per 1 health care institution...... 73 Table 33. Descriptive statistics of the number of inhabitants per 1 physician ......................... 74 Table 34. Descriptive statistics of the share of population with higher education................... 78 Table 35. Descriptive statistics of the share of population with vocational or lower education .................................................................................................................................................. 78 Table 36. Descriptive statistics of average lower secondaryschool exam results (mathematics and science) .............................................................................................................................. 79 Table 37. Descriptive statistics of upper secondary school matura results - mathematics (basic level) ......................................................................................................................................... 79 Table 38. Descriptive statistics of average lower secondaryschool exam results (humanities)80 Table 39. Descriptive statistics of upper secondary school matura exam results - Polish language (basic level) ............................................................................................................... 81 Table 40. Correlation matrix of the indicators ......................................................................... 89 Table 41. Age-standardized mortality ratio for overall mortality, total population, 2006–2008, descriptive statistics................................................................................................................ 120 4 Table 42. Age-standardized mortality ratio for overall mortality, population aged 0–64 years, 2006–2008, descriptive statistics............................................................................................ 124 Table 43. Age-standardized mortality ratio for overall mortality, population aged 65 years and over, 2006–2008, descriptive statistics .................................................................................. 128 Table 44. Age-standardized mortality ratio for cancer, total population, 2006–2008, descriptive statistics................................................................................................................ 132 Table 45. Age-standardized mortality ratio for cancer, population aged 0–64 years, 2006– 2008, descriptive statistics...................................................................................................... 136 Table 46. Age-standardized mortality ratio for cancer, population aged 65 years and over, 2006–2008, descriptive statistics............................................................................................ 140 Table 47. Age-standardized mortality ratio for cardiovascular diseases, total population, 2006–2008, descriptive statistics............................................................................................ 144 Table 48. Age-standardized mortality ratio for cardiovascular disases, population aged 0–64 years, 2006–2008, .................................................................................................................. 148 Table 49. Age-standardized mortality ratio for cardiovascular diseases, population aged 65 years and over, 2006–2008, descriptive statistics .................................................................. 152 Table 50. Age-standardized mortality ratio for diseases of the respiratory system, total population, 2006–2008, descriptive statistics ........................................................................ 156 Table 51. Age-standardized mortality ratio for respiratory system diseases, population aged 0– 64 years, 2006–2008, descriptive statistics ............................................................................ 160 Table 52. Age-standardized mortality ratio for respiratory system diseases, population aged 65 years and over, 2006–2008, descriptive statistics .................................................................. 164 Table 53. Age-standardized mortality ratio for diseases of the digestive system, total population, .............................................................................................................................. 168 Table 54. Age-standardized mortality ratio for diseases of the digestive system, population aged 0–64 years, 2006–2008, descriptive statistics................................................................ 172 Table 55. Age-standardized mortality ratio for diseases of the digestive system, population aged 65 years and over, 2006–2008, descriptive statistics ..................................................... 176 Table 56. Standardized mortality ratio for ill-defined causes of death, total population, 2006– 2008, descriptive statistics...................................................................................................... 180 Table 57. Standardized mortality ratio for external causes, total population, 2006–2008, descriptive statistics................................................................................................................ 183 Table 58. Standardized mortality ratio for external causes, population aged 0–64 years, 2006– 2008, descriptive statistics...................................................................................................... 187 Table 59. Standardized mortality ratio for external causes, population aged 65 years and over, 2006–2008, descriptive statistics............................................................................................ 191 Table 60. Descriptive statistics of infant mortality rates (per 1000 live births) by age in districts ................................................................................................................................... 195 Table 61. Summary statistics of life expectancy at birth in districts by gender, 2001–2003 and 2006–2008 .............................................................................................................................. 198 Table 62. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, total population .......................................................................... 204 Table 63. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, males .......................................................................................... 211 Table 64. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, females ....................................................................................... 218 Table 65. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, total population 0–64 years old ..................................... 225 Table 66. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, males 0–64 years old ..................................................... 232 5 Table 67. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, females 0–64 years old .............................................................. 239 Table 68. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, total population of age 65 years and more ..................... 246 Table 69. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, males of age 65 years and more ..................................... 253 Table 70. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, females of age 65 years and more.................................. 260 Table 71. Infant mortality rates by age and district of residence in 2001–2003 and 2006– 2008, per 1000 live births ....................................................................................................... 267 Table 72. Life expectancy at birth (in years) of males and females in 2001–2003 and 2006– 2008 ........................................................................................................................................ 276 Table 73 Standardized regression coefficients from the final multiple regression models for mortality due to all causes for each age and sex group .......................................................... 286 Table 74. Standardized regression coefficients from the final multiple regression models for cancer mortality for each age and sex group .......................................................................... 287 Table 75. Standardized regression coefficients from the final multiple regression models for mortality due to circulatory system diseases for each age and sex group .............................. 289 Table 76. Standardized regression coefficients from the final multiple regression models for mortality due to respiratory system diseases for each age and sex group .............................. 289 Table 77. Standardized regression coefficients from the final multiple regression models for mortality due to digestive system diseases for each age and sex group ................................. 291 Table 78. Standardized regression coefficients from the final multiple regression models for mortality due to ill-defined causes for each age and sex group ............................................. 292 Table 79. Standardized regression coefficients from the final multiple regression models for mortality due to external causes for each age and sex group ................................................. 293 Table 80. Standardized regression coefficients for infant mortality rate, total and in age groups ................................................................................................................................................ 294 Table 81. Standardized regression coefficients for life expectancy at birth of males and females ................................................................................................................................... 295 Table 82. Association between district SMR for all causes and socio-economic variables, total population, all ages ................................................................................................................. 299 Table 83. Association between district SMR for all causes and socio-economic variables, males, all ages ........................................................................................................................ 300 Table 84. Association between district SMR for all causes and socio-economic variables, females, all ages ..................................................................................................................... 301 Table 85. Association between district SMR for all causes and socio-economic variables, total population, aged 0–64 years ........................................................................................... 302 Table 86. Association between district SMR for all causes and socio-economic variables, males, aged 0–64 years ........................................................................................................... 303 Table 87. Association between district SMR for all causes and socio-economic variables, females, aged 0–64 years ....................................................................................................... 304 Table 88. Association between district SMR for all causes and socio-economic variables, total population, aged 65 years and over ........................................................................................ 305 Table 89. Association between district SMR for all causes and socio-economic variables, males, aged 65 years and over ................................................................................................ 306 Table 90. Association between district SMR for all causes and socio-economic variables, females, aged 65 years and over............................................................................................. 307 Table 91. Association between district SMR for malignant neoplasms and socio-economic variables, total population, all ages ........................................................................................ 308 6 Table 92. Association between district SMR for malignant neoplasms and socio-economic variables, males, all ages ........................................................................................................ 309 Table 93. Association between district SMR for malignant neoplasms and socio-economic variables, females, all ages ..................................................................................................... 310 Table 94. Association between district SMR for malignant neoplasms and socio-economic variables, total population, aged 0–64 years .......................................................................... 311 Table 95. Association between district SMR for malignant neoplasms and socio-economic variables, males, aged 0–64 years .......................................................................................... 312 Table 96. Association between district SMR for malignant neoplasms and socio-economic variables, females, aged 0–64 years ....................................................................................... 313 Table 97. Association between district SMR for malignant neoplasms and socio-economic variables, total population, aged 65 years and over ............................................................... 314 Table 98. Association between district SMR for malignant neoplasms and socio-economic variables, males, aged 65 years and over ............................................................................... 315 Table 99. Association between district SMR for malignant neoplasms and socio-economic variables, females aged 65 years and over ............................................................................. 316 Table 100. Association between district SMR for circulatory system diseases and socioeconomic variables, total population, all ages ........................................................................ 317 Table 101. Association between district SMR for circulatory system diseases and socioeconomic variables, males, all ages ....................................................................................... 318 Table 102. Association between district SMR for circulatory system diseases and socioeconomic variables, females, all ages .................................................................................... 319 Table 103. Association between district SMR for circulatory system diseases and socioeconomic variables, total population, aged 0–64 ................................................................... 320 Table 104. Association between district SMR for circulatory system diseases and socioeconomic variables, males, aged 0–64 ................................................................................... 321 Table 105. Association between district SMR for circulatory system diseases and socioeconomic variables, females, aged 0–64 ................................................................................ 322 Table 106. Association between district SMR for circulatory system diseases and socioeconomic variables, total population, aged 65 years and over ............................................... 323 Table 107. Association between district SMR for circulatory system diseases and socioeconomic variables, males, aged 65 years and over ............................................................... 324 Table 108. Association between district SMR for circulatory system diseases and socioeconomic variables, females, aged 65 years and over............................................................ 325 Table 109. Association between district SMR for respiratory system diseases and socioeconomic variables, total population, all ages ........................................................................ 326 Table 110. Association between district SMR for respiratory system diseases and socioeconomic variables, males, all ages ....................................................................................... 327 Table 111. Association between district SMR for respiratory system diseases and socioeconomic variables, females, all ages .................................................................................... 328 Table 112. Association between district SMR for respiratory system diseases and socioeconomic variables, total population, aged 0–64 ................................................................... 329 Table 113. Association between district SMR for respiratory system diseases and socioeconomic variables, males, aged 0–64 ................................................................................... 330 Table 114. Association between district SMR for respiratory system diseases and socioeconomic variables, females, aged 0–64 ................................................................................ 331 Table 115. Association between district SMR for respiratory system diseases and socioeconomic variables, total population, aged 65 years and over ............................................... 332 Table 116. Association between district SMR for respiratory system diseases and socioeconomic variables, males, aged 65 years and over ............................................................... 333 7 Table 117. Association between district SMR for respiratory system diseases and socioeconomic variables, females, aged 65 years and over............................................................ 334 Table 118. Association between district SMR for digestive system diseases and socioeconomic variables, total population, all ages ........................................................................ 335 Table 119. Association between district SMR for digestive system diseases and socioeconomic variables, males, all ages ....................................................................................... 336 Table 120. Association between district SMR for digestive system diseases and socioeconomic variables, females, all ages .................................................................................... 337 Table 121. Association between district SMR for digestive system diseases and socioeconomic variables, total population, aged 0–64 ................................................................... 338 Table 122. Association between district SMR for digestive system diseases and socioeconomic variables, males, aged 0–64 ................................................................................... 339 Table 123. Association between district SMR for digestive system diseases and socioeconomic variables, females, aged 0–64 ................................................................................ 340 Table 124. Association between district SMR for digestive system diseases and socioeconomic variables, total population, aged 65 years and over ............................................... 341 Table 125. Association between district SMR for digestive system diseases and socioeconomic variables, males, aged 65 years and over ............................................................... 342 Table 126. Association between district SMR for digestive system diseases and socioeconomic variables, females, aged 65 years and over............................................................ 343 Table 127. Association between district SMR for ill-defined causes and socio-economic variables, total population, all ages ........................................................................................ 344 Table 128. Association between district SMR for ill-defined causes and socio-economic variables, males, all ages ........................................................................................................ 345 Table 129. Association between district SMR for ill-defined causes and socio-economic variables, females, all ages ..................................................................................................... 346 Table 130. Association between district SMR for ill-defined causes and socio-economic variables, total population, aged 0–64 .................................................................................... 347 Table 131. Association between district SMR for ill-defined causes and socio-economic variables, males, aged 0–64.................................................................................................... 348 Table 132. Association between district SMR for ill-defined causes and socio-economic variables, females, aged 0–64 ................................................................................................ 349 Table 133. Association between district SMR for ill-defined causes and socio-economic variables, total population, aged 65 years and over ............................................................... 350 Table 134. Association between district SMR for ill-defined causes and socio-economic variables, males, aged 65 years and over ............................................................................... 351 Table 135. Association between district SMR for ill-defined causes and socio-economic variables, females, aged 65 years and over ............................................................................ 352 Table 136. Association between district SMR for external causes and socio-economic variables, total population, all ages ........................................................................................ 353 Table 137. Association between district SMR for external causes and socio-economic variables, males, all ages ........................................................................................................ 354 Table 138. Association between district SMR for external causes and socio-economic variables, females, all ages ..................................................................................................... 355 Table 139. Association between district SMR for external causes and socio-economic variables, total population, aged 0–64 .................................................................................... 356 Table 140. Association between district SMR for external causes and socio-economic variables, males, aged 0–64.................................................................................................... 357 Table 141. Association between district SMR for external causes and socio-economic variables, females, aged 0–64 ................................................................................................ 358 8 Table 142. Association between district SMR for external causes and socio-economic variables, total population, aged 65 years and over ............................................................... 359 Table 143. Association between district SMR for external causes and socio-economic variables, males, aged 65 years and over ............................................................................... 360 Table 144. Association between district SMR for external causes and socio-economic variables, females, aged 65 years and over ............................................................................ 361 Table 145. Association between district infant mortality rate and socio-economic variables 362 Table 146. Association between districts infant neonatal (0-27 days) mortality rate and socioeconomic variables ................................................................................................................. 363 Table 147. Association between districts infant postneonatal (28–365 days) mortality rate and socio-economic variables ....................................................................................................... 364 Table 148. Association between districts life expectancy and socio-economic variables, males ................................................................................................................................................ 365 Table 149. Association between districts life expectancy and socio-economic variables, females ................................................................................................................................... 366 Figures Fig. 1. Social determinants of health ........................................................................................ 13 Fig. 2. Effectiveness of governance in Poland and other countries in 2007 ........................... 32 Fig. 3. Effectiveness of Polish public administration in years 1966-2007 .............................. 32 Fig. 4. Conceptual framework of the Commission on Social Determinants of Health ............ 49 Fig. 5. Multiple levels of determination of health ................................................................... 50 Fig. 6 Histogram of feminization rate in 2007 (number of women per 100 men in age group 24-35) ....................................................................................................................................... 57 Fig. 7. Geographical distribution of feminization rate in 2007 ............................................... 57 Fig. 8. Histogram of old-age demographic dependency ratio in 2007 (people aged 60/65 and above per 100 people aged 18-59/65) ...................................................................................... 58 Fig. 9. Geographical distribution of old-age dependency ratio in 2007 .................................. 58 Fig. 10. Histogram of population density in 2007 (people per one square km) ...................... 59 Fig. 11. Geographical distribution of population density in 2007 .......................................... 59 Fig. 12. Histogram of own revenue of local budgets per capita in 2007 (in PLN) ................. 62 Fig. 13. Geographical distribution of own revenue of local budgets per capita in 2007 ......... 62 Fig. 14. Histogram of unemployment rate in 2007 (percentage) ............................................ 63 Fig. 15. Geographical distribution of unemployment rate in 2007 ......................................... 63 Fig. 16. Histogram of share of employment in agriculture in 2007 (percentage) .................... 64 Fig. 17. Geographical distribution of share of employment in agriculture in 2007 ................. 64 Fig. 18. Histogram of share of employment in hazardous conditions in 2007 (percentage) .. 65 Fig. 19. Geographical distribution of share of employment in hazardous conditions in 2007 65 Fig. 20. Histogram of pre-school participation rate of children aged 3-5 in 2007 (percentage) .................................................................................................................................................. 68 Fig. 21. Geographical distribution of the share of pre-school participation rate of children aged 3-5 in 2007 ....................................................................................................................... 68 Fig. 22. Histogram of library members per 1000 inhabitants in 2007 .................................... 69 Fig. 23. Geographical distribution of library members per 1000 inhabitants in 2007 ............. 69 Fig. 24. Histogram of the share of households equipped with a bathroom in 2007 (percentage) .................................................................................................................................................. 70 Fig. 25. Geographic distribution of the share of households equipped with a bathroom in 2007 (percentage) .............................................................................................................................. 70 Fig. 26. Histogram of local government elections turnout in 2006 (per cent) ........................ 71 9 Fig. 27. Geographical distribution of the share of local government elections turnout in 2006 .................................................................................................................................................. 71 Fig. 28. Histogram of the number of inhabitants per 1 health care institution in 2007 .......... 73 Fig. 29. Geographical distribution of the number of inhabitants per 1 health care institution in 2007 .......................................................................................................................................... 73 Fig. 30. Histogram of the share of the number of inhabitants per 1 physician in 2007 .......... 74 Fig. 31. Geographical distribution of the number of inhabitants per 1 physician in 2007 ....... 74 Fig. 32. Histogram of the share of population with higher education in 2002 (percentage)... 78 Fig. 33. Histogram of the share of population with vocational or lower education in 2002 (percentage) .............................................................................................................................. 78 Fig. 34. Histogram of average lower secondaryschool exam results (mathematics and science) in 2007 ........................................................................................................................ 79 Fig. 35. Histogram of upper secondary school matura results - mathematics (basic level) in 2007 .......................................................................................................................................... 79 Fig. 36. Histogram of the share of average lower secondaryschool exam results (humanities) in 2007 ...................................................................................................................................... 80 Fig. 37. Geographical distribution of average lower secondaryschool exam results (humanities) in 2007................................................................................................................. 80 Fig. 38. Histogram of the share of upper secondary school matura exam results - Polish language (basic level) in 2007 .................................................................................................. 81 Fig. 39. Geographical distribution of upper secondary school matura exam results - Polish language (basic level) in 2007 .................................................................................................. 81 Fig. 40. Polarisation of district characteristics in Poland ........................................................ 88 Fig. 41. Age-standardized mortality ratio (SMR) for overall mortality, ................................ 122 Fig. 42. Age-standardized mortality ratio (SMR) for overall mortality, females, 2006–2008 ................................................................................................................................................ 122 Fig. 43. Correlation between crude death rate ratio and age-standardized mortality ratio for overall mortality, total population, 2006–2008 ...................................................................... 123 Fig. 44. Correlation between age-standardized mortality ratios for overall mortality in 2001– 2003 (03) and 2006–2008 (08), total population.................................................................... 123 Fig. 45. Age-standardized mortality ratio (SMR) for overall mortality, ................................ 126 Fig 46. Age-standardized mortality ratio (SMR) for overall mortality, ................................. 126 Fig. 47. Correlation between crude death rate ratio and age-standardized mortality ratio for overall mortality, population aged 0–64 years, 2006–2008 ................................................... 127 Fig. 48. Correlation between age-standardized mortality ratios for overall mortality in 2001– 2003 (03) and 2006–2008 (08), population aged 0–64 years ................................................. 127 Fig. 49. Age-standardized mortality ratio (SMR) for overall mortality, ................................ 130 Fig. 50. Age-standardized mortality ratio (SMR) for overall mortality, ................................ 130 Fig. 51. Correlation between crude death rate ratio and age-standardized mortality ratio for overall mortality, population aged 65 years and over, 2006–2008 ........................................ 131 Fig. 52. Correlation between age-standardized mortality ratios for overall mortality in 2001– 2003 (03) and 2006–2008 (08), population aged 65 years and over ...................................... 131 Fig. 53. Age-standardized mortality ratio (SMR) for cancer, males, ..................................... 134 Fig. 54. Age-standardized mortality ratio (SMR) for cancer, females, .................................. 134 Fig. 55. Correlation between crude death rate ratio and age-standardized mortality ratio for cancer, total population, 2006–2008 ...................................................................................... 135 Fig. 56. Correlation between age-standardized mortality ratios for cancer in 2001–2003 (03) and 2006–2008 (08), total population .................................................................................... 135 Fig. 57. Age-standardized mortality ratio (SMR) for cancer, ................................................ 138 Fig. 58. Age-standardized mortality ratio (SMR) for cancer, ................................................ 138 10 Fig. 59. Correlation between crude death rate ratio and age-standardized mortality ratio for cancer, population aged 0–64 years, 2006–2008 ................................................................... 139 Fig. 60. Correlation between age-standardized mortality ratios for cancer in 2001–2003 (03) and 2006–2008 (08), population aged 0–64 years ................................................................. 139 Fig. 61. Age-standardized mortality ratio (SMR) for cancer, ................................................ 142 Fig. 62. Age-standardized mortality ratio (SMR) for cancer, ................................................ 142 Fig. 63. Correlation between crude death rate ratio and standardized mortality ratio for cancer, population aged 65 years and over, 2006–2008 ..................................................................... 143 Fig. 64. Correlation between standardized mortality ratios for cancer in 2001–2003 (03) and 2006–2008 (08), population aged 65 years and over ............................................................. 143 Fig. 65. Age-standardized mortality ratio (SMR) for cardiovascular diseases, ..................... 146 Fig. 66. Age-standardized mortality ratio (SMR) for cardiovascular diseases, ..................... 146 Fig. 67. Correlation between crude death rate ratio and standardized mortality ratio for cardiovascular diseases, ......................................................................................................... 147 Fig. 68. Correlation between age-standardized mortality ratios for cardiovascular diseases in 2001–2003 (03) and 2006–2008 (08), .................................................................................... 147 Fig. 69. Age-standardized mortality ratio (SMR) for cardiovascular diseases, ..................... 150 Fig. 70. Age-standardized mortality ratio (SMR) for cardiovascular diseases, ..................... 150 Fig. 71. Correlation between crude death rate ratio and age-standardized mortality ratio for cardiovascular diseases, population aged 0–64 years, ........................................................... 151 Fig. 72. Correlation between age-standardized mortality ratios for cardiovascular diseases in 2001–2003 (03) and 2006–2008 (08), population aged 0–64 years ....................................... 151 Fig. 73. Age-standardized mortality ratio (SMR for cardiovascular diseases, ...................... 154 Fig. 74. Age-standardized mortality ratio (SMR for cardiovascular diseases, ...................... 154 Fig. 75. Correlation between crude death rate ratio and age-standardized mortality ratio for cardiovascular diseases, population aged 65 years and over, 2006–2008 ............................. 155 Fig. 76. Correlation between age-standardized mortality ratios for cardiovascular diseases in 2001–2003 (03) and 2006–2008 (08), population aged 65 years and over ............................ 155 Fig. 77. Age-standardized mortality ratio (SMR) for respiratory system diseases, males, 2006– 2008 ........................................................................................................................................ 158 Fig. 78. Age-standardized mortality ratio (SMR) for respiratory system diseases, females, 2006–2008 .............................................................................................................................. 158 Fig. 79. Correlation between crude death rate ratio and standardized mortality ratio for respiratory system diseases, total population, 2006–2008 ..................................................... 159 Fig. 80. Correlation between standardized mortality ratios for respiratory system diseases in 2001–2003 (03) and 2006–2008 (08), total population.......................................................... 159 Fig. 81. Age-standardized mortality ratio (SMR) for respiratory system diseases, males aged 0–64 years, 2006–2008 .......................................................................................................... 162 Fig. 82. Age-standardized mortality ratio (SMR) for respiratory system diseases, females aged 0–64 years, 2006–2008 .......................................................................................................... 162 Fig. 83. Correlation between crude death rate ratio and standardized mortality ratio for respiratory system diseases, population aged 0–64 years, 2006–2008 .................................. 163 Fig. 84. Correlation between standardized mortality ratios for respiratory system diseases in 2001–2003 (03) and 2006–2008 (08), population aged 0–64 years ....................................... 163 Fig. 85. Age-standardized mortality ratio (SMR) for respiratory system diseases in 2006– 2008, males aged 65 years and over ....................................................................................... 166 Fig. 86. Age-standardized mortality ratio (SMR for respiratory system diseases in 2006–2008, females aged 65 years and over.............................................................................................. 166 Fig. 87. Correlation between crude death rate ratio and age-standardized mortality ratio for respiratory system diseases, population aged 65 years and over, 2006–2008 ....................... 167 11 Fig. 88. Correlation between age-standardized mortality ratios for respiratory system diseases in 2001–2003 (03) and 2006–2008 (08), population aged 65years and over ......................... 167 Fig. 89. Age-standardized mortality ratio (SMR) for diseases of the digestive system, males, 2006–2008 .............................................................................................................................. 170 Fig. 90. Age-standardized mortality ratio (SMR) for diseases of the digestive system, females, 2006–2008 .............................................................................................................................. 170 Fig. 91. Correlation between crude death rate ratio and age-standardized mortality ratio for diseases of the digestive system, total population, ................................................................. 171 Fig. 92. Correlation between age-standardized mortality ratios for diseases of the digestive system in 2001–2003 (03) and 2006–2008 (08), .................................................................... 171 Fig. 93. Age-standardized mortality ratio (SMR) for diseases of the digestive system, males aged 0–64 years, 2006–2008 .................................................................................................. 174 Fig. 94. Age-standardized mortality ratio (SMR) for diseases of the digestive system, females aged 0–64 years, 2006–2008 .................................................................................................. 174 Fig. 95. Correlation between crude death rate ratio and age-standardized mortality ratio for diseases of the digestive system, population aged ................................................................. 175 Fig. 96. Correlation between age-standardized mortality ratios for diseases of the digestive system in 2001–2003 (03) and 2006–2008 (08), population aged 0–64 years ...................... 175 Fig. 97. Age-standardized mortality ratio (SMR) for diseases of the digestive system, males aged 65 years and over, 2006–2008 ....................................................................................... 178 Fig. 98. Age-standardized mortality ratio (SMR) for diseases of the digestive system, females aged 65 years and over, 2006–2008 ....................................................................................... 178 Fig. 99. Correlation between crude death rate ratio and age-standardized mortality ratio for diseases of the digestive system, population aged ................................................................. 179 Fig. 100. Correlation between age-standardized mortality ratios for diseases of the digestive system in 2001–2003 (03) and 2006–2008 (08), population aged 65 years and over............ 179 Fig. 101. Age-standardized mortality ratio (SMR) for ill-defined causes,............................. 182 Fig. 102. Age-standardized mortality ratio (SMR) for ill-defined causes, females, 2006–2008 ................................................................................................................................................ 182 Fig. 103. Age-standardized mortality ratio (SMR) for external causes, males, 2006–2008 .. 185 Fig. 104. Age-standardized mortality ratio (SMR) for external causes, females, 2006–2008185 Fig. 105. Correlation between crude death rate ratio and standardized mortality ratio for external causes, total population, 2006–2008 ........................................................................ 186 Fig. 106. Correlation between standardized mortality ratios for external causes in 2001–2003 (03) and 2006–2008 (08), total population............................................................................. 186 Fig. 107. Age-standardized mortality ratio (SMR) for external causes, ................................ 189 Fig. 108. Age-standardized mortality ratio (SMR) for external causes, ................................ 189 Fig. 109. Correlation between crude death rate ratio and standardized mortality ratio for external causes, population aged 0–64 years, 2006–2008 ..................................................... 190 Fig. 110. Correlation between standardized mortality ratios for external causes in 2001–2003 (03) and 2006–2008 (08), population aged 0–64 years .......................................................... 190 Fig. 111. Age-standardized mortality ratio (SMR) for external causes, males aged 65 years and over, 2006–2008 .............................................................................................................. 193 Fig. 112. Age-standardized mortality ratio (SMR) for external causes, females aged 65 years and over, 2006–2008 .............................................................................................................. 193 Fig. 113. Correlation between crude death rate ratio and standardized mortality ratio for external causes, population aged 65 years and over,.............................................................. 194 Fig. 114. Correlation between standardized mortality ratios for external causes in 2001–2003 (03) and 2006–2008 (08), population aged 65 years and over ............................................... 194 Fig. 115. Infant mortality rate, 2001–2003 (per 1000 live births) ......................................... 197 12 Fig. 116. Infant mortality rate, 2006–2008 (per 1000 live births) ......................................... 197 Fig. 117. Males life expectancy at birth, 2001–2003 ............................................................. 200 Fig. 118. Males life expectancy at birth, 2006–2008 ............................................................. 200 Fig. 119. Females life expectancy at birth, 2001–2003.......................................................... 201 Fig. 120. Females life expectancy at birth, 2006–2008.......................................................... 201 Introduction In many countries, inequalities in health result from social determinants which affect the conditions in which people are born and raised, find employment and access medical treatment. They include “upstream” determinants, such as the type of economic policy, poverty and unemployment levels, health hazards at workplace, social capital, and organization and functioning of health care and welfare systems, as well as “downstream” determinants, which include lifestyle and behaviour (e.g. tobacco use, alcohol abuse, physical exercise, and diet), as well as the functioning of health care system [Dahlgren and Whitehead (2007)]. All these factors affect various social groups to varying degrees, which largely contributes to the existence of social inequalities in health. The figurebelow illustrates complex interrelations between social determinants and health status. Fig. 1. Social determinants of health Source: Dahlgren and Whitehead (2007) Impact of social determinants of health and their distribution varies across and within countries. Therefore, a national policy - aiming at the reduction of social inequalities in health 13 - should be based not only on international experience, but also on studies focused on the impact of social determinants on health in a particular country. The main focus of the report is to study geographic differences in health status of all Polish district populations as well as social factors behind these differences. The report could be used as: 1) a basis for setting long-term priorities and goals of health policies developed at the national, regional and local level, 2) a basis for development and evaluation of multi-sector, comprehensive strategies focused on general improvement of health status of the entire population, and at the reduction of social inequalities in health in particular districts, 3) a tool for periodic evaluation of the efficacy of long-term activities focused on health status improvement and reduction of social inequalities in health in particular districts or groups of districts. Therefore, it is expected that such an analysis will be carried out periodically every few years. The concept of the analysis was developed by Michal Marek in co-operation with Agnieszka Chlon Dominczak and Bodan Wojtyniak. The importance of analysis of that kind was emphasized in some governmental documents1. However, the analysis of such scope has been performed for the first time since the territorial reform of 1999, which re-established districts in Poland. The report is addressed to all organisations which should participate in the development and implementation of the multi-sector, comprehensive strategies mentioned above. Therefore, the list of its addressees is long and includes stakeholders acting at the national, regional, district and local levels, such as: - Ministry of Health (responsible for national health policy), - National Health Fund – the key public payer for health care services, - Ministry of Regional Development – the key public organ with central level responsibility for the development and implementation of regional strategies, 1 The documents such as: Obszary szczególnego zagrożenia życia [Areas of high risks to human life](M. Marek), in: Narodowy Plan Zdrowotny na lata 2004-2013 [National Health Plan for 2004-2013], Ministry of Health, Warsaw, pp. 223 et seq. (the plan was never implemented due to changes in legal regulations), Strategia poprawy stanu zdrowia społeczeństwa polskiego 2007-2013 (projekt) [Strategy for improvement of health status of the Polish population, Ministry of Health (draft), Warszawa, 26 November 2004 r. See also: Michal Marek, Jan Rutkowski, 1994, Projekt oceny jakości życia w gminach [Quality of life in local communities], in J.B. Karski (ed.) Problemy współpracy na rzecz zdrowia [Problems of co-operation for heath improvement], Annex 1, pp. 287-313 (based on empirical analysis conducted at the end of 1980’s.) 14 other ministries (e.g. Ministry of Education, Ministry of Labour and Social Policy, Ministry of Sports, Ministry of Infrastructure),- regional (NUT-2), district (NUT-3) and local authorities responsible for the well-being of their communities, - associations of regional, district or local authorities, - NGOs, - international organisations such as WHO, developing programmes aimed at improvement of health status and reduction of social inequalities in health. The report is divided into four chapters. In Chapter One there is a brief presentation of the history of administrative territorial reforms, followed by demographic and socio-economic characteristics of districts based on research analyses conducted during the last ten years. Selected (upstream) factors exerting positive as well as negative influence upon district development, such as social capital, functioning of metropolises, distribution of foreign investments, and Poland’s accession to the European Union, are also outlined. In Chapter Two, socio-economic characteristics of districts are presented based on five groups of indicators pertaining to the following areas: (a) demography; (b) economic and labour market situation; (c) social cohesion; (d) access to health care, and (e) education. Links between selected groups of indicators are presented and followed by analysis of their geographic distribution. Resulting diversity is not only linked to a region, but also to a type of district. Therefore, at the end of the chapter, features of a typical municipal and rural district are presented. The analysis covers years 2002 and 2007. In Chapter Three, health status of each district population is analysed based on standardized mortality ratio (SMR) and crude death rates (CDR) for two periods: 2001 –2003 and 2006 – 2008. The analysis takes into account: - total population and two age groups: below 65 (to include overall premature mortality) and 65 +, - two genders, - causes of death: (a) all causes, (b) cardiovascular diseases, (b) cancer, (c) external causes, (d) respiratory diseases, (e) digestive diseases, and additionally (f) ill-defined causes of death (for the entire population, each age group, and the two genders). - life expectancy at birth, - dynamics of changes in health status of district populations. Moreover, a separate analysis of district infant mortality rates for total (IMR), neonatal (0 –27 days) and post-neonatal (28 days- under a year) age categories is included. 15 Chapter Four begins with the presentation and discussion of results of standardized regression coefficients from final multiple regression models for mortality due to all causes and according to each cause of death included in Chapter Three (for each age group and gender.) Results of standardized regression coefficients for infant mortality rate are also presented. Moreover, the results of similar analysis are presented for life expectancy at birth for males and females. Regression analysis reveals that social determinants are strongly associated with overall mortality outcomes of district populations. Such association suggests that the most efficient improvement in health could only be achieved through the development and implementation of multi-sector, comprehensive, long-term programmes based on health in all policies principle. The report is a follow-up on earlier work entitled: Social inequalities in health. The purpose of the first study was to summarize the knowledge in the field of social inequalities in health prevailing in Poland, and to present a preliminary set of recommendations for long-term, multi-sector national health policy. The first report is focused on the health status of the entire population as well as on inequalities in health across the life course. In different sections of the report inequalities in health are discussed in the context of such social determinants as: age, gender, educational attainments, social and economic status, urban/rural areas, as well as non-health differences at regional level (labour market, household income). The authors of all sections of the report attempted to address at least two questions, namely: 1. What gap can be observed between Poland and the more developed European countries? 2. What challenges are facing Poland in terms of social inequalities in health? Furthermore, in several parts of the report a preliminary review is presented, detailing pro-health measures initiated to date. The first report is divided into four sections. In Section 1, selected upstream determinants of health in Poland are discussed, such as relative poverty, early years development, education, and expenditures on health care, including regional differences. In Section 2, seven risk factors are presented, which exert a strong influence on the health status of the entire population, as well as on social inequalities in health in Poland, namely: tobacco use, high blood pressure, high level of blood cholesterol, obesity, alcohol consumption, low consumption of fruit and vegetables, lack of physical exercise. 16 In Sections 3 and 4, social inequalities in the health of children and adolescents, as well as health status of three age groups (25–44, 45–65, and 65 plus), are analysed. The outcome of the analysis is used as the foundation for formulating a set of propositions regarding next steps and actions aimed at the reduction of social inequalities in health. References Dahlgren G, Whitehead M. European strategies for tackling social inequities in health: leveling up part 2. Copenhagen, WHO Regional Office for Europe, 2007, p. 23. Obszary szczególnego zagrożenia życia [Areas of high risks to life](M. Marek), in: Narodowy Plan Zdrowotny na lata 2004-2013 [National Health Plan for 2004-2013], Ministry of Health, Warsaw, pp. 223 et seq. Michal Marek, Jan Rutkowski, 1994, Projekt oceny jakości życia w gminach [Quality of life in local communities], in J.B. Karski (ed.) Problemy współpracy na rzecz zdrowia [Problems of co-operation for heath improvement], Annex 1, pp. 287-313. Strategia poprawy stanu zdrowia społeczeństwa polskiego 2007-2013 (projekt) [Strategy for improvement of health status of the Polish population, Ministry of Health (draft), Warszawa, 26 November 2004 r. 17 1. Polish Districts Michał Marek 1.1. Development of territorial units in Poland Polish regions (voivodships) and districts (poviats) were created in the fourteenth century. Their territorial and institutional development continued till the fall of the Polish state at the end of the eighteenth century. Following the collapse of the state, Poland, was divided among Austria, Prussia and Russia. As a result, Polish administrative territorial units were replaced by the units existing in the three countries. In 1918, when Poland regained independence, regions and districts were re-established. Their role was defined in the Polish constitution in March of 1921, but their size and role were finally shaped in 1933. All of the 16 regions were divided into 264 districts (including 23 municipalities) and all non-municipal districts were divided into 3,806 local communities (called gmina). The authorities were mostly responsible for local economy, health protection and cultural issues. Regions and districts were also present after the Second World War, though their selfgovernment role was limited due to restrictions imposed upon Polish political and social life under socialist regime. In 1975, all districts were dissolved and the territory of Poland was divided into 49 administrative regions, as well as into local communities. Furthermore, in the post-war period serious changes concerning local communities were also introduced. In 1952, three thousand local communities were replaced by eight thousand much smaller units (called gromada). The reform increased administrative costs and had adverse impact on the development of local communities. Therefore, in 1973, Poland was again divided into 2,365 local communities. In January 1999, twenty three years later, Poland was once more divided into 16 regions, 373 districts (including 65 municipal districts and 308 rural ones), and 2,489 local communities. The territory of an average newly created administrative region was equal to 19,543 sq. kms, and it was inhabited by 2.417 mln people2 . Table 1. Characteristics of administrative regions (2010.06.30) No. Name of the region and regional capital Population (000) Total urban Territory (000 sq. kms) No. of inhabitants per sq.km GDP/ per capita (PPP) 2005 2007 EU27=10 EU27= 0% 100% 2 Grzegorz Gorzelak, B. Jałowiecki, M. Stec, „Reforma terytorialnej organizacji kraju: dwa lata doświadczeń, Wydawnictwo Naukowe Scholar, Warszawa, 2001 p. 58. [Country territory administrative reform: two years of experience.] 18 No. Name of the region and regional capital Population (000) Total urban Territory (000 sq. kms) No. of inhabitants per sq.km GDP/ per capita (PPP) 2005 2007 EU27=10 EU27= 0% 100% 51.4 54.4 1 Total 38,187 23,284 312,679 122 2 Dolnośląskie (Wrocław*) Kujawsko-Pomorskie (Bydgoszcz) Lubelskie (Lublin) Lubuskie (Zielona Góra) Łódzkie (Łódź) Małopolskie (Kraków) Mazowieckiee (Warszawa) Opolskie (Opole) Podkarpackie (Rzeszów) Podlaskie (Białystok) Pomorskie (Gdańsk) Śląskie (Katowice) Świętokrzyskie 2,877 2,019 19,947 144 53.1 59.2 2,069 1,255 17,972 115 44.8 47.3 2,155 1,005 25,122 86 35.1 36.9 1,011 642 13,988 72 46.3 48.2 2,538 1,627 18,219 140 47.2 50.0 3,304 1,628 15,183 217 43.8 46.7 5,234 3,380 35,558 147 81.4 87.1 1,030 538 9,412 110 42.6 45.2 2,103 870 17,846 118 35.5 36.7 1,189 718 20,187 59 38.0 40.4 2,235 1,477 18,310 122 50.5 53.6 4,638 3,619 12,333 376 55.4 57.8 1,268 572 11,711 108 38.4 41.9 3 4 5 6 7 8 9 10 11 12 13 14 15 Warmińsko1,427 854 24,173 59 39.3 40.5 Mazurskie (Olsztyn) 16 Wielkopolskie 3,414 1,912 29,826 114 54.9 56.9 (Poznań) 17 Zachodniopomorskie 1,693 1,166 22,892 74 47.7 48.9 (Szczecin) *a regional capital of a particular region. Source: Powierzchnia i ludność w przekroju terytorialnym [Area and Population in the territorial profile in 2010], Central Statistical Office, Warszawa, 2010, p. 17 www.stat.gov.pl; Eurostat- Statistical Office of the European Communities; http//epp.eurostat.ec.europa.eu quoted after: Produkt Krajowy Brutto. Rachunki Regionalne w 2008 r., GUS [GDP. Regional Accounts in 2008, Central Statistical Office ], Katowice 2010, p. 42. In 2008, 53.6% of the total population of the employed in the national economy worked in the five regions of Mazowieckie, Śląskie, Wielkopolskie, Dolnośląskie and Małopolskie (in 2005 it was 53.2%), and these five regions generated 59.5% of the national value of GDP. Two regions – Mazowieckie and Śląskie – generated jointly 34.7% of the national value of GDP (similarly as in 2005), with 28.3% of the total population of the employed in the national economy working in their territory (in 2005 –28.4%). 19 In 2008, the group of regions with the lowest shares in the generation of GDP (3% and less each) included the following: Lubuskie, Podlaskie, Podkarpackie, Opolskie, Świętokrzyskie and Warmińsko-Mazurskie. The workforce of these regions represented 14.2% of the total number of the employed in the national economy (in 2005 - 14.4%), but the total share of these regions in GDP generation amounted to 12.4% (similarly as in 2005)3. Four of the regions, namely: Podlaskie, Podkarpackie, Świetokrzyskie and Warmińsko- Mazurskie, are located in the eastern part of the country (see table 14 in Annex 1.2). Territory of an average newly created district was equal to 996 sq. kms, and it was inhabited by 83.2 thousand people. In 1999, the districts were supposed to be created according to the following criteria: • social acceptance, • historic, cultural and geographic factors, • economic potential, • institutional potential - future district towns should host the following institutions, at the minimum: the court, prosecutor’s office and police local headquarters, fire department, tax office, job agency, sanitary inspectorate, pension office (district unit of ZUS), district hospital, high schools. Besides, it was decided that: • there will be no changes regarding the territories of local communities, • each district should be divided into at least five local communities, • district town should be inhabited by at least 10 000 citizens, • a rural district should be inhabited by at least 50 thousand people, • a municipal district should be inhabited by at least 100 thousand people. However, these requirements were met by 242 (of 373) districts4. Therefore, there are big discrepancies from one district to another (see Table 2). 3 GDP op. cit. GUS, Katowice, 2010 p. 40. History of Poland’s territorial units was described, among others, by Jacek Petryszyn, Powiaty w Polsce, Geografia w szkole, [Districts in Poland, Geography at school (teacher periodical)] No. 5, Nov.-Dec. 2004, pp. 260-268, Anna Tucholska, “Powiat między zbiorowością a wspólnotą”, Centrum Europejskich Studiów regionalnych i lokalnych UW, [District: between a group of people and a community] Wydawnictwo Naukowe Scholar, Warszawa, 2007, pp. 13-47. 4 20 Table 2. Extreme differences between districts (2002) No. Characteristics Extreme Differences deferences 1. Size (sq. kms) 2,985 vs. 13 229 [times] 2. Population (in 000) 1,688 vs. 13 62 3. Density of population (No. of 4,328 vs. 20 216 citizens per sq. km.) 4. Revenues of local budgets per 3,243 vs. 186 17 capita 5. Expenditures of local budgets per 3,753 vs. 179 20 capita Source: Powiaty w Polsce, [Districts in Poland], Główny Urząd Statystyczny [Central Statistical Office] Warszawa, 2003, pp.643 –645, 650, 651. There are big differences not only between municipal and rural districts, but also within each of these two groups – for instance, legal status of a municipal district has been assigned to well-developed cities as well as to small towns (see Table 15 16 and 17 in Annex 1.2). Table 3. Extreme differences between municipal districts (2002) No. Characteristics Differences Differences 1. Size (sq. kms) 517 vs. 13 39,7 [times] 2. Density (No. of citizens per sq. km.) 4,328 vs. 213 20,3 5. Expenditures (PLN per capita) 6,338 vs.99.3 63,8 Source: Powiaty w Polsce, GUS, [Districts in Poland, Central Statistical Office] Warszawa, 2003. Budgetary revenues of districts also vary to a significant extent (see Table 4). Table 4. Budgetary revenues of municipal districts per capita in 2005 Total LSMR > GSSB + EFRSB* LSMR < GSSB + budgetary EFRSB revenues per capita (PLN) less than 2000 Sosnowiec, Świętochłowice, Żary 2001 –2500 Białystok, Bydgoszcz, Bytom, Chorzów, Biała Podlaska, Chełm, Radom, Częstochowa, Jastrzębie Zdrój, Kielce, Lublin, Łódź, Łomża, Mysłowice, Piekary Śląskie, Piotrków Trybunalski, Tarnobrzeg Ruda Śląska, Siemianowice, Skierniewice, Szczecin, Toruń, Tychy 2501 –3000 Bielsko-Biala, Dąbrowa Górnicza, Elbląg, Gdańsk, Grudziądz, Nowy Sącz, Gdynia, Gliwice, Gorzów Wielkopolski, Jelenia Góra, Ostrołęka, Siedlce, Kalisz, Konin, Koszalin, Kraków, Legnica, Leszno, Suwałki, Przemyśl, Olsztyn, Opole, Poznań, Rybnik, Rzeszów, Słupsk, Tarnów, Zamość Włocławek, Zabrze, Zielona Góra 3001 –3500 Katowice, Wrocław, Świnoujście Krosno more than 3500 Płock, Sopot, Warszawa * LSMR - Local sources of municipal revenues, GSSB - general subvention from the state budget, EFRSB - earmarked financial resources from the state budget allocated to specific tasks. Source: A. Miszczak Finansowe aspekty funkcjonowania miast na prawach powiatu po wejściu Polski do Unii Europejskiej, w: Polska regionalna i lokalna w świetle badań EUROREGu [Financial aspects of 21 the functioning of municipal districts after Poland’s accession to the European Union], G. Gorzelak (ed.), Wydawnictwo Naukowe Scholar, Warszawa, 2007 p. 279. In 2002, seven rural districts were created, in most cases as a result of dividing one district in two, and the number of local communities was slightly reduced. Table 5. Number of districts and local communities in Poland (1999 –2010) Year 1999 2000 308 308 Rural Districts 65 65 Municipal Districts 2,489 2,489 Local Communities 5 Source: www.stat.gov.pl . 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 308 314 314 314 314 314 314 314 314 314 65 66 65 65 65 65 65 65 65 65 2,489 2,478 2,478 2,478 2,478 2,478 2,478 2,478 2,478 2,478 Additionally, some rather minor territorial changes were made each year at the district level6. The 1999 territorial reform is favourably perceived, in general, because it brought about many important changes, such as de-centralization of responsibilities and strengthening of democratic processes and local institutions. The reform also set the foundation for faster social and economic development of many local communities. However, some negative outcomes were also revealed. Too many small, economically weak districts were created, which were inherently incapable of performing their statutory role in a proper manner. For instance, there were 46 rural districts without any larger town. Therefore, their district authorities were unable to provide adequate educational and health care services to the inhabitants. Moreover, too many towns obtained the status of municipal districts. In such cases, surrounding areas were separated from these towns by administrative barriers. As a result, the supply of public services offered by municipal district administrators to the residents of surrounding areas was not properly adjusted to their needs. Besides, the cooperation between distsrict and local authorities may have been rather limited7. 5 In: Zarys Strategii Sprawne Państwo 2011-2020 (projekt) [Outline of national strategy for the development of effective governance 2011-2020, Ministry of Interior Affairs and Administration (draft), Warszawa, 2010, p. 7. 6 See annual reports of the Central Statistical Office: Powierzchnia i ludność w jednostkach podziału terytorialnego kraju [Territory and population of administrative units in Poland], Warszawa. 7 Grzegorz Gorzelak, B. Jałowiecki, M. Stec, Reforma terytorialnej organizacji kraju: dwa lata doświadczeń [Country territory administrative reform: two years of experience], Wydawnictwo Naukowe ”Scholar”, Warszawa, 2001r, p. 13 and 14. 22 1.2. Demographic, economic and technical characteristics of Polish districts In 2000, a multi-dementional analysis was conducted to evaluate the quality of life in 65 municipal districts (cf. List 1 in Annex 1.1) 8. In the study, all municipalities were divided into three groups. The first group included all large cities and towns with population over 150,000 each, the second group included towns inhabited by 75 –150,000 citizens, and the third one included municipalities with population below 75,000. Moreover, all municipalities were divided into four additional groups (cities and towns with the best quality of life were included in group A, and those with the worst one in group D). Additionally, municipalities in groups A-D were listed in the order reflecting their position in the ranking (see Table 6)9. Table 6. Quality of life in district municipalities (1999) Municipalities < 150,000 75 –150,000 > 75,000 Ranking A B C D Lublin*, Kraków, Nowy Sącz, Tarnów Rzeszów, Olsztyn Sopot Zielona Góra, Jaworzno, Opole, Koszalin, Chorzów Słupsk, Dąbrowa Górnicza, Kalisz, Gorzów Wielkopolski, Piotrków Trybunalski, Mysłowice, Jelenia Góra, Siedlce, Płock, Rybnik, Konin, Jastrzębie Zdrój Bytom, Częstochowa, Elbląg, Tychy, Legnica, Gliwice, Łódź, Zabrze, Włocławek, Siemianowice Śląskie, Bydgoszcz, Sosnowiec, Grudziądz. Radom, Ruda Śląska Krosno, Przemyśl Poznań, Gdańsk, Gdynia, Bielsko-Biała Katowice, Kielce, Warszawa, Wrocław, Szczecin, Białystok, Toruń Biała Podlaska, Zamość, Leszno, Chełm, Suwałki, Tarnobrzeg, Świnoujście Piekary Śląskie, Łomża, Świetochłowice, Ostrołęka, Skierniewice, Żory Source: K. Gawlikowska-Hueckel and others, op.cit., 2000, pp. 60 –62. * names of regional capitals are in bold. The quality of life in 16 regional capitals was varied. The best quality of life was observed in four regional capitals, namely: Lublin, Kraków, Rzeszów and Olsztyn (three of them are located in the poorest part of Poland), and the worst quality of life was reported in Łódź and in Bydgoszcz ( group D). 8 Krystyna Gawlikowska-Hueckel,Anna Hildebrandt, Stanislaw Uminski, Jakosc zycia w miastach-powiatach grodzkich [Quality of life in district municipalities], Instytut Badań nad Gospodarką Rynkową [The Gdansk Institute for Market Economics], Gdańsk, 2000, p. 10 and 11. The authors stated that their studies took into account similar analysis conducted by German research institutes. 9 There are also interesting rankings of the largest municipal districts conducted by Przekrój weekly magazine (June 18, 2009 and Nov. 9, 2010 (No. 45/2010); http://www.przekroj.pl/pub/files/tabele/rankingmiast_2010.pdf . The magazine takes into account 25 variables, but the methodology applied is not clear enough, therefore the results of this ranking are not included in the report. 23 Moving on to the quality of life in large municipalities, included in group D, there was poor environment, poor health status of their inhabitants, as well as high unemployment. In the case of mid-size and small towns (from group D), there was poor access to educational services, high unemployment and low living standards. In a study concerning rural districts10, description of their populations was based on 9 indicators (list 2 in Annex 1.1). All the districts were divided into three groups, and each group was characterized in the following way. Group One includes 124 districts located in the northern, north-western, mid-western and south-eastern parts of the country. Most of these districts (80%) belong to six regions: Pomorskie, Warminsko-Mazurskie, Kujawsko-Pomorskie, Wielkopolskie, Małopolskie and Podkarpackie. In all these districts density of population is similar to the average density in Poland (excluding municipal districts). There is also relatively high fertility (per 1,000 inhabitants), high number of new marriages per 1,000 inhabitants, and rather low infant mortality. Finally, balance of permanent migrations is at low negative level. Group Two includes 74 districts, which are located mostly in the central and eastern part of the country. Sixty percent of districts fromthis group belong to five regions – Łódzkie, Mazowieckie, Świetokrzyskie, Podlaskie and Lubelskie. In this group there is low fertility, low density of population, the number of new marriages is similar to average number for Poland (excluding municipal districts). There is also the lowest level of divorces and very high number of deaths per 1,000 inhabitants. Balance of permanent migrations is usually negative and very high. Group Three includes 109 districts located along western border of Poland as well as the western part of the southern boarder; in the neighbourhood of municipal districts. Most of the districts (84%) belong to five regions – Zachodniopomorskie, Lubuskie, Dolnosląskie, Opolskie and Śląskie. In this case there is high density of population, low fertility, rather high infant mortality, low number of new marriages and the highest number of divorces. Furthermore, balance of negative migration is relatively high (see map 1 in Annex 1.3). Description of rural district economies is based on 14 indicators (see List 3 in Annex 1.1). All the districts were divided into five groups. The groups are characterized in the following way. 10 Kamila Migdał –Najman, Krzysztof Najman „Zastosowanie sieci neuronowej typu SOM [self organizing map] w badaniu przestrzennego zróżnicowania powiatów. Wiadomości Statystyczne nr 5/2004 pp. 74 et seq. [Application of SOM (self-organizing map) neurone network in the research into spatial diversification of districts.] 24 Group One includes 48 districts located in direct vicinity of large cities – Warsaw, Katowice, Poznań, Wrocław, Szczecin, Opole, Gdańsk and Bielsko-Biała. In all the districts there is the lowest share of people working in agriculture (30.7%), with high share of people working in construction sector (30.4%) and market services (18.2%). These districts are characterized by the highest average gross salary (almost 2,000 PLN). There is very low unemployment rate, high labour productivity, very high revenues of local community budgets, the highest level of budgetary expenditures for investment purposes per capita, as well as the highest gross value of fixed assets in business per capita. Group Two includes 75 districts located mostly in the western part of the country. In this group there is relatively low number of registered companies11, relatively high unemployment rate, and high employment in non-market services. Gross average salary is lower than in Group One. In the districts gross value of fixed assets in business per capita is also relatively low. Group Three includes 31 districts located mostly in the central and the south-eastern part of the country. The districts are located in neighbourhood of former regional capitals (which played that role until 1999). In the districts there is relatively high level of employment, level of unemployment is similar to country average, share of people working in agriculture is rather high, and the share of those employed in industrial and construction sectors of the economy is relatively low. Group Four includes 48 districts, located mostly in the northern and the southern part of the country. In the districts, there is the highest number of people working in non-market services, and relatively high level of employment in market services and in industrial and construction sectors. Additionally, there is relatively low level of employment in agriculture. Many of the districts are located close to the seaside, where many people come for summer holidays. However, at the same time, , unemployment rate in the group is very high, and the share of working population per 1,000 inhabitants is very low. According to the authors of the analysis, this is mostly due to massive bankruptcy of state owned farms (PGR), in the northern part of the country, as well as reduction of personnel in the mining industry in the southern part of the country. These two factors resulted in high level of structural unemployment12. 11 In the national register called: REGON. See also: Tomasz Tokarski, Aleksandra Rogut [2000], Zróżnicowanie struktury pracujących a odpływy z bezrobocia” “Differentiation in the structure of employment and outflow from unemployment Wiadomości Statystyczne [Statistical News], No. 3/2000, Barbara A. Despiney-Żochowska, From Marshallian District to 12 25 Group Five includes 105 districts located in the central and eastern part of the country. In this group agricultural production dominates. Employment rate is high, but only a small portion of the population works for industry, construction sector, and market and non-market services. The number of businesses registered in these districts is the lowest one, but simultaneously the level of registered unemployment is also among the lowest13. In the districts there is domination of agricultural production. In this group, budgetary revenues of local communities per capita, their investment expenditures, equity holdings in the local companies, as well as the value of their fixed assets are at the lowest level. It means that the level of overall development of the districts is low14 (see map 2 in Annex 1.3). There are also significant differences in the development of infrastructure in rural districts15. The level of development was measured with a composite index including six indicators (see List 4 in Annex 1.1). The authors of the study present a list of 16 most developed and 16 least developed districts (see Table 18 in Annex 1.2). Additionally, all districts are divided into 5 groups (see Table 7). Table 7. Development of rural district technical infrastructure measured with an index Level development of Value of indicator Very high > 0.3 High (0.1; - 0.3> Average (0,0; - 0.,1) > Low the Number of districts in particular region (-0.1; 0.0) > Number of districts Śląskie(7), Małopolskie (5), Mazowieckie (2), Kujawsko-Pomorskie (1), Podkarpackie (1) Małopolskie (11), Podkarpackie (8), Dolnośląskie (5), Wielkopolskie (5), Łódzkie (4), Śląskie (4), Mazowieckie (3), Świętokrzyskie (3), Lubelskie (1), Pomorskie (1) Wielkopolskie (17), Mazowieckie (12), Łódzkie (10), Dolnośląskie (9), Kujawsko-Pomorskie (8), Opolskie (7), Podarpackie (7), Śląskie (6), Pomorskie (5), Świętokrzyskie (5), Lubelskie (4), Małopolskie (2), Zachodniopomorskie (1) Lubelskie (14), Dolnośląskie (12), Mazowieckie (11), Kujawsko-Pomorskie (8), Podlaskie (7), Warmińsko-Mazurskie (6), Zachodniopomorskie (6), Łódzkie (5), Pomorskie (5), Świętokrzyskie (5), Wielkopolskie (5), Opolskie (4), Lubuskie (3), Podkarpackie (2), Małopolskie (1) 16 45 93 94 Local Product Systems: The Polish Case in: Z. B. Liberda, A. Grochowska (eds.) Civilizational Competences and Regional Development in Poland, Warszawa, 2009, pp. 186 et seq. 13 In case of agriculture there is very often high level of hidden unemployment. 14 See tables No. 3 and No. 4 in Annex 2. 15 Jarosław Lira, Feliks Wysocki Zastosowanie pozycyjnego miernika rozwoju do pomiaru poziomu zagospodarowania infrastrukturalnego powiatów [Application of positional index of development to measure the level of infrastructural development of districts], Wiadomości Satystyczne, No. 9, 2004 pp. 39-47. 26 Level development Very low of Value of the Number of districts in particular region indicator Number of districts Warmińsko-Mazurskie (11), Zachodniopomorskie 59 (10), Mazowieckie (9), Lubuskie (8), Podlaskie (7), Pomorskie (4), Wielkopolskie (4), KujawskoPomorskie (2), Podkarpackie (2), Lubelskie (1), Łódzkie (1) ≤ -0.1 Source: J. Lira, F. Wysocki op. cit. p. 44. 1.3. Macro-level factors affecting district development In years 1989-2009 development of Poland was very dynamic. Polish GDP per capita went up from 35% to 55% of EU15 average. Average earnings in Poland increased five times thanks to the appreciation of Polish currency. There were also significant social changes, e.g. the number of higher education students increased four times (from 10% to 40%). Life expectancy increased by about 5 years. Number of trips abroad increased five times (from 10 mln in 1988 to 50 mln in 2008)16. For the last two decades there was also dynamic regional development strongly supported by central authorities which, among other things: • introduced a set of important legal regulations, • established the Ministry of Regional Development, • offered financial support to regional, district and local authorities, • introduced the National Strategy of Regional Development for years 2011-2020. However, fast national and regional development aggravated the differences among districts (see Table 8). Table 8. Increase of budgetary revenues of municipal districts in year 2005 and 2003 Increase in budgetary revenues in 2005 (2003=100%)* 100.1-110.0 110.1-120.0 120.1-130.0 Municipal districts Bytom, Chełm, Grudziądz, Jelenia Góra, Katowice**, Legnica, Skierniewice, Zamość Biała Podlaska, Elbląg, Gliwice, Gorzów Wielkopolski, Jaworzno, Kalisz, Kielce, Leszno, Lublin, Łomża, Łódź, Ostrołęka, Piotrków Trybunalski, Poznań, Przemyśl, Radom, Rzeszów, Sosnowiec, Świętochłowice, Świnoujście, Tarnobrzeg, Tarnów, Tychy, Żory Białystok, Bielsko Biała, Bydgoszcz, Chorzów, Dąbrowa Górnicza, Gdańsk, Konin, Kraków, Krosno, Mysłowice, Nowy Sącz, Olsztyn, Opole, Piekary Śląskie, Ruda Śląska, Rybnik, Siedlce, Siemianowice, Słupsk, Sopot, Szczecin, Toruń, Włocławek, Zabrze, Zielona Góra 130.1-140.0 Częstochowa, Jastrzębie Zdrój, Koszalin, Płock, Suwałki, Wrocław 16 Strategia Polska 2030 [Poland 2030 Strategy], Warszawa, 2010, p. 373. Fast development of Poland is also mentioned in recent UNDP report: Human Development Report 2010, The Real Wealth of Nations: Pathways to Human Development, p. 143, et seq. 27 Increase in budgetary revenues in 2005 (2003=100%)* 140.1-150.0 Municipal districts Gdynia, Warszawa Source: A. Miszczak op.cit. p. 279. *calculation of the dynamics based on PLN PPP, ** regional capitals in Poland. Social, economic and technical development of regions, districts and local communities depends on many factors such as social capital, functioning of public administration, development of metropolies, foreign capital invested in Poland, as well as the influence of European Union upon the country. These factors could also contribute to an increase or decrease of social inequalities in health. 1.3.1. Social capital Social capital has been recognized as a factor important not only for fast or low development, but also as an important social determinat of health17. It was the subject of careful studies conducted in Poland in years 2003, 2005 and 200718. In 2007, only 11.5% of young Polish adults trusted other people – much less than in Nordic countries such as Denmark (64.3), Norway (62.5%) or Finland (58.4), but also less than in the Czech Republik (19.1) and Hungary (14.9) (see Table 9). Denmark Norway Finland Sweden Netherlands Ireland Switzerland Austria UK Belgium Germany Spain France Slovenia Czech Rep. Italy Greece Hungary Portugal Poland Table 9. Share of people trusting other people (18 years of age and above) 64.3 62.3 58.4 52.1 47 45.8 42.3 31.7 30 27.5 27.4 25.1 20 19.7 19.1 18.6 15.3 14.9 13.6 10.9 Source: European Social Survey, Diagnoza społeczna [Social Diagnosis], 2007, see also: Poland 2030 Strategy, p.249. Moreover, participation rate of Polish citizens in different types of NGOs is the lowest in comparison to the other countries – 50% lower than in the case of Denmark, Holland or Ireland19. Therefore, the development of social capital was recognized as a top priority in 17 G.Dahlgren, M. Whitehead, European strategies for tackling social inequalities in heath. Leveling up, Part 2. WHO, Copenhagen, 2007, p. 80, et seq. 18 Czapinski T, T. Panek, 2009, Diagnoza społeczna- Warunki i jakość życia Polaków [ Social Diagnosis, Objective and Subjective Quality of Life in Poland]. The authors studied, among other, the following aspects of social capital: level of social trust, level of citizen’s activities, structure of NGOs, level of cultural potential, social attitudes and key social values. 19 Studies conducted by The Centre for Democracy and Civil Society. 28 ‘Poland 2030’ strategy. However, it is expected that social capital increase will be slow, even if all required measures are implemented. 1.3.2. Polish metropolises Polish metropolises play a key role in the development of Polish regions, districts and local communities, as well as the entire country. The following seven cities perform the function of metropolitan centres: Gdańsk, Kraków, Katowice, Łódź, Poznań, Warszawa, Wrocław20. There are significant differences among Polish metropolitan areas. In 2003, the population of Katowice and Warszawa metropolitan areas was about 2.5 mln inhabitants each (respectively: 2.7 mln and 2.6 mln citizens). The population of each of the remaining metropolises is close to one million. Warszawa, the most developed metropolitan centre, has the best prospects for the fastest future development. There are also good prospects for development of Poznań, Wrocław and Kraków. On the other hand, the development of Katowice metropolitan area21 has been relatively slow due to serious barriers resulting from historic development of mining and steel industry in Górnośląskie region22. Key information on the Polish metropolies is presented in Table 19, Annex 1.2. Development of metropolitan cities has usually been faster than the development of regions in which these cities are located (especially in the case of Kraków, Warszawa and Poznań). Besides, metropolitan influence is positive mostly in the case of istricts (and local communities) located in the distance of 20-50 kms from the city. However, more remote districts frequently experience long lasting crisis due to daily or weekly commuting of their most active citizens to the metropolitan area in search for much better career, educational and cultural opportunities. Moreover, within several years, many commuters relocate with their families to metropolitan city for a permanent residence. All kinds of daily, weekly or occasional inter- or intra- regional migrations have significant impact upon: household revenues, quality of life, access to health care services as well as treatment costs. Therefore, the impact of these migrations on the life of district populations 20 Bohdan Jałowiecki, Metropolie jako bieguny rozwoju, w: Polska regionalna i lokalna w świetle badań EUROREGu [Metropolises as growth poles, in: Regional and local Poland in the light of EUROREG research], G.Gorzelak (ed.), Wydawnictwo naukowe Scholar, Warszawa, 2007, pp. 155 et seq. . Other experts also include Szczecin and Bydgoszcz-Toruń as metropolises, and Lublin and Białystok as two emerging metropolitan areas, see: M. Smętkowski Dynamika rozwoju regionalnego Dynamics of regional development in: G. Gorzelak, A.Tucholska (eds.), Rozwój, region, przestrzeń [Development, region, space, Centrum Europejskich Studiów Regionalnych i Lokalnych UW, Warszawa, marzec 2007, p.229. 21 More precisely, Górnośląskie conurbation comprising 12 towns. 22 Taking into account experiences of similar regions of Ruhra and Pas de Calais, it could be predicted that revitalisation of Górnośląskie towns and post industrial areas that make up the conurbation could last even 3040 years (B. Jełowiecki, op.cit. p. 149). 29 should be included in further studies of social inequalities in health. Further analysis of migrations should be focused, among others, on the structure of helth care serviced delivered to patients from other regions. Moreover, train connections between district towns and regional capitals should be included, side by side with real average travelling time (which, in many cases, takes much longer than what is shown in the timetables), and the cost of travel. 1.3.3. Foreign investments Geographic differences in development are caused, inter alia, by uneven allocation of foreign investments in Poland. This kind of capital is very important because it improves innovation of Polish industry and creates many new jobs. In the country, total foreign investments were the highest in comparison to other former socialist countries (including the Visegrad Group)23. Table 10. Total amount of foreign investments in Visegrad Group countries (billions of USD) Country 2004 2005 2006 2007 2008 13.1 10.4 19.2 22.6 16.5 Poland 5.0 11.7 6.0 10.4 10.7 The Czech Republic 4.5 7.7 6.8 6.1 6.5 Hungary 3.0 2.1 4.2 3.3 3.4 The Slovak Republic Source: Sabina Krawczyk, “Implikacje napływu bezpośrednich inwestycji zagranicznych na gospodarki krajów Grupy Wyszechradzkiej, Dom Wydawniczy „Agnus”, Gliwice, 2010 p.84.[Implications of foreing direct investments for the economies of Visegrad Group countries] Moreover, the number of new jobs created thanks to foreign investments in Poland was among the highest in the EU. Table 11. New jobs created by foreign investments (2008) Position in the ranking 1 2 5 10 Country 2007 Percentage* (2007) 2008 Percentage * (2008) United Kingdom 24,186 14 20,196 14 Poland 18,399 10 15,512 10 Hungary 11,104 6 11,659 8 The Czech 15,102 9 5,626 4 Republic 12 The Slovak 8,479 5 3,660 2 Republic * percentage of the total number of new jobs created by foreign investments in Europe. Trend 2007 –2008 - 16 - 16 +5 - 63 - 57 23 However, Poland is at the bottom of the ranking list in terms of the amount of foreign investments per capita not only among Visegrad Group countries, but also in comparison to Romania, Bulgaria, Estonia, Lithuania, Slovenia and Latvia. 30 Source: Ernst and Young, Reinvesting European Growth. Ernst and Young’s 2009 European Atractiveness Survey. Ernst and Young, 2009, p. 16; quoted after: Sabina Krawczyk op. cit. p. 109. Foreign investors usually prefer those regions in which Polish metropolies are located. Therefore, the development of these regions has been faster, in comparison to other regions. Moreover, foreign investors prefer some metropolises over others (see Table 12). Table 12. Number of employees working for firms with foreign capital (until 2008) Region Number of Foreign capital Per cent Number of employees Per cent Total 21,092 145996.9 100% 1,531,668 100% Name of the metropolis located in the region - Dolnośląskie 2,112 13410.3 9.19 149,644 9.77 Wrocław Kujawsko- 537 2246.3 1.54 38,376 2.51 - Lubelskie 329 722.1 0.49 21,647 1.41 - Lubuskie 776 1939.5 1.33 37,455 2.45 - Łódzkie 867 3860.3 2.64 68,781 4.49 Łódź Małopolskie 1,251 10636.2 7.29 86,283 5.63 Kraków Mazowieckie 7,622 73084.1 50.06 535,589 34.97 Warszawa Opolskie 462 1455.8 1.00 25,292 1.65 - Podkarpackie 317 2009.8 1.38 44,569 2.91 - Podlaskie 127 275.4 0.19 10,130 0.66 - Pomorskie 1,216 3948.8 2.70 67,890 4.43 Gdańsk Śląskie 1,882 11739.0 8.04 157,527 10.28 Katowice Świętokrzyskie 164 2709.0 1.86 17,571 1.15 - Warmińsko- 291 1401.2 0.96 15,224 0.99 - 1,923 12880.1 8.82 205,417 13.41 Poznań 3679.2 2.52 50,273 3.28 - firms Pomorskie Mazurskie Wielkopolskie Zachodniopomorskie 1,216 Source: Statistical data of the Central Statistical Office, Warszawa, 2009, p. 36 www.stat.gov.pl. 31 1.3.4. Public governance Overall effectives of Polish public administration, in comparison to other countries, is low Fig. 2. Effectiveness of governance in Poland and other countries in 2007 Source: The Effectiveness of governance in Poland and other countries in 2007, quoted after: Strategia „Sprawne Państwo 2011-2020” [Draft of Effective Governance Strategy 20112020, p. 8.] Moreover, in years 1966-2007, decrease in effectiveness was observed. Fig. 3. Effectiveness of Polish public administration in years 1966-2007 Source: The Effectiveness of governance in Poland and other countries in 2007, quoted after: Strategia „Sprawne Państwo 2011-2020” [Draft of Effective Governance Strategy 2011-2020], p. 8. 32 It has also been emphasized that governance of national development is not effective due to: • insufficient integration of socio-economic and territorial planning, • domination of sectoral approach over inter-sectoral one, • insufficient integration of budgetary planning with strategic development goals, • no continuity of strategic thinking (due to political shifts of power), • lack of qualified personnel with capacity to properly develop and implement different strategies24. International analysis also revealed that functioning of public administration in former socialist countries is often not transparent. Unfortunately, Polish administration is not an exception in this case (see Table 13). Table 13. Countries with the lowest and the highest level of corruption Countries with the lowest level of corruption (according to Control of Corruption Index) 2000 1. Holland 2. Ireland 3. The United Kingdom 4. Germany 5. Finland 2003 1. Finland 2. Denmark 3. Luxembourg 4. The Netherlands 5. Sweden 2006 1. Finland 2. Denmark 3. Sweden 4. Holland 5. Luxembourg Countries with the highest level of corruption (according to the Control of Corruption Index) 2000 1. Latvia 2. The Slovak Republik 3. The Czech Republik 4. Lithuania 5. Poland 2003 1. Latvia 2. Lithuania 3. The Slovak Republik 4. The Czech Republik 5. Poland 2006 1. Lithuania 2. Poland 3. Italy 4. The Slovak Republik 5. The Czech Republik Source: Word Bank, quoted after: Effective Governance Strategy op. cit. p. 33. The weaknesses of Polish public administration could also negatively influence the development and implementation of complex, long range inter-sectoral programmes aiming at reduction of inequalities in health. 1.3.5. European Union The influence of European Union upon general development of Poland has been very significant. In 2004, Poland absorbed only 1.8 bln PLN, but in 2004-2008 the total amount of EU financial resources spent in Poland was equal to 28.4 bln PLN; including 4.6 bln PLN for 24 See: Strategia Sprawne Państwo, [Effective Governance Strategy], pp. 14-15, see also: A. Zybała (ed.) Wyzwania w systemie ochrony zdrowia- zasoby ludzkie i zasoby organizacyjne w centralnych instytucjach. Challenges in heath care – central human and organizational resources., KSAP, Warsaw, 2009 (The report commissioned by the World Health Organization (Regional Office for Europe). 33 human capital development. Thanks to this, 1.1 mln people (employed and unemployed) participated in the programmes financed by European Union aimed at the development of new professional skills, supply of new equipment to schools, and protecting people against social exclusion. It is estimated that, in 2004-2007, 15 – 20% of all new jobs in the country were created thanks to EUfinancial resources. EU resources also played an important role in reducing negative impact of global crisis on Polish economy25. Moreover, it is expected that unemployment rate in Poland will drop in 2013 by half, from 11.6% to 6% percent, thanks to all the activities based on EU financial support26 A significant increase in Polish labour market effectiveness is also expected in 2010-2013. Furthermore, a strategy for reducing differences between the most underdeveloped and the most developed Polish regions was created and will be implemented in 2013-202027. EU accession created new opportunities for massive migrations of Polish citizens abroad – first, to the United Kingdom, Ireland and Sweden, and two years later to other countries such as Holland, Spain, France and Italy. In the period of 2004-2007, about 2.3 million people migrated abroad. Most intensive migrations occurred in 2005 and 2006 (450 000 and 500 000 people left Poland at that time, respectively). However, in 2008 and 2009 the number of migrants dropped significantly due to the global crisis. Moreover, some migrants came back to Poland (mostly from the UK and Ireland), but many others went to countries less affected by the crisis. It is estimated that 80% of all migrants were looking for better job opportunities. Among those who left Poland, young people dominated – many of them with university or technical education and with good command of foreign languages. Almost half of them (47%) had been employed in Poland before departure, 22% were unemployed, and only 5% were inactive on labour market28. Most of the migrants lived in poorly urbanized parts of the country, in such regions as Podkarpackie, Opolskie, Świętokrzyskie and Zachodniopomorskie. Those migrations bring about some benefits, but they also incur high costs. Many migrants have improved their economic status and were able to offer higher financial support to their families living in Poland. In the period of 2004-2007 their cash transfers to Poland increased 25 See governmental programme: Plan stabilności i rozwoju, [Plan for Stability and Development], Nov. 30, 2008. The Chancellery of the Prime Minister. 26 This very optimistic prediction might not come true due to negative influence of global crisis. 27 5 lat Polski w Unii Europejskiej, [Five years of Poland in the European Union], UKIE, Warszawa, 2009 pp. 259, et seq. 28 Paweł Kaczmarczyk, Poakcesyjne migracje Polaków –próba bilansu [Post Accession Migrations of Poles – Attempt at Summation] in Studia Migracyjne i Polonijne (in print). 34 from 10 to 20 bln PLN. Families spent this money for a living, to improve their living conditions, and to educate their children. On the other hand, migrations generated many social and economic problems. Parents left their families, therefore one parent (or only grantparents or relatives) were looking after children. Besides, migration of many young people, often with the intention to stay abroad for good, could reinforce negative demographic trends in Poland. Due to migrations, serious and long lasting shortages on Polish regional and local labour markets emerged. In this case, health care sector was not an exception. Many medical doctors left Poland. Their migration has been more dangerous in Poland than in other countries. In 2008 there were only 2.2 medical doctors per 1,000 inhabitants in Poland, relative to 3.6 in the Czech Republic, 3.1 in Hungary, and 3.0 in the Slovak Republic29. Such shortages resulted in significant increase of earnings in Poland, despite the crisis, and stimulated an increase in labour costs and inflation; it also exerted negative influence on foreign investments in Poland. Moreover, they aggravated geographic differences, because in some regions, especially in many local communities and small towns, serious shortages on labour market brought about a decrease in investments30. According to some projections, benefits and costs of massive migration, presented above, might actually become even more pronounced in the near future, as Germany and Austria will grant Poles non-restricted access to their labour markets in 2011. Summary Polish regions and districts were created six hundred years ago, but their development was not stable due to the fall of Poland in the eighteenth century, and due to many changes introduced in the twentieth century, followed by the re-gaining of country independence. In consequence of the last reform of1999, Poland was divided into 16 regions, 373 municipal and rural districts, and about 2,500 municipalities. This introductory chapter: - presents historic outline of districts, - describes their territorial, population, economic and technical development, - outlines discrepancies among the districts. 29 Value for Money in Health Spending, OECD Health Policy Studies, Paris, 2010 p. 49. 5 years of Poland in EU op. cit. pp. , 254, 261-269, http://www.cie.gov.pl/HLP/files.nsf/0/ B6319D9A6E54228AC1257619004A5F5B/$file/piec_lat_polski_w_unii_europejskiej.pdf See also: Projekt opracowania: Polityka migracyjna Polski- stan obecny i postulowane działania [Draft. Migration policy of Poland – characteristics of curent situation and proposed actions], Ministerstwo Spraw Wewnętrznych i Administracji [Ministry of Interior Affairs and Administration], Warszawa, 2010 r. 30 35 Additionally, the chapter includes an analisis of the following factors stimulating and hampering ongoing development of the districts: - low level of social capital, - permanent and temporrary migrations influencing the life of district and local communities, - state policy strongly supporting fast development of local, distric and regional selfgovernance, - low effectiveness of governance in Poland, - positive and negative influence of metropolises upon regional, district and local development, - influence of uneven allocation of foreign capital in the country on regional and local labour markets, - positive and negative influence of the European Union on the social and economic development of the country. The above factors could also exert positive or negative influence on the implementation of complex, inter-sectoral strategy for reducing social inequalities in health that should be developed in the near future. Therefore, the analysis of issues discussed in this chapter should be continued. 36 Annex 1.1. Lists List 1. Groups of variables used in the index and sub-indexes to evaluate quality of life in municipal districts 1. demography (0.5 – weight of the indicator based on a survey), 2. natural environment (1.0), 3. living conditions (housing) (1.0), 4. access to commercial services (0.25), 5. municipal transport (1.0), 6. access to educational services (pre-schools, schools, universities) (1.0), 7. access to cultural services (museums, public libraries, cinemas, theatres, philharmonies) (0.75), 8. health status and access to health services (pre-mature deaths, deaths of infants, health centres, hospitals, clinics, pharmacies, number of medical doctors and dentists) (2.0), 9. standard of living (1.0), 10. level of public safety (2.0), 11. access to sports and leisure services (swimming pools, sports fields, tennis courts, recreational areas, etc.) (1.0). Source: Krystyna Gawlikowska-Hueckel and others op. cit. p.15. List 2. Variables used to characterise rural district populations 1. number of inhabitants in non-productive age per 100 people in productive age, 2. number of inhabitants per 1 sq. km, 3. fertility rate per 1,000 inhabitants, 4. number of marriages per 1,000 inhabitants, 5. number of divorces per 1,000 inhabitants, 6. number of new born live infants per 1,000 inhabitants, 7. number of deaths per 1,000 inhabitants, 8. balance of internal migrations (within Poland), 9. number of deaths of new born infants per 1,000 infants born alive. Source: Kamila Migdał- Najman, Krzysztof Najman, op.cit. 74, 75. 37 List 3. Variables used to characterize economic development of rural districts 1. total number of employees per 1,000 inhabitants, 2. share of people employed in: agriculture, hunting, forestry, fishery (% of the total), 3. share of people employed in industry and construction (% of the total), 4. share of people employed in market services sector (% of the total), 5. share of people employed in non-market services sector (% of the total), 6. total number of registered unemployed inhabitants, 7. total number of unemployed women, 8. gross average monthly earnings (in PLN), 9. unemployment rate (%), 10. budgetary revenues of local communities per capita (in PLN), 11. budgetary expenditures of local communities per capita (in PLN), 12. investments in industrial firms located in a particular district per capita (in PLN), 13. gross value of durable assets of industrial firms per capita (in PLN), 14. number of companies registered in the REGON: companies (with legal personality) and units of companies (without legal personality). Source: Powiaty w Polsce [ Districts in Poland, The Central Statistical Office], Warszawa, 2001, in: Kamila Migdał-Najman, Krzysztof. Najman op.cit. p.75. List 4. Variables used to measure the development of rural district technical infrastructure 1. length of water pipelines in kms per 100 sq. kms, 2. length of communal disposal pipelines in kms per 100 sq. kms, 3. length of gas pipelines in kms per 100 sq. kms, 4. inhabitants with access to wastewater treatment plants (% of the total number of inhabitants), 5. number of telephones per 1,000inhabitants, 6. length of public local and district roads. Source: Jarosław Lira, Feliks Wysocki, op.cit. p. 42. 38 Annex 1.2. Tables Table 14. Characteristics of the most underdeveloped regions (2008) No. Indicators Lubelskie Podlaskie Podkarpackie Świętokrzyskie 1. Rate of unemployment Number of employed people per 1000 inhabitants Number of people working in agriculture (% of all employed) Investments per capita (in PLN) Number of registered firms in REGON per 10,000 inhabitants Average gross monthly earnings (PLN) 11.2 9.7 13.0 355.9 351.5 36.2 2. 3. 4. 5. 6. Poland 13.7 Warmińskomazurskie 16.8 329 368.4 298.8 359.5 33.2 23.0 30.6 15.9 15.6 3,526 4,046 3,759 4,384 4,140 5,700 715 757 687 852 812 985 2,604 2,610 2,490 2,549 2,474 2942 9.5 Source: Wiolleta Czermel Grzybowska (ed.) Finansowanie rozwoju regionalnego z funduszy strukturalnych 2007-2013. Polska Wschodnia, szanse i możliwości rozwoju [Funding regional development from EU structural funds 2007-2013. Eastern Poland, chances and opportunities of development], Wydawnictwo Politechniki Białostockiej, Białystok, 2010, p. 27. Table 15. Differences among districts (2002) Territory Population Budgetary revenues No Budgetary expenditures per capita . Maximum District sq.kms District District PLN District PLN Number per per of capita capita citizens (000) 1. Białostocki 2985 Warszawa 1 688 Warszawa 3243 Warszawa 3753 2. Olsztyński 2840 Łódź 785 Sopot 3120 Sopot 3273 3. Bialski 2754 Kraków 757 Nowy Sącz 2907 Płock 2946 4. Słupski 2304 Wrocław 639 Płock 2855 Nowy Sącz 2732 39 Territory Population Budgetary revenues No Budgetary expenditures per capita . Maximum District sq.kms District District PLN District PLN Number per per of capita capita citizens (000) 5. Kielecki 2248 Poznań 577 Krosno 2688 Katowice 2687 6. Bytowski 2193 Gdańsk 461 Katowice 2688 Krosno 2675 7. Ostrołęcki 2099 Szczecin 415 Świnoujście 2685 Wrocław 2594 8. Sokolski 2054 Bydgoszcz 372 Gliwice 2523 Poznań 2560 9. Szczycieński 1933 Lublin 358 Opole 2448 Leszno 2530 10. Poznański 1900 Katowice 325 Ostrołęka 2397 Slupsk 2497 PLN District PLN Minimum District Km2 District Number District of per citizens capita (000) 1. Świętochłowice 13 Sejneński 27 Siedlecki 186 Siedlecki 179 2. Sopot 17 Bieszczadzki 22 Rybnicki 201 Rybnicki 205 3. Siemianowice 25 Węgorzewski 24 Kaliski 209 Skierniewicki 227 Śląskie 4. Ostrołęka 29 Leski 27 Przemyski 209 Kaliski 230 5. Zamość 30 Gołdapski 27 Skierniewicki 228 Częstochowsk 244 i 6. Leszno 32 Brzeziński 31 Koniński 235 Koniński 245 7. Siedlce 32 Łosicki 33 Częstochowski 241 Przemyski 245 8. Łomża 33 Bialobrzeski 34 Gliwicki 246 Gliwicki 246 9. Skierniewice 33 Nidzicki 34 Tarnowski 248 Poznański 250 10. Chorzów 34 Olecki 34 Bieruńsko- 249 Ppolski 251 lędziński Source: Powiaty w Polsce [Districts in Poland], GUS [Central Statistical Office], , Warszawa, 2003 r. p. 643-651 40 Table 16. Rural district populations. Average values of three groups of districts No. Variable Group 1 Group 2 Group 3 Average for Poland 69.4 74.8 62.6 68.3 2 Number of inhabitants in non-productive age per 100 people in productive age Number of inhabitants per 1 sq. km 89.7 63.9 139.1 101.0 3 Fertility rate per 1,000 inhabitants 2.9 -0.7 0.1 1.1 4 Number of marriages per 1,000 inhabitants 5.8 5.6 5.3 5.6 5 Number of divorces per 1,000 inhabitants 0.7 0.5 1.0 0.8 6 Number of new born live infants per 1,000 11.7 10.5 9.5 10.6 1 inhabitants 7 Number of deaths per 1,000 inhabitants 8.7 11.3 9.4 9.6 8 Balance of internal migrations (within -6.5 -115.9 89.0 1.0 7.7 7.8 8.3 8.0 Poland) Number of deaths of new born infants per 1,000 infants born alive 9 Source: Kamila Migdał Majman, Krzysztof Najman op. cit. p. 78 Table 17. Economic development of rural districts. Average values of five groups of districts and for the entire country No. Variable Group 1 Group 2 Group 3 Group 4 Group Poland 5 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Total number of employed per 1,000 inhabitants Employed in: agriculture, hunting, forestry, fishery (% of the total) Employed in industry and construction (% of the total) Employed in market services sector (% of the total) Employed in non-market services sector (% of the total) Total number of registered unemployed inhabitants Total number of unemployed women Gross average monthly earnings (in PLN) Rate of unemployment (%) Budgetary revenues of local communities per capita (in PLN) 357.4 318.8 397.9 302.6 444.6 373.3 30.7 42.5 61.7 34.6 70.1 50.8 34.9 25.9 17.5 30.0 12.1 22.4 18.2 13.7 8.9 16.4 6.8 12.0 16.3 17.9 11.9 19.1 11.0 14.9 5,714.8 5292.6 10993.4 10466.8 5039.2 6656.6 3,311.8 2940.9 5861.5 5830.1 2648.0 3645.4 1,959.6 1573.3 1635.4 1626.7 1596.2 1656.2 13.3 22.2 17.9 25.7 15.3 18.6 1334.7 1180.5 1096.8 1172.2 1081.1 1160.9 41 No. Variable Group 1 Group 2 Group 3 Group 4 Group Poland 5 11. Budgetary investment expenditures of local communities per capita (%) 23.1 19.7 22.2 12. Investments in industrial 2285.5 883.5 827.0 firms located in a particular district per capita (in PLN) 13. Gross value of fixed assets 25,752.4 8299.2 9559.8 of industrial firms per capita (in PLN) 14. Number of units registered 862.7 461.2 717.2 in the REGON: firms with legal personality and units of firms (without legal personality) Source: Kamila Migdał Najman, Krzysztof Najman op.cit. p. 82. 19.9 18.9 20.2 1085.3 644.2 1046.7 10549.8 6498.4 10891.3 789.9 373.6 571.3 Table 18. Rural districts with the best and the worst developed technical infrastructure The best developed districts The worst developed districts Pruszkowski Mazowieckie 0.784 Nowotomyski Wielkopolskie -0.143 Bielski Śląskie 0.601 Szczecinecki Zachodniopomorskie -0.143 Oświęcimski Małopolskie 0.538 Hajnowski Podlaskie -0.146 Łanńcucki Podkarpackie 0.483 Międzyrzecki Lubuskie -0.150 Cieszyński Śląskie 0.461 Sulenciński Lubuskie 0.150 Wodzisławski Śląskie 0.459 Krośnieński Lubuskie -0.151 Wielicki Małopolskie 0.444 Ostrołęcki Mazowieckie -0.152 Tyski Śląskie 0.441 Przysuski Mazowieckie -0.153 Chrzanowski Małopolskie 0.406 Słubicki Lubuskie -0.157 Krakowski Małopolskie 0.402 Szczycieński Warmińsko- -0.159 Mazurskie Wadowicki Małopolskie 0.396 Czarnkowsko- Wielkopolskie -0.159 Lubuskie 0.160 trzcinecki Piaseczyński Mazowieckie 0.396 Strzeleckodrezdenecki Aleksandrowski Kujawsko- 0370 Drawski Zachodniopomorskie -0.169 Pomorskie Mikołowski Śląskie 0.364 Walecki Zachodniopomorskie -0.175 Będziński Śląskie 0.361 Bieszczadzki Podkarpackie -0.195 Pszczyński Śląskie 0.302 Sokołowski Mazowieckie - 0.302 Source: J. Lira, F. Wysocki op. cit. p. 44. 42 Table 19 Characteristics of Polish metropolises Metropoli tan capital Popul ation Ad de d val ue (A V) AV Fixe d asse ts Revenue s of local commun ities (LCs) No. of work ing peopl e per 1,00 0 Investm ents of firms Investm ents of LCs No. of registe red firms Aver age salary Balanc e of migrati ons Rema rks (000) (00 (%) mln mln mln mln % 0) PL PLN PLN PLN PL N N Warszaw 1688. 72. 100. 104. 3058 473 13567 1020 509 100 ++ a 2 5 0 7 Katowice 1926, 52. 72.7 40.7 2235 287 2246 305 220 68 * 6 7 Łódż 785.1 51. 70.9 24.5 1952 267 2341 266 248 60 4 Kraków 757.5 53. 74.3 43.9 2355 350 3359 463 353 68 + 9 Gdańsk** 756.6 57. 79.0 45.1 2198 296 2891 478 349 78 3 Wrocław 634.0 53. 74.3 34.3 2385 315 5172 483 378 70 ++ 9 Poznań 577.1 63. 87.0 51.6 2243 385 7427 272 362 74 0 1 *More precisely, Górnośląskie conurbation including 12 towns31.** More precisely, agglomeration of Gdańsk, Gdynia and Sopot. Source: B. Jałowiecki Metropolie jako bieguny rozwoju [Metropolises as growth poles], in: G. Gorzelak, A. Tucholska op.cit. pp. 149, 150. 31 A conurbation is a region comprising a number of cities, large towns, and other urban areas that, through population growth and physical expansion, have merged to form one continuous urban and industrially developed area. In most cases, a conurbation is a polycentric urban agglomeration, in which transportation has developed to link areas to create a single urban labour market or travel to work area. The term "conurbation" was coined as a neologism in 1915 by Patrick Geddes in his book Cities In Evolution. See: the American Wikipedia. 43 Annex 1.3. Figures 44 References Chawla M., G. Betcherman, G. Benerji , 2008, From red to grey: the “third transition” of aging populationsin eastern Europe and the former Soviet Union, Washington, DC. 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Social and economic characteristics of districts in Poland Agnieszka Chłoń-Domińczak This chapter presents the assessment of social and economic characteristics of districts in Poland, with particular focus on those characteristics that may have impact on health status of Polish population. It draws from earlier work presented in the report entitled Social Inequalities in Health in Poland, which included the first description of selected social and economic indicators of districts with the lowest and the highest mortality levels. The analysis aims to assess changes in social and economic developments in all Polish districts over time, as well as to monitor the district (powiat) variation of selected characteristics. With the choice of this level it is possible, on the one hand, to grasp relatively small administrative units in order to reflect geographical variation of social and economic factors and, on the other hand, to select a relatively large set of available indicators. One of the most important assumptions is that this analysis can be repeated in the future. Thus, selection of variables is based on available statistical data, mainly from the Regional Data Bank (Bank Danych Regionalnych) available from the Central Statistical Office. In order to provide sufficient background information for further analysis of inter-relations between economic and social characteristics and mortality, the analysis is conducted primarily for two years: 2002 and 2007. In some cases, to ensure comparability of data, different years are used. The chapter is organized as follows: first, it presents the choice of a selected groups of variables as well as indicated limitations of data applied, followed by a brief analysis of variables selected. The analysis is followed by the assessment of relations between selected variables based on the correlations between them. The chapter ends with a summary and conclusions. 2.1. Selection of variables Social determinants of health are the conditions in which people are born, grow up, live, work and age. These conditions influence a person’s opportunity to be healthy, his/her risk of getting ill, and life expectancy. Social inequities in health – the unfair and avoidable differences in health status across groups in society – are those that result from uneven distribution of social determinants32. Commission on Social Determinants of Health (CSDH) presented a conceptual framework for understanding social determinants of health and health inequalities, which includes socio32 http://www.euro.who.int/en/what-we-do/health-topics/health-determinants/socioeconomic-determinants 48 economic and political context, social cohesion, as well as individual characteristics (Błąd! Nie można odnaleźć źródła odwołania.4). This portrays the significance of socio-economic, political and cultural contexts, an individual’s social position, health systems and health behaviour in shaping the distribution of health and well-being. SDH are related to specific features of societal conditions and the pathways by which they affect health. Examples include the prevailing political structure, income, education, occupation, family structure, service availability, sanitation, exposure to hazards, social support, racial discrimination, and access to resources linked to health (Marmot and Wilkinson 1999). Correspondingly, inadequate income, housing, and work environments are some of the SDH leading to health inequalities within and between countries (Wilkinson and Marmot 2003).33 Fig. 4. Conceptual framework of the Commission on Social Determinants of Health Source: Commission on Social Determinants of Health Social determinants of health vary from one country to another, but also within countries and within regions. The main goal of the report is to analyse socio-economic determinants of health in Polish districts. Florey et al. (2007) present a conceptual framework of multiple “levels” of determination of population health, including global, national and community levels, in which global-level factors influence national-level factors, which in turn shape 33 Lee at al. (2007), p. 16 49 community-level factors. In such an approach, by monitoring community-level factors, we can also control for higher-level factors that impact community outcomes ( 5). Fig. 5. Multiple levels of determination of health Florey et al. (2007) The framework of social determinants of health is based on interactions between individuals and their health and their social and economic characteristics, as well as the environment. However, the information on individual characteristics is usually scarce and based on sample surveys. Data from such surveys (such as EU Survey on Income and Living Conditions or Labour Force Survey) does not allow for detailed geographical decomposition of obtained results. In an attempt to understand these determinants on local level, one must identify indicators that are available on district level, mainly from administrative data or statistical information based on surveys covering the entire population (such as census data). In this chapter we aim to identify indicators that would serve as best proxy of social determinants of health and health inequalities, and which would be easily available and regularly updated, preferably based on statistical information. The main source of data for proposed indicators is the Regional Data Bank (Bank Danych Regionalnych) of Central Statistical Office. Additional complementary information is drawn from administrative sources: results of lower secondary school and matura exams from the Central Examination Board (Centralna Komisja 50 Egzaminacyjna), and local government election turnout from the National Electoral Commission (Państwowa Komisja Wyborcza), information on the number of physicians from Health Care Information Systems Centre (Centrum Systemów Informacyjnych Ochrony Zdrowia) 34. Proposed indicators are grouped into five areas: (i) demography; (ii) economic and labour market situation; (iii) social cohesion; (iv) access to health care, and (v) education. Selection approach corresponds to the idea of socio-economic and political context of social determinants of health proposed by the CSDH. Table 20. Indicators for district-level analysis of socio-economic determinants of health in Poland Area Demography Economic and labour market situation Indicator Definition feminization rate Share of women aged 25-34 per 100 men in the same age old-age demographic dependency ratio Number of people aged 60/65 and above per 100 people aged 18-59/64 population density Number of inhabitants per square kilometre revenue of local budgets per capita Own revenue at gmina (municipality) level (aggragated for districts) from taxation per one inhabitant unemployment rate Registered unemployment rate (number of persons registered as unemployed in relation to the total number of employed and unemployed) share of employment in agriculture Proportion of people working in agriculture to the total number of people employed share of employment in hazardous conditions Proportion of people working in hazardous conditions (in all defined groups of risk) to the total number of people employed pre-school participation rate of children aged 3-5 Shareof children aged 3-5 attending pre-schools library members per 1000 inhabitants Number of registered library members per 1 000 inhabitants in a district share of households with a bathroom Number of houses/apartments equipped with bathroom divided by the total number of houses / apartments local government election turnout Number of valid votes as percentage of total number of voters in elections to gmina councils number of inhabitants per 1 health care institution Number of inhabitants divided by the number of health care institutions (Zakłady Opieki Zdrowotnej) number of inhabitants per 1 physician Number of inhabitants divided by the number of physicians who work in a district as their primary employment share of population with higher education Number of people aged 15 and more with higher education as percentage of total population aged 15 and more share of population with vocational or lower education Number of people aged 15 and more with vocational education as percentage of total population aged 15 and more Average lower secondary school exams results (mathematics and science) Average results of lowe secondary school tests aggregated by district from mathematics and science exams average lower secondary school exams results (humanities) Average results of lower secondary school tests aggregated by district from humanities exams Matura examl results - Polish language (basic level) Average results of mandatory Imatura tests at Polish language and literature on basic level. aggregated by district Social cohesion Access to health care Education 34 The author would like to thank Dorota Węziak-Białowolska and Henryk Szaleniec from Educational Reseach Institute for their help in providing the information on the results of middle school and high school exams; Marek Dmowski from CSIOZ for providing data on the number of physicians, and the National Electoral Commission for providing information on election turnout results. 51 Area Indicator Definition Matura exam results - mathematics (basic level) Average results of mandatory matura tests at mathematics on basic level aggregated, by district Source:Author’s analysis In the area of demography three indicators are proposed for further analysis. Differences in feminization rate reflect the outcome of long-term migration processes. In view of the fact that young women are, on average, the most mobile group of population, districts affected by long-lasting outflow due to migration have lower feminization rate. Thus, this indicator can be applied to capture the outcomes of migration that could be caused by generally unfavourable local social and economic conditions, which may be important from SDH perspective. The second indicator in this area is the demographic dependency rate, showing the ratio of people in the so-called post-productive age to those in the so-called productive age. As a result, we can capture the share of population above retirement age. Assuming that the health situation deteriorates with age, this indicator helps identify potential “risk” districts that have more aged population. The third indicator shows population density. According to the literature (Marmot and Wilkinson (2006); WHO (2008), Blas and Kurup (2010), Wallace (2008), Galea (2007)) population density can be one of social determinants of health. In particular, higher population density may predict many health effects, including infectious diseases. This is due to the fact that high population density areas are more exposed to spread of infectious diseases. On the other hand, very low population density may lead to reduced access to some health care services. As far as economic and labour market situation in the districts is concerned, we suggest four indicators. The first one is related to the own income from taxation revenues per capita. This shows the level of taxation income generated from various taxation revenue, both from enterprises and individuals at the local level. As a result, this indicator is a good proxy for general macroeconomic situation of districts. The remaining three indicators in this area are related to labour market situation. The first indicator is unemployment rate. According to available research (Bartley et al, 2006) unemployment is associated with higher prevalence of ill health and mortality, as well as damage to psychological health. Second and third indicators are related to the structure of employment. Employment in hazardous conditions or in selected branches can also be a factor affecting health outcomes. In the case of Poland, particularly employment in agriculture can be investigated. High share of employment in agriculture can be related first to difficult working conditions, but secondly it may indicate hidden unemployment. 52 Social cohesion indicators group various characteristics. The first indicator is the share of children aged 3-5 in pre-school education. This indicator relates directly to the recommendation presented in WHO (2008) on the focus on early child development – education, including pre-school, shapes children’s lifetime trajectories and health. It helps to equalize chances of children in future life, especially for children from deprived environments. As 6-year-old children are covered by mandatory pre-school education, we focus on these children who are in pre-school age, but their participation is based both on institutional availability and parental decision. The second indicator is the share of public library members per 1000 inhabitants. This indicator can be used as a proxy to measure the actual educational level and approach of people living in communities to the notion of life-long learning in informal way. However, this indicator is only a proxy, as some people prefer to have their own (sometimes sizeable) libraries, which may distort the observation. The use of this indicator is proposed due to availability of regularly updated information in the Regional Data Bank. The third indicator is intended to measure quality of living conditions through monitoring the share of houses and apartments equipped with a bathroom. Access to bathrooms is a precondition for necessary hygiene level that has a direct influence on mitigation of various health risks. The fourth indicator is aimed to measure social activity of communities, which can be approached through monitoring the level of election turnout. Local elections were chosen with the purpose to focus on general public interest with the activity of local governments for communities. Election turnout, according to Putnam’s theory, is one of measures of social capital. We also suggest looking at the indicators that could serve as a proxy of access to healthcare. Two such indicators are applied. The first one relates to the number of inhabitants per one health care institution (the so-called ‘Zakład Opieki Zdrowotnej’/ZOZ), and the other one to the number of inhabitants per one physician. With these indicators we can monitor the availability of resources compared to population level. It should be noted, however, that these indicators can serve as a very rough approximation. In particular, there is a difference in the number of physicians in large cities vs. the surrounding districts. There is a tendency to cluster physicians in the cities, but they provide services to surrounding districts as well. The last area with proposed indicators is education. Level of educational attainments is one of the most frequently quoted determinants of health. In our database we put forward indicators related to the educational structure of district population – including the share of 53 population with higher education, as well as the share of population with vocational or lower education. These indicators are based on national census findings, thus they can be assessed only for 2002. Another group of proposed indicators includes average results of country-wide exams: at the level of lower secondary school and upper-secondary school (so-calle matura). They include results from tests at humanities as well as at mathematics. It should be noted, however, that at present exam results are not comparable in time, thus only the analysis of space distribution across districts can be made. Matura exam results are presented only for 2007, as 2002 data was not based on standardized approach. Additionally, as matura mathematics examinations have been mandatory only since 2010, results include only those students who took this exam at their preference in 2007. This means that results are not comparable to Polish language exams, which are mandatory. 54 2.2. Time and space characteristics of selected variables In this section statistical description of proposed indicators is presented. For each indicator, descriptive statistics include: non-weighted average, standard deviation, coefficient of variation, median, first and third quartile minimum and maximum, as well as skewness and kurtosis coefficients. These statistics are presented for both analysed years, so the direction of changes in time can be assessed, both from the perspective of changes in values and also distribution, which is important to evaluate potential improvements in cohesion between districts. There are also histograms for each indicator, presented for the last analysed year (in most cases, 2007, with the exception of election turnout which is based on the indicator for 2006 elections, as well as the share of people with selected educational attainment, based on 2002 census results). Attached maps illustrate regional distribution of monitored characteristics. 2.2.1. Demographic indicators Feminization rate Between 2002 and 2007, average feminization rate in Polish districts slightly declined (Błąd! Nie można odnaleźć źródła odwołania.). The decline was accompanied by deepening variation of this indicator. In particular, the range of values between minimum and maximum increased, due to a drop in minimum value and increase in maximum value. Feminization rate is the highest in the case of large cities (it is the highest for Warszawa) and surrounding districts (i.e. powiat piaseczyński). Geographical distribution shows that feminization rate is much lower in the eastern part of Poland. If we look at the distribution of values, depicted in Błąd! Nie można odnaleźć źródła odwołania.6, we can see that the distribution of feminization rate across districts is a bit skewed on the left. The change in skewness coefficient also shows that it deepened between 2002 and 2007. In 249 out of 379 districts feminization rate decreased. These developments could be caused by migration processes that were observed, especially after the EU accession. Significant portion of migrants are young women, which could explain the reduction of feminization rate in the observed majority of districts. Old-age demographic dependency ratio Between 2002 and 2007, old-age demographic dependency ratio increased on average in Polish districts, which is an expected consequence of population ageing. However, geographical variance of this indicator decreased, which is shown by reduced value of the 55 coefficient of variation. Despite that, the variation of demographic dependency ratio is relatively high. The change of the value of coefficient was to a large extent caused by increased values in relatively “young” districts, rather than further decreases of the value in the relatively “old” districts. This development can be attributed to the observed birth decline in the analysed period, as well as to migration processes. Distribution of this indicators is slightly skewed to the right, but between 2002 to 2007 skewness was reduced, which means that old-age dependency ratio increased in more districts. In 30 districts there are more than 3 people in post-productive age per 10 people in productive age. Geographical distribution shows that eastern and southern-central parts of Poland are relatively older, especially compared to the north-western districts. Population density Average population density decreased between 2002 and 2007, while median remained almost unchanged. This is caused by some reduction in population density in most congested districts. Distribution of population density is heavily skewed to the right. Average population density is highly affected by the districts with very high population density (cities), as reflected in a significant difference between average and median value. Three quarters of districts have population density below 185.5. Variance of observed values is very high, leading to very high values of the coefficient of variation. As far as geographical distribution is concerned, we can observe that northern part of the country as well as the eastern border are least populated, while the areas around Warszawa and Katowice are the most dense. 56 Table 21. Descriptive statistics of feminization rate Fig. 6 Histogram of feminization rate in 2007 (number of women per 100 men in age group 2435) feminization rate 2002 2007 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 95.73 3.69 3.86 95.88 93.67 98.21 84.98 105.03 -0.168 0.104 94.32 5.60 5.93 94.55 91.74 97.40 75.26 111.59 -0.333 1.005 Fig. 7. Geographical distribution of feminization rate in 2007 Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank) 57 Table 22. Descriptive statistics of old-age dempgraphic dependency ratio Fig. 8. Histogram of old-age demographic dependency ratio in 2007 (people aged 60/65 and above per 100 people aged 18-59/65) Old-age demographic dependency ratio 2002 2007 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 24.12 4.43 18.35 23.50 21.00 26.65 9.80 41.30 0.666 0.951 24.25 3.92 16.18 23.90 21.50 26.55 13.00 41.40 0.603 1.157 Fig. 9. Geographical distribution of old-age dependency ratio in 2007 Source: Author’s calculations based on Bank Danych Regionalnych(Regional Data Bank) 58 Table 23. Descriptive statistics of population density Fig. 10. Histogram of population density in 2007 (people per one square km) Population density 2002 2007 Average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 392.47 385.08 716.85 694.20 182.65 180.27 88.00 89.00 61.50 61.00 184.00 185.50 20.00 19.00 4256.00 4097.00 2.456 2.421 5.624 5.423 Fig. 11. Geographical distribution of population density in 2007 Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank) 59 2.2.2. Economic and labour market indicators In this section we present basic description of economic and labour market characteristics of districts. In the case of labour market indicators, the first year of analysis is changed to 2004 as regards unemployment rate, and to 2003 as regards employment structure indicators. Such change was made in order to ensure comparability of results between the first year under analysis and 2007 in the light of methodological changes to labour market statistics introduced by Central Statistical Office. In that way, we can analyse not only district-level distribution of the characteristics, but also changes in time. Own revenue of local budgets per capita Between 2002 and 2007, average nominal own revenue of local budget per capita in districts increased, which was, of course, to be expected. The increase was accompanied by the increase of variation, which shows that increases in the districts with lower revenues were lower in comparison to the districts with higher revenues, which resulted in increased skewness, already very high in 2002. Distribution of own revenues, depicted in the histogram below, shows that own revenue of districts has features similar to the distribution of income in the population – while the median income is below average, there is a group of districts with higher income on the right side of the distribution. Distribution of own revenues of local budgets is also peaked, with high concentration of districts around median value; as a result, kurtosis coefficient is high. Between 2002 and 2007, peakedness of own revenue distribution increased. Unemployment rate District-level analysis of unemployment can be based on registered unemployment data, pertaining to individuals registered in labour offices. It should be noted that this indicator differs from the economic (ILO) definition of unemployment, i.e. the one stipulating that unemployed persons are not working, are actively seeking work and are able to start working. All of these conditions are not necessarily fulfilled by those registered as unemployed (for example, some people registered may not be ready to start work immediately). Nevertheless, the link between these two concepts of unemployment is sufficient to validate the analysis based on registered data. Labour market situation, measured by the level of registered unemployment rate, improved between 2004 and 2007 – the non-weighted average value of indicator dropped by more than a third. However, again we can see an increase in the coefficient of variation, showing that 60 this change was unevenly redistributed, and improvements were faster in the districts with already low unemployment and slower in those with relatively high unemployment. As a result, distribution of unemployment rate became more skewed to the left. There is significant variation of unemployment between districts. In one quarter of districts, unemployment rate in 2007 was higher than 18 percent, and in one quarter of districts it was below 9 percent. Distribution of unemployment rate is also relatively flat, as reflected in the negative value of kurtosis coefficient. Yet, between 2004 and 2007 its value increased. Share of employment in agriculture Between 2003 and 2007, share of employment in agriculture decreased, on average, which follows the gradual trend of a decreasing share of people employed in agriculture, observed for the past decades. In the future, this trend should continue, as the employment structure in Poland should converge to those observed in Europe. The decrease was relatively small, which also confirms observed trends. In half of the districts, share of employment in agriculture was lower than 26.77 percent – among those, there is a share of urban districts (including cities with district rights), which can be noted at the histogram, forming a peak at values below 4.3 percent of total employment. In one quarter of all districts the share of employment in agriculture is high and exceeds 44.4 percent. Distribution of employment in agriculture is skewed to the left and relatively flat (with negative kurtosis coefficient). Relatively high share of employment in agriculture is thus observed in a significant part of all districts in Poland, which can indicate that this represents a universal risk of poorer health outcomes. Share of employment in hazardous conditions Average share of employment in hazardous conditions did not change between 2003 and 2007. However, standard deviation of such employment decreased, showing that there was a reduction in variation of employment in hazardous conditions between districts, which is a positive development. This is also confirmed by other statistics. In particular, the value of third quartile was decreased. This translates into reduction in the number of districts with higher shares of employment in hazardous conditions. Distribution of this labour market characteristic is highly skewed to the right, with very high skewneness coefficient values. It is also relatively steep, which is shown by high values of kurtosis coefficients. 61 Statistics show that high shares of employment in hazardous conditions are observed in relatively few districts, i.e. potential risk from population health status perspective is not universal. Table 24. Descriptive statistics of own revenue of local budgets per capita Fig. 12. Histogram of own revenue of local budgets per capita in 2007 (in PLN) Own revenue of local budgets per capita 2004 2007 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 725.98 295.65 40.72 644.36 542.68 842.92 304.20 2600.64 2.124 7.566 1154.79 556.19 48.16 979.29 797.93 1349.40 456.88 4885.13 2.312 8.703 Fig. 13. Geographical distribution of own revenue of local budgets per capita in 2007 Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank) 62 Table 25. Descriptive statistics of unemployment rate Fig. 14. Histogram of unemployment rate in 2007 (percentage) Unemployment rate 2004 2007 Average standard deviation coefficient of variation Median first quartile third quartile Minimum Maximum skewness coefficient kurtosis coefficient 22.43 7.71 34.39 21.50 16.95 27.70 6.20 42.70 0.397 -0.388 14.05 6.19 44.05 13.10 9.30 18.00 2.40 33.60 0.549 -0.047 Fig. 15. Geographical distribution of unemployment rate in 2007 Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank) 63 Table 26. Descriptive statistics of share of employment in agriculture Fig. 16. Histogram of share of employment in agriculture in 2007 (percentage) Share of employment in agriculture 2003 2007 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 30.98 21.88 70.61 28.85 13.40 48.12 0.21 79.79 0.302 -0.916 29.32 21.35 72.82 26.77 12.23 44.40 0.17 78.95 0.405 -0.823 Fig. 17. Geographical distribution of share of employment in agriculture in 2007 Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank) 64 Table 27. Descriptive statistics of share of employment in hazardous conditions Fig. 18. Histogram of share of employment in hazardous conditions in 2007 (percentage) Share of employment in hazardous conditions 2003 2007 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 5.98 6.31 105.59 4.41 2.17 7.32 0.20 49.83 3.149 14.477 5.28 4.39 83.21 4.41 2.38 6.90 0.08 33.55 2.344 9.323 Fig. 19. Geographical distribution of share of employment in hazardous conditions in 2007 Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank) 65 2.2.3. Social cohesion indicators Pre-school participation rate of children aged 3-5 Between 2002 and 2007 pre-school participation rate of children aged 3-5 in Polish districts increased, on average, which resulted from an increase in the number of available places (by 65.4 thousand) and a decrease in the number of children at this age by 126.1 thousand. Thus, approximately a third of the observed decrease can be attributed to increased availability of pre-schools. In a quarter of districts, less than 25 percent of children in the analysed age group attend pre-schools. In the top quartile participation rate is above 51 percent. Distribution of pre-school participation rate is skewed to the right, i.e. there are more districts with relatively lower pre-school participation rates. It is also relatively flat: kurtosis coefficient is negative. Most of the districts in the top quartile are urban districts or districts adjacent to cities. On the other hand, most of bottom quartile districts are rural. This is a factor that can further aggravate existing gap between urban and rural areas of Poland, which requires policymakers’ attention. Library members per 1000 inhabitants The number of library members per 100 inhabitants decreased between 2002 and 2007, which is probably caused by the liquidation of some of public libraries, particularly in rural areas. In one fourth of districts, there are less than 139 library members per 1000 inhabitants, and in another one fourth – more than 192. Distribution of this indicator is skewed to the right, which deepened between 2002 and 2007. Kurtosis coefficient also shows that the distribution is peaked (there was a significant increase of the value of kurtosis coefficient between 2002 and 2007). Looking at geographical distribution one can again observe relatively larger share of library members in the cities, as well as in southern and western parts of Poland, with some exceptions. Lower participation in libraries can be observed in the case of eastern parts of Poland, particularly in the rural parts of Mazowieckie voivodship, which is probably related to the lack of access to public libraries in these districts. Share of households equipped with a bathroom Surprisingly, between 2002 and 2007 the share of households equipped with a bathroom decreased. In 2007, in half of the districts there were less than 85.7 percent of households with 66 a bathroom, while in a quarter of districts less than 78.1 percent of households had a bathroom. Distribution of this indicator is skewed to the left, whereas kurtosis coefficient shows that it is slightly flat. This is a change compared to 2002, when distribution of the share of households equipped with a bathroom was more peaked. This change seems to result from an increase in the number of districts with relatively smaller share of households with bathrooms. Geographical distribution of this indicator is very interesting. Districts of the lowest quartile are almost exclusively located in the central and eastern parts of Poland, which by and large corresponds to the borders of Russian annexation, which lasted for about 150 years. On the other hand, districts with the highest share of households with bathrooms are large city districts (Warszawa, Katowice, Szczecin, Gdańsk, Wrocław and Poznań), and districts in their close neighbourhood. Local government election turnout Local government election turnout was analysed for two election years: 2002 and 2006. Statistics show that this indicator did not change significantly between elections. The third quartile and median levels slightly decreased, while the first quartile slightly increased. This confirms that the differences between districts decreased, which is also reflected in the smaller value of coefficient of variation. Distribution of this indicator shows that it is relatively close to normal distribution, slightly skewed to the left and a little more peaked (coefficient of kurtosis is positive). These characteristics did not change significantly between election years either, in 2002 the distribution of election turnout was more skewed than in 2006. Geographical distribution shows that the districts with the highest turnout are located mainly in central and eastern parts of Poland. Moreover, election turnout seems lower in most of the urban districts. Lowest turnout is observed in districts located in Śląskie and KujawskoPomorskie voivodships. Interestingly enough, local election turnout statistics vary from the same indicator as regards Parliamentary or Presidential elections. In the case of the latter, bigger cities usually exhibit higher turnout. Such development can support the hypothesis that local election turnout may be a good indicator to monitor the level of social engagement of local community. 67 Table 28. Descriptive statistics of preschool participation rate of children aged 3-5 Fig. 20. Histogram of pre-school participation rate of children aged 3-5 in 2007 (percentage) Pre-school participation rate of children aged 3-5 2002 2007 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 30.50 14.14 46.36 27.32 19.22 40.11 2.49 73.43 0.694 -0.151 39.11 17.35 44.36 35.57 25.82 51.18 0.00 89.52 0.505 -0.467 Fig. 21. Geographical distribution of the share of pre-school participation rate of children aged 3-5 in 2007 Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank) 68 Table 29. Descriptive statistics of library members per 1000 inhabitants Fig. 22. Histogram of library members per 1000 inhabitants in 2007 Library members per 1000 inhabitants 2002 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 191.08 49.73 26.02 181.00 154.50 216.50 102.00 372.00 1.020 1.296 2007 169.49 43.84 25.87 162.00 139.00 192.00 82.00 380.00 1.293 3.096 Fig. 23. Geographical distribution of library members per 1000 inhabitants in 2007 Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank) 69 Table 30. Descriptive statistics of the share of households equipped with a bathroom Fig. 24. Histogram of the share of households equipped with a bathroom in 2007 (percentage) Share of households equippedwith bathroom 2002 2007 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 87.29 8.96 10.26 89.46 81.79 93.95 58.55 100.00 -0.746 0.069 83.74 8.77 10.47 85.72 78.12 89.94 55.50 99.02 -0.681 -0.105 Fig. 25. Geographic distribution of the share of households equipped with a bathroom in 2007 (percentage) Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank) 70 Table 31. Descriptive statistics of local government elections turnout Fig. 26. Histogram of local government elections turnout in 2006 (per cent) Local government elections turnout 2002 2006 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 45.70 7.44 16.29 47.15 41.77 50.85 22.86 63.30 -0.710 0.182 45.46 5.27 11.59 45.73 42.34 49.06 26.67 60.28 -0.310 0.216 Fig. 27. Geographical distribution of the share of local government elections turnout in 2006 Source: Author’s calculations based on Państwowa Komisja Wyborcza (National Electoral Commission) 71 2.2.4. Health care access indicators In this section we present the characteristics of proposed indicators related to access to health care on a district level. However, it should be taken with some caution. First of all, the network of healthcare institutions is to some extent developed not in line with the boundaries of districts, so people living in some districts may use health care services provided in another district. Secondly, physicians tend to work in many places, which is not fully recognised in available statistics. Comparison of data provided by Central Statistical Office and CSIOZ also shows some differences, presumably related to the differences in measurement. Due to lack of comparability of data in the Regional Data Bank, this source of data was not used in the analysis, but it can be used in the future, once comparable information is available. Number of inhabitants per 1 health care institution Access to health care institutions, measured as the number of inhabitants per one institution (zakład opieki zdrowotnej/ZOZ) shows some improvement between 2002 and 2007, both from the perspective of average value as well as variation. In a quarter of districts, there are less than 2274 inhabitants per one institution, and in another quarter there are more than 3588. There is significant range in the value of this indicator – from the minimum of 308 inhabitants to the maximum of more than 18 thousand inhabitants. Distribution of the indicator is highly skewed to the right. It is also peaked – half of the districts have the value of the indicator ranging between 2.2 thousand and 3.6 thousand. Geographical distribution of this indicator is rather scattered. The one feature that can be observed is that the number of inhabitants per one health care institution is smaller in urban districts (cities), which shows that the cities tend to attract health care institutions, which in turn leads to potentially better access to health care services in urban areas. This is usually accompanied by high number of inhabitants per one institution in districts surrounding the cities, which shows that there is a tendency to “push” the development of institutions to the nearest cities. Number of inhabitants per 1 physician The second indicator proposed to measure access to health care has similar distribution as the previous one. However, between 2002 and 2007 the number of inhabitants per one physician increased. This is mainly due to the reduced number of employed physicians, which decreased by 11.8 thousand during these five years: from 90 thousand in 2002 to 78.2 thousand in 2007. Decrease in the number of employed physicians results from that fact that more and more doctors decide to become self-employed. Consequently, the findings cannot be fully 72 comparable between the two observations. The coefficient of variation of this indicator decreased between 2002 and 2007, which is a positive development, just as the reduction of the maximum value from 34.7 to 18.2 thousand inhabitants per one physician. In a quarter of districts the number of inhabitants per one physician in 2007 was below 533, while in another quarter it was more than 1 111. Analogically to the previous indicator, distribution of the number of inhabitants per one physician is skewed to the right and highly peaked, it is also scattered geographically. Table 32. Descriptive statistics of the number of inhabitants per 1 health care institution Fig. 28. Histogram of the number of inhabitants per 1 health care institution in 2007 Number of inhabitants per 1 health care institution 2002 2007 average 4165.28 3218.55 standard deviation 3004.03 1827.43 coefficient of variation 72.12 56.78 median 3465.08 2839.26 first quartile 2680.43 2274.39 third quartile 4649.30 3588.10 minimum 320.94 307.08 maximum 34692.33 18210.40 skewness coefficient 4.664 3.737 kurtosis coefficient 34.555 22.416 Fig. 29. Geographical distribution of the number of inhabitants per 1 health care institution in 2007 Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank) 73 Table 33. Descriptive statistics of the number of inhabitants per 1 physician Fig. 30. Histogram of the share of the number of inhabitants per 1 physician in 2007 number of inhabitants per 1 physician 2002 2007 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 920.75 943.66 1635.33 753.95 177.61 79.90 667.27 777.19 476.50 533.73 951.94 1111.23 17.60 24.37 25546.00 7312.57 11.736 3.421 160.542 19.526 Fig. 31. Geographical distribution of the number of inhabitants per 1 physician in 2007 Source: Author’s calculations based on Centrum Systemów Informacyjnych Ochrony Zdrowia (Health Care Information Systems Centre) 74 2.2.5. Educational indicators Education is frequently identified as one of the most important determinants of health. There is strong correlation between the level of education and life expectancy, which can be attributed, among others, to the impact of educational attainments on healthier lifestyles and habits of population. There are, however, limitations in the availability of data for the analysis of this group of determinants at district level in Poland. The best potential indicator, i.e. share of population with different levels of educational attainments at the district level, is available only from national census data (i.e. since 2002). Given significant changes in educational attainments of young population, as well as observed post-accession migration, census data may not be a very good indicator of current characteristics of a district. As mentioned in the introduction, annually available indicators linked to education are associated with the results of lower secondary school and upper secondary school matura exams. In the set of indicators we suggest taking into account both levels of exams, with results from humanities as well as mathematics and science. These indicators are available at district level. More importantly, these exams are conducted in such a way that guarantees comparability of results between districts in each year. However, they are not comparable in time, so we cannot assess the progress of results based on observed values.35. Lower secondary school exams are taken by all students in compulsory education system. Thus, they cover more or less the entire population of youth around age 15. A note of caution is related to upper secondary school (matura) exams results, which are available at comparable national level for 2007 observation (as unified exams were introduced in 2005). Matura exams are taken only by a part of population around age 18, since not all the youth choose to continue with upper secondary education that ends with this exam. Thus, the results have selection bias. This is even more so in the case of mathematics, because prior to 2010 this examination was not compulsory. Thus, for further analysis of social determinants of health in the next chapter, only the results of exams in humanities are used. In the future, both types of exams may be used for analytical purposes, following the introduction of compulsory high school mathematics exams. As a result, only some of the identified indicators are used further for the analysis of health indicators (namely, the results of lower secondary and upper secondary school exams in 35 Currently, Educational Research Institute in Warsaw is running a project aimed at introducing comparability in the reporting of exams results. 75 humanities or Polish language). However, in this section we provide short description of all proposed indicators, as they provide important contextual information. Share of population with higher education As indicated before, the share of population with given educational attainment is provided only for year 2002 and is based on census results. Nevertheless, considering significant link between education and health outcomes underlined in literature (Marmot and Wilkinson, 2006, Bartley et al., 2006), this indicator is included in the analysis framework. Education is also linked to other social determinants of health, such as employment conditions, unemployment, or lifestyle. Looking at geographical distribution of the share of population with higher educational attainments in 2002, we can observe significant variation between districts, similarly to other indicators. The distribution of the percentage of population with higher education is skewed to the right. In half of the districts the share of people with such educational attainment is above 6.3 percent, while in a quarter it is above 8.07 percent. Values across districts range between 3 and 25 percent of total population. Again, we can see that urban districts are at the top of the list (top 40 districts are all urban ones). Distribution of higher educational attainments of the population is also peaked with high concentration of districts, in which the share of such population ranges from 5 to 7 percent. Share of population with vocational or lower education This indicator can be treated as a “mirror” indicator relative to the previous one, showing the distribution of lowest educational attainments. The analysis of descriptive statistics shows that, first of all, the share of population with vocational or lower education is on average much higher – ranging from the lowest 28 percent to the highest 78 percent of total population. Variation of this indicator is lower compared to the previous one, as coefficient of variation is below 15 percent. In half of the districts the share of the population with low educational attainments is below 65.74 percent, and in a quarter – below 60.03 percent. Distribution of this indicator, as shown in the histogram, indicates that it is skewed to the left, matching the distribution of population with higher educational attainment. Distribution is also relatively peaked. Concentration of population with vocational or lower education is higher in rural districts, in particular in the eastern parts of Poland. Average lower secondary school exam results (mathematics and science) Average lower secondary school exam results in mathematics and science show relatively little variation, with the coefficient of variation below 10 percent. 2002 results exhibit slightly higher variation than those from 2007 High (one should remember that the results are not 76 comparable between the two years). In 2007, distribution of results was a little skewed to the right (in 2002 it was skewed to the left), and more peaked than normal distribution. Upper secondary school matura results - mathematics (basic level) Upper secondary school matura mathematics exams scores show slightlyhigher variation, compared to lower secondaryschool results, but the range is quite high – from the lowest 8.75 to the highest above 31. Half of the districts had average exam score below 20.85. Distribution is skewed to the left and peaked. In contrast to lower secondaryschool exams, there is no observed link between the type of district (municipal) and the outcome (highest results). Average lower secondaryschool exam results (humanities) Average lower secondaryschool exam scores in humanities also show relatively little variation, with the coefficient of variation around 5 percent. Variation of results in 2002 and in 2007 is similar (one should remember that the results are not comparable between the two years). In 2007, distribution of results was slightly` skewed to the right, with median (30.85) slightly below average (30.87) and relatively flat, compared to normal distribution. Better results are observed in central and south-eastern Poland. Similarly to mathematics and science exams, municipal districts have, on average, better lower secondaryschool exam results in humanities. Upper secondary school matura exam results - Polish language (basic level) Upper secondary school maturaPolish language exam results show slightly higher variation compared to lower secondaryschool results (at 7.6 percent), though lower than in the case of mathematics. Half of the districts had average exam score below 34.07. Distribution of results is skewed to the left and a bit more peaked than normal distribution. Territorial distribution shows that better results are obtained in bigger cities and around them, which indicates some potential diffusion of knowledge between the cities and surrounding districts. 77 Table 34. Descriptive statistics of the share of population with higher education Fig. 32. Histogram of the share of population with higher education in 2002 (percentage) share of population with higher education 2002 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 7.60 3.76 49.46 6.30 5.49 8.07 3.31 25.40 2.137 4.693 Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank) Table 35. Descriptive statistics of the share of population with vocational or lower education Fig. 33. Histogram of the share of population with vocational or lower education in 2002 (percentage) share of population with vocational or lower education 2002 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 63.20 9.27 14.66 65.74 60.34 69.01 28.54 78.91 -1.360 1.487 Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank) 78 Table 36. Descriptive statistics of average lower secondaryschool exam results (mathematics and science) Fig. 34. Histogram of average lower secondaryschool exam results (mathematics and science) in 2007 average middle school exam results (mathematics and science) 2002 2007 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 27.80 2.45 8.83 27.53 25.83 29.65 22.43 35.26 0.328 -0.490 24.74 1.43 5.78 24.65 23.65 25.48 21.70 29.72 0.696 0.451 Source: Author’s calculations based on Centralna Komisja Egzaminacyjna (Central Examination Board) Table 37. Descriptive statistics of upper secondary school matura results mathematics (basic level) Fig. 35. Histogram of upper secondary school matura results - mathematics (basic level) in 2007 high school results mathematics (basic level) 2007 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 20.72 2.84 13.73 20.85 19.05 22.70 8.75 31.09 -0.400 1.820 Source: Author’s calculations based on Centralna Komisja Egzaminacyjna (Central Examination Board) 79 Table 38. Descriptive statistics of average lower secondaryschool exam results (humanities) Fig. 36. Histogram of the share of average lower secondaryschool exam results (humanities) in 2007 average middle school exam results (humanities) 2002 2007 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 29.61 1.58 5.33 29.52 28.44 30.66 25.00 34.19 0.193 0.118 30.87 1.59 5.15 30.85 29.70 31.94 26.43 35.41 0.264 -0.233 Fig. 37. Geographical distribution of average lower secondaryschool exam results (humanities) in 2007 Source: Author’s calculations based on Centralna Komisja Egzaminacyjna(Central Examination Board) 80 Table 39. Descriptive statistics of upper secondary school matura exam results - Polish language (basic level) Fig. 38. Histogram of the share of upper secondary school matura exam results - Polish language (basic level) in 2007 high school exam results - Polish language (basic level) 2007 average standard deviation coefficient of variation median first quartile third quartile minimum maximum skewness coefficient kurtosis coefficient 33.97 2.58 7.59 34.07 32.25 35.66 25.38 41.37 -0.176 0.192 Fig. 39. Geographical distribution of upper secondary school matura exam results - Polish language (basic level) in 2007 Source: Author’s calculations based on Centralna Komisja Egzaminacyjna (Central Examination Board) 81 82 2.3. Relations between selected variables In this section, correlations between selected indictors are analysed. This is done for several purposes. First, it is important to identify whether there are some relations between variables, in particular between those from different groups. Second, given that the indicators are also used for further selection of variables explaining mortality and life expectancy, it is important to identify those indicators which can reflect wider set of potential factors influencing social determinants of health. The matrix presenting correlations between indicators is shown in Błąd! Nie można odnaleźć źródła odwołania.. A short analysis of obtained results is presented below. The analysis is carried out for each group of indicators. In order to avoid repetitions, correlations that were not discussed before are discussed for each group. At the end of this section we conclude with a proposal of classification of “typical” groups of districts in Poland, selecting the factors that tend to co-exist together. Demographic indicators Feminization rate shows strong correlations (above 0.5 or below -0.5) with economic and labour market as well as social indicators. There is a strong negative correlation between feminization rate and the share of employment in agriculture. This confirms the interpretation that feminization rate reflects the outcome of migration processes, usually from poorer, agricultural districts to the cities. This indicator is also strongly positively correlated with income from local taxation per inhabitant. This shows that young females tend to move to the districts with better economic situation, which indicates potential direction of migrations. As far as social indicators are concerned, there is a strong positive correlation between feminization and the share of children aged 3-5 in pre-school education as well as library members. The former can be potentially attributed to the fact that higher share of females aged 24-35 leads to higher number of small children, which in turn increases the demand for development of pre-school education. The latter can indicate that women, who participate in higher education more frequently than men, also tend to use libraries more frequently, but this would require additional research. On the other hand, feminization rate is weakly correlated with indicators in the area of access to healthcare. Also in the case of educational variables, correlations are not very strong, with the exception of census data on the shares of population with higher, or vocational or lower education. In the case of the former, there is a relatively strong positive correlation, mirrored by relatively strong negative correlation in the case of the latter indicator. There is also moderate positive correlation between feminization rate and lower secondary school exam 83 results. Such correlation again confirms that there is a link between educational outcomes of children and the level of education of their parents, which is also corroborated by, for example, the results of PISA survey in Poland36. Old-age demographic dependency ratio is strongly and positively correlated with the share of employment in agriculture. This shows that the outcomes of demographic processes, in scope of ageing as well as migration, affect demographic structure of rural areas in Poland. This indicator is also strongly and negatively correlated with the share of households equipped with a bathroom, which may indicate that older people may inhabit lower quality dwellings. Population density, higher in urban areas, is strongly and positively correlated with local budget revenues, which once again confirms that urban areas are relatively more affluent. By the same token, there is strong negative correlation between population density and the share of employment in agriculture. This indicator is also strongly correlated with social indicators: the correlation is positive in the case of pre-school participation, library membership and quality of housing (houses equipped with a bathroom), and negative as regards local government election turnout. Those positive correlations once again confirm the intuition related to general features of urban districts. Negative correlation indicates that local elections are of less priority to urban citizens. Similarly to other demographic indicators, population density is moderately (around -0.3) negatively correlated with indicators measuring access to health care, which shows that the number of inhabitants per one physician is slightly lower in highly populated areas. Taking into account correlation between population density and educational indicators, we can again observe a strong correlation between this variable and population structure by education – urban areas are inhabited byrelatively better educated population, which also leads to relatively better exam results. However, as regards the latter, the correlation is not that strong. There is weak (and, surprisingly, negative) correlation between population density and high school mathematics exam results, yet, this can be influenced by the fact that this measure relates to exams taken on a voluntary basis. Economic and labour market indicators Economic and labour market indicators show some strong correlations between one another. Own revenue of local budgets per capita shows strong negative correlation with employment in agriculture, which indicates that rural districts tend to be poorer than urban ones. It is also 36 The PISA (Programme of International Student Assessment) is an international survey measuring numeracy, literacy and problem solving abilities of 15-year olds, developed and co-ordinated by the OECD (http://www.pisa.oecd.org/) 84 moderately and negatively correlated with unemployment rate, which shows that better labour market performance is observed in the districts with higher revenues. Employment in agriculture, particularly for 2007, also shows relatively strong negative correlation with employment in hazardous conditions, which indicates that such working conditions are observedin non-rural parts of Poland. There are also strong correlations between economic and labour market indicators, and social indicators. Strong positive correlation between revenues of local budgets and pre-school participation rate of children aged 3-5 shows that investment in pre-school education may depend on availability of sources atthe local level, as the development of kindergartens is a responsibility of local governments. Housing conditions also tend to be better in those districts that have higher incomes. Own revenues of local budgets show moderate positive correlation with library membership, which again confirms that relatively richer districts have more developed social services. Interestingly, local budget revenues show moderate negative correlation with local government election turnout, which indicates that this aspect of social activity is observed more frequently in poorer areas of Poland. Less efficient labour markets, i.e. those with higher unemployment rates or higher share of employment in agriculture, are relatively strongly correlated with a lower number of children attending pre-schools. Analogically, strong negative correlations are observed between the share of employment in agriculture, library membership and housing quality. Only election turnout shows positive correlation with employment in agriculture. Unemployment rate is weakly correlated with social variables other than pre-school participation rate. There is certain moderate positive correlation between the share of employment in hazardous conditions and housing quality, and negative correlation with election turnout. This again indicates that employment in hazardous conditions usually tends to occur in districts with urban characteristics. Similarly to the previous group of indicators, we cannot see strong correlations with access to health care. These is a moderate positive correlation between the number of inhabitants per 1 physician and unemployment rate, as well as employment in agriculture. The latter, in particular, confirms the belief that in rural areas there is worse access to health care. Economic and labour market indicators are also strongly correlated with educational indicators. Strong positive correlation with local budget revenue and the share of people with higher education shows that richer districts are inhabited by better educated citizens. Labour market conditions measured by lower unemployment and lower share of employment in agriculture also tend to co-exist with higher share of people with higher education. Similar 85 direction of correlations (though moderately strong) is observed in the case of results of both lower secondary and upper secondary school exams, with the exception of upper secondary school matura mathematics exams.37 Specifically, correlation coefficient between lower secondary school exam results and unemployment rate in 2007 was at around -0.5, which is the strongest observed relation between analysed groups. Social indicators Social indicators are mutually inter-dependent. There is a relatively strong, positive correlation between pre-school participation rate and the quality of housing, and negative correlation between pre-school participation rate and election turnout, side by side witha moderate positive correlation between pre-school participation rate and library membership. Similarly to previous groups, there are weak (usually negative) correlations between social indicators and access to health care services indicators. Again, educational indicators are also strongly correlated with social indicators. The higher the share of population with higher education, the higher the participation in pre-school education and the quality of housing. There is also relatively strong correlation between structure of educational attainments and library membership. On the other hand, local election turnout is relatively strongly and negatively correlated with the share of population with higher education. Strong to moderately strong correlation occurs between the first three social indicators and the results of middle school exams, particularly in humanities. Similarly to previous groups, there is only slight correlation with the results of upper secondary school matura mathematics exams. Health care access indicators There is a relatively strong correlation between proposed health-care access variables, particularly those from 2007 observations, which shows that a higher number of health care institutions generally leads to a larger number of available physicians. As mentioned before, health care access indicators demonstrate rather weak correlations with other variables. There is a moderate positive correlation with the share of employment in agriculture and the share of employment in hazardous condition (of about 0.2 and 0.3, respectively), and the share of population with vocational or lower education (0.4), as well as negative correlations of similar strength with population density (-0.3), pre-school 37 A note of caution: these are results of exams based on voluntary choice. As choices were non-random, this affects the results of correlation analysis. 86 participation rate (-0.3), or with the share of population with higher education (-0.35) and lower secondary school exam results (about -0.3). This shows some, but not very strong, evidence, that inhabitants of rural districts have less access to health care services, as the number of inhabitants per one health care institution or physician tends to be higher. Educational indicators Educational indicators, similarly to social indicators, exhibit strong correlations within the group. In particular, the share of people with higher education is very strongly, negatively correlated with the share of people with vocational or lower education, which of course should be expected. Lower secondary school exams, particularly in 2007, demonstrate relatively strong positive correlation (about 0.6) with the share of people with higher education (observed in 2002). This may indicate that there is a tendency to replicate the existing education structure in the new generation. Lower secondary school exam results for humanities and mathematics and science also show similar positive correlation. Results of upper secondary school maturaexams are not that strongly correlated with other variables, particularly in the case of mathematics examination. There is certain weak positive correlation (or about 0.3) observed in the case of 2007 lower secondary school exam results (in the case of humanities and mathematics and science alike), and upper secondaryschool resuls in scope of matura exam in Polish language. To summarise, we can see inter-relations between selected groups of indicators, which shows that districts in Poland develop in different ways. As shown in the analysis of geographical distribution, such diversity is not only linked to the region, but also to the type of district. Urban districts in particular are quite different in their characteristics, compared to the rural ones. We may even say that there is certain polarisation of districts based on their socioeconomic situation. Based on the correlation between selected indicators, we can present characteristics of two groups of “typical” districts. The first one represents features of municipal districts, and the other one has features frequently observed in the case of rural districts (see ). Needless to add, such a breakdown does not cover all existing diversities (Fig. 40) nevertheless, it can illustrate what kind of phenomena tend to co-exist in Polish districts. 87 Fig. 40. Polarisation of district characteristics in Poland Typical municipal district Typical rural district High feminisation rate and high population density Low feminisation rate and low population density High revenues of local budgets Low revenues of local budgets Low employment in agriculture High employment in agriculture High participation of children in pre-school education Low participation of children in pre-school educations Higher library membership Lower library membership Better housing conditions Worse housing conditions Lower election turnout Higher election turnout High share of people with higher education Low share of people with higher education Low share of people with vocational and lower education High share of people with vocational or lower education 88 share of population w ith vocational or low er education average low er secondary school exam results (m athem atics and science) average low er secondary school exam results (hum anities) ECO_4_2007 num ber of inhabitants per 1 physician share of population w ith higher education ECO_4_2003 num ber of inhabitants per 1 health care institution ECO_3_2007 local governm ent election turnout ECO_3_2003 share of households equipped w ith bathroom ECO_2_2007 library m em bers per 1000 inhabitants ECO_2_2004 pre-school participation rate of children aged 3-5 ECO_1_2007 share of em ploym ent in hazardous conditions ECO_1_2002 share of em ploym ent in agriculture DEM_3_2007 unem ploym ent rate DEM_3_2002 population density ow n revenue of local budgets per capita DEM_2_2007 EDU_3_2002 EDU_3_2007 EDU_4_2002 EDU_4_2007 old-age dem ographic dependency ratio DEM_2_2002 EDU_2_2002 fem inization rate DEM_1_2007 DEM_1_2002 DEM_1_2007 DEM_2_2002 DEM_2_2007 DEM_3_2002 DEM_3_2007 ECO_1_2002 ECO_1_2007 ECO_2_2004 ECO_2_2007 ECO_3_2003 ECO_3_2007 ECO_4_2003 ECO_4_2007 SOC_1_2002 SOC_1_2007 SOC_2_2002 SOC_2_2007 SOC_3_2002 SOC_3_2007 SOC_4_2002 SOC_4_2006 HEALTH_1_2002 HEALTH_1_2007 HEALTH_2_2002 HEALTH_2_2007 EDU_1_2002 DEM_1_2002 Table 40. Correlation matrix of the indicators 1,00 0,81 - 0,44 - 0,32 0,38 0,38 0,50 0,48 - 0,21 - 0,30 - 0,61 - 0,61 0,19 0,28 0,52 0,57 0,24 0,23 0,60 0,59 - 0,43 - 0,43 - 0,11 - 0,05 - 0,10 - 0,13 0,48 - 0,49 0,81 1,00 - 0,50 - 0,35 0,47 0,48 0,57 0,57 - 0,26 - 0,37 - 0,68 - 0,68 0,22 0,34 0,59 0,64 0,27 0,26 0,69 0,68 - 0,53 - 0,50 - 0,12 - 0,01 - 0,13 - 0,16 0,55 - 0,55 - 0,44 - 0,50 1,00 0,95 - 0,16 - 0,16 - 0,34 - 0,32 - 0,25 - 0,04 0,62 0,64 - 0,33 - 0,45 - 0,25 - 0,31 - 0,36 - 0,26 - 0,72 - 0,76 0,37 0,39 - 0,03 - 0,03 0,14 0,04 - 0,18 0,22 - 0,32 - 0,35 0,95 1,00 0,06 0,06 - 0,17 - 0,13 - 0,35 - 0,16 0,41 0,43 - 0,28 - 0,34 - 0,02 - 0,08 - 0,21 - 0,12 - 0,55 - 0,59 0,17 0,22 - 0,09 - 0,09 0,05 - 0,10 0,03 - 0,01 0,38 0,47 - 0,16 0,06 1,00 1,00 0,53 0,59 - 0,31 - 0,33 - 0,59 - 0,57 0,09 0,17 0,65 0,65 0,40 0,36 0,39 0,41 - 0,58 - 0,48 - 0,21 - 0,19 - 0,15 - 0,32 0,76 - 0,74 0,38 0,48 - 0,16 0,06 1,00 1,00 0,54 0,60 - 0,31 - 0,34 - 0,60 - 0,58 0,09 0,17 0,65 0,65 0,40 0,36 0,39 0,41 - 0,58 - 0,48 - 0,21 - 0,19 - 0,15 - 0,33 0,76 - 0,75 0,50 0,57 - 0,34 - 0,17 0,53 0,54 1,00 0,93 - 0,29 - 0,39 - 0,69 - 0,68 0,25 0,40 0,62 0,65 0,35 0,32 0,58 0,58 - 0,46 - 0,33 - 0,06 - 0,03 - 0,16 - 0,21 0,65 - 0,65 0,48 0,57 - 0,32 - 0,13 0,59 0,60 0,93 1,00 - 0,32 - 0,43 - 0,71 - 0,70 0,21 0,37 0,65 0,68 0,36 0,34 0,60 0,60 - 0,49 - 0,34 - 0,09 - 0,06 - 0,15 - 0,23 0,74 - 0,73 - 0,21 - 0,26 - 0,25 - 0,35 - 0,31 - 0,31 - 0,29 - 0,32 1,00 0,91 0,06 0,05 0,06 - 0,10 - 0,45 - 0,44 - 0,10 - 0,19 - 0,10 - 0,05 0,17 0,06 0,21 0,14 0,04 0,22 - 0,41 0,37 - 0,30 - 0,37 - 0,04 - 0,16 - 0,33 - 0,34 - 0,39 - 0,43 0,91 1,00 0,22 0,23 - 0,04 - 0,20 - 0,50 - 0,51 - 0,13 - 0,18 - 0,26 - 0,22 0,26 0,17 0,18 0,11 0,06 0,21 - 0,41 0,38 - 0,61 - 0,68 0,62 0,41 - 0,59 - 0,60 - 0,69 - 0,71 0,06 0,22 1,00 1,00 - 0,32 - 0,52 - 0,70 - 0,76 - 0,53 - 0,44 - 0,81 - 0,83 0,64 0,59 0,13 0,11 0,25 0,33 - 0,65 0,72 - 0,61 - 0,68 0,64 0,43 - 0,57 - 0,58 - 0,68 - 0,70 0,05 0,23 1,00 1,00 - 0,34 - 0,52 - 0,69 - 0,75 - 0,52 - 0,42 - 0,81 - 0,84 0,63 0,59 0,13 0,10 0,25 0,31 - 0,63 0,71 0,19 0,22 - 0,33 - 0,28 0,09 0,09 0,25 0,21 0,06 - 0,04 - 0,32 - 0,34 1,00 0,55 0,15 0,18 0,21 0,18 0,29 0,32 - 0,25 - 0,32 0,02 0,04 - 0,05 0,04 0,01 - 0,03 0,28 0,34 - 0,45 - 0,34 0,17 0,17 0,40 0,37 - 0,10 - 0,20 - 0,52 - 0,52 0,55 1,00 0,31 0,34 0,33 0,28 0,45 0,49 - 0,30 - 0,33 - 0,07 - 0,01 - 0,12 - 0,11 0,12 - 0,16 - 0,14 0,24 0,25 0,29 - 0,12 0,29 0,34 0,32 0,40 0,10 0,09 0,08 0,43 0,23 0,25 0,23 0,11 0,39 0,50 0,45 0,11 0,39 0,50 0,45 - 0,10 0,31 0,42 0,28 - 0,07 0,38 0,47 0,35 - 0,36 - 0,58 - 0,53 - 0,58 - 0,22 - 0,50 - 0,52 - 0,50 0,23 - 0,23 - 0,37 - 0,27 0,24 - 0,22 - 0,35 - 0,26 - 0,30 - 0,09 - 0,05 - 0,10 - 0,29 - 0,03 0,10 0,03 EDU_5_2007 upper secondary school matura exam results - Polish language (basic level) 0,17 0,19 - 0,17 - 0,05 0,25 0,25 0,12 0,13 - 0,26 - 0,24 - 0,24 - 0,24 0,02 0,13 EDU_6_2007 upper secondary school matura exam results - m athem atics (basic level) - 0,08 - 0,10 0,05 0,05 - 0,01 - 0,01 - 0,23 - 0,23 0,01 0,09 0,13 0,14 - 0,08 - 0,12 Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank), Centralna Komisja Egzaminacyjna (Central Examination Board), Państwowa Komisja Wyborcza (National Electoral Commission) and Centrum Systemów Informacyjnych Ochrony Zdrowia (Health Care Information Systems Centre) 89 num ber of inhabitants per 1 health care institution num ber of inhabitants per 1 physician share of population w ith higher education share of population w ith vocational or low er education average low er secondary school exam results (m athem atics and science) average low er secondary school exam results (hum anities) upper secondary school matura exam results - Polish language (basic level) upper secondary school matura exam results - m athem atics (basic level) HEALTH_2_2007 local governm ent election turnout HEALTH_2_2002 share of households equipped w ith bathroom HEALTH_1_2007 library m em bers per 1000 inhabitants HEALTH_1_2002 pre-school participation rate of children aged 3-5 SOC_4_2006 share of em ploym ent in hazardous conditions SOC_4_2002 share of em ploym ent in agriculture SOC_3_2007 unem ploym ent rate SOC_3_2002 ow n revenue of local budgets per capita SOC_2_2007 EDU_6_2007 population density SOC_2_2002 EDU_5_2007 old-age dem ographic dependency ratio SOC_1_2007 EDU_3_2002 EDU_3_2007 EDU_4_2002 EDU_4_2007 fem inization rate SOC_1_2002 DEM_1_2002 DEM_1_2007 DEM_2_2002 DEM_2_2007 DEM_3_2002 DEM_3_2007 ECO_1_2002 ECO_1_2007 ECO_2_2004 ECO_2_2007 ECO_3_2003 ECO_3_2007 ECO_4_2003 ECO_4_2007 SOC_1_2002 SOC_1_2007 SOC_2_2002 SOC_2_2007 SOC_3_2002 SOC_3_2007 SOC_4_2002 SOC_4_2006 HEALTH_1_2002 HEALTH_1_2007 HEALTH_2_2002 HEALTH_2_2007 EDU_1_2002 EDU_2_2002 0,52 0,59 - 0,25 - 0,02 0,65 0,65 0,62 0,65 - 0,45 - 0,50 - 0,70 - 0,69 0,15 0,31 1,00 0,96 0,45 0,45 0,61 0,60 - 0,59 - 0,48 - 0,17 - 0,16 - 0,22 - 0,35 0,73 - 0,76 0,01 0,43 0,54 0,47 0,57 0,64 - 0,31 - 0,08 0,65 0,65 0,65 0,68 - 0,44 - 0,51 - 0,76 - 0,75 0,18 0,34 0,96 1,00 0,48 0,46 0,67 0,66 - 0,61 - 0,51 - 0,16 - 0,14 - 0,23 - 0,34 0,74 - 0,78 - 0,01 0,45 0,53 0,49 0,24 0,27 - 0,36 - 0,21 0,40 0,40 0,35 0,36 - 0,10 - 0,13 - 0,53 - 0,52 0,21 0,33 0,45 0,48 1,00 0,90 0,46 0,48 - 0,38 - 0,36 - 0,11 - 0,13 - 0,15 - 0,26 0,43 - 0,49 - 0,05 0,19 0,30 0,28 0,23 0,26 - 0,26 - 0,12 0,36 0,36 0,32 0,34 - 0,19 - 0,18 - 0,44 - 0,42 0,18 0,28 0,45 0,46 0,90 1,00 0,40 0,41 - 0,30 - 0,26 - 0,09 - 0,12 - 0,13 - 0,24 0,40 - 0,45 0,00 0,23 0,31 0,32 0,60 0,69 - 0,72 - 0,55 0,39 0,39 0,58 0,60 - 0,10 - 0,26 - 0,81 - 0,81 0,29 0,45 0,61 0,67 0,46 0,40 1,00 0,98 - 0,55 - 0,53 0,03 - 0,02 - 0,17 - 0,20 0,54 - 0,58 - 0,27 0,21 0,27 0,21 0,59 0,68 - 0,76 - 0,59 0,41 0,41 0,58 0,60 - 0,05 - 0,22 - 0,83 - 0,84 0,32 0,49 0,60 0,66 0,48 0,41 0,98 1,00 - 0,56 - 0,55 0,02 - 0,01 - 0,17 - 0,19 0,54 - 0,57 - 0,30 0,18 0,24 0,17 - 0,43 - 0,53 0,37 0,17 - 0,58 - 0,58 - 0,46 - 0,49 0,17 0,26 0,64 0,63 - 0,25 - 0,30 - 0,59 - 0,61 - 0,38 - 0,30 - 0,55 - 0,56 1,00 0,89 - 0,02 - 0,15 0,09 0,12 - 0,52 0,56 0,11 - 0,20 - 0,32 - 0,25 - 0,43 - 0,50 0,39 0,22 - 0,48 - 0,48 - 0,33 - 0,34 0,06 0,17 0,59 0,59 - 0,32 - 0,33 - 0,48 - 0,51 - 0,36 - 0,26 - 0,53 - 0,55 0,89 1,00 - 0,00 - 0,10 0,10 0,12 - 0,35 0,40 0,22 - 0,08 - 0,20 - 0,14 - 0,11 - 0,12 - 0,03 - 0,09 - 0,21 - 0,21 - 0,06 - 0,09 0,21 0,18 0,13 0,13 0,02 - 0,07 - 0,17 - 0,16 - 0,11 - 0,09 0,03 0,02 - 0,02 - 0,00 1,00 0,71 0,19 0,49 - 0,16 0,18 - 0,11 - 0,17 - 0,22 - 0,26 - 0,05 - 0,01 - 0,03 - 0,09 - 0,19 - 0,19 - 0,03 - 0,06 0,14 0,11 0,11 0,10 0,04 - 0,01 - 0,16 - 0,14 - 0,13 - 0,12 - 0,02 - 0,01 - 0,15 - 0,10 0,71 1,00 0,21 0,58 - 0,14 0,18 - 0,10 - 0,14 - 0,15 - 0,21 - 0,10 - 0,13 0,14 0,05 - 0,15 - 0,15 - 0,16 - 0,15 0,04 0,06 0,25 0,25 - 0,05 - 0,12 - 0,22 - 0,23 - 0,15 - 0,13 - 0,17 - 0,17 0,09 0,10 0,19 0,21 1,00 0,57 - 0,19 0,23 - 0,00 - 0,14 - 0,13 - 0,17 - 0,13 - 0,16 0,04 - 0,10 - 0,32 - 0,33 - 0,21 - 0,23 0,22 0,21 0,33 0,31 0,04 - 0,11 - 0,35 - 0,34 - 0,26 - 0,24 - 0,20 - 0,19 0,12 0,12 0,49 0,58 0,57 1,00 - 0,35 0,40 - 0,14 - 0,29 - 0,32 - 0,33 0,20 0,23 0,24 0,26 0,24 0,23 - 0,23 - 0,21 - 0,17 - 0,16 - 0,24 - 0,29 - 0,11 - 0,12 - 0,01 0,00 - 0,04 - 0,04 0,04 - 0,01 - 0,06 - 0,08 - 0,07 - 0,14 Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank), Centralna Komisja Egzaminacyjna (Central Examination Board), Państwowa Komisja Wyborcza (National Electoral Commission) and Centrum Systemów Informacyjnych Ochrony Zdrowia (Health Care Information Systems Centre) 90 pre-school participation rate of children aged 3-5 library m em bers per 1000 inhabitants share of households equipped w ith bathroom local governm ent election turnout num ber of inhabitants per 1 health care institution num ber of inhabitants per 1 physician share of population w ith higher education share of population w ith vocational or low er education average low er secondary school exam results (m athem atics and science) average low er secondary school exam results (hum anities) EDU_6_2007 share of em ploym ent in hazardous conditions EDU_5_2007 share of em ploym ent in agriculture EDU_4_2007 unem ploym ent rate EDU_4_2002 ow n revenue of local budgets per capita EDU_3_2007 population density EDU_3_2002 old-age dem ographic dependency ratio EDU_2_2002 EDU_3_2002 EDU_3_2007 EDU_4_2002 EDU_4_2007 fem inization rate EDU_1_2002 DEM_1_2002 DEM_1_2007 DEM_2_2002 DEM_2_2007 DEM_3_2002 DEM_3_2007 ECO_1_2002 ECO_1_2007 ECO_2_2004 ECO_2_2007 ECO_3_2003 ECO_3_2007 ECO_4_2003 ECO_4_2007 SOC_1_2002 SOC_1_2007 SOC_2_2002 SOC_2_2007 SOC_3_2002 SOC_3_2007 SOC_4_2002 SOC_4_2006 HEALTH_1_2002 HEALTH_1_2007 HEALTH_2_2002 HEALTH_2_2007 EDU_1_2002 EDU_2_2002 0,48 0,55 - 0,18 0,03 0,76 0,76 0,65 0,74 - 0,41 - 0,41 - 0,65 - 0,63 0,01 0,12 0,73 0,74 0,43 0,40 0,54 0,54 - 0,52 - 0,35 - 0,16 - 0,14 - 0,19 - 0,35 1,00 - 0,96 0,22 0,65 0,62 0,62 - 0,49 - 0,55 0,22 - 0,01 - 0,74 - 0,75 - 0,65 - 0,73 0,37 0,38 0,72 0,71 - 0,03 - 0,16 - 0,76 - 0,78 - 0,49 - 0,45 - 0,58 - 0,57 0,56 0,40 0,18 0,18 0,23 0,40 - 0,96 1,00 - 0,20 - 0,59 - 0,63 - 0,61 - 0,14 - 0,12 0,40 0,43 0,11 0,11 - 0,10 - 0,07 - 0,36 - 0,22 0,23 0,24 - 0,30 - 0,29 0,01 - 0,01 - 0,05 0,00 - 0,27 - 0,30 0,11 0,22 - 0,11 - 0,10 - 0,00 - 0,14 0,22 - 0,20 1,00 0,48 0,52 0,42 0,24 0,29 0,10 0,23 0,39 0,39 0,31 0,38 - 0,58 - 0,50 - 0,23 - 0,22 - 0,09 - 0,03 0,43 0,45 0,19 0,23 0,21 0,18 - 0,20 - 0,08 - 0,17 - 0,14 - 0,14 - 0,29 0,65 - 0,59 0,48 1,00 0,63 0,80 0,25 0,34 0,09 0,25 0,50 0,50 0,42 0,47 - 0,53 - 0,52 - 0,37 - 0,35 - 0,05 0,10 0,54 0,53 0,30 0,31 0,27 0,24 - 0,32 - 0,20 - 0,22 - 0,15 - 0,13 - 0,32 0,62 - 0,63 0,52 0,63 1,00 0,69 0,29 0,32 0,08 0,23 0,45 0,45 0,28 0,35 - 0,58 - 0,50 - 0,27 - 0,26 - 0,10 0,03 0,47 0,49 0,28 0,32 0,21 0,17 - 0,25 - 0,14 - 0,26 - 0,21 - 0,17 - 0,33 0,62 - 0,61 0,42 0,80 0,69 1,00 0,17 0,19 - 0,17 - 0,05 0,25 0,25 0,12 0,13 - 0,26 - 0,24 - 0,24 - 0,24 0,02 0,13 0,20 0,23 0,24 0,26 0,24 0,23 - 0,23 - 0,21 - 0,17 - 0,16 - 0,24 - 0,29 0,26 - 0,27 0,07 0,32 0,19 0,34 - 0,08 - 0,10 0,05 0,05 - 0,01 - 0,01 - 0,23 - 0,23 0,01 0,09 0,13 0,14 - 0,08 - 0,12 - 0,11 - 0,12 - 0,01 0,00 - 0,04 - 0,04 0,04 - 0,01 - 0,06 - 0,08 - 0,07 - 0,14 - 0,04 0,07 0,05 0,10 - 0,04 0,01 EDU_5_2007 upper secondary school matura exam results - Polish language (basic level) 0,26 - 0,27 0,07 0,32 0,19 0,34 1,00 0,23 EDU_6_2007 upper secondary school matura exam results - m athem atics (basic level) - 0,04 0,07 0,05 0,10 - 0,04 0,01 0,23 1,00 Source: Author’s calculations based on Bank Danych Regionalnych (Regional Data Bank), Centralna Komisja Egzaminacyjna (Central Examination Board), Państwowa Komisja Wyborcza (National Electoral Commission) and Centrum Systemów Informacyjnych Ochrony Zdrowia (Health Care Information Systems Centre) 91 References WHO (2008) Commission on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Geneva, World Health Organization, 2008 (http://www.who.int/social_determinants/resources/gkn_lee_al.pdf). Florey, Lia S., Sandro Galea and Mark L. Wilson, Macrosocial Determinants of Population Health in the Context of Globalisation, in: Sandro Galea (2007) Macrosocial determinants of population health, Springer Marmot, F.G, Richard G.Wilkinson (eds.), 2006, Social Determinants of Health, Oxford University Press McMurray, Anne (2006), Community Health and Wellness: A Socio-ecological Approach, Elsevier Blas, Erik and A.S. Kurup (eds), 2010, Equity, Social Determinants and Public Health Programmes, World Health Organisation Wallace, Barbara C. (ed.), 2008, Toward equity in health: a new global approach to health disparities, Springer Publishing Company Bartley M, J.Ferrie and S.M.Montgomery, 2006, Health and labour market disadvantage: unemployment, non-employment and job insecurity, in: Marmot, F.G, Richard G.Wilkinson (2006), Social Determinants of Health, Oxford University Press 92 Annex 2. Values of selected indicators by district 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 (TERYT: National Official Register of Territorial Division of the Country) 117 3. Differences in health status of the population across districts in Poland Bogdan Wojtyniak, Daniel Rabczenko, Jakub Stokwiszewski – National Institute of Public Health - National Institute of Hygiene Introduction Health status of the population across district units is rarely subject to analysis on a national scale. The main reason is a large number of units (379), and lack of good quality data collected within the framework of public statistics. Database with deaths of Polish population represents one of the few reliable sources of information pertaining to the health status of district residents. This chapter presents the assessment of discrepancies across districts in health status of their population availing mortality based indicators. Information on deaths and mortality based indicators is recognized as the best basis for characteristics of health status of a population because of the legal obligation to record each case of death, together with the cause of death. This requirement is also binding in Poland. Information about deaths of Polish inhabitants is gathered by the Central Statistical Office (CSO) by means of a Statistical Form to a Death Certificate (Pu - M67). The certificate is filled in by a physician or another person authorised to issue death certificates (i.e. hospital attendant /paramedic, midwife nurse). At the moment, almost all (99.6%) death certificates in Poland are filled in by physicians. A physician who fills in a death certificate specifies, among other things, the underlying, direct and secondary causes of death. However, he/she does not assign the ICD code of the cause of death. Coding is centrally conducted at the regional level by specially trained physicians (about four in each of the 16 regions), who verify and code an underlying cause of death in accordance with the 4-digit International Classification of Diseases (the ICD-10), introduced to Poland in 1997. The mortality database of the CSO makes it possible to calculate for each district different mortality based indicators, such as life expectancy, mortality rates by cause of death, infant mortality rates. In view of a relatively small number of deaths occurring in a district unit within a year, especially in smaller districts, it is necessary to examine health status of district population jointly for several consecutive years, and to analyse causes of death only for the most frequent, main groups of causes. Hereafter, we present the analysis of mortality across districts over a three-year period of 2006–2008 generated by all causes: cancer (ICD-10 C00-C97), cardiovascular diseases (ICD10 I00-I99), diseases of the respiratory system (ICD-10 J00-J99), diseases of the digestive system (ICD-10 K00-K93), symptoms, signs and ill-defined conditions (ICD-10 R00-R99), 118 and external causes of death (ICD-10 V01-Y98), as well as mortality generated by selected causes. Since the age structure of the population across district units is noticeably varied, it was necessary to calculate mortality rates standardized for age in order to eliminate the impact of those variations on the level of mortality across districts. Due to a small number of deaths in most of the districts, the so-called indirect standardization had to be carried out, where standardized mortality ratios (SMRs) for selected causes were calculated for each district unit, on the basis of death rates in 5-year age groups computed for entire Poland (standard rates). SMRs were calculated and mortality was analysed for the total population, those aged below 65 years (to be called premature mortality) and the elderly population of age 65 years and over. Once the value of SMR is multiplied by 100, one can obtain a percentage of excess mortality (when the ratio is higher than 100) in a given district unit versus average national mortality level, or a percentage of ‘deficit’ of mortality (if the ratio is less than 100), i.e. the percentage by which such mortality rate is lower than the national mortality level. We also computed crude death rate ratios to compare them with corresponding SMRs, since both are important to characterize health status of district population. Furthermore, we calculated district infant mortality rates for total (IMR), neonatal (0-27 days), and post-neonatal (28 days - below 1 year of age) age categories – IMR(0-27) and IMR(28+), respectively. Average life expectancy was also estimated for males and females in each district unit. Additionally, we calculated the same indicators for a three-year period of 2001–2003, therefore we could assess the change in the health of district residents. When calculating SMRs for the earlier period, we applied as a standard Polish age-specific mortality rates in those years. Thus, a difference in the SMRs in the two periods for a given district reveals relative (in relation to mortality level in the whole country) improvement or deterioration of health status in this district. However, we have not presented all indicators for 2001–2003 due to space constrains; yet, all these indicators are available from the authors upon request. 119 3.1. Overall mortality 3.1.1. Total population In the three-year period of 2006–2008, there were 1,126.3 thousands deaths in Poland, i.e. 984.8 per 100 000 population per year. Total number of deaths varied between about 600 in Bieszczadzki and Leski districts, inhabited by about 20 thousand people, and about 53 thousand in the city of Warsaw, with about 1,700 thousand permanent residents. Tables 1-3 in Annex 3 present standardized mortality ratios (SMRs) for the total population by gender in each of 379 districts in 2006–2008, and summary statistics of the SMRs are shown in Table 41. There is a noticeable difference in the overall mortality level across districts. For an inhabitant of the district where the health status is the worst (Ruda Śląska), the risk of death was 27% higher than in the case of an average inhabitant of Poland; and for an inhabitant living in the district where mortality is the lowest (Rzeszów), the risk of death was about 25% lower than the country average. Table 41. Age-standardized mortality ratio for overall mortality, total population, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 1.028 0.085 0.765 1.272 1.034 0.973 1.085 -0.005 -0.186 Females 1.019 0.083 0.800 1.306 1.022 0.960 1.077 0.124 0.168 Males 1.034 0.104 0.731 1.293 1.037 0.962 1.102 -0.315 -0.091 Four of the ten districts where mortality was the highest were located in Łódzkie region (rural districts: Poddębicki, Brzeziński, Kutnowski, Lęczycki) and three were located in Śląskie region (towns: Ruda Śląska, Siemianowice, Chorzów38). On the other hand, across the ten districts with the lowest mortality, eight were towns from various regions (Rzeszów, Sopot, Olsztyn, Białystok, Warszawa, Tarnobrzeg, Opole, Kielce). However, four of the ten districts belong to Podkarpackie region, including the towns of Rzeszów and Tarnobrzeg, as well as Leski and Mielecki districts. In each region there are districts where mortality was below the national average, and districts where it was above the average. However, in Podkarpackie as well as Małopolskie regions all districts but one demonstrated mortality below the national average, while in Lódzkie region all districts but one demonstrated mortality above the average. Ranking of districts by female and male mortality differs to a limited extent (Spearman correlation coefficients 0.66). However, in the territorial units with the highest overall 38 i.e. a municipal district. 120 SMR,as well as those with the lowest overall SMR, SMR of males and females were also respectively high and low. As presented in two maps (Fig.41 and Fig. 42), districts with low mortality are located mostly in the east and south-east of Poland, especially in the case of females. Most elevated mortality is observed in the west, north-west, and in particular areas of central Poland. Rankings of districts based on crude (real) death rate (CDR) and mortality adjusted for differences in the age structure are not exactly the same (Spearman correlation coefficients 0.52 - see Fig. 43). It means that there are districts where mortality is high due to older age of the population, however, when adjusted for that difference, population health status is better than the average (it could be mentioned that the highest overall crude mortality is in Hajnowski district - 46.4% above the national average - while age standardised mortality for this district is only 1.6% above the average). On the other hand, there are also districts where mortality is low, but when age structure is taken into account the risk of death is elevated, indicating rather poor health status of the population. Sztumski district, where crude mortality level is 10% lower than the national average, while the age-adjusted mortality is 20% above the country level, can serve as a good example. It suggests that both indicators must be taken into account when health care needs of the population are assessed, since a different approach is necessary as regards the former and the latter group of the districts. According to Fig. 44, correlation between district mortality level in the period 2006–2008 and the level observed five years earlier, in 2001–2003, is rather high (rho=0.85). It means that the districts where mortality was below average retained their good position, and those where mortality was higher usually have not improved their situation to an extent greater than other districts. 121 Fig. 41. Age-standardized mortality ratio (SMR) for overall mortality, males, 2006–2008 Fig. 42. Age-standardized mortality ratio (SMR) for overall mortality, females, 2006–2008 122 Fig. 43. Correlation between crude death rate ratio and age-standardized mortality ratio for overall mortality, total population, 2006–2008 Fig. 44. Correlation between age-standardized mortality ratios for overall mortality in 2001–2003 (03) and 2006–2008 (08), total population 123 3.1.2. Population below 65 years of age Deaths in the population aged 0–64 years are usually treated and named as premature. In Poland, in years 2006–2008, 30.1% of all deaths occurredin this age group, and crude death rate was 348/100 000 per year. Tables 4-6 in Annex 3 present standardized mortality ratios for the population of that age by gender in each district in 2006–2008; Table 42 shows SMR summary statistics. A difference in premature mortality level across districts is quite substantial. An inhabitant below 65 years of age living in a district where health status is the worst (the town of Chorzów) experienced risk of death 50% higher than the average. An inhabitant living in a district where mortality is the lowest (the town of Rzeszów) had a risk of death 32% lower than the country average. Table 42. Age-standardized mortality ratio for overall mortality, population aged 0–64 years, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 1.021 0.144 0.682 1.503 1.027 0.920 1.115 0.065 0.268 Females 0.983 0.162 0.580 1.540 0.983 0.863 1.089 0.366 0.373 Males 1.025 0.157 0.666 1.503 1.028 0.901 1.133 -0.051 0.325 Five of the ten districts where mortality was the highest belonged to Łódzkie region (Kutnowski, Poddębicki, Brzeziński districts, the city of Łódź, and Tomaszowski district), and four are from Śląskie region (towns: Chorzów, Świętochłowice, Ruda Śląska and Siemianowice). The only district located in neither of these two regions was Chełmski district fromLubelskie. On the other hand, seven of the ten districts where premature mortality was the lowest were from Podkarpackie region, two were from Opolskie, and one from Małopolskie. In all regions but one there were districts where premature mortality was below the national average and districts where it was above the average, and only in Podkarpackie region all districts had mortality lower than the mean national level. In Łódzkie region all the districts but two had premature mortality above Poland’s average. Rankings of districts according to mortality of males and females are not very similar (Spearman correlation coefficients 0.46). It is interesting to note that there were districts where male premature mortality was high, while female mortality was at the average level (Chełmski, Tomaszowski), or even much lower (Zwoleński, Makowski). On the other hand, in some districts only female premature mortality was elevated, while male mortality was below the average level (e.g. Kościerski, Grodziski, Górowski, Międzyrzecki, Starogardzki). As shown on the maps (Fig. 45 and Fig. 46), districts with low premature mortality were 124 mostly concentrated in southern and central-western Poland in the case of males, and in outhern and eastern Poland in the case of females. Rankings of districts according to crude premature mortality level (CDRR) and premature mortality adjusted for differences in age structure (SMR) are similar (Spearman correlation coefficient 0.90) (Fig. 47). It means that in most cases high or low premature mortality level in the districts was not a result of favourable or unfavourable population age structure, but was a consequence of high or low risk of death. Therefore, in most of the districts crude death rate may well represent the problem of premature mortality. Correlation between district mortality levels in 2006–2008 and five years earlier, between 2001 and 2003, is high (rho=0.86) (Fig. 48). It means that those districts where mortality was below the average retained their good position, and those where mortality was higher usually were not able to improve their situation to an extent greater than other districts. The most visible deterioration occurred in Poddębicki district in Łódzkie region, where mortality in 2001–2003 was 13% higher than the national average, and in 2006–2008 it was 43% higher. The most significant improvement occured in Strzyżowski district (in Podkarpackie region), where mortality in 2001–2003 was at the average national level, while in 2006–2008 it was 26% lower than the average. 125 Fig. 45. Age-standardized mortality ratio (SMR) for overall mortality, males aged 0–64 years, 2006–2008 Fig 46. Age-standardized mortality ratio (SMR) for overall mortality, females aged 0–64 years, 2006–2008 126 Fig. 47. Correlation between crude death rate ratio and age-standardized mortality ratio for overall mortality, population aged 0–64 years, 2006–2008 Fig. 48. Correlation between age-standardized mortality ratios for overall mortality in 2001–2003 (03) and 2006–2008 (08), population aged 0–64 years 127 3.1.3. Population aged 65 years and over People aged 65 years and over are considered as an elderly population, and about 70% of all deaths in Poland in 2006–2008 occurred in this age group, and the crude death rate was 5092/100 000 per year. Tables 7-9 in Annex 3 present standardized mortality ratios for the population of this age by sex in each district in 2006–2008, and Table 43 shows SMR summary statistics. A difference in mortality level of the elderly population between districts is smaller than in the case of premature mortality. For an inhabitant living in the district where health status is the worst (Sztumski district), the risk of death was 24% higher than for an average elderly (65+), and an inhabitant living in the district where mortality is the lowest (the town of Sopot) was exposed to the risk of death 22% lower than country average. Table 43. Age-standardized mortality ratio for overall mortality, population aged 65 years and over, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 1.034 0.076 0.776 1.241 1.033 0.989 1.083 0.351 -0.287 Females 1.026 0.079 0.804 1.241 1.025 0.974 1.075 0.078 0.062 Males 1.044 0.093 0.738 1.351 1.048 0.986 1.104 0.467 -0.086 Across ten districts where mortality was the highest, two were from Dolnośląskie region (Lwówecki and Złotoryjski), two from Wielkopolskie region (Międzychodzki and Śremski,) and each of the other six districts was located in a different region. On the other hand, across ten districts with the lowest mortality, as many as nine districts were towns, with two from Podkarpackie region, another two from Mazowieckie region, and the remaining five towns all located in different regions. In all regions but one there are districts where mortality of the elderly was below the national average and districts where it was above the average; only in Łódzkie region mortality was higher than Poland’s average in all the districts. Rankings of districts according to mortality of males and females are not the same (Spearman correlation coefficient 0.63). There are districts where mortality of elderly men was high, while female mortality was at the average level (Nowodworski, Kętrzyński, Kwidzyński). On the other hand, in some districts only female mortality was elevated, while male mortality was about the average level (e.g. Kościerski, Wolsztyński). Districts with low elderly mortality are located mostly in southern and the east-northern Poland (the maps - Fig. 49 and Fig. 50). However, even in these regions there are some districts where inhabitants from that age group were exposed to an increased risk of death when compared to country average level. 128 Rankings of districts according to crude mortality level of the elderly population (CDRR) and mortality adjusted for differences in age structure (SMR) do not differ much (Spearman correlation coefficient 0.76) (Fig. 51). It means that in many districts crude death rate will reasonable well reflect the problem of total mortality of the elderly population. Correlation between district mortality level in 2006–2008 and five years earlier, between 2001 and 2003, is rather high (rho=0.77) (Fig. 52). It means that changes in mortality of the elderly population in the districts during this five-year period were mostly similar. The districts where mortality was below the average retained their good position, and those where mortality was higher usually were not able to improve their situation to an extent greater than other districts. Correlation between district mortality level for all causes of younger (below 65 years) and older (65 years and over) population is only moderate (Spearman correlation coefficient 0.55). It suggests that in order to properly assess and address health needs of a district population it is necessary to look independently at the younger and the older population groups. 129 Fig. 49. Age-standardized mortality ratio (SMR) for overall mortality, males aged 65 years and over, 2006–2008 Fig. 50. Age-standardized mortality ratio (SMR) for overall mortality, females aged 65 years and over, 2006–2008 130 Fig. 52. Correlation between age-standardized mortality ratios for overall mortality in 2001–2003 (03) and 2006–2008 (08), population aged 65 years and over Fig. 51. Correlation between crude death rate ratio and age-standardized mortality ratio for overall mortality, population aged 65 years and over, 2006–2008 131 3.2. Mortality from cancer 3.2.1. Total population Total number of deaths caused by cancer accounted for 24.6% of all deaths in Poland in the period of 2006–2008, and crude death rate was 243/100 000 per year. Tables 1-3 in Annex 3 present standardized mortality ratios for cancer (ICD-10 C00-C97), for the total population, by sex, in each of 379 districts in 2006–2008, and SMR summary statistics are shown in Table 44. There is a noticeable difference in overall cancer mortality level across districts. For an inhabitant of the district where health status is the worst (Sztumski), the risk of death was 35% higher than in the case of an average inhabitant of Poland; and an inhabitant living in the district where mortality is the lowest (Krasnostawski), was exposed to the risk of death 28% lower than the country average. Table 44. Age-standardized mortality ratio for cancer, total population, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 1.008 0.119 0.717 1.348 1.003 0.920 1.098 -0.410 0.040 Females 0.980 0.144 0.591 1.419 0.980 0.875 1.095 -0.371 -0.034 Males 1.028 0.131 0.700 1.626 1.023 0.934 1.110 0.606 0.449 Six of the ten districts where mortality was the highest were from Pomorskie region (Sztumski, Nowodworski, Słupski, Kościerski, Lęborski, Pucki), and two from Śląskie region (towns: Siemianowice, Mysłowice). On the other hand, six of the ten districts where mortality was the lowest were from Lubelskie region (Krasnostawski, Bialski, Lubelski, Janowski, Opolski, and the town of Chełm), and two districts were from Mazowieckie region (Przysuski and Garwoliński). It should be pointed out that in two regions - Lubelskie and Podkarpackie in all the districts the risk of cancer death was below national average, and in Świętokrzyskie region all districts but one also demonstrated mortality level below national average. On the other hand, in Kujawsko-Pomorskie region mortality caused by cancer was above the average in all the districts. Correlation of district mortality of males and females is not very strong (Spearman correlation coefficient 0.59). However, in the districts with the highest overall mortality and in those with the lowest mortality SMRs of males and females were also high and low, respectively. Nevertheless, there are some districts where SMRs of males and females differ quite significantly. A good example is Sztumski district, where total cancer mortality is the highest. In this case, male risk of death is 63% higher than the national average, however, female risk of death is exactly at the average level. On the other hand, in the town of Koszalin female 132 mortality caused by cancer was 30% above the average, while male mortality was not elevated above the average. Districts with low mortality have a tendency to concentrate in eastern and the south-eastern Poland. In the west, north-west and in certain areas of central Poland mortality is usually elevated (Fig.53 and Fig. 54). Rankings of those districts according to crude mortality level (CDRR) and mortality adjusted for differences in age structure are not exactly the same (Spearman correlation coefficient 0.62) (Fig. 55). There are districts where mortality is high due to older age structure of the population, however, when adjusted for age, population health status is better than the average. For example, high crude mortality caused by cancer is observed in Hajnowski, Pińczowski, Sokołowski, Łosicki districts - about 40% above the national average - while age standardised mortality is below or only slightly above the average. On the other hand, there are districts where crude mortality is low, but when age structure is taken into account, the risk of death is elevated, indicating rather poor health of the population. In this case, good examples are Sztumski, Pszczyński, Grodziski and Wałecki districts. It demonstrates that both indicators must be taken into consideration when health care needs of the population regarding cancer prevention and treatment are assessed. As illustrated in Fig. 56, correlation between district mortality levels in 2006–2008 and the levels observed five years earlier, in 2001–2003, is more than moderate (rho=0.75). It means that change in mortality in the districts during this five-year period was rather similar, and those districts where mortality was below the average retained their good position, whereas those where mortality was higher usually have not improved their status in relation to country average to an extent greater than other districts. Yet, there are exceptions to this rule. For example, in Radziejowski, Chełmiński, Słubick, Człuchowski and Świecki districts, recent level of mortality is noticeably higher than the national level, while five years earlier it was below the average. In Sztumski district SMR in the period of 2001–2003 revealed only 9% excess of cancer deaths in comparison to average country level, while in the period of 2006– 2008 the excess was 35%. 133 Fig. 53. Age-standardized mortality ratio (SMR) for cancer, males, 2006–2008 Fig. 54. Age-standardized mortality ratio (SMR) for cancer, females, 2006–2008 134 Fig. 55. Correlation between crude death rate ratio and age-standardized mortality ratio for cancer, total population, 2006–2008 Fig. 56. Correlation between age-standardized mortality ratios for cancer in 2001–2003 (03) and 2006–2008 (08), total population 135 3.2.2. Population below 65 years of age In 2006–2008 more than one-third (36.6%) of all cancer deaths occurred in the population aged 0–64 years; they accounted for 29.4% of all premature deaths, and crude death rate was 103/100 000 per year. Thus, cancer is the most common cause of deaths in the younger population of Poland. Tables 4-6 in Annex 3 present standardized mortality ratios for the population from that age group, by sex, in each of 379 districts in 2006–2008, and SMR summary statistics are shown in Table 45. A difference in the level of premature mortality from cancer across districts is quite substantial. An inhabitant of that age group, living in a district where health status is the worst (Sierpecki), had the risk of death 47% higher than an average inhabitant of Poland. And for an inhabitant living in the districts where mortality is the lowest (Włoszczowski district and the town of Rzeszów), the risk of death was 30% lower than the country average. Table 45. Age-standardized mortality ratio for cancer, population aged 0–64 years, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 1.021 0.142 0.691 1.466 1.021 0.924 1.112 -0.022 0.186 Females 0.993 0.171 0.597 1.607 0.983 0.871 1.107 -0.102 0.272 Males 1.033 0.155 0.658 1.567 1.028 0.923 1.126 0.219 0.251 Ten districts where mortality was the highest were quite dispersed, they were located in seven regions. On the other hand, five of the ten districts where premature cancer mortality was the lowest were located in Lubelskie region (the town of Chełm as well as Krasnostawski, Puławski, Lubelski and Janowski districts), and three in Podkarpackie region (the town of Rzeszów and Kolbuszowski and Tarnobrzeski districts). In all the regions but two there are districts where premature cancer mortality was below country average, and those where it was above the average. The only exceptional regions in that regard were: Kujawsko-Pomorskie, where in all the districts mortality was elevated above the national average level, and Podkarpackie, where in all the districts mortality was lower than the mean national level. Ranking of districts according to premature cancer mortality of males and females is not highly correlated (Spearman correlation coefficient 0.50). Noticeably, there were districts where male premature mortality was high while female mortality was at the average level (e.g. Brodnicki, Płocki), or even substantially lower (e.g. Zwoleński, Pajęczański, Białobrzeski). On the other hand, in some districts only female premature mortality was elevated, while male mortality was below the average level (e.g. Gołdapski and the towns of 136 Jelenia Góra, Włocławek, Koszalin). Districts with low premature cancer mortality mostly concentrated in the east of Poland, especially in south-eastern part of the country, while the districts where mortality was elevated were located mostly in the north and in central-northern part of Poland (Fig.57 and Fig. 58). Rankings of districts according to crude premature mortality level (CDRR) and premature mortality adjusted for differences in age structure (SMR) are quite similar (Spearman correlation coefficient 0.84) (Fig. 59). It means that in most cases high or low premature mortality level in a district was not a result of favourable or unfavourable population age structure,but instead it was a consequence of a high or low risk of death. Correlation between district mortality levels in 2006–2008 and five years earlier, between 2001 and 2003, is rather moderate (rho=0.65) (Fig. 60). It means that changes in mortality in districts during this five-year period were not very similar. However, in most cases the districts where mortality was below the average retained their good position, and those where mortality was higher usually were not able to improve their status to an extent greater than other districts. The most significant deterioration was observed in the districts: StrzeleckoDrezdeński, Wąbrzeski, Kazimierski, Radziejowski and Słubicki, where in 2001–2003 mortality was at the national average, but in 2006–2008 it was 30-40% higher than the average. The largest positive change occurred in Kamieński and Bełchatowski districts, where in 2001–2003 mortality was 12% and 19% above the national average level, respectively, while in 2006–2008 it was, respectively, 24% and 12% lower than the average. 137 Fig. 57. Age-standardized mortality ratio (SMR) for cancer, males aged 0–64 years, 2006–2008 Fig. 58. Age-standardized mortality ratio (SMR) for cancer, females aged 0–64 years, 2006–2008, 138 Fig. 59. Correlation between crude death rate ratio and age-standardized mortality ratio for cancer, population aged 0–64 years, 2006–2008 Fig. 60. Correlation between age-standardized mortality ratios for cancer in 2001–2003 (03) and 2006–2008 (08), population aged 0–64 years 139 3.2.3. Population aged 65 years and over In 2006–2008, about 63% of all deaths due to cancer in Poland occurred in the age group of 65 years and above; they represented 22.5% of all deaths of the elderly population. Tables 7-9 in Annex 3 present standardized mortality ratios for the population from that age group, by sex, in each district in 2006–2008;SMR summary statistics are shown in Table 46. Variation in mortality of elderly population across districts is quite similar to premature mortality. An inhabitant living in the district where health status was the worst (Działdowski district) had the risk of death 40% higher than an average elderly inhabitant of Poland. For an inhabitant living in the district where mortality was the lowest (Przysuski), the risk of death was 37% lower than the country average. Table 46. Age-standardized mortality ratio for cancer, population aged 65 years and over, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 1.004 0.131 0.631 1.405 1.003 0.907 1.095 -0.272 0.097 Females 0.975 0.161 0.588 1.472 0.969 0.858 1.093 -0.278 0.104 Males 1.028 0.151 0.648 1.674 1.019 0.925 1.116 0.790 0.532 Five of the ten districts where mortality was the highest (Pucki, Nowodworski, Lęborski, Kościerski, Sztumski) were from Pomorskie region, and two were from Śląskie region (towns: Siemianowice and Mysłowice). On the other hand, six of the ten districts where mortality was the lowest were located in Lubelskie region (Krasnostawski, Bialski, Lubelski, Janowski, Opolski, Łukowski), and another two in Mazowieckie region (districts: Przysuski and Garwoliński). In all the regions but two there were districts where cancer mortality of the elderly was above the national average, and those where it was below the average;only in Lubelskie and Świętokrzyskie region there were no district with mortality above Polish average. On the other hand, in Pomorskie region in all the districts but one mortality of the elderly due to cancer was higher than the national average. District mortality levels of males and females are not highly correlated (Spearman correlation coefficient 0.52). There are districts where male cancer mortality was considerably higher (more than 30%) than the country average, while female mortality was at the average level or below (e.g. Sztumski, Mogileński, Sejneński, Wąbrzeski, Słubicki, Toruński). Interestingly, in the first of the above-mentioned districts the excess of male mortality over the national average was 67%, whereas female mortality was 9% lower than the average. On the other hand, in some districts only female mortality was elevated, while male mortality was about the average level (e.g. the towns of: Suwałki, Opole, Gorzów, Słupsk, Grudziądz). As shown 140 on the maps (Fig. 61 and Fig. 62), districts with low cancer mortality of elderly population typically concentrated in the south-east and the east Poland, with some areas in the west of the country, while the districts where mortality is elevated are located mostly in the northern and the central-northern part of Poland. Rankings of the districts according to crude mortality level of the elderly population (CDRR) and mortality adjusted for differences in age structure (SMR) are very similar (Spearman correlation coefficient 0.99) (Fig. 63). It means that district crude death rate accurately reflects the problem of cancer mortality of the elderly population. Correlation between districts cancer mortality level of the elderly population in 2006–2008 and five years earlier, between 2001 and 2003, is rather high (rho=0.69) (Fig. 64). It means that changes in mortality in the districts during this five-year period were not very diverse. In most cases, the districts where mortality was below the average retained their good position, and those where mortality was higher usually were not able to improve their status to the extent greater than other districts. Significant deterioration was observed in Chełmiński, Kościerski, Sztumski and Mogileński districts, where in 2001–2003 mortality was about the national average level, but in 2006–2008 it was 25-30% higher than the average. The most significant improvement was reported in the town of Świnoujście and in Kwidzyński district, where in 2001–2003 mortality was, respectively, 29% and 46% above the national average level, while in 2006–2008 it was equal to the average and only 16% above the average, respectively. Correlation between district mortality levels from cancer observed among the younger (below 65) and the older (65 and above) population is only moderate (Spearman correlation coefficient 0.52). 141 Fig. 61. Age-standardized mortality ratio (SMR) for cancer, males aged 65 years and over, 2006–2008 Fig. 62. Age-standardized mortality ratio (SMR) for cancer, females aged 65 years and over, 2006–2008 142 Fig. 63. Correlation between crude death rate ratio and standardized mortality ratio for cancer, population aged 65 years and over, 2006–2008 Fig. 64. Correlation between standardized mortality ratios for cancer in 2001–2003 (03) and 2006–2008 (08), population aged 65 years and over 143 3.3. Mortality from circulatory system diseases 3.3.1. Total population Deaths caused by cardiovascular diseases (CVD) (ICD-10 I00-I99) accounted for 45.5% of all deaths in Poland in 2006–2008, and the annual crude death rate was 448/100 000. Tables 1-3 in Annex 3 present standardized mortality ratios for CVD for the total population, by sex, in each district in 2006–2008, and SMR summary statistics are shown in Table 47. There is a noticeable variation in the overall CVD mortality level across districts, which is larger than in the case of cancer mortality. An inhabitant of the district where cardiovascular health status is the worst (Brzeziński) had a risk of death 44% higher than the national average. For an inhabitant living in the district where mortality is the lowest (the town of Olsztyn), the risk of death was 39% lower than the country level. Table 47. Age-standardized mortality ratio for cardiovascular diseases, total population, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 1.046 0.140 0.608 1.438 1.053 0.950 1.143 -0.038 -0.182 Females 1.042 0.144 0.639 1.461 1.046 0.949 1.139 -0.046 -0.192 Males 1.046 0.149 0.582 1.417 1.036 0.943 1.147 -0.191 0.034 Three of the ten districts with the highest mortality were located in Łódzkie region (Brzeziński, Wieruszowski, Łęczycki), and two in Śląskie region (Żywiecki and the town of Świętochłowice). On the other hand, among the ten districts where mortality was the lowest, there were nine towns or cities, four of which were located in Pomorskie region (Sopot, Gdynia, Gdańsk, Słupsk), and two in Podlaskie region (Białystok and Łomża). The other towns or cities were dispersed all over the country (Olsztyn, Zielona Góra, Warszawa and Leski district). In one region (Podlaskie), mortality from CVD was below the national average in all districts. District CVD mortality levels of males and females are quite strongly correlated (Spearman correlation coefficient 0.83). Districts with low mortality were concentrated in the northern and north-eastern Poland, while the districts where mortality was elevated demonstrated lower concentration (Fig. 65 and Fig. 66). Rankings of districts according to crude mortality level (CDRR) and mortality adjusted for differences in age structure are not exactly the same (Spearman correlation coefficient 0.68) (Fig. 67). It means that there are districts where mortality is high due to older age structure of the population, but after adjustment for differences in age, mortality is actually lower than the average. For example, high crude mortality caused by CVD was observed in Hajnowski and 144 Bielski districts and in the city of Łódź - about 30–40% above the national average - while age-standardised mortality rate was below the average. On the other hand, there were districts where crude mortality rate was low, but when age structure was taken into account, the risk of death was elevated, indicating rather poor health of the population. Sztumski, Pszczyński or Braniewski districts are good examples of that phenomenon. It demonstrates that both indicators must be taken into account when assessing health care needs of the population regarding CVD prevention and treatment. Correlation between district mortality level in 2006–2008 and the level observed five years earlier, in 2001–2003, is quite strong (rho=0.78) (Fig. 68). It means that change in mortality in the districts during this five-year period was quite similar, and the districts where mortality was below average retained their good position, whereas those where mortality was higher usually have not improved their situation in relation to country average to an extent greater than other districts. However, some exceptions must be noted; for example in Sulęciński, Braniewski, Skarżyski or Krośnieński districts recent level of mortality is noticeably higher than the average national level, while five years earlier it was below the average. 145 Fig. 65. Age-standardized mortality ratio (SMR) for cardiovascular diseases, males, 2006–2008 Fig. 66. Age-standardized mortality ratio (SMR) for cardiovascular diseases, females, 2006–2008 146 Fig. 67. Correlation between crude death rate ratio and standardized mortality ratio for cardiovascular diseases, total population, 2006–2008 Fig. 68. Correlation between age-standardized mortality ratios for cardiovascular diseases in 2001–2003 (03) and 2006–2008 (08), total population 147 3.3.2. Population below 65 years of age In 2006–2008, less than one-fifth (17.7%) of all CVD deaths occurred in the population aged 0–64 years. They accounted for 26.3% of all premature deaths, and the annual crude death rate was 91.6/100 000. Thus, CVD deaths in this age group were less common than deaths caused by cancer. Tables 4–6 in Annex 3 present standardized mortality ratios for the population of that age, by sex, in each district in 2006–2008; and SMR summary statistics are shown in Table 48. A difference in the level of premature mortality caused by CVD across districts is large. An inhabitant below 65 years of age living in the district where cardiovascular health status is the worst (the town of Świętochłowice), was exposed to the risk of death 77% higher than the average inhabitant of Poland; and for an inhabitant living in the district where mortality is the lowest (the town of Olsztyn), the risk of death was reduced by 47% when compared to the country average. Table 48. Age-standardized mortality ratio for cardiovascular disases, population aged 0–64 years, 2006– 2008, Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 1.033 0.203 0.531 1.772 1.012 0.886 1.145 0.340 0.553 Females 1.002 0.261 0.385 2.028 0.972 0.823 1.158 0.383 0.534 Males 1.029 0.207 0.539 1.703 1.002 0.877 1.145 0.225 0.595 Three of the ten districts where CVD premature mortality was the highest belong to Śląskie region (towns: Świętochłowice, Chorzów, Siemianowice), three to Łódzkie region (districts: Wieruszewski, Brzeziński, Łowicki), and two are located in Lubuskie region (districts: Żagański and Żarski). On the other hand, across the ten districts where premature CVD mortality was the lowest, three districts belong to Podlaskie region (towns: Białystok and Łomża, and Zambrowski district), two to Lubelskie region (town of Zamość, Biłgorajski district), and two to Podkarpackie region (Leski, Leżajski). In all the regions there are districts where premature CVD mortality was below the country average, and districts where it was above the average. However, in Podkarpackie region mortality in all the districts but one was lower than Poland’s average. Correlation between district male and female premature CVD mortality level is of medium strength (Spearman correlation coefficient 0.53). There are districts where male premature mortality was high while female mortality was below the average level (e.g. Suwalski, Tomaszowski, Wieluński, Szydłowiecki, town of Piekary Śląskie). In Łowicki district male mortality was 70% higher than the national level, while female mortality was elevated by only 9%. On the other hand, in some districts female premature mortality was increased, while 148 male mortality was below the average level (e.g. Gołdapski, Wołowski, GolubskoDobrzyński, Świecki). Districts with low female premature CVD mortality concentrated primarily in eastern Poland, especially in the south-eastern part of the country, while the districts where male mortality was low were more dispersed. However, they can also be found in the south-east of Poland (Fig. 69 and Fig. 70). Rankings of districts according to crude premature mortality level (CDRR) and premature mortality adjusted for differences in age structure (SMR) are very similar (Spearman correlation coefficient 0.91) (Fig. 71). It means that in most cases high or low premature CVD mortality in districts was not a result of favourable or unfavourable population age structure, but rather high or low risk of death. Correlation between district mortality level in 2006–2008 and five years earlier, in 2001– 2003, is rather moderate (rho=0.65) (Fig. 72). It indicates that changes in mortality in the districts during this five-year period were not very similar. However, in most cases the districts where mortality was below the average retained their good position, and those where mortality was higher usually were not able to improve their situation to an extent greater than other districts. The most significant deterioration was observed in Poddębicki and Skarżyski districts, where in 2001–2003 mortality was below the national average, but in 2006–2008 it was, respectively, 49% and 41% above the average. The most significant improvement took place in Włodawski district, where in 2001–2003 mortality was 44% above the national average level, while in 2006–2008 it was 14% lower than the average. 149 Fig. 69. Age-standardized mortality ratio (SMR) for cardiovascular diseases, males aged 0–64 years, 2006–2008 Fig. 70. Age-standardized mortality ratio (SMR) for cardiovascular diseases, females aged 0–64 years, 2006–2008 150 Fig. 71. Correlation between crude death rate ratio and age-standardized mortality ratio for cardiovascular diseases, population aged 0–64 years, 2006–2008 Fig. 72. Correlation between age-standardized mortality ratios for cardiovascular diseases in 2001–2003 (03) and 2006–2008 (08), population aged 0–64 years 151 3.3.3. Population aged 65 years and over About 82% of all CVD deaths in Poland in 2006–2008 occurred in the age group of 65 years and above; they represented 54.0% of all deaths of the elderly population; annual crude death rate was 2751/100 000. Tables 7–9 in Annex 3 present standardized mortality ratios for the population of that age, by sex, in each district in 2006–2008; SMR summary statistics are shown in Table 49. Variation in mortality of elderly population between districts is smaller than in the case of CVD premature mortality, however, it is of similar magnitude as cancer mortality of elderly population. An inhabitant living in the district where cardiovascular health status was the worst (Brzeziński) had a risk of death 41% higher than an average elderly inhabitant of Poland; and in the case of an inhabitant living in the district where mortality was the lowest (the town of Sopot), the risk of death was 39% lower than country average. Table 49. Age-standardized mortality ratio for cardiovascular diseases, population aged 65 years and over, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness 1.049 0.139 0.611 1.410 1.057 0.958 1.147 0.042 -0.282 All 1.045 0.145 0.623 1.435 1.050 0.946 1.145 -0.040 -0.242 Females 1.056 0.150 0.591 1.462 1.057 0.953 1.154 0.030 -0.051 Males Four of the ten districts where mortality was the highest belong to Łódzkie region (districts: Brzeziński, Łęczycki, Wieruszowski, Opoczyński), and the remaining ones are dispersed all over the country. On the other hand, among the ten districts where mortality was the lowest, there were three towns located in Pomorskie region (Sopot, Gdańsk, Gdynia), two towns in Podlaskie region (Białystok, Suwałki), the two districts from Podkarpackie region (Leski, Mielecki). In all the regions but one there were districts where CVD mortality of the elderly was above the national average, and districts where it was below the average; only in Podlaskie region there was no district with mortality above Polish average. On the other hand, in Łódzkie region all the districts but one exhibited higher CVD mortality of the elderly than the national average. Correlation of district male and female mortality rates is rather high (Spearman correlation coefficient 0.80). There is only one district where male CVD mortality was substantially higher (more than 20%) than the country average, while female mortality was below the average level (Sępoliński), and only in one district (Tarnobrzeski) the situation was reversed, i.e. female mortality was noticeably elevated (by 24%) while male mortality was at the 152 average level. Districts with low CVD mortality of elderly population were usually located in central and eastern part of northern Poland. Districts where mortality is elevated are more dispersed, but in the case of males and females some of those districts are concentrated in the central part of the east of the country (Fig. 73 and Fig. 74). Rankings of districts according to crude mortality level of the elderly population (CDRR) and mortality adjusted for differences in age structure (SMR) are very similar (Spearman correlation coefficient 0.88) (Fig. 75). It means that district CVD crude death rates quite accurately reflect the differences between districts in terms of life threat posed by CVD in the population of this age. Correlation between district CVD mortality level of the elderly population in2006–2008 and five years earlier, in 2001–2003, is rather strong (rho=0.78) (Fig. 76). It means that changes in mortality in the districts during this five-year period did not differ very much. In most cases, the districts where mortality was below the average retained their good position, and those where mortality was higher usually were not able to improve their status to an extent greater than other districts. Significant deterioration was noted in Sulęciński and Olecki districts, where in 2001–2003 mortality was below the national average, but in 2006–2008 it was about 20% higher than the country level. The largest relative improvement was observed in the Ostrzeszowskiski district, where 2001–2003 mortality was 57% above the national average level, while in 2006–2008 it was 29% below the average. Correlation between district CVD mortality of younger (below 65 years) and older (65 years and over) population is rather moderate (Spearman correlation coefficients 0.60). 153 Fig. 73. Age-standardized mortality ratio (SMR for cardiovascular diseases, males aged 65 years and over, 2006–2008 Fig. 74. Age-standardized mortality ratio (SMR for cardiovascular diseases, females aged 65 years and over, 2006–2008 154 Fig. 75. Correlation between crude death rate ratio and age-standardized mortality ratio for cardiovascular diseases, population aged 65 years and over, 2006–2008 Fig. 76. Correlation between age-standardized mortality ratios for cardiovascular diseases in 2001–2003 (03) and 2006–2008 (08), population aged 65 years and over 155 3.4. Mortality from diseases of the respiratory system 3.4.1. Total population Deaths caused by diseases of the respiratory system (ICD-10 J00-J99) accounted for 5.1% of all deaths in Poland in 2006–2008, and the annual crude death rate was 50.0/100 000. Tables 1–3 in Annex 3 present standardized mortality ratios due to respiratory diseases for the total population, by sex, in each district in 2006–2008; SMRs summary statistics are shown in Table 50. There is noticeable variation in the level of mortality from respiratory diseases across districts, larger than in the case of cancer and CVD mortality. An inhabitant of the district with the worst respiratory health status (Nidzicki) was exposed to the risk of death 2.6 times higher than the national average; and for an inhabitant living in the district where mortality is the lowest (Niżański), the risk of death was 65% lower than the country level. Table 50. Age-standardized mortality ratio for diseases of the respiratory system, total population, 2006– 2008, descriptive statistics Skewness Population Mean SD Min Max Median Q1 Q3 Kurtosis All 1.018 0.305 0.350 2.616 1.000 0.816 1.181 1.749 0.814 Females 0.970 0.361 0.281 2.732 0.923 0.719 1.184 1.373 0.781 Males 1.048 0.311 0.391 2.545 1.021 0.831 1.238 1.243 0.732 Eight of the ten districts where mortality was the highest were from Warmińsko-Mazurskie region (Nidzicki, Olsztyński, Węgorzewski, Bartoszycki, Szczycieński, Elbląski, Kętrzyński, Giżycki). On the other hand, across the ten districts where mortality was the lowest, five were from the Podkarpackie region (Niżański, Jarosławski, Dębicki, Ropczycko-Sędziszowski and the town of Tarnobrzeg), and the remaining ones were dispersed all over the country. In one region (Warmińsko-Mazurskie) mortality caused by respiratory diseases was higher than the national average in all the districts. On the other hand, in Opolskie region mortality in all the districts but one was below the average. Rankings of districts according to respiratory mortality of males and females is similar to a certain extent (Spearman correlation coefficient 0.65). Districts with high mortality were usually located in the north-east of Poland, while the districts where mortality was low were dispersed throughout the rest of the country, with larger number observed in the south-east of Poland(Fig. 77 and Fig. 78). Rankings of districts according to crude mortality level (CDRR) and mortality adjusted for differences in age structure (SMR) are quite similar (Spearman correlation coefficient 0.88). It means that district’s crude death rate quite accurately reflects the problems of mortality 156 caused by respiratory diseases of the population. It may be pointed out that in Nidzicki district both indicators were more than twice as high as Poland’s average. Correlation between district mortality levels from the period of 2006–2008 and five years earlier, between 2001 and2003, is moderate (rho=0.67) (Fig. 80), which means that changes in mortality in the districts during this five-year period varied to some extent. However, in most cases the districts where mortality was below average retained such relatively low level, and those where mortality was higher usually were not able to improve their situation to an extent greater than other districts. Significant deterioration occurred, for example, in Łęczyński district and in the town of Elbląg, where mortality in 2001–2003 was below the average, and five years later it was about 50% higher than the country level. On the other hand, in Świebodziński and Sulęciński districts in 2001–2003 mortality caused by respiratory diseases was more than 60% above the average, whereas in 2006–2008 it was elevated above the average by less than 10%. Mortality in Nidzicki district is consistently the highest in analysed period – about 2.6 times above the average country level in 2006-2008 as well as five years earlier. 157 Fig. 77. Age-standardized mortality ratio (SMR) for respiratory system diseases, males, 2006–2008 Fig. 78. Age-standardized mortality ratio (SMR) for respiratory system diseases, females, 2006–2008 158 Fig. 79. Correlation between crude death rate ratio and standardized mortality ratio for respiratory system diseases, total population, 2006–2008 Fig. 80. Correlation between standardized mortality ratios for respiratory system diseases in 2001–2003 (03) and 2006–2008 (08), total population 159 3.4.2. Population below 65 years of age In 2006–2008, 18.8% of all deaths caused by respiratory diseases occurred in the age group below 65 years, they accounted for 3.1% of all premature deaths, and the annual crude death rate was 10.9/100 000. Tables 4–6 in Annex 3 present standardized mortality ratios for the population of that age, by sex, in each district in 2006–2008; SMR summary statistics are presented in Table 51. A difference in the level of premature mortality from respiratory diseases across districts is very large. A person under 65 years living in the district where the respiratory health status is the worst (Węgorzewski) had a risk of death 2.7 times higher than an average Polish inhabitant. For a person living in the district with the lowest mortality (Przeworski), the risk of death was 80% lower than the country average. Table 51. Age-standardized mortality ratio for respiratory system diseases, population aged 0–64 years, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All Females Males 1.003 0.979 1.002 0.379 0.579 0.394 0.201 0.000 0.186 2.703 3.655 2.959 0.974 0.900 0.975 0.739 0.566 0.699 1.221 1.258 1.238 1.122 1.596 1.505 0.787 0.969 0.800 Six of the ten districts where premature mortality generated by respiratory diseases was the highest belong to Warmińsko-Mazurskie region (Węgorzewski, Nidzicki, Giżycki, Elbląski, Bartoszycki, Kętrzyński), and three are the towns in Śląskie region (Siemianowice, Chorzów, Świętochłowice). On the other hand, of the ten districts where premature respiratory diseases mortality was the lowest, as many as five districts belong to Podkarpackie region (Przeworski, town of Tarnobrzeg, Niżański, Stalowolski, Strzyżowski), while the other five are dispersed all over the country. In all the regions there are districts where premature mortality due to respiratory diseases was below country average, and the districts where it was above the average. Yet, in Podkarpackie region mortality in all the districts but one was lower than Poland’s average, while in Warmińsko-Mazurskie region mortality level was above country average in all the districts but one. Correlation between male and female district mortality rates is rather low (Spearman correlation coefficient 0.37). It could partly be explained by a small number of female deaths and the presence of districts where there were no female deaths at all. Therefore, those differences between males and females should be interpreted with caution. It may be emphasised that in most of the districts where mortality was high, rates were elevated for 160 males as well as females, and in those where mortality was low, it was reduced for both sex groups (Fig. 81 and Fig. 82). Districts with low premature mortality caused by respiratory diseases usually concentrated in western and south-eastern parts of Poland, for men and women alike. However, the former location applies more often to men than women, while the reverse is true for the latter location. The districts where mortality was elevated concentrate primarily in the north of Poland, especially in its central and eastern part. Rankings of districts according to crude premature mortality level (CDRR) and premature mortality adjusted for differences in age structure (SMR) are almost the same (Spearman correlation coefficient 0.98) (Fig. 83). It means that in most cases high or low level of premature mortality caused by respiratory diseases in the district did not result from a favourable or unfavourable population age structure, but was a result of high or low risk of death. Correlation between district mortality levels in 2006–2008 and five years earlier, in 2001– 2003, is rather weak (rho=0.37) (Fig. 84). It means that changes in mortality in the districts during this five-year period were quite different. There are many districts where the difference between district level of mortality and the national average has increased, and many where the difference has declined. However, there is also a number of districts where mortality was above the average in both periods. The most striking example is Węgorzewski district, where mortality in 2001–2003 was 3.6 times higher than the Polish average level, and in 2006–2008 it was still 2.7 times higher. 161 Fig. 81. Age-standardized mortality ratio (SMR) for respiratory system diseases, males aged 0–64 years, 2006–2008 Fig. 82. Age-standardized mortality ratio (SMR) for respiratory system diseases, females aged 0–64 years, 2006–2008 162 Fig. 83. Correlation between crude death rate ratio and standardized mortality ratio for respiratory system diseases, population aged 0–64 years, 2006–2008 Fig. 84. Correlation between standardized mortality ratios for respiratory system diseases in 2001–2003 (03) and 2006–2008 (08), population aged 0–64 years 163 3.4.3. Population aged 65 years and over About 81% of all deaths from respiratory diseases in Poland in 2006–2008 occurred in the age group of 65 years and over; they represented 5.9% of all deaths of the elderly population, and the annual crude death rate was 302/100 000. It means that respiratory diseases are the third main cause of deaths (after CVD and cancer) in this age group. Tables 7-9 in Annex 3 present standardized mortality ratios for the population of that age, by sex, in each district in 2006– 2008, and SMR summary statistics are shown in Table 52. Variation in mortality of the elderly population across districts is slightly less pronounced than in the case of premature mortality. An inhabitant living in the district where respiratory health status is the worst (Nidzicki) was exposed to the risk of death 2.7 times higher than the average for elderly inhabitants of Poland. For an inhabitant living in the district where mortality is the lowest (Niżański), the risk of death was 65% lower than the country average. Table 52. Age-standardized mortality ratio for respiratory system diseases, population aged 65 years and over, 2006–2008, descriptive statistics Population Mean All Females Males 1.021 0.967 1.062 SD Min Max 0.321 0.346 2.707 0.374 0.230 2.700 0.335 0.321 2.736 Median Q1 Q3 Kurtosis Skewness 0.980 0.928 1.027 0.793 0.712 0.822 1.202 1.191 1.247 1.702 0.980 1.549 0.805 0.680 0.795 Five of the ten districts where mortality was the highest belong to the Warmińsko-Mazurskie region (Nidzicki, Olsztyński, Szczycieński, Bartoszycki, Elbląski), and two are from Mazowieckie region (town of Ostrołęka and Ciechanowski district). On the other hand, across the ten districts where mortality was the lowest five are located in Podkarpackie region (Niżański, Jarosławski, Dębicki and the towns: Tarnobrzeg and Przemyśl), and two towns are located in Śląskie region (Bielsko-Biała, Świętochłowice). In all the regions but one there are districts where mortality of the elderly due to respiratory diseases was above the national average, and districts where it was below the average, and only in Warmińsko-Mazurskie region there was no district where mortality was below Polish average. On the other hand, in Opolskie region respiratory mortality of the elderly was lower than the national average in all the districts but one. Correlation between district mortality level of males and females is rather moderate (Spearman correlation coefficient 0.62). Analogically to the case of premature mortality, differences in male and female rates have to be treated with some caution due to rather small number of female deaths in many districts. Districts with low mortality caused by respiratory 164 diseases were mostly concentrated in western and the south-eastern parts of Poland, for men and women alike. However, the former location is more visible in the case of male rather than female mortality, while the reverse is true for the latter area. Districts with elevated mortality are concentrated primarily in the north of Poland, especially in its central andeastern part (Fig. 85 and Fig. 86). Rankings of districts according to crude mortality level of the elderly population (CDRR) and mortality adjusted for differences in age structure (SMR) are almost the same (Spearman correlation coefficient 0.98) (Fig. 87). It means that district’s crude death rate reflects quite accurately the problem of mortality of the elderly due to respiratory diseases. Correlation between district respiratory mortality levels of the elderly population in 2006– 2008 and five years earlier, in 2001–2003, is rather moderate (rho=0.66) (Fig. 88). It means that changes in mortality in the districts during this five-year period were not very similar. There are many districts where the difference between district mortality and the national average has increased, and many where the difference has declined. However, there is also a number of districts where mortality was above the average in both periods. The most noticeable example is Nidzicki district, where in 2001–2003 mortality was three times higher than the average Polish level, and in 2006–2008 it was still 2.7 times higher. There are also other districts in Warmińsko-Mazurskie region where mortality was elevated in both periods, such as: Olsztyński, Bartoszycki, Piski, Węgorzewski. It means that excess mortality generated by respiratory diseases in that part of Poland is quite persistent. Correlation between respiratory mortality district levels of younger (below 65 years of age) and older (aged 65 years and over) population is rather moderate (Spearman correlation coefficient 0.62). 165 Fig. 85. Age-standardized mortality ratio (SMR) for respiratory system diseases in 2006–2008, males aged 65 years and over Fig. 86. Age-standardized mortality ratio (SMR for respiratory system diseases in 2006–2008, females aged 65 years and over 166 Fig. 87. Correlation between crude death rate ratio and age-standardized mortality ratio for respiratory system diseases, population aged 65 years and over, 2006–2008 Fig. 88. Correlation between age-standardized mortality ratios for respiratory system diseases in 2001–2003 (03) and 2006–2008 (08), population aged 65years and over 167 3.5. Mortality from diseases of the digestive system 3.5.1. Total population Deaths caused by diseases of the digestive system (ICD-10 K00-K92) accounted for 4.5% of all deaths in Poland in 2006–2008, and the annual crude death rate was 43.8/100 000. Tables 1-3 in Annex 3 present standardized mortality ratios for digestive system diseases for the total population, by sex, in each district in 2006–2008; and SMR summary statistics are shown in Table 53. There is noticeable variation in the level of mortality from digestive system diseases across districts. An inhabitant of the district where health status is the worst (the town of Chorzów) had a risk of death 1.95 times higher than the national average, and for an inhabitant living in the district with the lowest mortality (Nowomiejski) the risk of death was 52% lower than the country level. Table 53. Age-standardized mortality ratio for diseases of the digestive system, total population, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 0.959 0.228 0.481 1.949 0.933 0.813 1.072 2.134 1.053 Females 0.945 0.263 0.314 2.194 0.921 0.779 1.076 2.255 0.950 Males 0.966 0.255 0.329 2.074 0.947 0.787 1.101 1.366 0.866 Four of the ten districts where mortality was the lowest were from the Podkarpackie region (Kolbuszowski, Niżański, the town of Rzeszów, Dębicki), and two from the KujawskoPomorskie region (Radziejowski, Wąbrzeski). On the other hand, of the ten districts with the highest mortality, five were from Śląskie region (towns: Chorzów, Ruda Śląska, Siemianowice Śląskie, Świętochłowice and Mysłowice), two from Łódzkie region (the city of Łódź and Zgierski district), and two from Warmińsko-Mazurskie region (Bartoszycki, Lidzbarski). Mortality generated by digestive system diseases was below the national average in all the districts of Opolskie region and in all districts but one in Podkarpackie region. There was no region with mortality elevated above national average in all the districts. District mortality levels (SMRs) of males and females are only moderately correlated (Spearman correlation coefficient 0.53). Districts with high mortality are quite dispersed, with relatively small groupings in central and south-western Poland, while the districts where mortality is low are concentrated in the southeastern and central-northern Poland (Fig. 89 and Fig. 90). Rankings of the districts according to crude mortality level (CDRR) and mortality adjusted for differences in age structure (SMR) are quite similar (Spearman correlation coefficient 0.91) 168 (Fig. 91). It means that a district’s crude death rate quite accurately reflects the problems of population mortality due to respiratory diseases. It could be noted that there are few districts where CDRR is below one (indicating mortality lower than the national level) while SMR is above one (indicating mortality higher than the national level), or where the situation is opposite. However, in those districts where CDRR and SMR show different relation to the national level, absolute difference between indicators and average level is small. Correlation between district mortality levels in 2006–2008 and five years earlier, in 2001– 2003, is only moderate (rho=0.60) (Fig. 92). It means that changes in mortality in the districts during this five-year period were somewhat different. However, in most cases the districts where mortality was below average retained their relatively good position, and those where mortality was higher usually were not able to improve their situation to an extent greater than other districts. Mortality in the Silesian towns Chorzów, Ruda Śląska, Siemianowice Śląskie, Świętochłowice and Mysłowice and in Łódź city was very high in both the periods. It may be pointed out that deaths caused by digestive system diseases are rather rare, so differences of observed magnitude are not surprising. 169 Fig. 89. Age-standardized mortality ratio (SMR) for diseases of the digestive system, males, 2006–2008 Fig. 90. Age-standardized mortality ratio (SMR) for diseases of the digestive system, females, 2006–2008 170 Fig. 91. Correlation between crude death rate ratio and age-standardized mortality ratio for diseases of the digestive system, total population, 2006–2008 Fig. 92. Correlation between age-standardized mortality ratios for diseases of the digestive system in 2001–2003 (03) and 2006–2008 (08), total population 171 3.5.2. Population below 65 years of age In 2006–2008, almost half (48.0%) of all deaths caused by diseases of the digestive system occurred in the age group below 65 years of age; they accounted for 7.0% of all premature deaths; and the annual crude death rate was 24.3/100 000. In this age group digestive system diseases are responsible for more deaths than respiratory diseases. Tables 4-6 in Annex 3 present standardized mortality ratios for digestive system diseases for the population of that age, by sex, in each district in 2006–2008; and SMR summary statistics are shown in Table 54. Variation in the level of mortality caused by digestive system diseases across districts is higher than in total population. An inhabitants of the district where the situation is the worst (the town of Chorzów) had a risk of death 2.3 times higher than the national average; whereas for an inhabitant living in the district where mortality is the lowest (Nowomiejski), the risk of death was 76% lower than the country level. Table 54. Age-standardized mortality ratio for diseases of the digestive system, population aged 0–64 years, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 0.935 0.325 0.240 2.326 0.886 0.730 1.069 2.268 1.231 Females 0.879 0.458 0.000 2.893 0.810 0.561 1.094 1.953 1.134 Males 0.947 0.322 0.199 2.294 0.890 0.728 1.111 1.599 1.023 Five of the ten districts where digestive mortality was the highest are towns from Śląskie region (Chorzów, Ruda Śląska, Siemianowice Śląskie, Świętochłowice and Mysłowice), and three districts are located in Dolnośląskie region (Wałbrzyski, Złotoryjski, Dzierżoniowski). On the other hand, of the ten districts where mortality from digestive system diseases was the lowest, three districts belong to Podparpackie region (Bieszczadzki, Kolbuszowski, Ropczycko-Sędziszowski), and the others are dispersed throughout the country. Mortality caused by digestive system diseases was below national average in all the districts of Opolskie region and in all the districts of Podkarpackie region, except one. There was no region with mortality elevated above the national average in all the districts. Districts mortality due to digestive system diseases of males and females are correlated only moderately (Spearman correlation coefficient 0.54). For example, in Starogardzki and Słupski districts, SMRs for males are much below one (0.694 and 0.728, respectively), while for females they are high above one (1.49 and 1.51, respectively). Female mortality demonstrates higher regional variation than male mortality (Table 54). Districts with low male mortality are located mostly in south-eastern and the central-northern Poland, and those with low female mortality are concentrated in south-eastern Poland (Fig. 93 172 and Fig. 94). Regions with elevated mortality are more or less the same for males and females alike –Śląskie, Donośląskie and Łódzkie regions, and north-eastern Poland. Rankings of districts according to crude premature mortality level (CDRR) and premature mortality adjusted for differences in age structure (SMR) are almost the same (Spearman correlation coefficient 0.98) (Fig. 95). It means that, in most cases, high or low mortality level due to digestive system diseases in districts was not a result of favourable or unfavourable population age structure, but rather a consequence of high or low risk of death. Correlation between district mortality levels in 2006–2008 and five years earlier, in2001– 2003, is only moderate (rho=0.59) (Fig. 96). It means that changes in mortality in the districts during this five-year period were not very similar. The most significant deterioration occurred in Dzierżoniowski district, where in 2001–2003 mortality was 24% below the national average, but in 2006–2008 it was 81% above it. However, in the towns of Chorzów, Świętochłowice, Ruda Śląska, Siemianowice Śląskie and Mysłowice (Śląskie region), and in the city of Łódź, where mortality was the highest in 2006–2008, it was also very high in 2001–2003. 173 Fig. 93. Age-standardized mortality ratio (SMR) for diseases of the digestive system, males aged 0–64 years, 2006–2008 Fig. 94. Age-standardized mortality ratio (SMR) for diseases of the digestive system, females aged 0–64 years, 2006–2008 174 Fig. 95. Correlation between crude death rate ratio and age-standardized mortality ratio for diseases of the digestive system, population aged 0–64 years, 2006–2008 Fig. 96. Correlation between age-standardized mortality ratios for diseases of the digestive system in 2001–2003 (03) and 2006–2008 (08), population aged 0–64 years 175 3.5.3. Population aged 65 years and over About half (52%) of all deaths from diseases of the digestive system in 2006–2008 occurred in the age group of 65 years and above; they represented 3.3% of all deaths of the elderly population; and the annual crude death rate was 170/100 000. It means that in the elderly population deaths caused by this group of diseases are less frequent than deaths from respiratory diseases. Tables 7-9 in Annex 3 present standardized mortality ratios for digestive system diseases for the population of that age, by sex, in each district in 2006–2008; and SMR summary statistics are shown in Table 55. Variation in elderly population mortality across districts is smaller than in the case of mortality of younger population. A person living in the district with the worst situation (Międzychodzki) was exposed to the risk of death 77% higher than an average elderly inhabitant of Poland; and for a person living in the district with the lowest mortality (Dębicki), the risk of death 51% lower than the country average. Table 55. Age-standardized mortality ratio for diseases of the digestive system, population aged 65 years and over, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 0.987 0.221 0.488 1.766 0.972 0.830 1.117 0.272 0.486 Females 0.972 0.256 0.237 1.895 0.951 0.798 1.116 0.905 0.516 Males 1.005 0.284 0.369 2.063 0.985 0.792 1.174 0.325 0.558 Five of the ten districts where mortality was the highest were from Śląskie region (Wodzisławski district and the towns: Siemianowice Śląskie, Chorzów, Ruda Śląska, Jastrzębie-Zdrój), and the others were dispersed all over the country. On the other hand, of the ten districts with the lowest mortality five were located in Podkarpackie region (Dębicki, Lubaczowski, Nizański, Kolbuszowski, and the town of Tarnobrzeg). In all the districts of Opolskie region mortality of elderly population from digestive system diseases is below the national average. There is no region where mortality in all districts is higher than the country level. Correlation between male and female mortality due to digestive system diseases is weak (Spearman correlation coefficient 0.36). Regional variation of mortality is high for both males and females, with some tendency of low mortality districts to concentrate in the south-east of Poland; and high mortality districts in the north-western and the central Poland and in Śląskie region (Fig. 97 and Fig. 98). Rankings of districts according to crude mortality level of the elderly population (CDRR) and mortality adjusted for differences in age structure (SMR) are almost the same (Spearman correlation 176 coefficient 0.98) (Fig. 99). It means that a district’s crude death rate accurately reflects problems of district’s elderly population mortality caused by digestive diseases. Correlation between district mortality of the elderly population due to digestive system diseases in 2006–2008 and five years earlier, between 2001 and 2003, is rather weak (rho=0.43) (Fig. 100). It means that the changes in mortality in the districts during this fiveyear period vary. However, in three towns from Śląskie region (Siemianowice, Chorzów, Ruda Śląska), where in 2006–2008 mortality was one of the highest in Poland, it was also the highest five years earlier. Correlation between district mortality levels due to digestive system diseases of the younger (under 65 years) and older (65 years and above) population is rather low (Spearman correlation coefficient 0.39). 177 Fig. 97. Age-standardized mortality ratio (SMR) for diseases of the digestive system, males aged 65 years and over, 2006–2008 Fig. 98. Age-standardized mortality ratio (SMR) for diseases of the digestive system, females aged 65 years and over, 2006–2008 178 Fig. 99. Correlation between crude death rate ratio and age-standardized mortality ratio for diseases of the digestive system, population aged 65 years and over, 2006–2008 Fig. 100. Correlation between age-standardized mortality ratios for diseases of the digestive system in 2001–2003 (03) and 2006–2008 (08), population aged 65 years and over 179 3.6. Mortality from ill-defined causes (symptoms, signs and abnormal clinical and laboratory findings) Deaths attributed to ill-defined causes such as symptoms, signs, abnormal findings, etc. (ICD10 R00-R99), without designation of any specific disease as the cause, accounted for 6.5% of all deaths in Poland in 2006–2008; and the annual crude death rate was 64/100 000. It means that they were more common as the cause of death than respiratory system or digestive system diseases. These ill-defined causes of deaths are an indicator of the quality of the system of classifying and coding causes of deaths, and do not provide useful information about health status of the population. Therefore, differences between districts are described briefly to point out the districts where the problem of poor quality of data is the most urgent. However, tables and figures present the data in the same way as in the case of specific causes of deaths. It should be underlined that in the districts where death rates for ill-defined conditions are high, other, specific causes of deaths are underestimated, which affects proper assessment of the volume of more exact health problems in those districts, and may distort district comparisons. There is a striking variation in the level of mortality due to ill-defined conditions across districts, much larger than in the case of mortality from specific causes (Table 56, Tables 1-3 in Annex 3). While in the district where the situation is the worst (Hrubieszowski), observed number of deaths was 3.2 times higher than expected, in the district where the situation is the best and mortality from these causes is the lowest (Żywiecki), observed number of deaths was 91% lower than expected on the basis of national prevalence. Table 56. Standardized mortality ratio for ill-defined causes of death, total population, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 0.989 0.447 0.089 3.231 0.899 0.682 1.232 1.739 1.043 Females 1.024 0.508 0.05 3.397 0.942 0.637 1.262 1.118 0.932 Males 0.961 0.491 0.1 3.064 0.829 0.622 1.199 1.362 1.131 Four of the ten districts where mortality was the highest were from Lubelskie region (Hrubieszowski, Zamojski, Biłgorajski, Chełmski), and the others were dispersed all over the country. On the other hand, of the ten districts where mortality was the lowest, as many as seven werelocated in Śląskie region (Żywiecki, Bielski, Pszczyński, Cieszyński, BieruńskoLędziński, towns: Bielsko-Biała and Żory), two districts are in Łódzkie region (Łowicki, Skierniewicki), and one in Dolnośląskie region (Oleśnicki). Interestingly, in the districts where mortality was the lowest, crude death rate was about 5 per 100 000 population; while in the districts where mortality was the highest, crude death rate was about 200 per 100 000. 180 Correlation between district mortality levels of males and females is only moderate (Spearman correlation coefficient 0.54). It suggests that the quality of coding of the causes of deaths in a district may differ depending on the sex of deceased. As shown on the maps (Fig. 101 and Fig. 102), the districts where female mortality was elevated were rather dispersed all over the country, while the districts where male mortality was high were usually concentrated in central-eastern part of Poland (Lubelskie region). It must be highlighted that those ill-defined causes of deaths are relatively more prevalent in the case of premature mortality than in the case of deaths of the elderly - they are assigned to 8.9% of deaths below 65 years and to 5.4% of deaths in the age group 65 years and over. 181 Fig. 101. Age-standardized mortality ratio (SMR) for ill-defined causes, males, 2006–2008 Fig. 102. Age-standardized mortality ratio (SMR) for ill-defined causes, females, 2006–2008 182 3.7. Mortality from external causes 3.7.1. Total population Deaths from external causes of mortality (ICD-10 V01-Y98) accounted for 6.7% of all deaths in Poland in 2006–2008, and the annual crude death rate was 65.8/100 000. Tables 1-3 in the Annex 3 present standardized mortality ratios for external causes for the total population, by sex, in each district in 2006–2008; and SMR summary statistics are presented in Table 57. Variation in mortality level across districts is noticeable. An inhabitant living in the district where health status was the worst (Poddębicki) had a risk of death 78% higher than the national average; and for a person living in the district where mortality was the lowest (the town of Lublin), the risk of death was 51% lower than the country level. Table 57. Standardized mortality ratio for external causes, total population, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 1.070 0.229 0.492 1.781 1.049 0.920 1.223 -0.114 0.341 Females 1.006 0.281 0.382 2.192 0.976 0.815 1.172 0.986 0.715 Males 1.080 0.252 0.440 1.764 1.055 0.900 1.248 -0.270 0.323 Five of the ten districts with the highest mortality (Poddębicki, Brzeziński, Piotrkówski, Łęczycki and Rawski) belong to Łódzkie region, and three (Lipski, Pułtuski and Płoński) to Mazowieckie region. On the other hand, of the ten districts where mortality was the lowest, three (the town of Lublin, Janowski, and Świdnicki) are from Lubelskie region, two from Podkarpackie region (towns: Rzeszów and Tarnobrzeg), and two (the town of Bydgoszcz and Wąbrzeski district) from Kujawsko-Pomorskie region. Mortality in Łódzkie region in all the districts except the city of Łódź and the town of Skierniewice was above the national average. District mortality for males and females is weakly correlated (Spearman correlation coefficient 0.32). Mortality in districts located in the south-east of Poland was (with few exceptions such as, for example, female mortality in Bieszczadzki district) lower than the national average, both for males and females (Fig. 103 and Fig. 104). Male and female mortality varies substantially in the districts located in the following regions: Wielkopolskie (low male and high female mortality), Warmińsko-Mazurskie and Podlaskie (low female and high male mortality). There is very high correlation between crude mortality (CDRR) level and mortality adjusted for age structure (SMR) - Spearman correlation coefficient is 0.98 (Fig. 105). Correlation between district mortality level in the period of 2006–2008 and the level observed five years earlier, between 2001 and 2003, is more than moderate (rho=0.74) (Fig. 106). It 183 means that the change in mortality in the districts during this five-year period was often quite similar: the districts where mortality was below average retained their good position, and those where mortality was higher usually have not changed their position in relation to the country average to an extent greater than other districts. 184 Fig. 103. Age-standardized mortality ratio (SMR) for external causes, males, 2006–2008 Fig. 104. Age-standardized mortality ratio (SMR) for external causes, females, 2006–2008 185 Fig. 105. Correlation between crude death rate ratio and standardized mortality ratio for external causes, total population, 2006–2008 Fig. 106. Correlation between standardized mortality ratios for external causes in 2001–2003 (03) and 2006–2008 (08), total population 186 3.7.2. Population below 65 years of age In 2006–2008, almost three-quarters (73.7%) of all deaths due to external causes occurred in the age group below 65, they accounted for as much as 16.1% of all premature deaths; and the annual crude death rate was 56.0/100 000. Tables 4-6 in Annex 3 present standardized mortality ratios for external causes, by sex, in each district in 2006–2008; and SMR summary statistics are shown in Table 58. A difference in the level of premature mortality due to external causes across districts is large and varies from more than 83% above the average (in Piotrkowski district), to 59% below the national average (the town of Lublin). Table 58. Standardized mortality ratio for external causes, population aged 0–64 years, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 1.089 0.271 0.412 1.832 1.063 0.884 1.271 -0.284 0.381 Females 1.019 0.335 0.174 2.412 0.972 0.792 1.211 0.886 0.665 Males 1.087 0.280 0.412 1.887 1.063 0.881 1.280 -0.241 0.423 Six of the ten districts where mortality was the highest (Piotrkowski, Łęczycki, Brzeziński, Rawski, Skierniewicki and Poddębicki) are from Łódzkie region. On the other hand, of the ten districts with the lowest mortality, three (the town of Lublin, Janowski and Świdnicki) belong to Lubelskie region, and another two (the town of Rzeszów and Mielecki district) are located in Podkarpackie region. In Łódzkie region in all the districts but one (the town of Skierniewice), and in Warmińsko-Mazurskie region in all the districts but two, (the towns of Olsztyn and Elbląg), mortality was higher than Poland’s average. Correlation between male and female mortality from external causes is rather weak (Spearman correlation coefficient 0.39). It means that high level of male mortality is not necessarily associated with high level of female mortality (eg. in Bieszczadzki district male mortality is 7%, while female mortality is 140% above the national average, while in Brzeziński district female mortality is equal to the national average, and male mortality is 88% higher than the average). There are regions where the relation of both male and female mortality to the national average is similar (the south-east and the north-west of Poland), as well as regions where mortality of males and females differs – as in the north-east of Poland (Fig. 107 and Fig. 108). Districts with increased male mortality tend to be concentrated in the central and the north-eastern parts of Poland, while in the case of females such districts are rather dispersed all over the country. 187 Rankings of districts according to crude mortality rates (CDRR) and mortality adjusted for differences in age structure (SMR) are very similar (Spearman correlation coefficients 0.99) (Fig. 109). It means that, in most cases, high or low level of mortality due to external causes in the districts was not a result of favourable or unfavourable population age structure, but was a consequence of high or low risk of death. Correlation between district mortality levels from the period of 2006–2008 and five years earlier, between 2001 and 2003, is quite strong (rho=0.79) (Fig. 110). It means that changes in mortality in the districts during this five-year period were similar. With that, one should note the relative deterioration of the situation in Bieszczadzki (SMR changed from 33% below the national average to 29% above the average) and Starogardzki districts (from 33% below the national average to 30% above the average). 188 Fig. 107. Age-standardized mortality ratio (SMR) for external causes, males aged 0–64 years, 2006–2008 Fig. 108. Age-standardized mortality ratio (SMR) for external causes, females aged 0–64 years, 2006–2008 189 Fig. 109. Correlation between crude death rate ratio and standardized mortality ratio for external causes, population aged 0–64 years, 2006–2008 Fig. 110. Correlation between standardized mortality ratios for external causes in 2001–2003 (03) and 2006–2008 (08), population aged 0–64 years 190 3.7.3. Population aged 65 years and over About one-fourth (26.3%) of all deaths due to external causes in 2006–2008 occurred in the age group of 65 years and above, they represented only 2.5% of all deaths of the elderly population, and the annual crude death rate was 129/100 000. Tables 7-9 in Annex 3 present standardized mortality ratios for the population of that age, by sex, in each district in 2006– 2008, and SMR summary statistics are shown in Table 59. Variation in mortality due to external causes across districts is large. A person living in the district where mortality was the highest (Wągrowiecki), had a risk of death 148% higher than the average for elderly inhabitants of Poland; and in the district where mortality was the lowest (GolubskoDobrzyński), the risk of death was 78% below the country average. Table 59. Standardized mortality ratio for external causes, population aged 65 years and over, 2006–2008, descriptive statistics Population Mean SD Min Max Median Q1 Q3 Kurtosis Skewness All 1.027 0.308 0.232 2.484 1.001 0.826 1.182 2.013 0.861 Females 0.994 0.416 0.088 2.846 0.945 0.735 1.197 1.932 1.019 Males 1.056 0.324 0.088 2.249 1.045 0.841 1.238 0.877 0.485 Eight of the ten districts where mortality was the highest were located in Wielkopolskie region (Wągrowiecki, Obornicki, Złotowski, Międzychodzki, Pleszewski, Nowotomyski, Gostyński, Rawicki). On the other hand, of the ten districts with the lowest mortality, six belong to Kujawsko-Pomorskie region (Golubsko-Dobrzyński, Bydgoski, Tucholski, Chełmiński, Wąbrzeski, the town of Bydgoszcz), and two to Warmińsko-Mazurskie region (Elbląski district and the town of Elbląg). In all the districts of Kujawsko-Pomorskie region and in all but one in Warmińsko-Mazurskie, mortality of the elderly due to external causes was below the national average. On the other hand, in Wielkopolskie region in all the districts but one mortality was higher than Poland’s average. Correlation between male and female mortality due to external causes is rather weak (Spearman correlation coefficient 0.34). It means that high level of male mortality is not necessarily associated with high level of female mortality (eg. in Leszczyński district male mortality is 15%, and female mortality 112%, above the national average, while in Łobeski district female mortality is 8% below the national average, and male mortality is 94% higher than the average). 191 Districts with high mortality of elderly population due to external causes are rather scattered all over the country in the case of male mortality, and tend to concentrate in central-western part of Poland in the case of female mortality (Fig. 111 and Fig. 112). It is noticeable that the districts with low female mortality are located mostly in northern and central-northern parts of the country. Rankings of districts according to crude mortality due to external causes among the elderly population (CDRR) and mortality adjusted for differences in age structure (SMR) are almost identical (Spearman correlation coefficient 0.99) (Fig. 113). It means that a district’s crude death rate reflects quite accurately mortality problems of the population of this age group. Correlation between mortality of the elderly population from external causes in 2006–2008 and five years earlier, between 2001 and 2003, is relatively weak (rho=0.42) (Fig. 114) indicating differences in temporal changes of districts mortality. However, as can be seen on the figure, there are districts with very high mortality in both periods - for example, Wągrowiecki (excess of mortality by 78% and 148% in the first and second period respectively) and Międzychodzki (excess by 112% and 92%). Correlation between district mortality levels for external causes of the younger (under 65 years) and older (65 years and above) population is low (Spearman correlation coefficient 0.24) indicating many “disagreements” in district’s risk of death for younger and elderly population. For example in districts Gostyński and Kościański mortality of the elderly population was about 75% above the country average while mortality of those below 65 years was 15% below the average. On the other hand in Bartoszycki and Hajnowski districts mortality of elderly was 15% lower than national level while mortality of younger population was some 70% higher than average for Poland. 192 Fig. 111. Age-standardized mortality ratio (SMR) for external causes, males aged 65 years and over, 2006–2008 Fig. 112. Age-standardized mortality ratio (SMR) for external causes, females aged 65 years and over, 2006–2008 193 Fig. 113. Correlation between crude death rate ratio and standardized mortality ratio for external causes, population aged 65 years and over, 2006–2008 Fig. 114. Correlation between standardized mortality ratios for external causes in 2001–2003 (03) and 2006–2008 (08), population aged 65 years and over 194 3.8. Infant mortality Infant mortality rate (IMR), and especially neonatal mortality, is considered as one of the key indicators of health care development and performance, even in developed countries. In Poland, there were 6 897 deaths of children below one year of age (infants), i.e. 5.86 per 1000 live birth per year in the three-year period of 2006–2008. The absolute number of infant deaths in districts varied between 2 in the town of Sopot, where mothers gave birth to 848 live born children, and about 252 in Warsaw city, where 52 250 children were born alive. Most of infant deaths (71.3%) occurred during the first four weeks of life (below 28 days), and only 28.7% occurred later but before the child’s 1st birthday. Table 10 of Annex 3 presents total infant mortality rates (IMR), rates in neonatal period IMR(0-27) and in the post neonatal period IMR(28+) in each of 379 districts from 2006–2008 and five years earlier from 2001–2003. The summary statistics of the IMRs are shown in Table 60. The interpretation of differences in IMR across districts and observed changes during the 5-year period should be cautious due to small number of deaths in many districts and possible large random variation. Table 60. Descriptive statistics of infant mortality rates (per 1000 live births) by age in districts Period 2001– 2003 2006– 2008 Indicator Mean SD Min Max Median Q1 Q3 Kurtosis Skewness IMR(0-27) 5.173 1.914 0.493 16.092 5.058 3.778 6.315 2.358 0.697 IMR(28+) 2.184 1.097 0 7.789 2.095 1.345 2.787 1.72 0.823 IMR 7.358 2.289 2.392 18.673 7.315 5.864 8.609 1.326 0.584 IMR(0-27) 4.173 1.48 0 8.929 4.071 3.155 5.183 0.078 0.282 IMR(28+) 1.721 0.99 0 4.862 1.603 1.04 2.258 0.404 0.688 IMR 5.894 1.788 1.951 12.542 5.753 4.659 7.08 0.184 0.418 There is a noticeable difference between districts in the overall infant mortality level. In nine districts more than ten infant deaths per 1000 live births were registered in years 2006–2008 and in the Zwoleński district, where mortality was the highest, IMR was 12.5. Three of the ten districts where IMR was the highest are located in the Dolnośląskie region (Strzeliński, Oławski, Trzebnicki), two in the Mazowieckie region (Zwoleński, Białobrzeski) and the other five are placed all over the country. On the other hand, in 17 districts IMR was even below 3 per 1000 live births and in the best the Prudnicki district (belonging to the Opolski region) it was only 1.95. Three of the ten districts where IMR was the lowest are from the Podlaski 195 region (Wysokomazowiecki, Augustowski, Sokólski), two are located in the Mazowiecki region (Sokołowski, Nowodworski) and the other five are dispersed over the country. In all regions there are districts where infant mortality was above the national average and districts where it was below the average (Fig.116). Such a dispersion was also observed five years earlier in years 2001–2003 (Fig. 115), however, districts where IMR was high or low very often differ - the correlation between IMR in 2001–2003 and in 2006–2008 is low (rho=0.163). Nevertheless, it is necessary to emphasise that there are more than a few districts where IMR was very high in the recent years and five years earlier as well, for instance: the districts Leski (10.4 and 12.2), Strzeliński (10.3 and 8.1), Oławski (10.1 and 8.5), Trzebnicki (10.1 and 13.0), the towns: Bytom (9.9 and 11.3), Rybnik (9.8 and 10.4), Katowice (9.3 and 12.0) and several others. In total, there are 52 districts where IMR in the both periods: 2001– 2003 and 2006–2008 was in the highest quartile. 196 Fig. 115. Infant mortality rate, 2001–2003 (per 1000 live births) Fig. 116. Infant mortality rate, 2006–2008 (per 1000 live births) 197 3.9. Life expectancy In Poland, in the period of 2006–2008 the average life expectancy of a new-born boy was 71.0 years, and of a new-born girl 79.8 years. It was about a year longer than five years earlier, in 2001–2003, when these values were 70.2 and 78.6 years for boys and girls, respectively. Table 11 in Annex 3 presents life expectancy values in each of 379 districts, in 2006–2008 and five years earlier, in 2001–2003, with summary statistics shown in Table 61. There is a noticeable variation in life expectancy of people living in different districts. Men in the district where health status is the worst (Kutnowski and Chełmski) could expect to live on average 66.5 years, i.e. 4.5 years less than an average male inhabitant in Poland. A man living in the district where mortality is the lowest (Rzeszów) could expect to live 75.3 years, i.e. 4.3 years longer than an average man in Poland, and 8.8 years longer than a man in the districts where life expectancy is the shortest. Five years earlier the shortest life could also be expected by a man in Chełmski district, and its length was the same as in 2006–2008, while life expectancy of a man living in the town of Sopot was 7.7 years longer (74.2 years). Thus, in recent years the disparity in male life expectancy slightly increased. In 63 districts there was no improvement in male life expectancy in the 5-year period between 2001–2003 and 2006– 2008, or life expectancy prospects deteriorated (in Poddębicki district even by two years). Table 61. Summary statistics of life expectancy at birth in districts by gender, 2001–2003 and 2006–2008 Sex Period Mean SD Min Max Median Q1 Q3 Kurtosis Skewness Males 2001–2003 69.9 1.3 66.5 74.2 69.9 69.1 70.8 0.0 0.2 2006–2008 70.6 1.5 66.5 75.3 70.5 69.6 71.7 -0.2 0.2 2001–2003 78.6 1.0 75.3 81.0 78.6 77.9 79.3 0.3 -0.2 2006–2008 79.7 1.0 76.3 82.5 79.8 78.9 80.5 -0.3 -0.1 Females Five of the ten districts where in 2006–2008 male life expectancy was the shortest were located in Łódzkie region (Kutnowski, Brzeziński, Poddębicki, Tomaszowski, and the city of Łódź), and the remaining five were dispersed throughout the country. On the other hand, of the ten districts where men could expect the longest life, eight are towns from different regions (Rzeszów, Opole, Sopot, Olsztyn, Warszawa, Gdynia, Kraków, Koszalin), and the remaining two districts belong to Podkarpackie and Opolskie regions (in addition to the towns of Rzeszów and Opole, Mielecki and Opolski districts as well). In all regions there were districts where male life expectancy was below the national average and districts where it was above the average, however, in Podkarpackie region in all the districts but one a man could 198 expect to live longer than an average male inhabitant of Poland. In contrast, in Łódzkie region in all the districts but one a man could expect to live shorter than the country average. In both periods of 2001–2003 and 2006–2008, the districts with the highest male life expectancy were concentrated in the south of Poland, as well as in central-northern and central-western parts of the country (Fig. 117 and Fig. 118). In the case of women, variation in life expectancy associated with the district of residence is much smaller than in the case of men. A woman in the districts where health status is the worst (towns of Siemianowice Śląskie and Ruda Śląska) could expect to live to the age of 76.3 and 76.5, respectively i.e. about three and a half years less than an average female in Poland. A woman living in a district where mortality is the lowest (Leski) could expect to live to the age of 82.5, i.e. 2.7 years longer than an average woman in Poland, and 6.2 years longer than a woman in the district with the shortest life expectancy. Five years earlier, in 2001– 2003, a woman who could expect the shortest life was living in Międzychodzki district (75.3 years), while life expectancy of those living in the town of Zamość was 5.7 years longer (81.0 years). Thus, in recent years the disparity between female and man life expectancy slightly increased. Only in 17 districts there was no improvement in female life expectancy over the 5year period between 2001–2003 and 2006–2008, or life expectancy deteriorated (in Kościerski district by 1.7 years). On the other hand, in 31 districts female life expectancy increased by 2.0-2.4 years. Of the ten districts where in 2006–2008 female life expectancy was the shortest, five were the towns from Śląskie region (Siemianowice Śląskie, Ruda Śląska, Chorzów, Świętochłowice, Mysłowice), and two were districts from Łódzkie region (Kutnoski and the city of Łódź). On the other hand, five of the ten districts where female life expectancy was the longest belonged to Podkarpackie region (Leski, Niżański, Ropczycko-Sędziszowski, towns of Rzeszów and Tarnobrzeg), and two districts were located in Lubelskie region (towns: Chełm and Zamość). Interestingly enough, in Podkarpackie and Podlaskie regions there are no districts where a woman could expect to live shorter than an average female inhabitant in Poland, whereas in Łódzkie region in all the districts but one women lived shorter than the country average. In both periods of 2001–2003 and 2006–2008, districts with the highest female life expectancy were located mostly in the east of Poland, while those with low life expectancy were prevailing in the western parts of the country (Fig. 119 and Fig. 120). 199 Fig. 117. Males life expectancy at birth, 2001–2003 Fig. 118. Males life expectancy at birth, 2006–2008 200 Fig. 119. Females life expectancy at birth, 2001–2003 Fig. 120. Females life expectancy at birth, 2006–2008 201 Summary There are substantial differences in mortality and, consequently, in life expectancy in districts in Poland. Most of the analysed mortality ratios in 2006–2008 have shown moderate correlation with the values reported five years earlier, in 2001–2003. It means that the change in mortality in the districts during this five-year period was rather similar, and the districts where mortality was below average retained their good position, and those where mortality was higher usually have not improved their situation in relation to the country average more than other districts. However, there are examples of districts where mortality indicators improved, and districts where they deteriorated. Correlation between district mortality indicators (SMRs) for younger (below 65 years of age) and older (65 years and above) population for all analysed causes was not very strong. It indicates that in order to properly assess and address health needs of a district population it could be necessary to look independently at the younger and older population groups. In several cases correlation between district crude death rates (CDR) and age-standardised mortality ratios has shown only average strength. It means that both indicators must be taken into account when health care needs of the population are assessed, since a different approach is necessary in the districts where CDR is high and SMR is not elevated, than in those where situation is reversed, or where both indicators are high. To summarize differences in mortality across districts in Poland, and especially to characterize mortality in the ten districts where total SMR was the highest, it is worth noting that such a high risk of death does not result from extremely high mortality caused by one particular group of diseases, although high mortality generated by cardiovascular diseases does play the most important role. The number of CVD deaths observed in those districts was higher than expected by 20 to 40 %. The situation in each of the ten districts where total mortality was the most elevated can be summarized as follows: 1. Ruda Śląska (town in Śląskie voivodship) – the second highest mortality across districts generated by digestive system diseases, very high mortality due to cancer and CVD, high mortality due to respiratory system diseases; 2. Poddębicki district (Łódzkie voivodship) – the highest mortality due to external causes, high mortality from CVD, respiratory diseases and ill-defined causes; 3. Siemianowice Śląskie (town in Śląskie voivodship) – very high mortality caused by cancer and digestive system diseases; high mortality due to CVD and respiratory diseases; 202 4. Chorzów (town in Śląskie voivodship) – the highest mortality from digestive system diseases, very high mortality from respiratory diseases, high mortality due to external causes, CVD and cancer; 5. Brzeziński district (Łódzkie voivodship) – the highest mortality across districts from CVD and the second highest due to external causes, very high mortality caused by digestive system diseases; 6. Lwówecki district (Dolnośląskie voivodship) – very high mortality from CVD, high mortality due to digestive system diseases and ill-defined causes; 7. Kutnowski district (Łódzkie voivodship) – high mortality from ill-defined causes, CVD and external causes; 8. Sztumski district (Pomorskie voivodship) – the highest mortality across districts generated by cancer, very high mortality caused by CVD; 9. Łęczycki district (Łódzkie voivodship) – very high mortality from CVD and external causes, elevated mortality due to respiratory diseases; 10. Sulęciński district (Lubuskie voivodship) – mortality from all analysed causes is increased, but in no case it is elevated to a very high level. It should be pointed out that among the districts with the highest mortality according to each analysed specific group of diseases, only few are included in the group of the ten districts with the highest overall mortality. Of the 20 districts with the highest cancer mortality, only two belong to that group, of the 20 districts with the highest CVD mortality – four, of those with the highest mortality due to respiratory diseases – none, mortality due to digestive system diseases – three, and with the highest external causes – also three. It may be noted that – with regard to improvement plans for the districts where population health status is really life-threatening - it would seem reasonable to select districts not only on the basis of overall mortality rate (or life expectancy), but also to take into account the risk of death from particular causes (groups of diseases): with such an approach, action steps can be more focused and more effective. 203 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Annex 3 Table 62. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, total population TERYT District bolesławiecki dzierżoniowski głogowski górowski jaworski jeleniogórski kamiennogórski kłodzki legnicki lubański lubiński lwówecki milicki oleśnicki oławski polkowicki strzeliński średzki świdnicki trzebnicki wałbrzyski wołowski wrocławski ząbkowicki zgorzelecki złotoryjski m. Jelenia Góra m. Legnica m. Wrocław 0201 0202 0203 0204 0205 0206 0207 0208 0209 0210 0211 0212 0213 0214 0215 0216 0217 0218 0219 0220 0221 0222 0223 0224 0225 0226 0261 0262 0264 Total 1.009 1.036 1.013 1.015 1.080 1.107 1.111 1.127 1.048 1.095 0.971 1.218 1.029 1.022 0.982 1.060 1.055 1.171 1.082 1.085 1.174 1.094 1.015 1.076 1.130 1.163 0.986 1.056 0.901 Cancer 1.122 1.021 1.054 1.079 1.070 1.104 1.003 1.107 1.060 0.992 1.080 1.049 0.993 1.036 1.035 1.109 1.116 1.110 1.155 1.166 1.148 1.127 1.001 1.048 1.133 1.195 1.057 1.153 0.964 CVD 1.010 1.077 1.054 1.139 1.142 1.094 1.085 1.234 1.113 1.309 0.970 1.273 1.208 1.163 1.026 1.095 1.232 1.291 1.131 1.198 1.196 1.245 1.095 1.148 1.211 1.220 0.921 0.999 0.934 aleksandrowski brodnicki bydgoski chełmiński golubsko-dobrzyński grudziądzki inowrocławski lipnowski mogileński nakielski radziejowski rypiński sępoleński świecki toruński tucholski wąbrzeski włocławski żniński m. Bydgoszcz m. Grudziądz m. Toruń 0401 0402 0403 0404 0405 0406 0407 0408 0409 0410 0411 0412 0413 0414 0415 0416 0417 0418 0419 0461 0462 0463 1.085 1.070 1.013 1.155 0.976 1.114 1.085 1.161 1.105 1.153 1.096 1.086 0.981 1.098 1.083 1.026 1.085 1.130 1.030 0.935 1.092 0.908 1.027 1.113 1.103 1.240 1.026 1.145 1.140 1.038 1.172 1.164 1.175 1.157 1.054 1.169 1.230 1.081 1.234 1.045 1.131 1.113 1.166 1.075 1.228 1.079 1.005 1.054 0.936 1.114 1.177 1.197 1.192 1.384 1.122 1.163 1.072 1.203 0.949 1.113 1.009 1.247 1.017 0.884 1.078 0.773 Page 204 Respiratory Digestive Ill-defined 0.866 0.880 0.615 0.961 1.291 1.100 0.882 1.233 0.713 0.818 0.794 0.809 1.035 1.259 0.700 1.168 1.438 0.803 1.131 1.179 2.041 1.168 1.113 0.862 1.034 0.987 1.141 0.829 0.815 0.800 0.832 1.134 0.758 1.158 1.371 1.533 0.529 0.834 0.869 0.909 1.010 0.357 0.547 0.929 1.154 0.826 0.904 1.033 0.493 0.789 0.744 0.970 1.256 1.052 0.761 1.196 1.044 0.802 0.866 0.818 1.168 1.476 1.488 0.832 1.039 0.816 0.863 1.104 0.813 0.945 1.178 1.043 1.017 1.146 0.846 1.230 1.413 0.787 0.995 1.223 1.012 0.787 1.416 1.460 0.638 1.057 1.003 0.745 1.248 1.480 1.204 1.399 1.056 1.333 1.499 0.912 0.913 1.652 1.021 1.117 1.002 1.458 1.336 1.225 1.206 1.019 1.045 1.065 1.115 0.891 0.902 0.944 0.978 0.678 0.716 1.248 0.835 0.801 0.837 0.599 0.689 0.790 0.902 0.877 0.719 0.578 0.846 0.762 0.892 0.945 1.011 0.873 1.198 0.806 1.580 1.029 1.224 0.427 1.201 1.029 0.608 0.847 0.626 0.548 0.763 1.113 0.693 1.144 0.606 1.128 1.033 0.960 1.141 External 1.117 0.964 0.925 0.973 1.306 1.094 0.860 1.115 0.924 0.923 1.038 1.190 0.934 1.073 1.072 1.163 0.986 1.165 1.137 1.101 1.071 0.817 1.063 0.981 1.213 1.273 0.988 0.943 0.702 1.018 0.863 0.789 0.945 0.858 1.220 0.971 1.307 0.956 0.943 0.964 1.072 0.887 1.035 1.215 0.870 0.644 1.362 0.939 0.603 0.946 0.721 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 TERYT District m. Włocławek 0464 Total 1.051 Cancer 1.102 CVD 1.030 bialski biłgorajski chełmski hrubieszowski janowski krasnostawski kraśnicki lubartowski lubelski łęczyński łukowski opolski parczewski puławski radzyński rycki świdnicki tomaszowski włodawski zamojski m. Biała Podlaska m. Chełm m. Lublin m. Zamość 0601 0602 0603 0604 0605 0606 0607 0608 0609 0610 0611 0612 0613 0614 0615 0616 0617 0618 0619 0620 0661 0662 0663 0664 1.117 0.982 1.188 1.053 1.043 1.078 1.000 1.076 1.060 1.085 1.040 1.074 1.040 0.963 1.088 1.027 0.978 0.999 1.160 1.037 0.944 0.932 0.926 0.854 0.743 0.785 0.837 0.834 0.748 0.717 0.842 0.919 0.746 0.804 0.816 0.754 0.909 0.864 0.849 0.865 0.833 0.797 0.862 0.813 0.820 0.774 0.887 0.802 1.280 0.956 1.223 0.868 1.184 1.163 1.158 1.171 1.225 1.134 1.164 1.263 1.117 0.921 1.126 1.158 1.030 1.059 1.284 0.932 0.959 0.982 0.911 0.791 0.657 0.919 0.948 0.850 1.004 1.338 0.826 0.789 0.818 1.560 0.707 0.783 0.862 0.665 0.935 0.689 0.445 0.537 0.636 0.853 0.732 0.682 0.822 0.725 0.849 0.589 1.031 0.851 0.823 0.929 0.781 0.903 0.990 0.846 0.672 0.871 0.893 0.922 1.026 0.855 0.793 0.887 1.047 0.710 0.717 1.043 0.971 0.781 1.346 2.308 2.098 3.231 1.700 1.664 0.882 1.256 1.282 1.675 1.527 1.192 1.415 1.958 1.538 1.206 1.972 1.438 1.533 2.506 1.246 1.250 1.500 1.260 1.483 0.747 1.441 1.148 0.588 0.960 0.861 1.084 0.889 0.902 0.931 0.978 0.861 0.792 1.300 0.907 0.648 1.197 1.249 1.251 0.967 0.880 0.492 0.811 gorzowski krośnieński międzyrzecki nowosolski słubicki strzelecko-drezdenecki sulęciński świebodziński zielonogórski żagański żarski wschowski m. Gorzów Wielkopolski m. Zielona Góra 0801 0802 0803 0804 0805 0806 0807 0808 0809 0810 0811 0812 0861 0862 1.034 1.120 1.099 1.018 1.168 1.083 1.188 1.079 1.050 1.115 1.131 1.068 0.939 0.895 1.015 0.974 1.022 0.969 1.202 1.161 1.069 0.921 1.020 1.048 1.034 1.025 0.986 0.964 0.992 1.174 1.074 0.981 1.136 0.977 1.196 1.161 0.944 1.287 1.320 0.989 0.790 0.711 0.842 1.365 1.222 0.775 1.210 1.078 1.085 1.013 0.803 0.707 0.694 0.595 0.822 0.697 0.846 0.916 1.053 1.171 1.257 0.916 1.114 1.043 0.970 1.027 0.990 0.873 0.805 0.900 1.572 0.873 1.678 0.908 1.122 1.812 1.119 1.135 1.955 0.458 0.814 1.404 1.974 1.866 1.175 1.107 0.955 1.104 1.161 1.174 1.283 0.888 1.084 1.119 1.111 1.009 0.664 0.807 bełchatowski kutnowski łaski łęczycki łowicki łódzki wschodni opoczyński pabianicki pajęczański piotrkowski poddębicki radomszczański rawski sieradzki skierniewicki tomaszowski 1001 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1012 1013 1014 1015 1016 1.039 1.217 1.066 1.192 1.076 1.143 1.091 1.101 1.018 1.154 1.241 1.096 1.018 1.037 1.024 1.133 0.999 1.142 0.916 1.009 0.981 0.969 0.858 0.948 0.989 0.853 1.106 0.924 0.913 1.019 0.966 0.973 1.082 1.236 1.115 1.373 1.290 1.183 1.291 1.071 1.018 1.274 1.245 1.171 0.994 1.070 1.103 1.140 1.123 0.920 1.035 1.309 1.062 1.199 0.916 1.073 1.101 1.108 1.220 1.058 1.397 1.236 0.964 1.135 1.162 1.163 1.144 1.129 1.059 1.367 1.038 1.373 0.862 1.223 0.989 0.826 1.114 1.030 0.976 1.247 0.899 1.729 1.023 0.438 0.251 1.095 0.618 1.334 1.089 0.918 1.425 1.540 0.790 0.612 0.327 1.322 1.160 1.286 1.348 1.630 1.005 1.234 1.412 1.377 1.037 1.655 1.781 1.206 1.600 1.282 1.536 1.241 Page 205 Respiratory Digestive Ill-defined 0.924 1.382 0.618 External 1.213 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District TERYT wieluński wieruszowski zduńskowolski zgierski brzeziński m. Łódź m. Piotrków Trybunalski m. Skierniewice 1017 1018 1019 1020 1021 1061 1062 1063 Total 1.059 1.137 1.101 1.126 1.225 1.134 1.080 0.990 Cancer 1.003 0.984 1.058 0.987 0.915 1.005 0.926 1.038 CVD 1.167 1.393 1.100 1.113 1.438 0.972 1.131 1.065 bocheński brzeski chrzanowski dąbrowski gorlicki krakowski limanowski miechowski myślenicki nowosądecki nowotarski olkuski oświęcimski proszowicki suski tarnowski tatrzański wadowicki wielicki m. Kraków m. Nowy Sącz m. Tarnów 1201 1202 1203 1204 1205 1206 1207 1208 1209 1210 1211 1212 1213 1214 1215 1216 1217 1218 1219 1261 1262 1263 0.960 0.955 0.988 0.915 0.926 0.968 0.947 1.020 0.980 0.940 0.898 0.945 0.936 0.996 1.000 0.919 0.985 0.961 0.960 0.860 0.863 0.919 0.880 0.761 0.977 0.914 0.811 0.963 0.921 0.941 0.935 0.893 0.861 0.907 1.018 0.914 1.010 0.892 0.992 0.971 0.932 0.955 0.954 0.969 1.047 1.166 1.022 0.977 1.066 1.061 0.989 1.086 1.113 0.980 0.983 0.950 0.975 1.030 1.093 0.989 1.041 1.070 1.088 0.868 0.835 0.969 1.057 0.777 1.105 0.803 0.893 0.913 1.284 1.014 0.748 1.034 0.778 1.086 1.140 1.714 0.930 0.988 0.763 0.878 0.636 0.720 0.736 0.852 0.771 0.738 0.994 0.616 0.889 0.780 0.549 0.836 1.088 0.842 0.647 0.768 0.876 0.609 0.677 0.678 0.966 0.780 0.849 0.850 0.833 0.846 0.957 0.905 0.961 1.128 0.716 0.726 0.811 0.528 0.502 1.045 0.869 1.027 0.560 0.480 0.815 1.041 0.664 0.595 0.628 0.733 0.993 0.803 0.855 0.775 0.950 0.673 0.692 0.900 1.026 1.491 1.055 0.906 0.836 0.920 0.723 1.375 1.008 0.779 1.076 0.929 0.934 0.724 0.613 0.760 białobrzeski ciechanowski garwoliński gostyniński grodziski grójecki kozienicki legionowski lipski łosicki makowski miński mławski nowodworski ostrołęcki ostrowski otwocki piaseczyński płocki płoński pruszkowski przasnyski przysuski pułtuski radomski 1401 1402 1403 1404 1405 1406 1407 1408 1409 1410 1411 1412 1413 1414 1415 1416 1417 1418 1419 1420 1421 1422 1423 1424 1425 1.093 1.071 1.003 1.071 1.018 1.100 0.966 0.931 1.021 0.999 1.051 1.044 1.092 1.123 1.055 0.991 0.937 0.962 1.121 1.127 0.890 1.175 1.002 1.083 1.044 0.882 1.115 0.776 1.050 1.125 0.971 0.917 0.999 0.814 0.889 0.987 0.973 1.186 1.222 0.966 0.880 0.913 0.962 1.082 1.027 1.012 1.059 0.736 1.116 0.951 1.133 1.005 1.121 0.966 1.013 1.208 0.972 0.890 1.078 1.047 1.090 1.070 1.057 1.061 1.045 1.054 0.923 0.945 1.063 1.166 0.849 1.251 1.157 1.064 1.080 0.891 1.682 0.918 1.278 1.174 1.150 1.019 1.295 1.102 1.087 1.063 1.417 1.312 1.231 1.633 0.966 0.739 1.164 1.425 1.005 0.953 1.223 1.121 1.207 1.090 1.041 1.014 0.998 0.746 0.908 1.027 0.756 0.938 0.958 1.037 0.641 0.957 0.999 1.108 0.645 0.956 1.035 1.040 0.861 1.044 0.976 0.847 0.816 0.672 0.763 1.475 0.441 0.897 2.052 0.828 0.720 0.920 0.715 0.990 0.703 0.599 0.579 0.894 0.785 0.936 0.902 1.251 0.761 1.579 0.938 0.633 0.998 0.666 0.998 1.238 1.463 1.462 1.343 1.101 1.044 1.414 1.337 1.080 1.665 1.340 1.554 1.481 1.298 1.555 1.367 1.297 1.047 1.087 1.232 1.606 0.946 1.491 1.255 1.660 1.294 Page 206 Respiratory Digestive Ill-defined 1.102 0.868 0.555 0.638 1.006 0.601 1.063 1.161 1.279 1.276 1.588 1.233 0.847 1.352 0.754 1.367 1.596 2.481 1.002 1.324 0.887 0.884 0.901 0.585 External 1.080 1.168 1.048 1.256 1.698 0.986 1.223 0.945 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District TERYT siedlecki sierpecki sochaczewski sokołowski szydłowiecki warszawski zachodni węgrowski wołomiński wyszkowski zwoleński żuromiński żyrardowski m. Ostrołęka m. Płock m. Radom m. Siedlce m. st. Warszawa 1426 1427 1428 1429 1430 1432 1433 1434 1435 1436 1437 1438 1461 1462 1463 1464 1465 Total 1.040 1.079 1.102 0.979 1.053 0.887 1.027 1.055 1.035 1.134 1.015 1.144 0.948 1.029 0.982 0.869 0.832 Cancer 0.881 1.174 1.064 0.870 0.861 0.957 0.880 1.003 0.894 0.943 1.174 1.139 0.976 1.156 0.953 0.895 0.956 CVD 1.057 1.053 1.186 1.044 1.135 0.838 1.034 1.028 1.036 1.125 1.041 1.114 0.795 0.874 0.918 0.903 0.715 brzeski głubczycki kędzierzyńsko-kozielski kluczborski krapkowicki namysłowski nyski oleski opolski prudnicki strzelecki m. Opole 1601 1602 1603 1604 1605 1606 1607 1608 1609 1610 1611 1661 1.006 1.109 0.926 1.029 0.961 1.019 1.008 0.948 0.877 1.059 0.948 0.844 0.968 1.128 0.925 0.995 0.834 1.102 1.023 0.960 0.885 0.995 0.820 0.969 0.985 1.281 0.980 1.161 1.090 0.955 1.145 1.115 0.948 1.221 1.178 0.839 0.764 0.820 0.755 0.762 0.990 1.101 0.889 0.471 0.960 0.908 0.816 0.944 0.856 0.868 0.815 0.838 0.775 0.690 0.704 0.682 0.660 0.733 0.780 0.775 1.792 0.535 1.060 0.762 0.690 1.574 0.537 0.748 0.592 0.801 0.476 0.583 1.005 1.104 0.766 1.055 0.827 1.133 1.008 0.827 0.795 0.960 0.720 0.677 bieszczadzki brzozowski dębicki jarosławski jasielski kolbuszowski krośnieński leżajski lubaczowski łańcucki mielecki niżański przemyski przeworski ropczycko-sędziszowski rzeszowski sanocki stalowowolski strzyżowski tarnobrzeski leski m. Krosno m. Przemyśl m. Rzeszów m. Tarnobrzeg 1801 1802 1803 1804 1805 1806 1807 1808 1809 1810 1811 1812 1813 1814 1815 1816 1817 1818 1819 1820 1821 1861 1862 1863 1864 1.024 0.942 0.906 0.991 0.949 0.885 0.910 0.923 0.976 0.916 0.847 0.931 0.975 0.947 0.921 0.915 0.884 0.956 0.938 0.930 0.847 0.859 0.975 0.765 0.835 0.938 0.939 0.968 0.891 0.909 0.780 0.862 0.855 0.898 0.818 0.899 0.854 0.850 0.838 0.839 0.821 0.840 0.920 0.892 0.811 0.994 0.940 0.978 0.836 0.864 1.042 0.925 1.050 1.189 0.987 1.039 0.861 0.987 1.109 1.059 0.763 1.072 1.031 1.089 1.133 1.075 0.866 1.080 0.923 1.113 0.710 0.771 1.024 0.810 0.938 1.294 1.126 0.493 0.451 0.735 0.832 0.897 0.598 0.782 0.575 1.050 0.350 0.518 0.758 0.508 0.716 0.831 0.620 0.823 0.567 0.893 0.656 0.540 0.531 0.396 0.824 0.698 0.606 0.715 0.985 0.514 0.661 0.703 0.616 0.816 0.653 0.557 0.914 0.633 0.671 0.671 0.804 0.784 0.664 0.746 0.903 0.902 1.028 0.577 0.683 0.956 1.341 0.425 1.030 1.387 0.406 1.520 1.176 0.774 0.630 1.019 1.275 1.723 0.815 0.419 0.663 1.155 0.823 1.723 0.399 1.083 1.219 1.142 0.523 0.424 1.126 0.793 0.763 0.896 0.781 0.968 0.860 0.942 0.991 0.989 0.733 0.845 0.973 0.903 0.958 0.831 0.859 0.758 0.797 0.847 0.934 0.754 0.759 0.642 0.620 augustowski 2001 0.962 0.983 0.875 0.859 1.073 1.274 1.181 Page 207 Respiratory Digestive Ill-defined 1.352 0.965 0.894 1.086 0.881 0.839 1.271 0.888 0.680 1.408 0.700 0.428 1.163 0.854 0.864 1.141 0.994 0.800 1.157 1.172 0.960 1.358 1.135 1.239 1.660 0.921 0.682 1.623 0.836 1.243 1.083 0.585 0.558 1.588 1.117 1.214 1.683 0.817 0.872 1.313 1.149 1.280 0.952 1.082 1.565 0.742 1.053 0.511 1.118 1.077 0.892 External 1.425 1.302 1.244 1.251 1.470 0.960 1.471 1.179 1.500 1.355 0.997 1.167 1.024 0.951 0.993 0.955 0.739 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 TERYT District białostocki bielski grajewski hajnowski kolneński łomżyński moniecki sejneński siemiatycki sokólski suwalski wysokomazowiecki zambrowski m. Białystok m. Łomża m. Suwałki 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2061 2062 2063 Total 0.994 0.936 0.978 1.016 1.019 0.962 0.908 1.041 0.999 1.010 1.011 0.965 0.959 0.823 0.910 0.891 Cancer 0.906 0.859 0.999 0.914 0.871 0.902 0.909 1.127 0.936 0.912 1.019 0.888 0.974 0.918 1.098 1.012 CVD 0.924 0.928 0.942 0.925 0.893 0.827 0.797 0.897 0.942 0.983 0.967 0.965 0.920 0.702 0.748 0.759 bytowski chojnicki człuchowski gdański kartuski kościerski kwidzyński lęborski malborski nowodworski pucki słupski starogardzki tczewski wejherowski sztumski m. Gdańsk m. Gdynia m. Słupsk m. Sopot 2201 2202 2203 2204 2205 2206 2207 2208 2209 2210 2211 2212 2213 2214 2215 2216 2261 2262 2263 2264 1.022 1.006 1.017 0.972 0.916 1.055 1.083 1.072 1.089 1.123 1.047 1.091 1.082 1.048 0.992 1.196 0.897 0.867 0.977 0.795 0.985 1.139 1.169 1.078 0.993 1.252 1.179 1.251 1.009 1.277 1.248 1.262 1.134 1.224 1.112 1.348 1.078 1.101 1.056 1.121 0.954 0.970 0.892 0.880 0.913 0.956 1.098 0.948 1.081 1.048 0.948 0.836 0.949 0.972 0.820 1.314 0.750 0.738 0.752 0.645 1.408 1.117 0.882 1.238 0.822 1.466 1.122 1.113 1.107 1.250 0.935 1.040 1.729 1.152 1.459 0.620 1.025 0.814 0.723 0.770 0.949 0.887 0.846 0.994 0.799 0.632 1.162 1.010 1.176 1.095 0.974 1.072 0.935 1.031 0.973 1.097 1.091 0.942 1.387 0.847 1.039 0.973 1.786 0.690 0.816 0.948 0.630 0.795 1.705 1.231 1.027 1.945 0.811 0.641 1.105 0.670 0.922 0.825 2.046 0.829 1.079 0.874 0.871 1.166 0.922 0.879 1.098 1.381 1.028 0.967 0.856 1.105 1.306 0.998 0.962 1.212 0.885 0.776 0.884 0.640 będziński bielski cieszyński częstochowski gliwicki kłobucki lubliniecki mikołowski myszkowski pszczyński raciborski rybnicki tarnogórski bieruńsko-lędziński wodzisławski zawierciański żywiecki m. Bielsko-Biała m. Bytom 2401 2402 2403 2404 2405 2406 2407 2408 2409 2410 2411 2412 2413 2414 2415 2416 2417 2461 2462 1.147 0.937 0.985 1.093 1.064 1.013 0.971 1.000 1.093 1.001 1.000 1.067 0.973 1.055 1.028 1.141 1.069 0.876 1.088 1.087 0.868 0.960 0.993 1.060 0.916 0.867 0.942 0.962 0.970 1.000 1.016 0.972 1.062 1.087 1.059 0.919 0.893 1.059 1.211 1.168 1.100 1.204 1.071 1.149 1.141 1.141 1.211 1.239 0.968 1.122 1.046 1.169 0.992 1.167 1.343 1.030 0.980 0.961 0.565 1.115 1.002 1.122 0.988 0.820 1.126 1.031 0.661 1.012 1.572 1.028 1.120 1.244 1.256 0.602 0.462 1.018 1.485 0.759 0.788 1.088 1.100 0.841 0.946 1.057 0.988 0.735 1.168 1.154 0.974 1.177 1.321 1.216 1.160 0.745 1.452 0.699 0.100 0.167 0.713 0.963 0.461 0.523 0.423 0.909 0.101 1.443 0.736 0.747 0.313 0.678 0.597 0.089 0.166 1.467 1.274 0.841 0.928 1.253 1.010 1.202 0.786 0.759 1.197 1.032 0.662 0.943 0.766 0.909 0.836 1.243 1.135 0.830 1.264 Page 208 Respiratory Digestive Ill-defined 1.295 0.954 1.420 1.029 0.817 0.776 0.920 0.820 0.663 1.349 1.371 0.968 1.684 0.665 2.082 1.235 0.823 1.519 1.435 1.015 1.002 0.865 0.922 1.180 1.369 0.801 0.780 1.089 1.107 0.930 0.851 0.868 1.070 1.237 0.769 0.850 0.986 0.823 0.668 0.817 1.037 1.031 0.665 0.784 0.839 0.923 0.968 0.507 External 1.049 1.567 1.105 1.378 0.878 1.392 0.920 1.352 1.539 1.323 1.376 1.239 1.329 0.759 0.998 0.994 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 TERYT District m. Chorzów m. Częstochowa m. Dąbrowa Górnicza m. Gliwice m. Jastrzębie-Zdrój m. Jaworzno m. Katowice m. Mysłowice m. Piekary Śląskie m. Ruda Śląska m. Rybnik m. Siemianowice Śląskie m. Sosnowiec m. Świętochłowice m. Tychy m. Zabrze m. Żory 2463 2464 2465 2466 2467 2468 2469 2470 2471 2472 2473 2474 2475 2476 2477 2478 2479 Total 1.230 1.033 1.106 0.929 1.006 1.050 1.023 1.146 1.099 1.272 0.972 1.231 1.115 1.185 0.972 0.951 0.923 Cancer 1.175 0.985 1.074 1.052 1.082 1.107 1.058 1.250 1.046 1.189 0.985 1.283 1.129 1.034 1.021 1.003 1.041 CVD 1.205 1.065 1.149 0.837 0.913 1.122 0.994 1.176 1.234 1.271 0.981 1.254 1.119 1.309 1.013 0.820 0.926 buski jędrzejowski kazimierski kielecki konecki opatowski ostrowiecki pińczowski sandomierski skarżyski starachowicki staszowski włoszczowski m. Kielce 2601 2602 2603 2604 2605 2606 2607 2608 2609 2610 2611 2612 2613 2661 0.987 1.010 1.118 1.022 1.054 1.073 1.029 0.997 0.929 1.052 1.012 1.013 1.034 0.846 0.884 0.865 1.082 0.932 0.943 0.941 0.975 0.879 0.925 0.921 0.913 0.921 0.736 0.854 0.910 1.088 1.074 1.006 1.164 1.146 1.178 1.039 0.950 1.184 1.031 1.100 1.176 0.762 1.075 1.249 1.286 1.294 0.946 0.890 0.503 0.786 0.607 0.822 1.106 0.636 0.927 1.036 0.800 0.744 0.742 0.775 0.956 0.720 0.812 0.866 1.003 1.042 0.961 0.828 0.759 0.853 1.974 0.801 1.416 1.235 0.691 1.259 0.567 1.445 0.856 0.511 0.619 0.920 0.713 1.300 1.036 1.091 1.101 1.144 1.111 1.261 0.950 1.062 0.871 1.113 1.165 1.141 1.186 0.659 bartoszycki braniewski działdowski elbląski ełcki giżycki iławski kętrzyński lidzbarski mrągowski nidzicki nowomiejski olecki olsztyński ostródzki piski szczycieński gołdapski węgorzewski m. Elbląg m. Olsztyn 2801 2802 2803 2804 2805 2806 2807 2808 2809 2810 2811 2812 2813 2814 2815 2816 2817 2818 2819 2861 2862 1.131 1.136 1.092 1.117 1.035 1.045 0.983 1.130 1.117 1.051 1.149 0.987 1.077 1.087 1.005 1.033 1.045 1.072 1.086 1.033 0.804 1.049 1.099 1.321 1.123 1.020 0.948 1.078 1.203 1.203 1.100 1.236 1.129 0.957 1.103 1.057 0.978 0.935 0.985 1.030 1.149 0.929 0.998 1.184 0.958 0.932 0.882 0.969 0.907 1.029 1.053 0.939 0.931 0.864 1.203 0.938 0.902 0.961 0.935 0.955 0.905 0.835 0.608 1.827 1.415 1.436 1.787 1.084 1.732 1.316 1.748 1.242 1.587 2.616 1.527 1.088 2.061 1.441 1.672 1.803 1.372 1.851 1.509 1.339 1.594 1.095 0.786 0.929 1.005 1.085 0.767 1.134 1.476 0.931 1.116 0.481 0.667 0.712 1.057 0.643 0.835 0.769 0.952 1.056 0.828 0.752 0.805 0.803 2.021 2.017 1.009 1.022 0.956 1.126 1.245 1.421 1.029 0.696 1.253 1.014 1.020 1.598 2.060 1.730 1.760 1.284 1.501 1.042 1.014 1.016 0.953 1.280 0.993 1.251 1.237 1.105 1.138 1.042 1.153 1.398 1.127 1.286 1.145 1.216 1.264 0.767 0.804 chodzieski czarnkowsko-trzcianecki gnieźnieński 3001 3002 3003 1.048 1.067 1.029 1.123 1.182 1.117 0.929 0.958 0.989 1.073 0.845 0.728 0.610 0.722 0.987 1.528 1.510 0.896 1.036 1.122 1.021 Page 209 Respiratory Digestive Ill-defined 1.418 1.949 0.594 0.991 1.269 0.856 1.115 1.357 0.673 0.838 1.190 0.917 1.056 1.147 0.906 0.881 1.005 0.674 1.107 1.383 0.623 1.188 1.715 0.423 0.934 1.370 0.608 1.214 1.914 0.929 1.198 1.048 0.534 1.407 1.835 0.388 1.161 1.450 0.726 0.784 1.795 0.588 1.161 1.115 0.424 1.000 1.345 1.064 0.845 1.389 0.228 External 1.291 1.062 1.040 0.819 0.907 0.941 1.081 0.999 0.797 1.096 0.869 1.092 1.090 1.337 0.784 0.945 0.871 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District TERYT gostyński grodziski jarociński kaliski kępiński kolski koniński kościański krotoszyński leszczyński międzychodzki nowotomyski obornicki ostrowski ostrzeszowski pilski pleszewski poznański rawicki słupecki szamotulski średzki śremski turecki wągrowiecki wolsztyński wrzesiński złotowski m. Kalisz m. Konin m. Leszno m. Poznań 3004 3005 3006 3007 3008 3009 3010 3011 3012 3013 3014 3015 3016 3017 3018 3019 3020 3021 3022 3023 3024 3025 3026 3027 3028 3029 3030 3031 3061 3062 3063 3064 Total 1.045 1.102 1.005 1.029 0.979 1.065 0.985 0.994 1.079 1.009 1.151 1.058 1.123 0.973 1.076 1.043 1.081 0.983 1.055 1.040 1.059 1.047 1.091 1.093 1.061 1.061 1.036 1.043 0.970 0.861 0.955 0.910 Cancer 1.106 0.935 1.076 0.961 0.971 1.090 1.070 1.092 1.093 1.079 0.998 1.089 1.247 1.114 0.925 1.127 1.063 1.109 1.091 1.157 1.193 1.059 1.169 1.107 1.093 1.079 1.098 1.099 1.052 1.026 1.105 1.060 CVD 1.000 1.280 1.063 0.949 1.039 1.157 0.956 0.879 1.134 1.019 1.078 1.038 1.047 0.910 1.247 0.964 1.167 0.983 1.139 1.002 1.038 1.067 1.069 1.052 0.923 1.187 1.037 1.036 0.938 0.779 0.895 0.853 białogardzki choszczeński drawski goleniowski gryficki gryfiński kamieński kołobrzeski koszaliński myśliborski policki pyrzycki sławieński stargardzki szczecinecki świdwiński wałecki łobeski m. Koszalin m. Szczecin m. Świnoujście 3201 3202 3203 3204 3205 3206 3207 3208 3209 3210 3211 3212 3213 3214 3215 3216 3217 3218 3261 3262 3263 1.138 1.082 1.112 1.059 1.138 1.058 1.036 0.951 1.138 1.087 0.973 1.059 1.063 1.034 1.156 1.066 1.127 1.083 0.859 0.969 1.019 1.179 1.043 1.018 1.046 1.048 1.042 0.901 1.046 1.200 0.977 0.957 1.014 1.195 1.026 0.996 1.133 1.149 0.993 1.145 1.057 1.037 1.237 1.115 1.185 1.050 1.140 1.135 1.096 0.798 1.145 1.160 0.926 1.054 1.124 1.018 1.293 1.059 1.201 1.118 0.780 0.934 1.070 0.954 1.452 0.916 1.065 1.374 0.878 1.039 0.634 0.936 1.384 0.976 0.950 0.518 1.236 0.809 1.055 1.083 1.213 0.679 0.864 0.768 1.134 0.904 0.934 1.164 1.215 0.833 1.035 0.886 0.845 0.996 1.017 1.092 1.049 0.970 1.028 1.091 1.155 1.073 0.855 1.155 1.039 0.481 0.609 0.759 0.888 1.582 0.694 0.916 1.912 1.357 0.924 1.162 1.292 0.629 0.886 1.006 0.852 0.468 0.844 0.682 0.708 1.249 1.392 1.255 1.400 1.283 1.087 1.168 1.031 0.952 0.980 1.129 0.982 1.216 1.320 1.171 1.183 1.181 1.364 1.338 0.738 0.963 0.777 1.000 1.000 1.000 1.000 1.000 1.000 1.000 Polska Page 210 Respiratory Digestive Ill-defined 0.904 0.930 1.176 0.815 1.254 0.614 0.630 0.673 0.502 0.960 0.890 1.876 0.983 0.722 0.555 0.659 1.066 0.535 0.896 0.882 0.828 0.581 0.983 1.640 0.917 1.121 0.494 0.721 0.808 0.891 0.829 1.101 1.997 0.659 0.976 1.021 0.665 0.968 1.023 0.872 0.858 0.653 0.713 0.831 0.360 1.068 0.867 1.070 0.732 0.936 0.790 0.759 0.932 0.776 0.901 0.860 0.482 1.394 0.923 0.435 0.660 0.779 1.236 0.849 0.933 0.412 1.082 0.992 0.830 1.125 1.050 1.195 1.092 0.924 0.699 0.679 0.987 0.471 1.165 1.004 0.442 0.722 0.640 0.938 0.768 1.050 1.035 0.829 0.977 0.644 0.705 0.958 0.748 0.698 0.911 0.846 External 1.075 1.149 1.287 1.205 1.302 1.281 1.138 1.049 1.131 0.992 1.400 1.193 1.270 1.042 1.244 1.099 1.198 0.868 1.222 1.182 1.079 1.086 0.977 1.252 1.643 1.002 1.126 1.370 0.927 0.923 0.922 0.786 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Table 63. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, males District bolesławiecki dzierżoniowski głogowski górowski jaworski jeleniogórski kamiennogórski kłodzki legnicki lubański lubiński lwówecki milicki oleśnicki oławski polkowicki strzeliński średzki świdnicki trzebnicki wałbrzyski wołowski wrocławski ząbkowicki zgorzelecki złotoryjski m. Jelenia Góra m. Legnica m. Wrocław TERYT 0201 0202 0203 0204 0205 0206 0207 0208 0209 0210 0211 0212 0213 0214 0215 0216 0217 0218 0219 0220 0221 0222 0223 0224 0225 0226 0261 0262 0264 Total 1.018 1.074 0.989 0.979 1.098 1.132 1.142 1.144 1.065 1.126 0.949 1.281 1.012 1.081 0.996 1.068 1.082 1.231 1.101 1.112 1.172 1.056 1.039 1.061 1.187 1.212 0.978 1.076 0.890 Cancer 1.124 1.048 0.994 1.099 1.134 1.117 0.973 1.161 1.103 1.099 1.098 1.190 1.051 1.087 1.080 1.215 1.195 1.233 1.152 1.179 1.123 1.114 1.003 1.011 1.139 1.292 0.980 1.107 0.919 CVD 1.017 1.121 1.094 1.137 1.122 1.120 1.121 1.270 1.142 1.325 0.932 1.406 1.177 1.280 1.028 1.048 1.248 1.374 1.202 1.252 1.156 1.210 1.146 1.135 1.311 1.250 0.976 1.044 0.940 aleksandrowski brodnicki bydgoski chełmiński golubsko-dobrzyński grudziądzki inowrocławski lipnowski mogileński nakielski radziejowski rypiński sępoleński świecki toruński tucholski wąbrzeski włocławski żniński m. Bydgoszcz m. Grudziądz m. Toruń m. Włocławek 0401 0402 0403 0404 0405 0406 0407 0408 0409 0410 0411 0412 0413 0414 0415 0416 0417 0418 0419 0461 0462 0463 0464 1.120 1.060 0.979 1.144 1.015 1.116 1.092 1.197 1.093 1.133 1.117 1.046 0.993 1.032 1.075 1.019 1.096 1.185 1.015 0.924 1.069 0.919 1.052 1.056 1.228 1.058 1.209 1.160 1.191 1.152 1.071 1.316 1.156 1.163 1.137 1.061 1.128 1.333 1.047 1.342 1.168 1.129 1.067 1.120 1.090 1.013 1.210 1.049 0.987 1.012 0.924 1.097 1.194 1.185 1.134 1.393 1.178 1.069 1.179 1.103 0.856 1.131 0.961 1.242 1.001 0.891 1.063 0.788 1.028 0.938 1.549 1.395 1.355 1.563 1.016 1.419 1.742 0.802 1.017 1.692 1.141 1.133 0.969 1.461 1.296 1.165 1.399 1.069 0.919 0.985 1.062 0.996 0.786 0.761 0.816 1.011 0.685 0.487 1.165 0.805 0.677 0.735 0.577 0.636 0.745 0.955 0.757 0.800 0.751 0.859 0.638 0.827 0.956 1.030 1.437 1.143 0.847 0.929 1.452 1.080 1.344 0.455 1.294 0.999 0.585 0.794 0.518 0.185 0.580 1.047 0.629 1.223 0.501 1.113 1.205 0.956 1.110 0.554 1.182 0.857 0.820 1.020 0.934 1.352 1.061 1.416 1.045 0.967 1.078 1.224 0.964 1.070 1.282 0.874 0.716 1.536 1.006 0.620 0.983 0.750 1.274 bialski 0601 1.160 0.730 1.327 0.744 0.885 1.577 1.499 Page 211 Respiratory Digestive Ill-defined 0.778 0.760 0.737 1.031 1.598 0.976 1.014 1.172 0.495 0.782 0.930 0.561 1.127 1.292 0.611 1.244 1.225 0.787 1.225 1.247 2.146 1.291 1.123 0.706 1.021 1.164 1.158 0.892 1.030 0.712 0.853 1.165 0.554 1.300 1.252 1.056 0.595 1.150 0.749 1.070 1.082 0.447 0.567 0.870 1.237 0.938 0.929 0.930 0.551 0.791 0.923 1.052 1.322 1.043 0.867 1.368 0.815 0.898 0.863 0.942 1.396 1.590 1.505 0.861 1.065 0.745 0.899 1.028 1.008 1.065 1.315 0.782 1.022 1.149 0.964 1.276 1.714 0.560 0.955 1.187 0.808 0.832 1.546 1.369 0.579 1.055 1.155 External 1.136 1.040 0.949 0.857 1.341 1.223 0.906 1.172 0.834 0.966 1.001 1.279 0.889 1.078 1.054 1.197 0.998 1.241 1.139 1.128 1.102 0.837 1.082 0.998 1.269 1.358 1.014 0.974 0.667 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District biłgorajski chełmski hrubieszowski janowski krasnostawski kraśnicki lubartowski lubelski łęczyński łukowski opolski parczewski puławski radzyński rycki świdnicki tomaszowski włodawski zamojski m. Biała Podlaska m. Chełm m. Lublin m. Zamość TERYT 0602 0603 0604 0605 0606 0607 0608 0609 0610 0611 0612 0613 0614 0615 0616 0617 0618 0619 0620 0661 0662 0663 0664 Total 0.996 1.293 1.116 1.043 1.130 0.995 1.115 1.102 1.161 1.075 1.113 1.088 1.000 1.090 1.078 1.019 1.017 1.212 1.078 0.964 1.024 0.927 0.869 Cancer 0.873 0.902 0.898 0.808 0.803 0.850 0.964 0.862 0.877 0.828 0.834 0.929 0.913 0.859 0.920 0.879 0.870 0.934 0.870 0.700 0.812 0.895 0.767 CVD 0.894 1.278 0.864 1.115 1.184 1.147 1.165 1.208 1.129 1.169 1.253 1.129 0.909 1.114 1.147 0.998 1.059 1.269 0.915 0.947 1.057 0.884 0.763 gorzowski krośnieński międzyrzecki nowosolski słubicki strzelecko-drezdenecki sulęciński świebodziński zielonogórski żagański żarski wschowski m. Gorzów Wielkopolski m. Zielona Góra 0801 0802 0803 0804 0805 0806 0807 0808 0809 0810 0811 0812 0861 0862 1.006 1.161 1.112 1.000 1.214 1.110 1.219 1.093 1.089 1.137 1.118 1.058 0.904 0.868 0.978 1.040 1.068 0.940 1.282 1.275 1.123 0.945 1.044 1.092 0.974 1.016 0.912 0.905 0.941 1.210 1.102 0.964 1.173 0.957 1.269 1.197 1.000 1.361 1.372 1.010 0.792 0.724 0.803 1.423 1.241 0.755 1.347 1.259 1.087 0.950 0.859 0.709 0.749 0.770 0.765 0.705 0.845 1.038 1.025 1.086 1.142 0.787 0.950 1.197 0.946 1.103 0.999 0.705 0.756 0.864 1.572 0.644 1.581 0.668 1.090 1.627 0.948 1.069 1.826 0.437 0.733 1.295 1.825 1.555 1.230 1.236 0.981 1.146 1.196 1.212 1.373 0.982 1.163 1.161 1.134 0.965 0.646 0.816 bełchatowski kutnowski łaski łęczycki łowicki łódzki wschodni opoczyński pabianicki pajęczański piotrkowski poddębicki radomszczański rawski sieradzki skierniewicki tomaszowski wieluński wieruszowski 1001 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1012 1013 1014 1015 1016 1017 1018 1.060 1.292 1.096 1.194 1.131 1.181 1.092 1.142 1.034 1.178 1.252 1.144 1.028 1.043 1.059 1.251 1.126 1.133 1.039 1.214 0.971 1.007 1.036 1.004 0.944 1.019 1.082 0.852 1.201 0.991 0.898 1.024 1.042 1.013 1.103 1.013 1.039 1.189 1.091 1.337 1.389 1.192 1.201 1.073 0.929 1.290 1.174 1.166 0.959 1.056 1.040 1.250 1.222 1.396 1.034 1.087 1.042 1.564 1.235 1.209 1.124 1.026 1.112 1.162 1.279 1.163 1.319 1.371 1.032 1.235 1.350 0.730 1.290 1.345 1.062 1.005 1.052 1.609 0.947 1.273 0.927 1.168 0.921 0.870 1.106 1.033 0.975 1.505 0.926 1.050 1.058 2.374 1.250 0.546 0.306 1.228 0.768 1.582 1.279 0.982 1.583 1.755 1.005 0.594 0.360 1.668 0.654 0.599 1.233 1.289 1.494 1.714 1.045 1.158 1.392 1.320 1.056 1.667 1.742 1.248 1.598 1.269 1.650 1.353 1.103 1.135 Page 212 Respiratory Digestive Ill-defined 0.950 0.550 2.284 1.217 1.130 2.350 1.017 0.915 3.064 1.376 1.179 1.582 1.574 0.831 1.789 1.020 0.761 0.896 0.957 0.845 1.548 0.928 1.016 1.697 1.641 0.785 2.279 0.874 0.703 1.932 0.982 0.887 1.292 0.830 0.978 1.810 0.730 0.934 2.228 0.815 1.021 1.711 0.822 0.984 1.600 0.520 0.806 2.499 0.631 0.973 1.263 0.757 1.351 1.516 1.033 0.751 2.378 0.806 0.740 1.608 0.768 1.141 1.656 0.809 0.986 1.847 0.755 1.011 1.479 External 0.794 1.547 1.284 0.592 0.939 0.892 1.164 0.842 0.872 0.896 1.094 0.937 0.795 1.269 0.916 0.653 1.230 1.303 1.356 1.069 0.924 0.440 0.833 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District zduńskowolski zgierski brzeziński m. Łódź m. Piotrków Trybunalski m. Skierniewice TERYT 1019 1020 1021 1061 1062 1063 Total 1.100 1.182 1.243 1.195 1.096 0.969 Cancer 1.054 1.040 0.951 0.980 0.959 0.991 CVD 1.013 1.130 1.417 1.021 1.134 1.011 bocheński brzeski chrzanowski dąbrowski gorlicki krakowski limanowski miechowski myślenicki nowosądecki nowotarski olkuski oświęcimski proszowicki suski tarnowski tatrzański wadowicki wielicki m. Kraków m. Nowy Sącz m. Tarnów 1201 1202 1203 1204 1205 1206 1207 1208 1209 1210 1211 1212 1213 1214 1215 1216 1217 1218 1219 1261 1262 1263 0.911 0.936 0.964 0.842 0.892 0.965 0.920 0.990 0.971 0.934 0.893 0.935 0.902 1.054 1.025 0.906 0.998 0.945 0.973 0.821 0.844 0.908 0.934 0.786 0.972 0.874 0.768 0.992 0.991 0.875 0.958 0.982 0.847 0.895 1.027 1.046 1.060 0.946 1.023 1.028 0.979 0.891 0.929 0.952 0.991 1.150 1.016 0.928 1.028 1.048 0.933 1.027 1.116 0.951 0.971 0.896 0.930 0.956 1.165 1.005 1.073 1.029 1.099 0.833 0.877 1.004 0.991 0.945 0.975 0.908 1.029 0.893 1.104 1.109 0.808 0.995 0.897 1.020 1.148 1.876 0.905 0.939 0.730 0.877 0.532 0.632 0.723 0.741 0.707 0.722 0.917 0.597 0.841 0.756 0.533 0.779 0.880 0.813 0.677 0.739 0.889 0.716 0.813 0.632 0.905 0.701 0.882 0.818 0.775 0.777 0.810 0.662 0.964 0.746 0.712 0.829 0.617 0.554 0.451 0.923 0.827 1.212 0.498 0.715 0.634 0.772 0.528 0.642 0.756 0.811 0.905 0.709 0.837 0.844 0.893 0.660 0.699 0.915 1.057 1.616 1.062 0.902 0.852 0.941 0.701 1.470 0.974 0.806 1.072 0.934 0.928 0.703 0.548 0.794 białobrzeski ciechanowski garwoliński gostyniński grodziski grójecki kozienicki legionowski lipski łosicki makowski miński mławski nowodworski ostrołęcki ostrowski otwocki piaseczyński płocki płoński pruszkowski przasnyski przysuski pułtuski radomski siedlecki sierpecki 1401 1402 1403 1404 1405 1406 1407 1408 1409 1410 1411 1412 1413 1414 1415 1416 1417 1418 1419 1420 1421 1422 1423 1424 1425 1426 1427 1.101 1.092 1.047 1.074 1.037 1.094 0.993 0.922 1.052 1.005 1.130 1.089 1.170 1.140 1.094 1.033 0.957 0.959 1.147 1.180 0.877 1.239 1.037 1.098 1.066 1.037 1.110 0.949 1.118 0.823 1.119 1.135 0.930 0.979 0.982 0.792 0.840 1.059 1.028 1.262 1.252 1.066 0.962 0.899 0.947 1.173 1.105 0.964 1.190 0.763 1.143 0.982 0.870 1.242 1.125 1.018 1.143 0.943 1.019 1.214 0.958 0.920 1.127 1.065 1.175 1.104 1.102 1.030 1.007 1.062 0.915 0.912 1.036 1.207 0.821 1.331 1.186 1.016 1.064 1.018 1.040 1.013 1.674 0.939 1.210 1.014 1.171 1.164 1.171 1.216 0.963 1.137 1.409 1.438 1.266 1.868 1.148 0.750 1.135 1.540 0.952 0.967 1.244 1.242 1.346 1.226 1.362 1.273 1.125 1.032 1.000 0.663 0.902 1.131 0.787 0.832 1.011 1.122 0.588 1.062 1.138 1.258 0.742 0.978 1.042 1.098 0.748 1.004 0.995 0.978 0.886 0.675 0.769 0.962 0.923 1.129 0.372 1.092 2.024 0.993 0.620 1.023 0.766 0.919 0.745 0.625 0.604 0.981 0.839 0.982 0.914 1.521 0.813 1.696 1.045 0.721 0.674 0.686 0.903 1.352 0.952 0.934 1.398 1.539 1.398 1.069 1.097 1.493 1.250 0.941 1.735 1.437 1.675 1.566 1.389 1.523 1.393 1.337 1.088 1.090 1.242 1.702 0.947 1.572 1.311 1.663 1.324 1.469 1.310 Page 213 Respiratory Digestive Ill-defined 0.830 1.274 1.666 1.384 1.677 1.380 0.965 1.364 0.619 1.276 1.686 2.870 1.012 1.232 0.884 0.792 0.892 0.775 External 1.126 1.280 1.764 0.999 1.201 0.955 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District sochaczewski sokołowski szydłowiecki warszawski zachodni węgrowski wołomiński wyszkowski zwoleński żuromiński żyrardowski m. Ostrołęka m. Płock m. Radom m. Siedlce m. st. Warszawa TERYT 1428 1429 1430 1432 1433 1434 1435 1436 1437 1438 1461 1462 1463 1464 1465 Total 1.121 0.977 1.124 0.883 1.023 1.090 1.083 1.131 0.999 1.182 0.959 1.062 1.014 0.894 0.803 Cancer 1.115 0.919 0.942 0.956 0.850 1.031 0.893 1.034 1.229 1.162 1.067 1.177 0.956 0.829 0.874 CVD 1.167 1.045 1.219 0.837 1.030 1.019 1.079 1.122 0.957 1.109 0.811 0.870 0.949 0.953 0.699 brzeski głubczycki kędzierzyńsko-kozielski kluczborski krapkowicki namysłowski nyski oleski opolski prudnicki strzelecki m. Opole 1601 1602 1603 1604 1605 1606 1607 1608 1609 1610 1611 1661 1.054 1.151 0.894 1.049 0.915 1.046 0.987 0.911 0.836 1.073 0.916 0.792 1.031 1.135 0.879 1.050 0.837 1.164 1.041 0.969 0.870 1.029 0.857 0.871 1.021 1.392 0.975 1.219 1.031 0.978 1.103 1.113 0.916 1.247 1.129 0.799 0.896 0.893 0.763 0.737 1.082 1.275 0.963 0.566 0.932 0.963 0.765 0.906 0.904 0.909 0.851 0.825 0.632 0.729 0.793 0.679 0.595 0.847 0.749 0.752 1.829 0.535 1.018 0.626 0.693 1.370 0.586 0.472 0.655 0.821 0.484 0.625 1.044 1.115 0.735 1.126 0.839 1.151 0.999 0.818 0.804 1.032 0.788 0.651 bieszczadzki brzozowski dębicki jarosławski jasielski kolbuszowski krośnieński leżajski lubaczowski łańcucki mielecki niżański przemyski przeworski ropczycko-sędziszowski rzeszowski sanocki stalowowolski strzyżowski tarnobrzeski leski m. Krosno m. Przemyśl m. Rzeszów m. Tarnobrzeg 1801 1802 1803 1804 1805 1806 1807 1808 1809 1810 1811 1812 1813 1814 1815 1816 1817 1818 1819 1820 1821 1861 1862 1863 1864 1.034 0.908 0.906 0.961 0.939 0.850 0.882 0.878 1.009 0.883 0.808 0.954 0.971 0.916 0.955 0.892 0.856 0.901 0.917 0.918 0.848 0.830 0.981 0.731 0.831 1.011 0.971 0.970 0.881 0.978 0.840 0.877 0.874 0.929 0.827 0.910 0.921 0.888 0.874 0.880 0.870 0.815 0.919 0.930 0.948 0.973 0.993 0.982 0.810 0.848 1.155 0.885 1.061 1.132 1.006 0.994 0.895 0.904 1.142 0.991 0.760 1.115 0.979 1.002 1.226 1.044 0.919 1.015 0.937 1.018 0.732 0.797 0.980 0.777 0.964 1.251 1.185 0.618 0.522 0.870 0.831 0.931 0.635 0.887 0.654 0.956 0.391 0.624 0.841 0.613 0.810 0.755 0.670 0.861 0.694 0.862 0.557 0.569 0.481 0.395 0.630 0.749 0.647 0.758 0.993 0.519 0.582 0.745 0.595 0.717 0.660 0.657 0.890 0.591 0.547 0.638 0.718 0.847 0.546 0.669 0.987 0.815 1.021 0.504 0.885 0.701 0.759 0.431 1.031 0.831 0.232 0.861 1.003 0.740 0.670 0.660 0.940 1.788 0.844 0.363 0.555 0.644 0.540 1.145 0.374 0.723 0.553 1.308 0.558 0.421 0.988 0.863 0.754 0.926 0.830 0.950 0.876 0.845 1.048 1.024 0.655 0.909 0.964 0.938 1.011 0.833 0.901 0.735 0.860 0.887 1.039 0.799 0.846 0.620 0.632 augustowski białostocki bielski 2001 2002 2003 0.976 1.025 0.913 0.996 0.939 0.820 0.898 0.984 0.876 0.851 1.268 1.044 1.169 0.976 0.864 1.080 1.142 0.652 1.222 1.050 1.573 Page 214 Respiratory Digestive Ill-defined 1.293 0.969 0.904 1.358 0.558 0.407 1.382 0.800 0.796 0.913 0.902 0.902 1.102 1.125 1.059 1.412 1.142 1.407 1.759 0.964 0.711 1.556 0.875 0.910 1.148 0.542 0.536 1.401 1.358 1.584 1.581 0.882 0.727 1.250 1.254 1.597 0.984 1.135 1.666 0.875 1.065 0.653 0.952 1.052 0.999 External 1.240 1.270 1.497 0.953 1.376 1.233 1.566 1.468 0.904 1.169 0.991 0.904 1.003 0.899 0.684 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District grajewski hajnowski kolneński łomżyński moniecki sejneński siemiatycki sokólski suwalski wysokomazowiecki zambrowski m. Białystok m. Łomża m. Suwałki TERYT 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2061 2062 2063 Total 1.039 1.031 1.047 0.984 0.902 1.051 1.005 1.058 1.043 0.952 0.967 0.834 0.907 0.887 Cancer 1.081 0.957 0.905 0.952 0.860 1.239 0.980 0.953 1.117 0.828 1.026 0.882 1.095 0.947 CVD 0.969 0.926 0.949 0.840 0.814 0.843 0.933 1.030 1.056 0.933 0.887 0.741 0.789 0.796 bytowski chojnicki człuchowski gdański kartuski kościerski kwidzyński lęborski malborski nowodworski pucki słupski starogardzki tczewski wejherowski sztumski m. Gdańsk m. Gdynia m. Słupsk m. Sopot 2201 2202 2203 2204 2205 2206 2207 2208 2209 2210 2211 2212 2213 2214 2215 2216 2261 2262 2263 2264 0.992 0.953 1.023 0.966 0.900 0.901 1.130 1.103 1.098 1.206 0.987 1.106 1.026 1.039 0.949 1.252 0.882 0.816 1.002 0.770 0.965 1.100 1.248 1.118 1.054 1.100 1.293 1.321 1.070 1.411 1.165 1.335 1.085 1.239 1.072 1.626 1.026 1.004 1.023 1.110 0.919 0.938 0.879 0.891 0.910 0.861 1.209 0.961 1.087 1.138 0.964 0.839 0.924 0.996 0.798 1.303 0.786 0.753 0.773 0.646 1.388 1.210 0.920 1.133 0.844 1.389 1.076 1.109 1.018 1.310 0.822 1.072 1.576 1.063 1.252 0.587 0.934 0.734 0.621 0.575 0.948 0.692 0.833 0.955 0.778 0.550 1.302 1.080 1.333 1.124 0.985 0.952 0.848 1.056 0.975 1.205 1.036 0.840 1.258 0.947 0.891 0.755 1.696 0.481 0.527 0.593 0.362 0.526 1.670 1.244 0.671 1.742 0.469 0.403 0.816 0.459 0.678 0.541 2.165 0.495 1.075 0.886 0.879 1.127 0.937 0.799 1.143 1.434 0.967 0.968 0.837 1.039 1.284 0.988 0.957 1.310 0.852 0.719 0.912 0.577 będziński bielski cieszyński częstochowski gliwicki kłobucki lubliniecki mikołowski myszkowski pszczyński raciborski rybnicki tarnogórski bieruńsko-lędziński wodzisławski zawierciański żywiecki m. Bielsko-Biała m. Bytom m. Chorzów m. Częstochowa 2401 2402 2403 2404 2405 2406 2407 2408 2409 2410 2411 2412 2413 2414 2415 2416 2417 2461 2462 2463 2464 1.184 0.880 0.930 1.109 1.045 1.009 0.913 0.940 1.096 0.968 0.951 1.029 0.923 1.021 0.990 1.148 1.064 0.862 1.078 1.254 1.034 1.092 0.834 0.960 1.031 1.053 0.971 0.833 0.937 1.004 0.937 0.990 1.024 0.915 1.015 1.065 1.088 0.978 0.873 1.000 1.153 0.941 1.242 1.145 1.058 1.164 1.050 1.108 1.082 1.106 1.222 1.260 0.943 1.126 0.995 1.191 0.982 1.172 1.374 1.075 0.972 1.252 1.038 1.061 0.483 0.964 1.178 1.087 1.191 0.846 0.940 1.084 0.622 1.048 1.473 1.045 1.181 1.124 1.267 0.536 0.400 1.094 1.383 0.972 1.613 0.727 0.831 1.138 1.032 0.802 1.058 0.962 1.079 0.616 1.058 1.092 0.992 1.076 1.300 1.173 1.138 0.725 1.397 2.074 1.305 0.778 0.104 0.205 0.893 1.054 0.426 0.431 0.373 0.745 0.130 1.248 0.671 0.691 0.347 0.608 0.475 0.100 0.209 1.461 0.677 1.088 1.266 0.822 0.835 1.274 0.975 1.196 0.783 0.723 1.209 1.048 0.544 0.848 0.726 0.854 0.799 1.283 1.120 0.755 1.230 1.201 1.069 Page 215 Respiratory Digestive Ill-defined 1.062 0.922 0.482 1.210 1.406 0.668 1.818 0.771 1.993 1.353 0.675 1.212 1.313 1.089 0.836 0.920 0.998 0.676 1.260 0.840 0.573 1.109 1.261 0.701 0.806 0.687 0.687 1.327 0.757 0.779 1.070 0.912 0.561 0.722 1.032 0.932 0.697 0.750 0.746 0.877 1.095 0.324 External 1.149 1.388 0.852 1.437 1.031 1.490 1.408 1.379 1.444 1.294 1.332 0.744 0.949 1.032 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District m. Dąbrowa Górnicza m. Gliwice m. Jastrzębie-Zdrój m. Jaworzno m. Katowice m. Mysłowice m. Piekary Śląskie m. Ruda Śląska m. Rybnik m. Siemianowice Śląskie m. Sosnowiec m. Świętochłowice m. Tychy m. Zabrze m. Żory TERYT 2465 2466 2467 2468 2469 2470 2471 2472 2473 2474 2475 2476 2477 2478 2479 Total 1.124 0.891 0.947 1.051 0.991 1.095 1.121 1.243 0.920 1.178 1.109 1.209 0.931 0.941 0.881 Cancer 1.067 0.972 0.985 1.160 0.993 1.161 1.047 1.140 0.918 1.269 1.093 1.018 1.038 0.928 1.046 CVD 1.164 0.808 0.877 1.137 0.980 1.129 1.326 1.264 0.968 1.207 1.115 1.330 0.963 0.822 0.932 buski jędrzejowski kazimierski kielecki konecki opatowski ostrowiecki pińczowski sandomierski skarżyski starachowicki staszowski włoszczowski m. Kielce 2601 2602 2603 2604 2605 2606 2607 2608 2609 2610 2611 2612 2613 2661 0.985 1.000 1.181 1.064 1.101 1.101 1.037 1.054 0.961 1.082 1.037 1.010 0.989 0.831 0.934 0.913 1.155 0.998 0.975 1.021 1.034 0.932 0.933 0.937 0.921 0.910 0.731 0.830 0.934 1.070 1.118 1.015 1.166 1.161 1.187 1.149 1.021 1.235 1.029 1.102 1.101 0.745 1.103 1.136 1.554 1.316 1.251 1.036 0.579 0.865 0.601 0.838 1.228 0.738 0.883 0.901 0.829 0.810 0.755 0.830 1.057 0.644 0.880 0.997 1.073 1.203 1.059 0.849 0.710 0.844 1.551 0.649 1.497 1.328 0.815 1.067 0.677 1.193 0.763 0.593 0.810 0.720 0.679 1.412 1.092 1.109 1.038 1.180 1.209 1.302 0.912 1.059 0.931 1.181 1.059 1.244 1.198 0.643 bartoszycki braniewski działdowski elbląski ełcki giżycki iławski kętrzyński lidzbarski mrągowski nidzicki nowomiejski olecki olsztyński ostródzki piski szczycieński gołdapski węgorzewski m. Elbląg m. Olsztyn 2801 2802 2803 2804 2805 2806 2807 2808 2809 2810 2811 2812 2813 2814 2815 2816 2817 2818 2819 2861 2862 1.210 1.165 1.102 1.137 1.104 1.126 0.996 1.233 1.179 1.089 1.201 1.002 1.074 1.110 1.049 1.081 1.093 1.075 1.090 1.051 0.802 1.110 1.234 1.371 1.201 1.101 0.969 1.189 1.326 1.250 1.179 1.338 1.176 1.038 1.137 1.099 0.976 0.986 0.867 1.036 1.134 0.896 1.018 1.200 0.948 0.856 0.905 1.015 0.848 1.119 1.064 0.938 0.891 0.926 1.137 0.940 0.913 0.996 0.932 0.966 0.850 0.840 0.582 1.960 1.206 1.377 1.792 0.970 1.670 1.339 1.593 1.364 1.667 2.545 1.598 1.069 1.922 1.347 1.664 1.921 1.506 2.027 1.376 1.167 1.455 0.811 0.794 0.911 1.050 1.234 0.763 1.328 1.390 0.872 1.271 0.329 0.709 0.716 1.197 0.748 0.897 0.744 0.952 1.124 0.867 0.782 0.906 0.707 2.084 2.250 1.163 0.957 0.985 1.342 1.192 1.470 0.829 0.800 1.126 1.105 1.001 1.518 2.089 1.676 2.029 1.389 1.673 1.075 1.053 1.113 1.017 1.423 0.988 1.328 1.409 1.246 1.244 1.026 1.171 1.435 1.210 1.406 1.247 1.365 1.271 0.714 0.801 chodzieski czarnkowsko-trzcianecki gnieźnieński gostyński grodziski 3001 3002 3003 3004 3005 1.017 1.035 0.987 0.980 1.046 1.095 1.177 1.067 1.060 0.902 0.933 0.942 1.000 0.999 1.284 1.225 0.822 0.800 0.993 0.822 0.637 0.681 0.988 0.881 1.246 1.213 1.410 0.558 0.877 0.442 0.957 1.053 0.961 0.846 1.029 Page 216 Respiratory Digestive Ill-defined 1.039 1.464 0.780 0.729 1.168 0.981 0.961 1.114 0.980 0.847 0.990 0.624 1.030 1.287 0.673 1.316 1.682 0.428 0.929 1.422 0.788 1.243 1.717 0.947 1.211 0.986 0.476 1.353 1.672 0.316 1.123 1.519 0.842 0.908 1.957 0.667 1.164 1.100 0.393 1.028 1.341 1.086 0.578 1.362 0.148 External 1.055 0.761 0.858 0.947 1.010 0.852 0.791 1.058 0.777 0.985 1.023 1.342 0.750 0.897 0.794 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District jarociński kaliski kępiński kolski koniński kościański krotoszyński leszczyński międzychodzki nowotomyski obornicki ostrowski ostrzeszowski pilski pleszewski poznański rawicki słupecki szamotulski średzki śremski turecki wągrowiecki wolsztyński wrzesiński złotowski m. Kalisz m. Konin m. Leszno m. Poznań TERYT 3006 3007 3008 3009 3010 3011 3012 3013 3014 3015 3016 3017 3018 3019 3020 3021 3022 3023 3024 3025 3026 3027 3028 3029 3030 3031 3061 3062 3063 3064 Total 0.945 1.032 0.944 1.088 1.012 1.007 1.035 0.986 1.094 1.049 1.096 0.980 1.053 1.050 1.009 0.934 0.999 1.033 1.014 1.033 1.021 1.110 1.020 0.989 1.058 1.043 0.980 0.867 0.929 0.882 Cancer 1.010 0.998 0.974 1.117 1.170 1.110 1.047 1.180 0.914 1.077 1.230 1.152 0.957 1.158 1.018 1.106 1.103 1.145 1.235 1.021 1.241 1.102 1.021 1.045 1.114 1.103 1.040 0.961 1.061 0.993 CVD 0.999 0.887 0.972 1.249 0.958 0.952 1.066 0.986 1.097 1.078 1.057 0.925 1.199 0.989 1.052 0.951 1.088 0.970 0.998 1.132 0.994 1.078 0.868 1.118 1.131 1.033 0.945 0.850 0.890 0.862 białogardzki choszczeński drawski goleniowski gryficki gryfiński kamieński kołobrzeski koszaliński myśliborski policki pyrzycki sławieński stargardzki szczecinecki świdwiński wałecki łobeski m. Koszalin m. Szczecin m. Świnoujście 3201 3202 3203 3204 3205 3206 3207 3208 3209 3210 3211 3212 3213 3214 3215 3216 3217 3218 3261 3262 3263 1.225 1.069 1.135 1.083 1.154 1.027 1.026 0.948 1.155 1.113 0.965 1.110 1.092 1.018 1.162 1.128 1.137 1.177 0.833 0.961 0.988 1.230 1.062 1.027 1.010 1.075 1.093 0.875 1.080 1.237 1.024 0.901 1.158 1.222 1.050 1.076 1.171 1.213 1.078 1.022 0.998 1.026 1.330 1.074 1.249 1.070 1.123 1.107 1.130 0.750 1.201 1.157 0.946 1.019 1.166 1.000 1.281 1.148 1.210 1.195 0.811 0.965 1.035 1.083 1.624 0.911 1.068 1.393 0.862 0.934 0.608 0.967 1.393 1.097 0.908 0.601 1.116 0.823 1.083 1.056 1.566 0.595 0.802 0.587 1.397 0.808 0.966 1.172 1.001 0.814 0.988 0.974 0.814 0.984 0.844 1.218 0.941 0.862 1.078 1.100 1.367 1.259 0.955 1.158 0.963 0.380 0.612 0.471 0.925 1.654 0.542 0.810 2.108 1.358 1.054 1.171 1.584 0.673 0.873 0.987 0.865 0.373 0.828 0.739 0.687 1.396 1.536 1.293 1.456 1.345 1.128 1.122 1.000 0.806 0.935 1.152 0.993 1.278 1.340 1.184 1.269 1.245 1.357 1.389 0.600 0.931 0.787 1.000 1.000 1.000 1.000 1.000 1.000 1.000 Polska Page 217 Respiratory Digestive Ill-defined 0.702 0.620 0.436 1.047 0.919 1.818 1.141 0.754 0.555 0.756 0.980 0.577 1.082 0.855 0.774 0.543 0.972 1.500 1.109 1.232 0.472 0.809 0.783 0.792 0.913 0.898 1.676 0.690 0.877 0.902 0.748 0.948 0.942 0.960 0.846 0.723 0.979 0.843 0.419 1.100 0.822 0.995 0.814 0.849 0.829 0.728 0.849 0.688 1.029 0.607 0.463 1.515 0.982 0.355 0.658 0.622 0.869 0.849 0.805 0.342 1.050 1.000 0.538 1.354 1.063 1.174 1.176 0.984 0.604 0.713 0.831 0.496 1.150 0.980 0.306 0.817 0.590 0.816 0.757 1.125 1.144 0.872 1.102 0.615 0.827 1.073 0.586 0.601 0.889 0.948 External 1.231 1.282 1.225 1.197 1.096 0.916 1.084 0.822 1.155 1.119 1.117 0.912 1.290 1.053 1.080 0.763 1.060 1.186 1.027 1.031 0.798 1.228 1.490 0.986 1.085 1.287 0.921 0.889 0.905 0.670 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Table 64. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, females District bolesławiecki dzierżoniowski głogowski górowski jaworski jeleniogórski kamiennogórski kłodzki legnicki lubański lubiński lwówecki milicki oleśnicki oławski polkowicki strzeliński średzki świdnicki trzebnicki wałbrzyski wołowski wrocławski ząbkowicki zgorzelecki złotoryjski m. Jelenia Góra m. Legnica m. Wrocław TERYT 0201 0202 0203 0204 0205 0206 0207 0208 0209 0210 0211 0212 0213 0214 0215 0216 0217 0218 0219 0220 0221 0222 0223 0224 0225 0226 0261 0262 0264 Total 1.009 1.030 1.045 1.048 1.062 1.111 1.104 1.132 1.046 1.094 0.989 1.167 1.042 0.959 0.956 1.039 1.033 1.109 1.085 1.054 1.200 1.142 0.982 1.109 1.078 1.130 1.018 1.059 0.924 Cancer 1.139 1.041 1.133 1.056 1.001 1.137 1.081 1.078 1.038 0.912 1.030 0.912 0.915 0.990 0.963 0.968 1.046 0.978 1.195 1.162 1.210 1.158 1.002 1.122 1.151 1.123 1.180 1.241 1.031 CVD 1.013 1.068 1.011 1.135 1.161 1.095 1.077 1.223 1.100 1.325 1.002 1.177 1.230 1.066 1.017 1.137 1.227 1.227 1.089 1.151 1.249 1.283 1.046 1.171 1.135 1.212 0.891 0.977 0.938 aleksandrowski brodnicki bydgoski chełmiński golubsko-dobrzyński grudziądzki inowrocławski lipnowski mogileński nakielski radziejowski rypiński sępoleński świecki toruński tucholski wąbrzeski włocławski żniński m. Bydgoszcz m. Grudziądz m. Toruń m. Włocławek 0401 0402 0403 0404 0405 0406 0407 0408 0409 0410 0411 0412 0413 0414 0415 0416 0417 0418 0419 0461 0462 0463 0464 1.056 1.077 1.035 1.167 0.922 1.089 1.082 1.123 1.117 1.168 1.062 1.125 0.951 1.168 1.079 1.014 1.069 1.050 1.028 0.960 1.136 0.916 1.077 1.005 0.966 1.139 1.282 0.848 1.065 1.131 1.009 0.985 1.165 1.186 1.177 1.031 1.211 1.077 1.102 1.099 0.869 1.106 1.179 1.242 1.078 1.235 1.251 1.102 1.007 1.090 0.941 1.114 1.166 1.209 1.245 1.367 1.066 1.239 0.963 1.286 1.026 1.079 1.049 1.240 1.016 0.886 1.105 0.773 1.048 0.484 0.809 1.562 0.996 1.162 1.107 1.221 1.183 1.075 0.727 1.602 0.839 1.083 1.050 1.438 1.363 1.327 0.894 0.906 1.241 1.215 1.230 0.871 1.035 1.089 1.121 0.926 0.656 1.043 1.373 0.868 0.975 0.981 0.615 0.752 0.833 0.807 1.035 0.577 0.331 0.802 0.931 1.002 0.952 1.023 1.354 0.534 1.667 0.586 1.752 0.936 0.981 0.390 1.057 1.064 0.636 0.890 0.762 1.043 1.030 1.182 0.763 1.018 0.729 1.122 0.842 0.993 1.229 0.729 0.520 0.847 0.635 0.681 0.551 0.636 0.683 0.891 0.628 0.816 0.534 0.536 0.556 0.877 0.916 0.794 0.382 0.672 0.657 0.597 0.890 0.718 1.136 bialski 0601 1.046 0.744 1.224 0.482 0.782 1.006 1.312 Page 218 Respiratory Digestive Ill-defined 1.024 1.061 0.428 0.938 0.944 1.292 0.688 1.333 1.100 0.880 0.581 1.144 0.923 1.200 0.817 1.169 1.728 0.834 1.069 1.105 1.926 1.056 1.114 1.092 1.109 0.749 1.116 0.803 0.548 0.942 0.763 1.075 1.152 1.012 1.526 2.215 0.437 0.369 1.020 0.709 0.903 0.225 0.512 1.011 1.008 0.658 0.841 1.184 0.430 0.781 0.493 0.882 1.147 1.047 0.653 0.983 1.384 0.679 0.855 0.621 0.884 1.354 1.499 0.794 0.996 0.919 0.816 1.192 0.500 0.830 1.004 1.388 1.050 1.147 0.672 1.255 0.993 1.113 1.098 1.303 1.307 0.758 1.277 1.645 0.728 1.086 0.832 External 1.066 0.787 0.852 1.288 1.140 0.727 0.716 0.958 1.204 0.808 1.186 0.874 1.032 1.031 1.114 0.962 0.896 0.846 1.163 0.954 1.018 0.728 0.945 0.927 1.024 0.964 0.975 0.916 0.852 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District biłgorajski chełmski hrubieszowski janowski krasnostawski kraśnicki lubartowski lubelski łęczyński łukowski opolski parczewski puławski radzyński rycki świdnicki tomaszowski włodawski zamojski m. Biała Podlaska m. Chełm m. Lublin m. Zamość TERYT 0602 0603 0604 0605 0606 0607 0608 0609 0610 0611 0612 0613 0614 0615 0616 0617 0618 0619 0620 0661 0662 0663 0664 Total 0.958 1.078 0.975 1.022 1.023 0.992 1.032 1.004 0.990 0.982 1.027 0.978 0.917 1.063 0.954 0.927 0.969 1.090 0.977 0.935 0.848 0.949 0.853 Cancer 0.666 0.765 0.747 0.652 0.610 0.815 0.867 0.591 0.713 0.785 0.650 0.875 0.790 0.815 0.779 0.764 0.698 0.763 0.727 0.977 0.739 0.898 0.858 CVD 1.006 1.181 0.869 1.233 1.145 1.159 1.174 1.235 1.138 1.148 1.268 1.100 0.929 1.122 1.158 1.057 1.054 1.291 0.939 0.982 0.929 0.951 0.826 gorzowski krośnieński międzyrzecki nowosolski słubicki strzelecko-drezdenecki sulęciński świebodziński zielonogórski żagański żarski wschowski m. Gorzów Wielkopolski m. Zielona Góra 0801 0802 0803 0804 0805 0806 0807 0808 0809 0810 0811 0812 0861 0862 1.064 1.077 1.076 1.045 1.128 1.050 1.160 1.070 0.993 1.112 1.166 1.081 0.996 0.936 1.067 0.907 0.961 1.016 1.130 1.028 1.025 0.901 0.986 1.031 1.137 1.040 1.091 1.041 1.037 1.146 1.042 1.003 1.113 0.996 1.140 1.134 0.887 1.242 1.293 0.972 0.796 0.703 0.911 1.312 1.207 0.819 1.046 0.835 1.132 1.131 0.722 0.739 0.645 0.345 0.923 0.676 0.831 0.730 1.077 1.294 1.429 1.086 1.327 0.822 0.986 0.929 0.985 1.107 0.897 0.971 1.540 1.228 1.798 1.273 1.177 2.047 1.339 1.235 2.113 0.494 0.944 1.549 2.261 2.392 0.930 0.621 0.829 0.971 1.012 0.982 0.892 0.572 0.748 0.979 1.046 1.126 0.766 0.842 bełchatowski kutnowski łaski łęczycki łowicki łódzki wschodni opoczyński pabianicki pajęczański piotrkowski poddębicki radomszczański rawski sieradzki skierniewicki tomaszowski wieluński wieruszowski 1001 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1012 1013 1014 1015 1016 1017 1018 0.999 1.147 1.025 1.177 1.010 1.104 1.081 1.085 0.978 1.117 1.208 1.033 0.983 1.017 0.963 1.015 0.991 1.128 0.931 1.067 0.839 0.999 0.907 0.927 0.746 0.891 0.842 0.851 0.959 0.831 0.911 0.997 0.840 0.939 0.887 0.937 1.111 1.282 1.133 1.397 1.202 1.177 1.367 1.087 1.085 1.255 1.298 1.171 1.015 1.075 1.145 1.055 1.125 1.381 1.242 0.710 1.007 0.879 0.804 1.193 0.596 1.187 1.035 1.009 1.072 0.890 1.448 0.985 0.806 1.013 0.781 0.489 0.945 0.934 1.246 1.282 1.060 1.037 1.139 1.538 0.744 1.273 1.061 0.754 1.098 1.012 0.947 0.922 0.787 0.928 0.636 0.931 0.711 0.294 0.179 0.915 0.399 1.070 0.800 0.817 1.190 1.233 0.452 0.628 0.276 0.882 0.431 0.591 0.861 1.296 0.845 1.313 0.858 1.485 1.352 1.648 0.864 1.513 1.757 1.014 1.475 1.278 1.035 0.917 0.974 1.192 Page 219 Respiratory Digestive Ill-defined 0.860 0.631 2.303 0.582 0.891 1.761 0.589 0.757 3.397 0.370 0.314 1.803 0.991 1.041 1.514 0.477 0.798 0.852 0.558 0.966 0.886 0.640 0.941 0.724 1.446 0.927 0.718 0.426 0.615 0.949 0.492 0.839 1.051 0.894 0.772 0.911 0.556 0.910 1.616 1.081 1.007 1.257 0.465 0.666 0.662 0.318 0.779 1.245 0.390 0.757 1.632 0.442 0.616 1.531 0.562 0.641 2.593 0.638 0.705 0.721 0.570 0.950 0.738 0.866 0.995 1.127 0.710 0.483 0.998 External 0.557 1.019 0.675 0.510 0.987 0.727 0.791 0.994 0.976 0.964 0.587 0.578 0.788 1.274 0.800 0.636 1.011 0.999 0.845 0.681 0.828 0.712 0.810 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District zduńskowolski zgierski brzeziński m. Łódź m. Piotrków Trybunalski m. Skierniewice TERYT 1019 1020 1021 1061 1062 1063 Total 1.102 1.077 1.206 1.123 1.084 1.028 Cancer 1.060 0.935 0.872 1.085 0.902 1.108 CVD 1.182 1.108 1.461 0.964 1.145 1.124 bocheński brzeski chrzanowski dąbrowski gorlicki krakowski limanowski miechowski myślenicki nowosądecki nowotarski olkuski oświęcimski proszowicki suski tarnowski tatrzański wadowicki wielicki m. Kraków m. Nowy Sącz m. Tarnów 1201 1202 1203 1204 1205 1206 1207 1208 1209 1210 1211 1212 1213 1214 1215 1216 1217 1218 1219 1261 1262 1263 1.005 0.967 1.010 0.982 0.957 0.959 0.960 1.031 0.977 0.925 0.888 0.936 0.967 0.917 0.955 0.917 0.979 0.978 0.942 0.913 0.890 0.944 0.802 0.724 0.973 0.946 0.864 0.910 0.811 1.002 0.900 0.751 0.864 0.894 0.987 0.719 0.933 0.801 0.963 0.899 0.872 1.039 0.982 0.998 1.086 1.172 1.022 1.009 1.093 1.063 1.026 1.121 1.100 0.991 0.983 0.985 1.011 1.080 1.017 0.963 1.020 1.105 1.076 0.905 0.798 0.946 1.153 0.518 1.297 0.593 0.682 0.931 1.535 0.832 0.670 1.061 0.548 1.133 1.090 1.439 0.950 1.035 0.817 0.886 0.795 0.852 0.753 1.030 0.843 0.744 1.096 0.623 0.944 0.800 0.553 0.887 1.351 0.857 0.590 0.797 0.851 0.453 0.467 0.723 1.057 0.884 0.795 0.913 0.929 0.961 1.131 1.222 0.951 1.639 0.710 0.574 1.054 0.487 0.555 1.184 0.916 0.736 0.650 0.186 1.042 1.380 0.853 0.522 0.449 0.655 1.137 0.954 0.873 0.503 1.122 0.650 0.640 0.815 0.818 1.034 0.940 0.841 0.750 0.812 0.781 0.998 1.036 0.632 1.114 0.884 0.938 0.841 0.860 0.703 białobrzeski ciechanowski garwoliński gostyniński grodziski grójecki kozienicki legionowski lipski łosicki makowski miński mławski nowodworski ostrołęcki ostrowski otwocki piaseczyński płocki płoński pruszkowski przasnyski przysuski pułtuski radomski siedlecki sierpecki 1401 1402 1403 1404 1405 1406 1407 1408 1409 1410 1411 1412 1413 1414 1415 1416 1417 1418 1419 1420 1421 1422 1423 1424 1425 1426 1427 1.053 1.046 0.935 1.068 1.007 1.091 0.922 0.943 0.974 0.963 0.936 0.979 0.997 1.091 0.978 0.920 0.919 0.962 1.069 1.056 0.908 1.089 0.953 1.046 1.001 1.003 1.047 0.760 1.114 0.696 0.962 1.126 1.007 0.821 1.013 0.832 0.921 0.866 0.889 1.083 1.169 0.805 0.743 0.936 0.974 0.939 0.915 1.067 0.882 0.701 1.058 0.894 0.850 1.099 1.120 0.994 1.089 0.984 1.015 1.192 0.975 0.859 1.029 1.013 1.000 1.032 1.014 1.084 1.061 1.031 0.933 0.972 1.075 1.124 0.875 1.174 1.129 1.096 1.084 1.067 1.065 0.631 1.699 0.848 1.392 1.426 1.076 0.778 1.479 0.918 1.204 0.896 1.390 1.099 1.145 1.169 0.628 0.724 1.194 1.199 1.068 0.922 1.185 0.920 0.945 0.849 1.206 0.824 0.880 0.985 0.971 0.856 0.926 0.866 0.700 1.103 0.866 0.888 0.692 0.799 0.803 0.878 0.478 0.899 1.034 0.963 0.994 1.084 0.965 0.647 0.708 0.652 0.734 0.926 0.820 1.898 0.534 0.624 2.080 0.634 0.838 0.772 0.647 1.041 0.626 0.545 0.537 0.768 0.698 0.825 0.859 0.919 0.693 1.369 0.781 0.526 1.389 0.625 1.104 1.045 0.777 0.712 1.490 1.172 1.059 1.188 0.924 1.080 1.513 1.596 1.285 0.873 1.011 1.151 0.953 1.631 1.069 1.054 0.947 1.108 1.091 1.218 0.999 1.090 0.969 1.532 1.090 1.090 1.242 Page 220 Respiratory Digestive Ill-defined 1.409 1.012 0.755 1.147 1.494 1.062 0.654 1.333 0.953 1.600 1.566 2.174 1.018 1.488 0.922 1.043 0.932 0.317 External 0.812 1.231 1.456 1.070 1.384 0.967 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District sochaczewski sokołowski szydłowiecki warszawski zachodni węgrowski wołomiński wyszkowski zwoleński żuromiński żyrardowski m. Ostrołęka m. Płock m. Radom m. Siedlce m. st. Warszawa TERYT 1428 1429 1430 1432 1433 1434 1435 1436 1437 1438 1461 1462 1463 1464 1465 Total 1.069 0.953 0.976 0.883 1.005 1.014 0.964 1.114 1.020 1.120 0.941 0.999 0.963 0.856 0.873 Cancer 0.980 0.765 0.768 0.940 0.891 0.968 0.883 0.805 1.088 1.133 0.854 1.130 0.967 0.988 1.063 CVD 1.195 1.025 1.066 0.832 1.022 1.037 0.988 1.114 1.105 1.130 0.781 0.882 0.904 0.869 0.734 brzeski głubczycki kędzierzyńsko-kozielski kluczborski krapkowicki namysłowski nyski oleski opolski prudnicki strzelecki m. Opole 1601 1602 1603 1604 1605 1606 1607 1608 1609 1610 1611 1661 0.963 1.067 0.960 1.001 1.007 0.993 1.039 0.978 0.916 1.058 0.971 0.916 0.911 1.140 0.980 0.919 0.819 1.042 1.016 0.934 0.896 0.979 0.756 1.098 0.963 1.190 0.978 1.105 1.135 0.938 1.187 1.104 0.968 1.210 1.208 0.882 0.612 0.741 0.749 0.803 0.848 0.892 0.808 0.322 1.007 0.888 0.892 1.008 0.792 0.798 0.755 0.849 0.979 0.629 0.578 0.671 0.741 0.586 0.807 0.827 1.741 0.525 1.111 0.952 0.666 1.834 0.465 1.112 0.487 0.772 0.448 0.541 0.865 1.005 0.865 0.793 0.765 1.030 1.022 0.817 0.740 0.742 0.452 0.815 bieszczadzki brzozowski dębicki jarosławski jasielski kolbuszowski krośnieński leżajski lubaczowski łańcucki mielecki niżański przemyski przeworski ropczycko-sędziszowski rzeszowski sanocki stalowowolski strzyżowski tarnobrzeski leski m. Krosno m. Przemyśl m. Rzeszów m. Tarnobrzeg 1801 1802 1803 1804 1805 1806 1807 1808 1809 1810 1811 1812 1813 1814 1815 1816 1817 1818 1819 1820 1821 1861 1862 1863 1864 0.981 0.962 0.893 1.026 0.954 0.900 0.938 0.963 0.914 0.950 0.875 0.891 0.961 0.970 0.866 0.928 0.907 1.011 0.949 0.934 0.800 0.902 0.992 0.809 0.843 0.804 0.873 0.950 0.906 0.817 0.669 0.845 0.818 0.834 0.804 0.850 0.756 0.787 0.778 0.771 0.745 0.860 0.903 0.834 0.626 0.960 0.879 0.995 0.863 0.877 0.901 0.948 1.029 1.242 0.966 1.059 0.830 1.053 1.062 1.116 0.751 1.024 1.065 1.154 1.037 1.092 0.807 1.133 0.902 1.190 0.657 0.753 1.077 0.845 0.912 1.299 0.983 0.281 0.344 0.524 0.791 0.849 0.526 0.568 0.450 1.142 0.283 0.339 0.616 0.340 0.566 0.931 0.516 0.755 0.374 0.843 0.818 0.519 0.594 0.393 1.112 0.608 0.535 0.655 0.963 0.488 0.760 0.629 0.625 0.941 0.626 0.401 0.919 0.676 0.830 0.700 0.921 0.683 0.809 0.842 0.721 1.045 1.077 0.695 0.384 1.360 2.100 0.408 1.026 2.133 0.634 2.369 1.395 0.797 0.574 1.555 1.685 1.574 0.760 0.484 0.788 1.893 1.247 2.456 0.426 1.624 2.148 0.982 0.488 0.438 1.559 0.506 0.762 0.795 0.590 0.932 0.779 1.214 0.693 0.866 0.960 0.561 0.908 0.744 0.715 0.776 0.693 0.824 0.530 0.671 0.452 0.669 0.586 0.761 0.616 augustowski białostocki bielski 2001 2002 2003 0.926 0.937 0.930 0.936 0.838 0.870 0.843 0.858 0.958 0.822 1.276 0.895 0.921 0.899 0.729 1.511 1.753 0.916 0.989 0.972 1.389 Page 221 Respiratory Digestive Ill-defined 1.198 0.768 0.359 1.375 0.869 0.441 0.878 0.908 0.933 1.458 1.122 0.658 1.172 1.196 0.803 1.276 1.127 0.999 1.471 0.842 0.625 1.673 0.759 1.627 0.963 0.630 0.577 1.909 0.821 0.759 1.868 0.731 1.129 1.430 1.024 0.844 0.927 1.043 1.479 0.573 1.068 0.330 1.355 1.137 0.794 External 1.235 1.078 1.291 0.985 1.599 1.010 1.186 0.867 1.214 1.202 1.196 1.172 1.023 1.223 0.955 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District grajewski hajnowski kolneński łomżyński moniecki sejneński siemiatycki sokólski suwalski wysokomazowiecki zambrowski m. Białystok m. Łomża m. Suwałki TERYT 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2061 2062 2063 Total 0.886 0.984 0.950 0.898 0.877 0.988 0.960 0.938 0.931 0.935 0.927 0.829 0.918 0.907 Cancer 0.862 0.838 0.791 0.783 0.926 0.905 0.831 0.842 0.828 0.913 0.873 0.977 1.096 1.104 CVD 0.903 0.917 0.821 0.794 0.761 0.927 0.932 0.933 0.856 0.965 0.939 0.679 0.709 0.733 bytowski chojnicki człuchowski gdański kartuski kościerski kwidzyński lęborski malborski nowodworski pucki słupski starogardzki tczewski wejherowski sztumski m. Gdańsk m. Gdynia m. Słupsk m. Sopot 2201 2202 2203 2204 2205 2206 2207 2208 2209 2210 2211 2212 2213 2214 2215 2216 2261 2262 2263 2264 1.041 1.060 1.004 0.963 0.903 1.225 1.028 1.041 1.090 1.031 1.101 1.059 1.143 1.052 1.026 1.127 0.916 0.919 0.964 0.825 0.995 1.176 1.066 1.003 0.860 1.419 1.046 1.177 0.953 1.126 1.330 1.160 1.191 1.194 1.137 1.001 1.139 1.210 1.113 1.140 0.977 0.992 0.901 0.856 0.888 1.029 0.998 0.938 1.083 0.972 0.912 0.826 0.966 0.944 0.827 1.326 0.719 0.719 0.743 0.648 1.413 0.952 0.831 1.391 0.740 1.504 1.225 1.164 1.289 1.206 1.090 0.995 1.963 1.294 1.756 0.692 1.153 0.914 0.895 1.033 0.921 1.166 0.852 1.037 0.796 0.742 0.939 0.903 0.951 1.039 0.927 1.231 1.055 0.986 0.944 0.913 1.176 1.085 1.600 0.752 1.257 1.282 1.894 1.027 1.240 1.490 1.045 1.190 1.758 1.190 1.598 2.219 1.321 0.996 1.569 1.025 1.248 1.205 1.937 1.170 1.022 0.803 0.809 1.274 0.782 1.106 0.900 1.195 1.238 0.918 0.878 1.270 1.341 1.026 0.940 0.803 1.017 0.972 0.859 0.823 będziński bielski cieszyński częstochowski gliwicki kłobucki lubliniecki mikołowski myszkowski pszczyński raciborski rybnicki tarnogórski bieruńsko-lędziński wodzisławski zawierciański żywiecki m. Bielsko-Biała m. Bytom m. Chorzów m. Częstochowa 2401 2402 2403 2404 2405 2406 2407 2408 2409 2410 2411 2412 2413 2414 2415 2416 2417 2461 2462 2463 2464 1.114 0.997 1.048 1.066 1.069 1.006 1.028 1.066 1.085 1.030 1.056 1.100 1.017 1.082 1.063 1.129 1.068 0.904 1.090 1.219 1.055 1.091 0.901 0.953 0.941 1.046 0.836 0.901 0.939 0.901 1.004 1.011 0.993 1.023 1.110 1.099 1.020 0.837 0.930 1.127 1.223 1.063 1.189 1.180 1.134 1.233 1.075 1.175 1.181 1.165 1.198 1.204 0.985 1.107 1.079 1.130 0.990 1.161 1.308 1.001 0.979 1.175 1.104 0.836 0.686 1.344 0.739 1.153 0.675 0.783 1.419 0.937 0.724 0.980 1.718 0.961 1.019 1.425 1.244 0.705 0.566 0.898 1.530 1.061 1.328 0.800 0.727 1.002 1.185 0.874 0.764 1.187 0.861 0.908 1.319 1.227 0.929 1.306 1.335 1.266 1.172 0.788 1.519 1.800 1.255 0.600 0.091 0.113 0.469 0.791 0.494 0.638 0.492 1.127 0.050 1.712 0.819 0.815 0.245 0.770 0.754 0.073 0.116 1.460 0.491 0.582 1.332 0.892 1.240 1.112 1.111 1.140 0.761 0.875 1.148 0.945 1.059 1.236 0.881 1.071 0.954 1.095 1.127 1.114 1.360 1.594 1.114 Page 222 Respiratory Digestive Ill-defined 0.661 0.653 0.892 1.510 1.308 1.331 1.346 0.484 2.110 0.926 0.985 1.850 1.475 0.873 1.190 0.681 0.779 1.806 1.433 0.724 1.027 0.997 0.884 1.205 0.852 1.080 1.531 0.934 0.751 0.902 0.781 0.680 0.809 0.971 1.083 1.219 0.611 0.853 1.005 1.014 0.806 0.787 External 0.884 1.265 0.847 1.040 0.462 0.757 1.787 1.043 0.917 0.913 1.236 0.887 1.232 0.938 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District m. Dąbrowa Górnicza m. Gliwice m. Jastrzębie-Zdrój m. Jaworzno m. Katowice m. Mysłowice m. Piekary Śląskie m. Ruda Śląska m. Rybnik m. Siemianowice Śląskie m. Sosnowiec m. Świętochłowice m. Tychy m. Zabrze m. Żory TERYT 2465 2466 2467 2468 2469 2470 2471 2472 2473 2474 2475 2476 2477 2478 2479 Total 1.085 0.967 1.065 1.042 1.064 1.203 1.077 1.306 1.022 1.295 1.138 1.152 1.024 0.948 0.958 Cancer 1.084 1.140 1.181 1.026 1.142 1.361 1.053 1.256 1.058 1.296 1.191 1.054 0.989 1.083 0.991 CVD 1.134 0.858 0.929 1.102 1.008 1.214 1.154 1.272 0.980 1.295 1.133 1.283 1.061 0.807 0.888 buski jędrzejowski kazimierski kielecki konecki opatowski ostrowiecki pińczowski sandomierski skarżyski starachowicki staszowski włoszczowski m. Kielce 2601 2602 2603 2604 2605 2606 2607 2608 2609 2610 2611 2612 2613 2661 0.975 0.997 1.033 0.954 0.997 1.030 1.026 0.922 0.881 1.027 0.981 0.990 1.062 0.867 0.804 0.774 0.967 0.830 0.907 0.831 0.907 0.801 0.899 0.912 0.899 0.907 0.725 0.880 0.883 1.089 1.027 0.984 1.159 1.124 1.174 0.940 0.881 1.148 1.032 1.080 1.227 0.780 1.000 1.360 0.856 1.235 0.514 0.665 0.398 0.662 0.599 0.812 0.899 0.434 0.950 1.232 0.746 0.633 0.705 0.668 0.805 0.799 0.726 0.678 0.897 0.843 0.827 0.771 0.801 0.887 2.413 0.975 1.285 1.060 0.520 1.452 0.425 1.693 0.958 0.408 0.351 1.160 0.733 1.174 0.812 0.943 1.181 0.903 0.727 1.024 1.086 0.975 0.663 0.919 1.482 0.696 1.020 0.757 bartoszycki braniewski działdowski elbląski ełcki giżycki iławski kętrzyński lidzbarski mrągowski nidzicki nowomiejski olecki olsztyński ostródzki piski szczycieński gołdapski węgorzewski m. Elbląg m. Olsztyn 2801 2802 2803 2804 2805 2806 2807 2808 2809 2810 2811 2812 2813 2814 2815 2816 2817 2818 2819 2861 2862 1.059 1.090 1.076 1.094 0.958 0.962 0.965 1.036 1.046 1.008 1.080 0.962 1.081 1.050 0.956 0.955 0.979 1.063 1.068 1.033 0.819 1.002 0.918 1.257 1.044 0.925 0.938 0.936 1.093 1.154 1.008 1.105 1.064 0.862 1.054 1.012 0.971 0.869 1.143 1.023 1.195 0.978 0.991 1.164 0.966 1.000 0.865 0.937 0.959 0.967 1.046 0.943 0.967 0.805 1.265 0.932 0.895 0.917 0.936 0.943 0.949 0.844 0.639 1.739 1.750 1.526 1.838 1.279 1.882 1.296 2.070 1.074 1.503 2.732 1.439 1.135 2.297 1.614 1.642 1.606 1.150 1.575 1.769 1.602 1.793 1.516 0.771 0.934 0.941 0.877 0.767 0.877 1.589 1.018 0.873 0.683 0.598 0.693 0.849 0.465 0.727 0.794 0.922 0.984 0.805 0.711 0.615 0.939 1.879 1.650 0.788 1.112 0.922 0.807 1.328 1.324 1.266 0.527 1.431 0.871 1.023 1.699 1.971 1.747 1.409 1.193 0.919 0.847 0.863 0.614 0.722 0.782 0.988 0.993 0.618 0.586 0.702 1.033 1.026 1.197 0.811 0.739 0.709 0.626 1.097 0.979 0.906 chodzieski czarnkowsko-trzcianecki gnieźnieński gostyński grodziski 3001 3002 3003 3004 3005 1.088 1.099 1.078 1.109 1.150 1.169 1.189 1.182 1.148 0.960 0.927 0.969 0.977 0.990 1.259 0.883 0.886 0.626 0.726 0.771 0.569 0.767 0.981 0.986 1.229 1.986 1.628 1.375 1.609 0.857 1.291 1.301 1.214 1.821 1.489 Page 223 Respiratory Digestive Ill-defined 1.249 1.202 0.514 0.988 1.220 0.825 1.170 1.185 0.710 0.926 1.023 0.750 1.233 1.528 0.565 1.001 1.752 0.412 0.971 1.294 0.354 1.209 2.194 0.887 1.166 1.125 0.612 1.509 2.077 0.496 1.268 1.375 0.570 0.623 1.540 0.468 1.147 1.141 0.482 0.931 1.325 1.011 1.301 1.400 0.392 External 1.000 1.017 1.078 0.910 1.340 1.509 0.816 1.212 1.166 1.470 1.351 1.306 0.917 1.091 1.172 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District jarociński kaliski kępiński kolski koniński kościański krotoszyński leszczyński międzychodzki nowotomyski obornicki ostrowski ostrzeszowski pilski pleszewski poznański rawicki słupecki szamotulski średzki śremski turecki wągrowiecki wolsztyński wrzesiński złotowski m. Kalisz m. Konin m. Leszno m. Poznań TERYT 3006 3007 3008 3009 3010 3011 3012 3013 3014 3015 3016 3017 3018 3019 3020 3021 3022 3023 3024 3025 3026 3027 3028 3029 3030 3031 3061 3062 3063 3064 Total 1.067 1.010 1.010 1.037 0.944 0.978 1.125 1.018 1.212 1.071 1.151 0.957 1.090 1.034 1.151 1.037 1.115 1.029 1.110 1.057 1.172 1.068 1.095 1.140 1.007 1.034 0.986 0.861 0.994 0.956 Cancer 1.147 0.894 0.960 1.054 0.933 1.070 1.148 0.920 1.108 1.114 1.263 1.054 0.876 1.084 1.104 1.099 1.069 1.149 1.141 1.102 1.057 1.108 1.172 1.116 1.076 1.092 1.097 1.109 1.164 1.158 CVD 1.115 0.993 1.094 1.076 0.947 0.813 1.191 1.036 1.058 1.006 1.032 0.891 1.277 0.940 1.262 1.007 1.179 1.019 1.071 0.999 1.136 1.027 0.963 1.246 0.951 1.031 0.949 0.714 0.905 0.855 białogardzki choszczeński drawski goleniowski gryficki gryfiński kamieński kołobrzeski koszaliński myśliborski policki pyrzycki sławieński stargardzki szczecinecki świdwiński wałecki łobeski m. Koszalin m. Szczecin m. Świnoujście 3201 3202 3203 3204 3205 3206 3207 3208 3209 3210 3211 3212 3213 3214 3215 3216 3217 3218 3261 3262 3263 1.052 1.083 1.083 1.027 1.125 1.090 1.046 0.962 1.109 1.054 0.977 0.997 1.032 1.052 1.154 0.996 1.123 0.978 0.899 0.983 1.061 1.144 1.008 1.014 1.099 1.033 0.975 0.935 1.012 1.158 0.921 1.027 0.840 1.176 0.996 0.902 1.101 1.086 0.903 1.304 1.136 1.050 1.168 1.142 1.126 1.030 1.161 1.156 1.060 0.849 1.087 1.162 0.897 1.085 1.091 1.034 1.308 0.982 1.200 1.053 0.753 0.909 1.110 0.829 1.178 0.947 1.083 1.399 0.915 1.211 0.682 0.916 1.382 0.792 1.037 0.404 1.432 0.801 1.046 1.157 0.748 0.807 0.963 1.084 0.763 1.025 0.874 1.133 1.512 0.845 1.095 0.764 0.870 1.002 1.301 0.889 1.197 1.126 0.955 1.064 0.839 0.792 0.734 1.162 1.165 0.618 0.584 1.196 0.809 1.440 0.930 1.084 1.621 1.311 0.714 1.120 0.818 0.555 0.901 1.035 0.820 0.616 0.851 0.615 0.748 0.978 0.880 1.024 1.151 1.000 0.882 1.267 1.110 1.480 1.076 1.012 0.923 0.914 1.204 1.101 0.887 0.911 1.375 1.098 1.239 1.094 0.740 1.000 1.000 1.000 1.000 1.000 1.000 1.000 Polska Page 224 Respiratory Digestive Ill-defined 0.491 0.745 0.597 0.796 0.832 1.912 0.718 0.661 0.543 0.514 1.175 0.474 0.620 0.899 0.878 0.642 0.993 1.819 0.623 0.953 0.520 0.567 0.824 1.009 0.711 1.383 2.437 0.633 1.110 1.176 0.538 0.990 1.136 0.721 0.869 0.549 0.329 0.796 0.274 1.022 0.934 1.188 0.581 1.049 0.720 0.797 1.055 0.913 0.696 1.216 0.504 1.162 0.817 0.533 0.670 0.997 1.737 0.845 1.113 0.511 1.121 0.972 1.294 0.758 1.029 1.218 0.941 0.813 0.820 0.620 1.208 0.427 1.199 1.034 0.635 0.583 0.700 1.103 0.818 0.992 0.942 0.763 0.815 0.706 0.524 0.817 0.997 0.849 0.966 0.751 External 1.460 0.891 1.494 1.517 1.201 1.475 1.259 1.528 2.192 1.432 1.783 1.458 1.024 1.266 1.555 1.248 1.729 1.091 1.235 1.248 1.610 1.308 2.086 1.024 1.255 1.590 1.030 1.095 1.038 1.191 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Table 65. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, total population 0–64 years old District bolesławiecki dzierżoniowski głogowski górowski jaworski jeleniogórski kamiennogórski kłodzki legnicki lubański lubiński lwówecki milicki oleśnicki oławski polkowicki strzeliński średzki świdnicki trzebnicki wałbrzyski wołowski wrocławski ząbkowicki zgorzelecki złotoryjski m. Jelenia Góra m. Legnica m. Wrocław TERYT 0201 0202 0203 0204 0205 0206 0207 0208 0209 0210 0211 0212 0213 0214 0215 0216 0217 0218 0219 0220 0221 0222 0223 0224 0225 0226 0261 0262 0264 Total 0.956 1.122 0.879 0.992 1.152 1.175 1.155 1.155 1.100 1.114 0.894 1.218 1.059 1.045 0.920 1.020 1.116 1.223 1.137 1.120 1.324 1.070 1.010 1.126 1.236 1.092 0.999 1.104 0.927 Cancer 0.975 1.110 0.945 1.291 1.154 1.077 1.037 1.065 1.132 1.060 1.016 1.139 1.103 1.081 0.929 0.990 1.142 1.080 1.124 1.083 1.201 1.147 0.957 1.065 1.169 1.089 1.018 1.170 0.922 CVD 0.916 1.153 0.897 1.001 1.214 1.314 1.099 1.417 1.157 1.488 0.843 1.217 1.353 1.268 0.899 1.198 1.250 1.449 1.333 1.339 1.353 1.130 1.095 1.311 1.322 1.129 1.026 0.986 0.936 aleksandrowski brodnicki bydgoski chełmiński golubsko-dobrzyński grudziądzki inowrocławski lipnowski mogileński nakielski radziejowski rypiński sępoleński świecki toruński tucholski wąbrzeski włocławski żniński m. Bydgoszcz m. Grudziądz m. Toruń m. Włocławek 0401 0402 0403 0404 0405 0406 0407 0408 0409 0410 0411 0412 0413 0414 0415 0416 0417 0418 0419 0461 0462 0463 0464 1.216 1.038 0.964 1.130 1.017 1.032 1.083 1.217 0.997 1.135 1.075 1.052 0.884 1.017 1.056 0.970 1.099 1.192 0.999 0.916 1.112 0.904 1.114 1.210 1.210 1.063 1.247 1.164 1.141 1.170 1.044 1.054 1.253 1.358 1.152 1.042 1.114 1.262 1.204 1.430 1.012 1.100 1.049 1.289 1.060 1.107 1.236 1.123 0.986 0.849 0.960 0.930 1.287 1.209 1.059 1.507 1.029 1.047 1.043 1.135 0.804 1.074 0.986 1.359 1.059 0.878 1.050 0.774 1.001 0.946 1.386 1.480 1.588 1.541 0.688 1.549 1.705 1.080 0.873 1.393 0.839 1.013 1.158 1.256 1.207 1.175 1.345 1.263 0.838 1.262 1.275 1.141 1.055 0.754 0.739 0.869 0.609 0.483 1.063 0.917 0.689 0.837 0.544 0.488 0.533 0.745 0.705 0.568 0.476 0.848 0.566 0.824 0.988 0.985 1.415 1.489 0.672 0.979 1.648 1.032 1.153 0.415 1.358 1.045 0.483 0.574 0.553 0.159 0.450 0.988 0.413 1.367 0.705 1.057 1.313 0.867 0.977 0.499 1.121 0.978 0.886 1.093 1.070 1.419 1.035 1.495 0.967 1.047 1.126 1.236 0.954 1.172 1.326 1.007 0.701 1.537 0.983 0.647 0.988 0.740 1.346 bialski 0601 1.158 0.776 1.245 0.806 0.774 1.677 1.410 Page 225 Respiratory Digestive Ill-defined 0.680 0.653 0.825 1.333 1.808 0.921 0.867 1.086 0.456 1.209 0.630 0.768 1.142 1.503 0.644 1.624 1.469 0.665 1.360 1.268 1.927 1.631 1.389 0.561 1.872 1.232 1.120 1.143 0.933 0.500 0.890 1.180 0.536 1.171 1.448 0.955 0.673 1.084 0.674 0.785 0.994 0.476 0.516 0.822 1.152 0.527 0.992 0.833 0.569 0.858 1.227 0.974 1.506 1.120 1.078 1.479 0.644 0.876 0.897 1.095 1.380 1.969 1.712 0.984 1.466 0.909 0.838 1.023 1.058 1.243 1.587 0.603 1.132 1.268 1.154 1.007 1.828 0.633 1.417 1.350 0.511 0.996 1.797 1.353 0.668 1.158 1.491 External 1.113 1.015 0.894 0.971 1.338 1.137 0.834 1.228 0.928 0.955 1.022 1.269 0.915 1.108 1.077 1.217 1.101 1.246 1.169 1.110 1.188 0.905 1.084 1.072 1.293 1.281 0.968 0.917 0.664 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District biłgorajski chełmski hrubieszowski janowski krasnostawski kraśnicki lubartowski lubelski łęczyński łukowski opolski parczewski puławski radzyński rycki świdnicki tomaszowski włodawski zamojski m. Biała Podlaska m. Chełm m. Lublin m. Zamość TERYT 0602 0603 0604 0605 0606 0607 0608 0609 0610 0611 0612 0613 0614 0615 0616 0617 0618 0619 0620 0661 0662 0663 0664 Total 0.885 1.396 1.131 0.892 1.060 0.921 1.073 1.043 1.103 1.067 1.076 1.069 0.939 1.102 1.095 0.954 0.997 1.113 1.057 0.968 0.979 0.935 0.804 Cancer 0.803 0.995 0.956 0.754 0.730 0.826 0.961 0.752 0.861 0.929 0.760 1.109 0.747 1.016 0.938 0.781 0.769 0.843 0.795 0.796 0.727 0.862 0.806 CVD 0.637 1.287 0.734 1.035 1.093 1.009 0.978 1.109 0.967 0.927 1.331 0.950 0.749 0.813 1.184 0.727 0.962 0.859 0.746 0.904 1.081 0.798 0.557 gorzowski krośnieński międzyrzecki nowosolski słubicki strzelecko-drezdenecki sulęciński świebodziński zielonogórski żagański żarski wschowski m. Gorzów Wielkopolski m. Zielona Góra 0801 0802 0803 0804 0805 0806 0807 0808 0809 0810 0811 0812 0861 0862 1.033 1.080 1.043 1.040 1.227 1.148 1.145 1.120 1.065 1.179 1.165 1.032 0.907 0.868 1.043 0.901 1.036 1.024 1.319 1.438 1.110 1.003 1.104 1.069 1.092 1.058 0.876 0.946 0.881 1.403 0.975 0.914 1.253 0.848 1.114 1.306 0.930 1.554 1.497 0.881 0.775 0.728 0.848 0.999 1.259 0.914 1.356 1.478 0.423 1.530 1.161 0.913 0.792 0.566 0.799 0.587 0.618 1.075 1.036 1.175 1.052 0.630 0.743 0.909 0.951 1.072 1.030 0.591 0.740 0.894 1.633 0.558 1.470 0.527 1.007 1.396 0.937 0.929 1.397 0.373 0.716 1.245 1.654 1.026 1.231 1.135 0.926 1.175 1.206 1.230 1.321 1.025 1.129 1.217 1.265 0.992 0.676 0.853 bełchatowski kutnowski łaski łęczycki łowicki łódzki wschodni opoczyński pabianicki pajęczański piotrkowski poddębicki radomszczański rawski sieradzki skierniewicki tomaszowski wieluński wieruszowski 1001 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1012 1013 1014 1015 1016 1017 1018 0.994 1.452 1.171 1.213 1.129 1.225 1.164 1.211 1.064 1.291 1.430 1.150 1.062 1.038 1.090 1.348 1.051 1.167 0.885 1.306 1.063 0.987 1.025 1.016 1.003 0.981 1.084 0.980 1.203 1.005 0.890 1.014 0.996 1.088 0.985 1.181 1.006 1.117 1.078 1.355 1.565 1.267 1.202 0.978 0.967 1.478 1.494 1.047 0.809 1.118 1.017 1.364 1.228 1.610 0.674 1.760 0.952 1.379 1.415 0.937 0.958 1.215 0.686 0.949 1.078 1.173 0.932 1.065 0.808 1.184 1.147 0.943 1.069 1.445 1.110 1.014 1.026 1.379 1.207 1.600 0.807 1.200 1.056 0.946 1.127 0.977 1.050 1.518 0.702 1.047 1.056 2.851 1.492 0.745 0.423 1.133 1.036 1.766 1.256 0.903 2.092 1.966 1.179 0.646 0.390 2.101 0.788 0.512 1.236 1.491 1.477 1.829 1.106 1.322 1.536 1.371 1.131 1.832 1.744 1.292 1.753 1.252 1.753 1.345 1.117 1.144 Page 226 Respiratory Digestive Ill-defined 0.737 0.446 2.050 1.107 0.971 2.863 0.935 0.965 2.311 0.718 0.758 1.291 1.337 0.892 1.924 0.444 0.784 1.117 0.535 0.897 1.958 1.022 0.777 2.044 1.370 0.889 2.773 0.544 0.713 2.189 0.573 0.963 1.539 0.408 0.786 2.047 0.634 0.744 2.451 0.750 0.931 1.880 0.494 0.752 2.188 0.559 0.830 2.658 0.424 1.011 1.142 0.730 1.103 1.588 0.910 0.680 2.285 0.872 0.624 1.689 0.740 0.984 1.913 0.859 0.987 2.336 0.717 0.792 1.446 External 0.689 1.556 1.230 0.533 0.916 0.817 1.035 0.841 0.824 0.971 0.931 0.864 0.741 1.295 0.893 0.595 1.342 1.429 1.355 0.887 0.787 0.412 0.828 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District zduńskowolski zgierski brzeziński m. Łódź m. Piotrków Trybunalski m. Skierniewice TERYT 1019 1020 1021 1061 1062 1063 Total 1.219 1.234 1.384 1.368 1.212 0.930 Cancer 1.122 1.049 1.069 1.061 1.068 1.016 CVD 1.076 1.159 1.566 1.134 1.248 0.848 bocheński brzeski chrzanowski dąbrowski gorlicki krakowski limanowski miechowski myślenicki nowosądecki nowotarski olkuski oświęcimski proszowicki suski tarnowski tatrzański wadowicki wielicki m. Kraków m. Nowy Sącz m. Tarnów 1201 1202 1203 1204 1205 1206 1207 1208 1209 1210 1211 1212 1213 1214 1215 1216 1217 1218 1219 1261 1262 1263 0.815 0.790 0.913 0.820 0.775 0.882 0.851 1.031 0.858 0.858 0.801 0.900 0.866 1.027 0.932 0.804 0.929 0.912 0.884 0.802 0.733 0.856 0.999 0.805 0.872 0.891 0.778 0.936 0.915 1.006 0.958 0.919 0.830 0.925 1.063 0.978 1.026 0.869 0.894 1.022 0.932 0.878 0.796 0.859 0.832 1.000 0.962 1.086 0.841 0.957 0.858 1.056 0.862 0.910 0.824 0.810 0.916 0.976 1.121 0.985 1.055 0.969 0.937 0.739 0.785 1.031 0.667 0.753 0.914 0.630 0.956 0.879 1.044 0.414 0.534 0.861 0.761 0.600 1.154 0.752 0.489 0.587 0.641 0.847 0.643 0.698 0.677 0.786 0.616 0.675 0.980 0.466 0.738 0.728 0.533 0.573 0.769 0.740 0.582 0.722 0.859 0.610 0.700 0.474 1.253 0.845 0.745 0.824 0.650 0.829 0.557 0.384 1.009 0.361 0.584 0.828 0.446 0.646 0.448 0.742 0.774 1.430 0.460 0.890 0.474 0.455 0.548 0.638 0.861 0.921 0.653 0.720 0.830 0.769 0.921 0.708 0.684 0.839 1.057 1.706 1.026 0.813 0.834 0.848 0.664 1.492 1.009 0.836 0.970 0.868 0.854 0.720 0.551 0.745 białobrzeski ciechanowski garwoliński gostyniński grodziski grójecki kozienicki legionowski lipski łosicki makowski miński mławski nowodworski ostrołęcki ostrowski otwocki piaseczyński płocki płoński pruszkowski przasnyski przysuski pułtuski radomski siedlecki sierpecki 1401 1402 1403 1404 1405 1406 1407 1408 1409 1410 1411 1412 1413 1414 1415 1416 1417 1418 1419 1420 1421 1422 1423 1424 1425 1426 1427 1.154 1.105 1.077 1.055 1.029 1.201 0.995 0.884 1.058 1.047 1.134 1.143 1.252 1.189 1.094 1.042 0.997 0.890 1.156 1.267 0.889 1.303 1.103 1.144 1.018 1.106 1.197 1.073 1.151 0.898 1.136 1.136 1.116 1.070 0.924 0.789 0.944 1.023 1.006 1.338 1.239 0.994 0.906 0.934 0.887 1.146 1.144 0.965 1.130 0.992 1.202 0.988 0.980 1.466 1.171 1.120 1.110 0.861 1.011 1.474 0.844 0.882 1.162 1.016 1.144 1.272 1.269 1.110 1.168 1.050 0.958 0.800 0.974 1.276 0.813 1.594 1.267 1.040 0.881 1.053 1.055 1.061 1.237 1.246 1.111 0.982 1.147 0.811 0.996 1.472 0.690 1.421 1.450 1.099 1.151 1.318 1.080 0.942 1.062 1.386 1.006 1.000 1.336 1.236 1.224 1.029 1.306 1.143 0.902 1.016 1.020 0.669 0.877 0.994 0.775 0.723 0.708 1.150 0.592 0.940 0.930 1.016 0.483 1.034 0.916 1.043 0.751 0.994 1.079 1.021 0.678 0.577 0.699 0.727 0.858 0.697 0.436 1.168 1.982 1.136 0.581 1.227 0.900 0.828 0.895 0.747 0.639 1.066 0.955 0.868 0.874 1.609 0.795 1.923 1.196 0.820 0.714 0.558 0.473 1.295 0.984 1.036 1.420 1.430 1.403 1.011 1.035 1.539 1.189 0.958 1.681 1.394 1.700 1.569 1.378 1.584 1.478 1.413 1.115 1.049 1.189 1.683 0.906 1.520 1.451 1.807 1.308 1.538 1.388 Page 227 Respiratory Digestive Ill-defined 0.814 1.452 1.995 1.389 1.702 1.413 1.223 1.760 0.667 1.529 1.911 3.276 1.621 1.420 1.011 0.799 1.010 0.696 External 1.058 1.357 1.760 1.020 1.250 0.956 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District sochaczewski sokołowski szydłowiecki warszawski zachodni węgrowski wołomiński wyszkowski zwoleński żuromiński żyrardowski m. Ostrołęka m. Płock m. Radom m. Siedlce m. st. Warszawa TERYT 1428 1429 1430 1432 1433 1434 1435 1436 1437 1438 1461 1462 1463 1464 1465 Total 1.127 0.949 1.153 0.848 1.155 1.066 1.087 1.167 0.991 1.241 0.869 1.061 1.016 0.898 0.843 Cancer 1.061 0.931 1.056 0.872 1.025 0.981 0.930 1.117 1.106 1.128 0.827 1.149 0.900 0.899 0.884 CVD 1.315 1.074 1.298 0.794 1.109 1.034 1.058 1.225 1.072 1.233 0.778 0.848 0.985 0.956 0.775 brzeski głubczycki kędzierzyńsko-kozielski kluczborski krapkowicki namysłowski nyski oleski opolski prudnicki strzelecki m. Opole 1601 1602 1603 1604 1605 1606 1607 1608 1609 1610 1611 1661 1.023 1.051 0.888 0.960 0.843 0.974 0.958 0.816 0.735 1.023 0.855 0.763 1.061 1.143 0.984 1.060 0.885 1.115 1.022 0.865 0.735 1.243 0.854 0.831 0.848 1.264 0.910 1.145 0.904 0.745 1.055 1.127 0.811 1.046 1.087 0.808 1.082 1.195 1.039 0.739 1.005 1.383 1.150 0.996 0.893 1.061 1.070 1.034 0.924 0.752 0.890 0.770 0.623 0.793 0.849 0.625 0.562 0.494 0.812 0.756 1.761 0.514 0.960 0.509 0.636 1.293 0.738 0.225 0.572 0.963 0.519 0.611 1.006 1.107 0.729 1.012 0.829 1.146 0.997 0.760 0.784 1.032 0.733 0.653 bieszczadzki brzozowski dębicki jarosławski jasielski kolbuszowski krośnieński leżajski lubaczowski łańcucki mielecki niżański przemyski przeworski ropczycko-sędziszowski rzeszowski sanocki stalowowolski strzyżowski tarnobrzeski leski m. Krosno m. Przemyśl m. Rzeszów m. Tarnobrzeg 1801 1802 1803 1804 1805 1806 1807 1808 1809 1810 1811 1812 1813 1814 1815 1816 1817 1818 1819 1820 1821 1861 1862 1863 1864 0.933 0.751 0.801 0.897 0.850 0.719 0.804 0.772 0.914 0.810 0.755 0.856 0.894 0.798 0.816 0.772 0.744 0.773 0.742 0.835 0.788 0.740 0.917 0.682 0.780 0.890 0.822 0.846 0.868 0.958 0.734 0.810 0.785 0.810 0.832 0.841 0.857 0.837 0.816 0.858 0.852 0.763 0.792 0.796 0.739 0.906 0.866 0.877 0.703 0.797 1.118 0.804 0.893 0.963 0.925 0.851 0.921 0.669 0.980 0.771 0.876 0.968 0.721 0.808 0.986 0.804 0.845 0.895 0.935 0.969 0.628 0.713 0.799 0.713 0.839 0.516 0.810 0.509 0.726 0.610 0.814 0.821 0.514 1.109 0.506 0.553 0.366 0.464 0.201 0.513 0.610 0.618 0.386 0.392 0.633 0.436 0.482 0.877 0.602 0.326 0.301 0.532 0.731 0.566 0.794 0.424 0.493 0.762 0.739 0.708 0.635 0.586 0.772 0.519 0.461 0.566 0.515 0.873 0.527 0.657 0.770 0.806 1.114 0.518 0.798 0.466 0.260 0.380 1.052 0.419 0.140 0.320 0.768 0.596 0.601 0.311 0.681 1.510 0.699 0.395 0.438 0.307 0.346 0.159 0.340 0.498 0.218 1.250 0.591 0.462 1.294 0.811 0.750 0.935 0.834 0.908 0.896 0.816 1.109 0.910 0.627 0.876 1.012 0.913 0.991 0.825 0.912 0.728 0.805 0.934 0.980 0.785 0.723 0.558 0.667 augustowski białostocki bielski 2001 2002 2003 0.968 0.986 1.042 0.933 0.906 1.075 0.752 0.944 0.965 0.731 1.231 0.812 1.246 0.940 0.854 0.783 0.933 0.422 1.192 1.070 1.564 Page 228 Respiratory Digestive Ill-defined 1.039 0.868 0.976 1.227 0.642 0.500 0.869 0.860 0.600 0.852 0.889 0.895 1.619 1.035 1.392 1.354 1.091 1.425 1.704 0.954 0.681 1.560 0.560 0.471 1.450 0.434 0.639 1.284 1.221 1.922 1.299 0.677 0.878 1.263 1.081 1.809 0.942 1.010 1.542 0.891 0.999 0.607 0.960 1.104 1.101 External 1.245 1.249 1.608 0.884 1.505 1.139 1.553 1.544 0.996 1.230 0.882 0.862 1.062 1.009 0.645 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District grajewski hajnowski kolneński łomżyński moniecki sejneński siemiatycki sokólski suwalski wysokomazowiecki zambrowski m. Białystok m. Łomża m. Suwałki TERYT 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2061 2062 2063 Total 0.985 1.165 0.935 0.975 0.903 1.106 1.084 1.160 1.051 0.979 0.914 0.796 0.855 0.914 Cancer 0.995 0.962 0.911 0.885 0.800 0.924 1.028 0.994 0.998 0.903 0.940 0.785 0.986 0.963 CVD 0.920 1.069 0.719 0.772 0.791 1.120 1.111 1.269 1.378 0.978 0.688 0.660 0.689 0.856 bytowski chojnicki człuchowski gdański kartuski kościerski kwidzyński lęborski malborski nowodworski pucki słupski starogardzki tczewski wejherowski sztumski m. Gdańsk m. Gdynia m. Słupsk m. Sopot 2201 2202 2203 2204 2205 2206 2207 2208 2209 2210 2211 2212 2213 2214 2215 2216 2261 2262 2263 2264 0.897 0.916 1.014 0.920 0.811 0.926 1.073 1.056 1.032 1.086 0.935 1.169 1.067 1.018 0.931 1.124 0.914 0.831 1.069 0.863 0.870 0.980 1.146 1.068 0.952 1.169 1.205 1.149 1.049 1.191 1.121 1.286 1.193 1.196 1.046 1.407 1.021 0.961 0.997 1.036 0.887 1.005 0.906 0.904 0.877 0.933 1.410 0.992 1.003 1.128 0.888 0.891 1.016 1.018 0.881 1.130 0.920 0.825 0.772 0.893 1.012 0.836 0.577 0.923 0.622 1.294 0.606 0.858 1.031 1.483 0.824 1.233 1.358 1.043 1.125 0.275 1.121 1.015 0.494 1.100 0.693 0.795 0.791 0.773 0.617 0.472 0.967 0.785 1.159 0.923 0.885 0.943 0.908 1.034 0.852 1.202 1.078 0.915 1.493 0.985 0.605 0.730 1.534 0.254 0.237 0.344 0.191 0.374 1.000 1.111 0.703 1.530 0.281 0.316 0.557 0.279 0.323 0.299 2.027 0.345 1.069 0.864 0.855 1.131 0.905 0.862 1.079 1.471 1.057 0.985 0.754 1.133 1.302 0.975 0.933 1.361 0.879 0.774 0.919 0.612 będziński bielski cieszyński częstochowski gliwicki kłobucki lubliniecki mikołowski myszkowski pszczyński raciborski rybnicki tarnogórski bieruńsko-lędziński wodzisławski zawierciański żywiecki m. Bielsko-Biała m. Bytom m. Chorzów m. Częstochowa 2401 2402 2403 2404 2405 2406 2407 2408 2409 2410 2411 2412 2413 2414 2415 2416 2417 2461 2462 2463 2464 1.206 0.807 0.897 1.117 1.031 0.965 0.835 0.935 1.119 0.885 0.875 0.943 0.960 0.960 0.926 1.184 1.034 0.824 1.271 1.503 1.086 1.068 0.846 1.019 1.094 1.022 0.993 0.844 1.031 1.003 0.869 0.951 0.920 0.949 1.035 0.969 1.053 1.009 0.893 1.126 1.351 1.004 1.277 1.080 1.069 1.105 0.988 1.033 0.917 1.067 1.224 1.124 0.886 1.122 1.144 1.181 1.036 1.259 1.373 1.023 1.156 1.652 0.952 1.173 0.407 0.834 1.125 1.117 1.110 0.742 0.975 1.003 0.905 0.683 1.425 1.217 0.819 0.956 1.102 0.782 0.552 1.384 2.153 1.480 1.703 0.651 0.728 1.050 1.054 0.595 0.914 0.900 1.155 0.729 1.057 1.075 1.076 1.150 0.983 1.437 1.141 0.805 1.595 2.326 1.446 0.818 0.149 0.240 0.913 1.068 0.583 0.440 0.431 0.819 0.125 1.053 0.626 0.729 0.344 0.566 0.409 0.105 0.276 1.722 0.858 1.297 1.257 0.747 0.843 1.300 0.963 1.185 0.758 0.782 1.240 1.037 0.606 0.825 0.709 0.851 0.769 1.281 1.158 0.779 1.295 1.277 1.070 Page 229 Respiratory Digestive Ill-defined 0.707 1.044 0.296 0.797 1.707 0.386 1.051 0.469 2.135 0.750 0.818 0.862 1.503 1.090 0.585 0.366 0.981 0.381 0.628 0.672 0.414 0.581 1.401 0.684 0.720 0.644 0.207 0.867 0.900 0.581 1.054 0.814 0.661 0.830 1.071 0.851 0.746 0.669 0.714 1.057 0.999 0.222 External 1.120 1.696 0.874 1.518 1.085 1.474 1.564 1.450 1.517 1.296 1.324 0.701 0.889 1.063 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District m. Dąbrowa Górnicza m. Gliwice m. Jastrzębie-Zdrój m. Jaworzno m. Katowice m. Mysłowice m. Piekary Śląskie m. Ruda Śląska m. Rybnik m. Siemianowice Śląskie m. Sosnowiec m. Świętochłowice m. Tychy m. Zabrze m. Żory TERYT 2465 2466 2467 2468 2469 2470 2471 2472 2473 2474 2475 2476 2477 2478 2479 Total 1.143 0.985 0.935 1.062 1.131 1.137 1.147 1.382 0.953 1.339 1.164 1.441 0.925 1.115 0.825 Cancer 1.069 1.079 1.022 1.069 1.063 1.195 1.133 1.249 1.025 1.271 1.126 1.118 0.947 1.090 0.950 CVD 1.270 0.874 0.737 1.265 1.165 1.144 1.340 1.451 0.988 1.528 1.218 1.772 1.033 1.019 0.830 buski jędrzejowski kazimierski kielecki konecki opatowski ostrowiecki pińczowski sandomierski skarżyski starachowicki staszowski włoszczowski m. Kielce 2601 2602 2603 2604 2605 2606 2607 2608 2609 2610 2611 2612 2613 2661 0.983 0.995 1.157 1.036 1.054 1.111 0.976 1.031 0.879 1.124 1.066 0.975 0.983 0.809 0.918 0.990 1.296 0.996 0.986 1.088 0.960 1.045 0.911 1.012 0.936 0.907 0.691 0.860 1.138 1.216 0.907 1.002 1.165 1.187 1.218 1.172 0.912 1.414 1.062 1.116 1.116 0.662 0.821 1.033 0.816 0.927 1.199 1.119 0.457 1.084 0.483 0.794 1.102 0.595 1.005 0.678 0.900 0.792 0.786 0.674 0.860 0.641 0.765 0.907 0.918 1.343 1.075 0.797 0.669 0.714 0.565 0.519 1.658 1.400 0.890 1.022 0.779 0.709 0.716 0.584 0.917 0.345 0.712 1.574 1.109 1.104 1.207 1.151 1.188 1.323 0.895 1.091 0.911 1.114 1.195 1.250 1.335 0.572 bartoszycki braniewski działdowski elbląski ełcki giżycki iławski kętrzyński lidzbarski mrągowski nidzicki nowomiejski olecki olsztyński ostródzki piski szczycieński gołdapski węgorzewski m. Elbląg m. Olsztyn 2801 2802 2803 2804 2805 2806 2807 2808 2809 2810 2811 2812 2813 2814 2815 2816 2817 2818 2819 2861 2862 1.249 1.182 1.099 1.201 1.118 1.110 0.971 1.242 1.241 0.995 1.263 0.939 1.107 1.114 1.063 1.093 1.088 1.133 1.234 1.104 0.783 1.135 1.171 1.188 1.327 1.036 0.995 1.153 1.227 1.249 0.932 1.293 1.146 0.984 1.078 1.071 0.872 0.993 1.076 1.179 1.091 0.838 1.023 1.317 1.027 0.800 0.872 0.929 0.856 1.218 1.086 0.923 1.049 0.934 1.154 0.983 0.896 1.088 0.932 0.884 0.801 0.805 0.531 2.048 1.645 1.218 2.073 1.104 2.234 1.214 1.898 1.645 1.850 2.261 1.255 0.788 1.794 1.504 1.634 1.678 1.752 2.703 1.644 1.124 1.641 1.018 0.821 1.025 1.124 1.069 0.666 1.458 1.562 0.808 1.052 0.240 0.750 0.736 1.022 0.575 0.785 0.772 0.924 1.195 0.853 0.719 0.674 0.657 1.960 2.222 1.116 0.759 0.949 1.482 1.280 1.552 0.558 1.199 1.164 1.082 1.194 1.443 2.090 1.853 2.356 1.270 1.703 1.178 1.162 1.225 1.053 1.406 1.100 1.382 1.418 1.119 1.322 1.066 1.254 1.531 1.274 1.477 1.258 1.305 1.483 0.864 0.837 chodzieski czarnkowsko-trzcianecki gnieźnieński gostyński grodziski 3001 3002 3003 3004 3005 0.999 1.004 0.984 0.929 0.959 1.212 1.197 1.103 1.061 0.929 0.877 0.937 1.042 0.893 0.980 0.975 0.666 0.976 0.908 0.714 0.641 0.616 0.958 0.784 1.261 0.971 1.044 0.429 0.920 0.542 0.943 0.978 0.941 0.858 1.180 Page 230 Respiratory Digestive Ill-defined 0.811 1.473 0.864 0.865 1.194 1.093 1.082 0.955 0.917 1.414 1.019 0.709 1.599 1.506 0.839 1.821 1.954 0.503 1.649 1.461 0.807 1.580 2.186 1.084 1.132 1.145 0.595 2.158 1.981 0.528 1.271 1.591 0.971 1.851 2.300 0.732 1.070 1.138 0.555 1.364 1.392 1.309 0.811 1.376 0.158 External 1.024 0.781 0.872 0.902 1.026 0.884 0.786 1.070 0.782 1.106 1.042 1.348 0.800 0.937 0.806 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District jarociński kaliski kępiński kolski koniński kościański krotoszyński leszczyński międzychodzki nowotomyski obornicki ostrowski ostrzeszowski pilski pleszewski poznański rawicki słupecki szamotulski średzki śremski turecki wągrowiecki wolsztyński wrzesiński złotowski m. Kalisz m. Konin m. Leszno m. Poznań TERYT 3006 3007 3008 3009 3010 3011 3012 3013 3014 3015 3016 3017 3018 3019 3020 3021 3022 3023 3024 3025 3026 3027 3028 3029 3030 3031 3061 3062 3063 3064 Total 0.906 1.005 0.831 1.096 0.966 0.921 0.963 0.829 1.063 0.983 1.050 0.925 0.938 1.004 0.953 0.840 0.965 0.956 0.976 1.010 0.921 1.065 1.053 0.927 0.981 1.012 1.027 0.826 0.899 0.888 Cancer 1.021 0.987 0.903 1.153 1.002 1.133 1.098 1.019 1.119 1.074 1.220 1.111 0.931 1.079 1.069 1.006 1.150 1.092 1.107 1.223 1.085 1.165 1.190 1.142 1.046 1.156 1.076 0.939 1.091 1.010 CVD 0.922 0.864 0.826 1.197 0.970 0.801 0.915 0.827 0.953 1.000 1.056 0.883 1.058 0.984 0.845 0.869 1.081 0.930 1.072 1.068 1.016 0.844 0.951 1.116 1.182 0.954 0.976 0.846 0.880 0.906 białogardzki choszczeński drawski goleniowski gryficki gryfiński kamieński kołobrzeski koszaliński myśliborski policki pyrzycki sławieński stargardzki szczecinecki świdwiński wałecki łobeski m. Koszalin m. Szczecin m. Świnoujście 3201 3202 3203 3204 3205 3206 3207 3208 3209 3210 3211 3212 3213 3214 3215 3216 3217 3218 3261 3262 3263 1.242 1.022 1.097 1.141 1.137 1.034 0.987 0.920 1.099 1.097 0.937 1.074 1.159 1.025 1.088 1.129 1.106 1.161 0.813 0.976 0.936 1.364 0.989 1.007 1.134 1.097 1.053 0.764 0.974 1.154 1.016 0.847 1.001 1.279 1.012 1.041 1.184 1.174 1.132 1.065 0.961 1.090 1.289 1.050 1.193 1.064 1.118 1.098 1.216 0.603 1.186 1.102 0.906 1.050 1.313 0.975 1.279 1.123 1.263 1.290 0.744 1.012 0.791 1.118 1.340 0.782 0.979 1.334 0.858 1.387 0.662 0.634 1.302 0.760 0.786 0.498 1.225 0.676 1.148 1.216 1.113 0.531 1.048 0.365 1.125 0.785 0.906 1.102 1.022 0.850 0.857 0.784 0.803 0.898 0.886 0.936 1.021 0.863 0.847 0.855 1.052 0.988 0.655 1.220 1.054 0.412 0.684 0.394 1.027 1.432 0.646 0.646 1.885 1.190 1.202 1.325 1.549 0.601 0.944 0.707 0.912 0.332 0.865 0.725 0.591 1.218 1.540 1.292 1.469 1.408 1.175 1.185 1.089 0.993 1.002 1.162 0.961 1.299 1.420 1.200 1.272 1.312 1.215 1.311 0.700 0.948 0.730 1.000 1.000 1.000 1.000 1.000 1.000 1.000 Polska Page 231 Respiratory Digestive Ill-defined 0.771 0.459 0.339 0.567 0.846 1.379 0.467 0.538 0.441 1.037 1.101 0.464 0.834 0.811 0.605 0.475 0.799 1.078 0.954 1.260 0.514 0.836 0.475 0.499 0.875 0.524 1.392 0.766 0.574 0.730 0.647 1.070 0.829 0.652 0.776 0.746 0.936 0.603 0.421 1.082 0.771 0.859 0.528 0.715 0.884 0.738 0.765 0.603 0.722 0.681 0.423 1.066 0.842 0.283 0.634 0.849 0.513 0.878 0.747 0.348 0.799 0.962 0.256 1.387 1.002 0.948 0.872 0.804 0.491 0.338 0.610 0.237 1.018 0.826 0.338 0.652 0.530 0.709 0.801 1.278 1.109 0.830 1.117 0.395 0.781 0.778 0.423 0.672 0.839 0.975 External 1.218 1.193 1.189 1.278 1.205 0.833 0.954 0.808 1.253 1.019 0.996 0.841 1.111 1.057 0.985 0.767 1.059 1.126 1.046 1.003 0.811 1.250 1.394 0.929 0.977 1.191 0.884 0.807 0.869 0.629 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Table 66. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, males 0–64 years old Cancer District bolesławiecki dzierżoniowski głogowski górowski jaworski jeleniogórski kamiennogórski kłodzki legnicki lubański lubiński lwówecki milicki oleśnicki oławski polkowicki strzeliński średzki świdnicki trzebnicki wałbrzyski wołowski wrocławski ząbkowicki zgorzelecki złotoryjski m. Jelenia Góra m. Legnica m. Wrocław TERYT 0201 0202 0203 0204 0205 0206 0207 0208 0209 0210 0211 0212 0213 0214 0215 0216 0217 0218 0219 0220 0221 0222 0223 0224 0225 0226 0261 0262 0264 Total 0.984 1.143 0.830 0.886 1.141 1.179 1.132 1.155 1.060 1.123 0.858 1.245 1.043 1.051 0.917 0.991 1.087 1.208 1.129 1.110 1.296 1.006 0.983 1.114 1.257 1.111 0.954 1.069 0.912 1.004 1.172 0.842 1.162 1.190 1.099 0.997 1.127 1.196 1.092 0.984 1.162 1.147 1.066 0.911 1.053 1.191 1.087 1.085 1.085 1.144 1.118 0.941 1.006 1.097 1.166 0.871 1.090 0.886 CVD 0.941 1.182 0.887 0.920 1.214 1.319 1.058 1.387 1.109 1.443 0.818 1.276 1.304 1.321 0.906 1.057 1.183 1.404 1.340 1.304 1.318 0.983 1.013 1.343 1.393 1.142 1.037 0.963 0.951 aleksandrowski brodnicki bydgoski chełmiński golubsko-dobrzyński grudziądzki inowrocławski lipnowski mogileński nakielski radziejowski rypiński sępoleński świecki toruński tucholski wąbrzeski włocławski żniński m. Bydgoszcz m. Grudziądz m. Toruń m. Włocławek 0401 0402 0403 0404 0405 0406 0407 0408 0409 0410 0411 0412 0413 0414 0415 0416 0417 0418 0419 0461 0462 0463 0464 1.243 1.021 0.900 1.121 0.993 0.993 1.073 1.225 1.009 1.106 1.032 1.068 0.834 0.936 1.036 0.935 1.029 1.211 1.016 0.880 1.088 0.897 1.085 1.241 1.383 0.980 1.231 1.196 1.042 1.172 1.052 1.124 1.249 1.321 1.202 0.963 1.009 1.267 1.082 1.394 1.096 1.191 1.028 1.297 1.085 0.969 1.250 1.100 0.902 0.834 0.816 0.872 1.263 1.147 1.101 1.487 1.032 1.074 1.014 1.002 0.775 1.137 1.054 1.236 1.028 0.858 1.020 0.788 0.985 1.054 1.475 1.228 1.584 1.500 0.517 1.540 1.989 1.067 1.065 1.272 0.683 0.732 1.063 1.272 1.184 1.016 1.264 1.088 0.865 1.221 1.290 1.302 0.898 0.703 0.782 0.958 0.603 0.398 1.024 0.799 0.653 0.674 0.507 0.500 0.697 0.730 0.652 0.607 0.443 0.775 0.513 0.778 1.051 1.022 1.549 1.526 0.594 0.934 1.514 1.049 1.184 0.429 1.423 0.975 0.523 0.637 0.592 0.112 0.463 0.941 0.390 1.191 0.646 1.138 1.271 0.810 0.946 0.471 1.211 0.932 0.881 1.131 1.110 1.485 1.082 1.510 0.997 1.015 1.101 1.331 0.960 1.127 1.346 0.926 0.700 1.625 1.045 0.638 0.969 0.745 1.327 bialski 0601 1.236 0.762 1.261 0.998 0.831 1.777 1.453 Page 232 Respiratory Digestive Ill-defined 0.668 0.578 0.909 1.269 1.910 0.911 0.938 0.908 0.434 0.919 0.639 0.769 0.988 1.440 0.626 1.634 1.145 0.694 1.555 1.169 2.012 1.540 1.362 0.558 1.349 1.364 0.981 1.077 1.012 0.557 0.860 1.143 0.465 1.577 1.324 0.777 0.385 1.372 0.678 0.885 1.066 0.501 0.513 0.800 1.139 0.628 0.998 0.817 0.435 0.845 1.149 1.095 1.496 1.044 1.147 1.616 0.611 0.921 0.881 1.138 1.506 1.795 1.671 1.134 1.375 0.869 0.922 0.999 1.117 1.489 1.567 0.601 1.099 1.302 1.139 0.619 1.913 0.622 1.352 1.244 0.551 1.107 1.788 1.267 0.675 1.140 1.472 External 1.129 1.033 0.892 0.893 1.326 1.196 0.803 1.234 0.874 0.945 0.989 1.342 0.906 1.096 1.084 1.179 1.083 1.271 1.162 1.111 1.215 0.885 1.089 1.016 1.320 1.282 0.970 0.940 0.636 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Cancer District biłgorajski chełmski hrubieszowski janowski krasnostawski kraśnicki lubartowski lubelski łęczyński łukowski opolski parczewski puławski radzyński rycki świdnicki tomaszowski włodawski zamojski m. Biała Podlaska m. Chełm m. Lublin m. Zamość TERYT 0602 0603 0604 0605 0606 0607 0608 0609 0610 0611 0612 0613 0614 0615 0616 0617 0618 0619 0620 0661 0662 0663 0664 Total 0.941 1.492 1.212 0.931 1.136 0.970 1.132 1.099 1.175 1.134 1.104 1.097 1.007 1.116 1.157 1.015 1.042 1.203 1.140 0.974 1.102 0.957 0.849 0.923 1.158 1.034 0.831 0.804 0.905 0.949 0.854 0.949 0.949 0.777 1.146 0.782 0.992 0.985 0.741 0.789 0.877 0.883 0.673 0.731 0.855 0.807 CVD 0.616 1.224 0.742 0.997 1.135 1.084 1.058 1.078 0.955 0.985 1.278 0.821 0.761 0.854 1.181 0.719 0.954 0.916 0.757 0.832 1.216 0.825 0.555 gorzowski krośnieński międzyrzecki nowosolski słubicki strzelecko-drezdenecki sulęciński świebodziński zielonogórski żagański żarski wschowski m. Gorzów Wielkopolski m. Zielona Góra 0801 0802 0803 0804 0805 0806 0807 0808 0809 0810 0811 0812 0861 0862 1.000 1.107 1.033 0.984 1.200 1.140 1.136 1.122 1.061 1.172 1.177 1.017 0.858 0.838 1.017 0.908 1.006 0.980 1.218 1.551 1.137 1.044 1.077 1.095 1.044 1.097 0.838 0.897 0.844 1.369 1.021 0.816 1.191 0.827 1.106 1.257 0.894 1.577 1.583 0.922 0.744 0.736 0.753 0.756 1.206 0.437 1.623 1.599 0.424 1.228 1.279 0.651 0.691 0.387 0.809 0.482 0.617 1.097 1.022 1.114 1.076 0.620 0.729 0.923 0.951 1.103 1.070 0.568 0.620 0.824 1.473 0.485 1.355 0.541 0.978 1.299 0.931 0.939 1.441 0.376 0.687 1.226 1.587 1.004 1.248 1.251 0.958 1.133 1.219 1.201 1.311 1.067 1.137 1.213 1.220 0.891 0.625 0.844 bełchatowski kutnowski łaski łęczycki łowicki łódzki wschodni opoczyński pabianicki pajęczański piotrkowski poddębicki radomszczański rawski sieradzki skierniewicki tomaszowski wieluński wieruszowski 1001 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1012 1013 1014 1015 1016 1017 1018 1.041 1.502 1.222 1.255 1.159 1.266 1.205 1.226 1.107 1.320 1.496 1.192 1.113 1.070 1.144 1.483 1.128 1.199 0.949 1.312 1.120 0.945 1.069 1.107 1.069 1.013 1.262 1.007 1.341 1.034 0.826 1.024 1.070 1.172 1.055 1.230 0.967 1.145 1.033 1.436 1.703 1.247 1.215 0.956 0.953 1.457 1.413 1.038 0.846 1.096 0.971 1.524 1.344 1.614 0.515 2.110 0.842 1.616 1.296 1.083 0.832 1.132 0.635 0.664 1.243 1.077 1.058 1.134 0.937 1.260 1.308 1.041 1.160 1.525 1.166 0.921 0.966 1.598 1.151 1.457 0.801 1.204 1.050 0.941 1.146 1.116 0.999 1.719 0.853 1.229 1.142 2.878 1.630 0.756 0.420 1.186 1.075 1.846 1.258 0.959 2.239 2.013 1.275 0.729 0.410 2.171 0.788 0.571 1.283 1.430 1.570 1.827 1.028 1.176 1.502 1.310 1.083 1.793 1.752 1.295 1.726 1.290 1.781 1.404 1.132 1.069 Page 233 Respiratory Digestive Ill-defined 0.696 0.415 2.146 1.148 1.063 2.921 1.060 0.944 2.349 0.845 0.934 1.367 1.483 0.884 2.053 0.510 0.877 1.113 0.669 0.868 1.985 0.985 0.855 2.090 1.105 0.943 2.919 0.637 0.810 2.353 0.698 1.070 1.469 0.418 0.800 2.355 0.699 0.819 2.615 0.588 0.928 2.012 0.580 0.739 2.289 0.657 0.917 2.977 0.565 1.173 1.183 0.615 1.409 1.549 1.026 0.718 2.331 0.886 0.654 1.795 1.009 1.140 2.123 0.738 1.039 2.457 0.809 1.001 1.600 External 0.732 1.622 1.363 0.551 0.898 0.838 1.106 0.836 0.848 0.936 0.976 0.949 0.774 1.238 0.925 0.621 1.359 1.428 1.405 0.969 0.831 0.412 0.859 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Cancer District zduńskowolski zgierski brzeziński m. Łódź m. Piotrków Trybunalski m. Skierniewice TERYT 1019 1020 1021 1061 1062 1063 Total 1.252 1.298 1.469 1.381 1.220 0.938 1.158 0.998 1.118 1.015 1.148 0.890 CVD 1.049 1.193 1.512 1.118 1.226 0.899 bocheński brzeski chrzanowski dąbrowski gorlicki krakowski limanowski miechowski myślenicki nowosądecki nowotarski olkuski oświęcimski proszowicki suski tarnowski tatrzański wadowicki wielicki m. Kraków m. Nowy Sącz m. Tarnów 1201 1202 1203 1204 1205 1206 1207 1208 1209 1210 1211 1212 1213 1214 1215 1216 1217 1218 1219 1261 1262 1263 0.773 0.778 0.911 0.806 0.764 0.898 0.841 1.034 0.849 0.874 0.797 0.900 0.870 1.096 0.938 0.815 0.920 0.888 0.891 0.791 0.738 0.870 1.019 0.829 0.873 0.887 0.746 0.976 0.975 0.912 0.925 0.972 0.802 0.946 1.073 1.045 1.071 0.920 0.879 1.064 0.923 0.855 0.763 0.907 0.796 0.935 0.898 1.123 0.845 0.976 0.815 1.088 0.855 0.905 0.828 0.756 0.944 0.998 1.131 1.005 1.000 0.946 0.955 0.751 0.860 1.047 0.628 0.714 0.888 0.654 1.053 0.919 1.004 0.553 0.611 0.884 0.824 0.486 1.215 0.893 0.520 0.525 0.738 0.916 0.727 0.696 0.792 0.631 0.601 0.704 1.091 0.483 0.810 0.743 0.541 0.545 0.770 0.845 0.615 0.627 1.002 0.753 0.822 0.518 1.227 0.759 0.827 0.817 0.704 0.882 0.514 0.417 1.060 0.392 0.578 0.856 0.373 0.645 0.408 0.734 0.789 1.494 0.443 1.016 0.434 0.465 0.427 0.620 0.901 0.930 0.753 0.761 0.781 0.778 0.895 0.695 0.671 0.843 1.107 1.751 1.046 0.845 0.835 0.878 0.668 1.533 0.990 0.854 1.029 0.881 0.849 0.721 0.523 0.782 białobrzeski ciechanowski garwoliński gostyniński grodziski grójecki kozienicki legionowski lipski łosicki makowski miński mławski nowodworski ostrołęcki ostrowski otwocki piaseczyński płocki płoński pruszkowski przasnyski przysuski pułtuski radomski siedlecki sierpecki 1401 1402 1403 1404 1405 1406 1407 1408 1409 1410 1411 1412 1413 1414 1415 1416 1417 1418 1419 1420 1421 1422 1423 1424 1425 1426 1427 1.180 1.108 1.143 1.020 1.031 1.219 1.004 0.872 1.127 1.076 1.217 1.219 1.298 1.226 1.167 1.120 1.058 0.927 1.194 1.296 0.891 1.323 1.162 1.164 1.060 1.174 1.155 1.235 1.109 0.922 1.028 1.114 1.108 1.108 0.914 0.855 0.772 1.091 1.076 1.368 1.247 1.115 1.005 0.953 0.966 1.268 1.176 0.960 1.211 1.013 1.139 1.044 1.015 1.364 1.067 1.119 1.161 0.881 1.022 1.481 0.931 0.903 1.205 1.128 1.250 1.357 1.290 1.140 1.239 1.110 1.002 0.817 0.989 1.292 0.808 1.588 1.326 1.001 0.911 1.096 1.011 1.089 1.035 1.313 0.914 0.880 1.048 0.767 1.057 1.659 0.921 1.323 1.433 1.070 1.245 1.303 1.298 1.027 0.984 1.511 0.855 1.078 1.284 1.287 1.328 1.122 1.519 1.466 0.955 1.179 1.113 0.726 0.885 1.121 0.848 0.705 0.849 1.223 0.621 1.032 1.056 1.222 0.549 1.018 0.906 1.086 0.751 1.028 1.064 1.112 0.822 0.668 0.695 0.783 0.891 0.758 0.412 1.235 1.998 1.161 0.583 1.161 0.896 0.792 0.947 0.799 0.698 1.147 1.031 0.921 0.918 1.740 0.820 1.990 1.258 0.836 0.625 0.538 0.526 1.315 1.048 0.917 1.407 1.471 1.421 1.003 1.045 1.590 1.096 0.893 1.664 1.417 1.788 1.637 1.420 1.575 1.495 1.460 1.149 1.067 1.178 1.692 0.939 1.524 1.445 1.806 1.333 1.582 1.420 Page 234 Respiratory Digestive Ill-defined 0.714 1.530 2.047 1.624 1.766 1.553 1.235 1.641 0.765 1.515 1.907 3.236 1.647 1.268 0.943 0.754 1.002 0.846 External 1.094 1.413 1.887 1.016 1.159 0.965 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Cancer District sochaczewski sokołowski szydłowiecki warszawski zachodni węgrowski wołomiński wyszkowski zwoleński żuromiński żyrardowski m. Ostrołęka m. Płock m. Radom m. Siedlce m. st. Warszawa TERYT 1428 1429 1430 1432 1433 1434 1435 1436 1437 1438 1461 1462 1463 1464 1465 Total 1.133 1.029 1.201 0.872 1.169 1.126 1.151 1.259 0.984 1.251 0.910 1.081 1.062 0.907 0.819 1.004 1.052 1.050 0.974 1.111 1.017 0.983 1.342 1.145 1.086 0.876 1.183 0.914 0.814 0.806 CVD 1.307 1.162 1.360 0.808 1.124 1.035 1.106 1.234 1.015 1.222 0.827 0.844 1.019 0.980 0.780 brzeski głubczycki kędzierzyńsko-kozielski kluczborski krapkowicki namysłowski nyski oleski opolski prudnicki strzelecki m. Opole 1601 1602 1603 1604 1605 1606 1607 1608 1609 1610 1611 1661 1.028 1.035 0.837 0.988 0.811 0.951 0.946 0.823 0.722 1.008 0.863 0.718 1.069 1.056 0.987 1.133 0.991 1.142 1.045 0.902 0.738 1.282 0.928 0.745 0.899 1.248 0.860 1.141 0.808 0.694 1.070 1.112 0.822 1.001 1.028 0.781 1.103 1.124 0.907 0.731 0.829 1.515 1.069 1.036 0.774 1.100 1.241 0.968 0.941 0.862 0.792 0.790 0.447 0.805 0.879 0.635 0.566 0.549 0.797 0.697 1.747 0.518 0.876 0.573 0.648 1.226 0.686 0.200 0.588 0.973 0.500 0.640 0.977 1.144 0.697 1.064 0.845 1.109 0.954 0.812 0.791 1.061 0.765 0.619 bieszczadzki brzozowski dębicki jarosławski jasielski kolbuszowski krośnieński leżajski lubaczowski łańcucki mielecki niżański przemyski przeworski ropczycko-sędziszowski rzeszowski sanocki stalowowolski strzyżowski tarnobrzeski leski m. Krosno m. Przemyśl m. Rzeszów m. Tarnobrzeg 1801 1802 1803 1804 1805 1806 1807 1808 1809 1810 1811 1812 1813 1814 1815 1816 1817 1818 1819 1820 1821 1861 1862 1863 1864 0.886 0.735 0.790 0.901 0.834 0.715 0.806 0.776 0.973 0.841 0.733 0.898 0.873 0.836 0.847 0.795 0.762 0.787 0.756 0.894 0.841 0.731 0.952 0.666 0.788 0.893 0.796 0.848 0.822 0.951 0.699 0.779 0.795 0.874 0.917 0.853 0.942 0.819 0.842 0.902 0.919 0.776 0.808 0.834 0.799 0.998 0.868 0.885 0.658 0.746 1.069 0.781 0.877 0.938 0.920 0.861 0.965 0.683 1.014 0.812 0.860 0.958 0.699 0.871 1.084 0.842 0.895 0.924 0.978 1.068 0.673 0.724 0.801 0.741 0.893 0.688 0.755 0.572 0.740 0.510 0.811 0.825 0.613 1.203 0.417 0.710 0.403 0.384 0.272 0.309 0.657 0.637 0.308 0.440 0.664 0.383 0.397 0.604 0.589 0.186 0.199 0.551 0.747 0.690 0.881 0.471 0.529 0.839 0.639 0.738 0.690 0.653 0.730 0.538 0.473 0.559 0.511 0.970 0.535 0.623 0.917 0.800 1.147 0.467 0.965 0.552 0.280 0.420 1.066 0.418 0.136 0.353 0.770 0.667 0.598 0.324 0.694 1.404 0.747 0.422 0.478 0.291 0.339 0.159 0.376 0.465 0.217 1.318 0.632 0.440 1.072 0.845 0.739 0.960 0.827 0.944 0.877 0.756 1.164 0.962 0.577 0.890 0.965 0.942 1.007 0.845 0.929 0.722 0.788 0.951 1.099 0.812 0.837 0.547 0.701 augustowski białostocki bielski 2001 2002 2003 0.980 1.036 1.059 0.970 0.963 1.111 0.739 1.003 0.950 0.638 1.241 0.666 1.272 0.930 0.856 0.830 0.899 0.442 1.176 1.102 1.615 Page 235 Respiratory Digestive Ill-defined 0.953 0.890 1.096 1.374 0.688 0.507 1.157 0.897 0.624 0.757 0.889 0.898 1.618 0.978 1.340 1.603 1.164 1.511 1.942 1.040 0.767 1.529 0.728 0.506 1.325 0.520 0.643 1.099 1.380 1.988 1.467 0.713 0.856 1.058 1.119 1.935 1.028 1.086 1.629 1.021 1.197 0.616 0.969 1.099 1.119 External 1.235 1.285 1.573 0.889 1.363 1.174 1.580 1.663 0.984 1.222 0.864 0.877 1.061 0.939 0.636 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Cancer District grajewski hajnowski kolneński łomżyński moniecki sejneński siemiatycki sokólski suwalski wysokomazowiecki zambrowski m. Białystok m. Łomża m. Suwałki TERYT 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2061 2062 2063 Total 1.067 1.230 0.986 0.997 0.901 1.178 1.119 1.219 1.142 1.033 0.967 0.816 0.829 0.922 1.072 1.082 0.958 0.915 0.718 0.979 1.178 1.071 1.115 0.911 1.110 0.737 0.938 0.963 CVD 0.991 1.103 0.789 0.772 0.821 1.135 1.076 1.271 1.483 1.046 0.721 0.698 0.719 0.862 bytowski chojnicki człuchowski gdański kartuski kościerski kwidzyński lęborski malborski nowodworski pucki słupski starogardzki tczewski wejherowski sztumski m. Gdańsk m. Gdynia m. Słupsk m. Sopot 2201 2202 2203 2204 2205 2206 2207 2208 2209 2210 2211 2212 2213 2214 2215 2216 2261 2262 2263 2264 0.864 0.840 0.981 0.907 0.796 0.801 1.062 1.066 1.029 1.107 0.887 1.108 0.987 0.996 0.904 1.154 0.884 0.779 1.099 0.842 0.833 0.905 1.212 1.172 0.971 1.015 1.233 1.171 1.096 1.199 1.046 1.372 1.141 1.226 1.022 1.567 0.982 0.872 1.048 1.033 0.815 0.937 0.854 0.831 0.901 0.851 1.406 0.990 1.002 1.192 0.900 0.844 0.931 1.010 0.880 1.103 0.920 0.826 0.747 0.859 1.146 1.031 0.688 0.887 0.619 1.351 0.629 1.006 1.170 1.425 0.695 0.893 1.213 0.897 1.089 0.245 1.133 0.939 0.471 1.140 0.675 0.622 0.709 0.797 0.557 0.382 0.958 0.884 1.218 0.854 0.964 0.728 0.694 1.126 0.785 1.268 1.040 0.867 1.342 1.099 0.572 0.605 1.404 0.268 0.216 0.313 0.190 0.308 0.969 1.190 0.649 1.459 0.274 0.275 0.511 0.257 0.316 0.276 2.160 0.331 1.083 0.845 0.858 1.087 0.949 0.829 1.089 1.484 0.979 1.006 0.717 1.018 1.245 0.989 0.952 1.412 0.859 0.733 0.966 0.578 będziński bielski cieszyński częstochowski gliwicki kłobucki lubliniecki mikołowski myszkowski pszczyński raciborski rybnicki tarnogórski bieruńsko-lędziński wodzisławski zawierciański żywiecki m. Bielsko-Biała m. Bytom m. Chorzów m. Częstochowa 2401 2402 2403 2404 2405 2406 2407 2408 2409 2410 2411 2412 2413 2414 2415 2416 2417 2461 2462 2463 2464 1.242 0.788 0.887 1.142 1.006 0.972 0.818 0.890 1.114 0.881 0.841 0.882 0.926 0.932 0.906 1.208 1.055 0.811 1.201 1.503 1.091 1.122 0.825 1.068 1.121 1.066 1.028 0.864 0.961 0.998 0.933 0.936 0.909 0.888 1.016 1.067 1.095 1.078 0.908 1.064 1.379 0.933 1.299 1.092 1.058 1.104 0.927 1.070 0.883 1.090 1.222 1.107 0.877 1.075 1.122 1.218 1.025 1.304 1.375 1.038 1.033 1.596 0.966 1.175 0.457 0.843 1.178 0.725 1.146 0.738 0.911 1.115 0.972 0.655 1.035 1.297 0.922 0.975 0.960 0.715 0.661 1.551 2.425 1.599 1.775 0.707 0.772 1.112 0.979 0.555 0.899 0.868 1.075 0.605 0.893 1.016 1.008 1.016 0.879 1.437 1.109 0.775 1.453 2.294 1.411 0.814 0.121 0.242 0.975 1.151 0.547 0.425 0.360 0.834 0.120 1.026 0.583 0.664 0.300 0.497 0.403 0.094 0.234 1.538 0.843 1.330 1.230 0.749 0.816 1.292 0.979 1.156 0.746 0.750 1.220 1.044 0.588 0.810 0.688 0.795 0.757 1.330 1.158 0.724 1.257 1.221 1.061 Page 236 Respiratory Digestive Ill-defined 0.951 1.101 0.287 0.692 1.799 0.339 1.116 0.542 2.132 0.866 0.798 0.912 1.491 1.191 0.603 0.244 0.954 0.370 0.731 0.741 0.421 0.568 1.460 0.672 0.785 0.679 0.235 1.051 0.890 0.647 1.071 0.929 0.574 0.823 1.069 0.931 0.732 0.733 0.681 1.102 1.131 0.232 External 1.133 1.642 0.861 1.480 1.115 1.596 1.513 1.443 1.544 1.302 1.314 0.720 0.942 1.080 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Cancer District m. Dąbrowa Górnicza m. Gliwice m. Jastrzębie-Zdrój m. Jaworzno m. Katowice m. Mysłowice m. Piekary Śląskie m. Ruda Śląska m. Rybnik m. Siemianowice Śląskie m. Sosnowiec m. Świętochłowice m. Tychy m. Zabrze m. Żory TERYT 2465 2466 2467 2468 2469 2470 2471 2472 2473 2474 2475 2476 2477 2478 2479 Total 1.137 0.924 0.891 1.049 1.088 1.063 1.156 1.321 0.894 1.279 1.136 1.430 0.887 1.054 0.801 1.023 1.021 0.903 1.151 1.025 1.194 1.126 1.217 0.953 1.227 1.070 1.131 0.918 1.080 0.969 CVD 1.199 0.837 0.763 1.229 1.140 1.041 1.449 1.346 0.959 1.540 1.194 1.684 1.018 0.926 0.838 buski jędrzejowski kazimierski kielecki konecki opatowski ostrowiecki pińczowski sandomierski skarżyski starachowicki staszowski włoszczowski m. Kielce 2601 2602 2603 2604 2605 2606 2607 2608 2609 2610 2611 2612 2613 2661 1.019 1.007 1.174 1.062 1.120 1.117 1.024 1.072 0.903 1.172 1.084 1.000 0.994 0.818 1.021 1.002 1.399 1.058 1.000 1.081 1.046 1.070 0.960 1.003 0.882 0.875 0.693 0.851 1.159 1.215 0.834 1.011 1.242 1.210 1.282 1.226 0.959 1.451 1.111 1.164 1.063 0.667 0.908 0.944 1.078 0.916 1.272 1.295 0.516 1.327 0.480 0.933 1.383 0.650 1.316 0.734 0.952 0.823 0.778 0.734 0.958 0.673 0.878 0.980 0.885 1.390 1.086 0.858 0.724 0.762 0.606 0.542 1.759 1.398 0.963 1.020 0.813 0.755 0.731 0.686 1.013 0.340 0.790 1.622 1.142 1.104 1.140 1.144 1.226 1.225 0.889 1.083 0.918 1.183 1.099 1.327 1.303 0.570 bartoszycki braniewski działdowski elbląski ełcki giżycki iławski kętrzyński lidzbarski mrągowski nidzicki nowomiejski olecki olsztyński ostródzki piski szczycieński gołdapski węgorzewski m. Elbląg m. Olsztyn 2801 2802 2803 2804 2805 2806 2807 2808 2809 2810 2811 2812 2813 2814 2815 2816 2817 2818 2819 2861 2862 1.305 1.179 1.088 1.154 1.153 1.162 0.957 1.277 1.295 0.991 1.305 0.910 1.097 1.096 1.049 1.132 1.108 1.073 1.210 1.057 0.773 1.207 1.278 1.256 1.344 1.141 1.004 1.232 1.294 1.342 0.908 1.407 1.205 1.004 1.034 0.970 0.833 1.013 0.921 1.253 1.067 0.822 1.023 1.327 1.064 0.753 0.820 0.970 0.799 1.217 1.123 0.905 1.074 0.940 1.077 0.984 0.878 1.136 0.914 0.690 0.775 0.776 0.539 2.135 1.159 0.798 1.453 1.008 2.187 1.427 1.935 1.772 1.815 1.972 1.087 1.064 1.511 1.426 1.376 1.436 1.949 2.959 1.409 1.030 1.567 0.841 0.795 0.895 1.113 1.137 0.645 1.518 1.427 0.696 1.193 0.264 0.663 0.705 1.078 0.679 0.875 0.674 0.934 1.155 0.823 0.695 0.656 0.673 1.759 2.280 1.217 0.742 1.014 1.457 1.151 1.520 0.550 1.152 1.048 1.126 1.137 1.419 2.166 1.603 2.324 1.267 1.736 1.157 1.129 1.272 1.069 1.435 1.047 1.380 1.479 1.205 1.361 1.007 1.212 1.481 1.306 1.531 1.304 1.359 1.444 0.762 0.794 chodzieski czarnkowsko-trzcianecki gnieźnieński gostyński grodziski 3001 3002 3003 3004 3005 0.987 0.972 0.938 0.878 0.838 1.243 1.175 1.006 1.027 0.767 0.892 0.888 1.056 0.973 0.891 1.229 0.616 1.132 0.819 0.527 0.547 0.715 0.887 0.686 1.054 1.017 1.032 0.405 0.892 0.477 0.921 0.986 0.912 0.722 1.001 Page 237 Respiratory Digestive Ill-defined 0.848 1.519 0.903 0.810 1.143 1.062 1.102 0.897 0.942 1.215 1.043 0.593 1.548 1.374 0.808 1.697 1.754 0.422 1.332 1.334 0.911 1.568 1.920 1.099 1.211 1.131 0.493 2.032 1.833 0.423 1.333 1.597 0.981 1.891 2.249 0.763 0.993 1.109 0.503 1.480 1.295 1.136 0.677 1.365 0.148 External 1.061 0.750 0.883 0.927 0.988 0.807 0.796 1.056 0.747 0.955 0.966 1.339 0.784 0.879 0.764 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Cancer District jarociński kaliski kępiński kolski koniński kościański krotoszyński leszczyński międzychodzki nowotomyski obornicki ostrowski ostrzeszowski pilski pleszewski poznański rawicki słupecki szamotulski średzki śremski turecki wągrowiecki wolsztyński wrzesiński złotowski m. Kalisz m. Konin m. Leszno m. Poznań TERYT 3006 3007 3008 3009 3010 3011 3012 3013 3014 3015 3016 3017 3018 3019 3020 3021 3022 3023 3024 3025 3026 3027 3028 3029 3030 3031 3061 3062 3063 3064 Total 0.869 1.070 0.822 1.079 0.968 0.926 0.967 0.817 0.975 0.955 1.060 0.932 0.953 1.000 0.947 0.819 0.934 0.984 0.914 0.990 0.875 1.050 0.985 0.913 1.021 0.958 1.033 0.833 0.846 0.869 0.956 1.090 0.855 1.153 1.104 1.194 1.147 1.173 1.001 1.069 1.294 1.108 1.001 1.109 1.037 1.025 1.125 1.168 1.125 1.152 1.130 1.050 1.123 1.191 1.125 1.039 1.084 0.910 1.002 0.975 CVD 0.856 0.882 0.851 1.222 0.948 0.831 0.904 0.767 0.887 0.984 1.085 0.939 0.998 0.948 0.861 0.840 1.132 0.920 0.973 1.146 0.994 0.877 0.874 1.092 1.233 0.924 0.980 0.893 0.846 0.932 białogardzki choszczeński drawski goleniowski gryficki gryfiński kamieński kołobrzeski koszaliński myśliborski policki pyrzycki sławieński stargardzki szczecinecki świdwiński wałecki łobeski m. Koszalin m. Szczecin m. Świnoujście 3201 3202 3203 3204 3205 3206 3207 3208 3209 3210 3211 3212 3213 3214 3215 3216 3217 3218 3261 3262 3263 1.253 1.006 1.086 1.095 1.155 0.981 0.972 0.914 1.037 1.086 0.921 1.093 1.114 0.988 1.093 1.155 1.094 1.213 0.782 0.953 0.918 1.489 1.004 0.994 1.005 1.132 1.065 0.728 1.045 1.128 1.029 0.788 1.090 1.205 1.017 1.118 1.256 1.189 1.243 0.968 0.934 1.074 1.213 0.995 1.174 1.017 1.050 1.004 1.162 0.587 1.110 1.044 0.896 0.957 1.300 0.938 1.219 1.135 1.230 1.268 0.784 0.998 0.845 0.804 1.116 0.804 0.892 1.455 0.796 1.024 0.671 0.530 1.406 0.723 0.699 0.418 0.990 0.801 1.145 1.214 1.474 0.467 1.007 0.305 1.232 0.819 0.916 1.092 1.002 0.917 0.896 0.915 0.816 0.829 0.744 1.024 0.913 0.778 0.761 0.832 1.219 1.182 0.802 1.193 0.862 0.399 0.600 0.345 0.927 1.469 0.588 0.685 1.867 1.138 1.200 1.279 1.572 0.637 0.858 0.684 0.959 0.373 0.863 0.817 0.579 1.278 1.613 1.391 1.403 1.398 1.200 1.117 1.048 0.885 0.933 1.169 0.967 1.296 1.348 1.205 1.294 1.296 1.211 1.284 0.605 0.920 0.792 1.000 1.000 1.000 1.000 1.000 1.000 1.000 Polska Page 238 Respiratory Digestive Ill-defined 0.847 0.498 0.391 0.512 1.009 1.446 0.451 0.555 0.387 1.036 1.142 0.526 0.904 0.708 0.622 0.454 0.877 1.084 1.109 1.378 0.480 0.814 0.538 0.467 0.523 0.523 1.337 0.628 0.556 0.752 0.795 0.975 0.813 0.743 0.779 0.772 1.179 0.721 0.447 0.993 0.738 0.919 0.637 0.710 0.865 0.676 0.760 0.627 0.900 0.548 0.407 1.267 0.856 0.311 0.577 0.761 0.460 0.741 0.764 0.364 0.926 0.932 0.260 1.560 1.065 1.006 0.879 0.871 0.449 0.368 0.696 0.284 0.939 0.944 0.329 0.582 0.507 0.640 0.695 1.356 1.171 0.801 1.288 0.451 0.893 0.970 0.397 0.689 0.864 0.977 External 1.212 1.221 1.235 1.199 1.132 0.824 1.005 0.762 1.112 1.021 1.000 0.846 1.158 1.063 0.985 0.748 0.968 1.180 1.015 0.988 0.686 1.278 1.350 0.924 1.001 1.161 0.892 0.836 0.869 0.604 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Table 67. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, females 0–64 years old Cancer District bolesławiecki dzierżoniowski głogowski górowski jaworski jeleniogórski kamiennogórski kłodzki legnicki lubański lubiński lwówecki milicki oleśnicki oławski polkowicki strzeliński średzki świdnicki trzebnicki wałbrzyski wołowski wrocławski ząbkowicki zgorzelecki złotoryjski m. Jelenia Góra m. Legnica m. Wrocław TERYT 0201 0202 0203 0204 0205 0206 0207 0208 0209 0210 0211 0212 0213 0214 0215 0216 0217 0218 0219 0220 0221 0222 0223 0224 0225 0226 0261 0262 0264 Total 0.891 1.079 0.991 1.192 1.121 1.138 1.193 1.154 1.159 1.078 0.983 1.091 1.038 1.003 0.911 1.044 1.130 1.181 1.165 1.074 1.421 1.204 1.012 1.128 1.165 0.974 1.151 1.235 1.015 0.941 1.029 1.076 1.441 1.077 1.031 1.089 0.980 1.019 1.011 1.053 1.089 1.010 1.095 0.942 0.877 1.053 1.047 1.180 1.054 1.290 1.181 0.952 1.137 1.261 0.949 1.224 1.290 0.986 CVD 0.850 1.080 0.904 1.130 1.104 1.238 1.209 1.511 1.234 1.615 0.919 0.932 1.393 1.047 0.846 1.575 1.373 1.449 1.327 1.320 1.513 1.564 1.250 1.147 1.058 0.966 1.074 1.117 0.975 aleksandrowski brodnicki bydgoski chełmiński golubsko-dobrzyński grudziądzki inowrocławski lipnowski mogileński nakielski radziejowski rypiński sępoleński świecki toruński tucholski wąbrzeski włocławski żniński m. Bydgoszcz m. Grudziądz m. Toruń m. Włocławek 0401 0402 0403 0404 0405 0406 0407 0408 0409 0410 0411 0412 0413 0414 0415 0416 0417 0418 0419 0461 0462 0463 0464 1.158 1.055 1.094 1.138 1.033 1.052 1.113 1.147 0.958 1.170 1.114 0.974 0.956 1.194 1.053 1.007 1.242 1.050 0.913 1.061 1.223 0.993 1.253 1.173 0.960 1.164 1.261 1.103 1.256 1.166 1.021 0.961 1.242 1.385 1.069 1.132 1.249 1.225 1.359 1.468 0.865 0.944 1.099 1.299 1.053 1.304 1.206 1.156 1.198 0.877 1.374 1.002 1.372 1.340 0.922 1.483 0.903 0.900 1.023 1.513 0.825 0.758 0.709 1.629 1.087 1.031 1.220 0.826 1.146 Page 239 Respiratory Digestive Ill-defined 0.717 0.859 0.454 1.517 1.549 0.983 0.658 1.577 0.557 1.915 0.535 0.607 1.502 1.598 0.654 1.542 2.352 0.502 0.824 1.517 1.450 1.865 1.457 0.571 3.220 0.791 1.679 1.307 0.702 0.230 0.964 1.294 0.859 0.000 1.734 1.703 1.427 0.168 0.572 0.496 0.756 0.332 0.513 0.872 1.183 0.216 0.910 0.807 0.905 0.834 1.434 0.561 1.413 1.319 0.910 1.116 0.802 0.688 0.875 0.725 1.100 2.484 1.974 0.554 1.662 1.023 0.526 1.018 0.616 0.546 1.592 0.578 1.198 1.154 1.186 2.030 1.450 0.603 1.656 1.703 0.407 0.768 1.912 1.857 0.695 1.280 1.761 0.675 1.118 2.095 1.568 1.578 1.109 1.577 0.861 1.106 0.319 1.626 1.226 1.722 1.368 1.127 1.194 1.561 1.460 1.678 0.838 1.434 1.349 0.829 1.486 0.873 0.583 0.608 0.589 0.694 1.181 1.214 0.780 1.268 0.609 0.432 0.000 0.761 0.818 0.415 0.547 0.986 0.693 1.006 0.882 0.991 1.199 1.332 0.988 1.106 2.213 0.836 0.783 0.359 0.914 1.332 0.254 0.173 0.326 0.363 0.361 1.095 0.470 2.075 0.864 0.593 1.696 1.203 1.290 0.691 External 1.024 0.943 0.926 1.250 1.266 0.799 0.950 1.181 1.158 0.985 1.235 0.735 0.852 1.102 1.015 1.294 1.025 0.917 1.223 0.972 1.089 0.935 0.939 1.323 1.096 1.143 1.054 0.901 0.897 0.633 1.152 0.863 0.862 0.715 0.823 0.803 1.252 0.753 1.151 1.086 0.611 0.779 1.356 1.106 1.348 0.646 0.754 0.566 0.796 1.188 0.867 1.658 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Cancer District bialski biłgorajski chełmski hrubieszowski janowski krasnostawski kraśnicki lubartowski lubelski łęczyński łukowski opolski parczewski puławski radzyński rycki świdnicki tomaszowski włodawski zamojski m. Biała Podlaska m. Chełm m. Lublin m. Zamość TERYT 0601 0602 0603 0604 0605 0606 0607 0608 0609 0610 0611 0612 0613 0614 0615 0616 0617 0618 0619 0620 0661 0662 0663 0664 Total 0.898 0.695 1.023 0.884 0.712 0.847 0.784 0.873 0.859 0.865 0.841 0.958 0.961 0.815 1.001 0.870 0.833 0.810 0.824 0.755 0.998 0.779 0.986 0.748 0.793 0.617 0.731 0.839 0.620 0.626 0.717 0.968 0.597 0.720 0.891 0.729 1.053 0.715 1.038 0.853 0.842 0.726 0.781 0.651 0.959 0.739 0.903 0.816 CVD 1.114 0.662 1.355 0.676 1.040 0.937 0.754 0.650 1.151 0.933 0.673 1.420 1.333 0.764 0.614 1.105 0.784 0.896 0.606 0.632 1.187 0.833 0.855 0.611 gorzowski krośnieński międzyrzecki nowosolski słubicki strzelecko-drezdenecki sulęciński świebodziński zielonogórski żagański żarski wschowski m. Gorzów Wielkopolski m. Zielona Góra 0801 0802 0803 0804 0805 0806 0807 0808 0809 0810 0811 0812 0861 0862 1.061 0.959 1.018 1.170 1.257 1.101 1.100 1.101 1.012 1.163 1.117 1.047 1.065 0.987 1.058 0.873 1.059 1.077 1.448 1.239 1.055 0.941 1.114 1.023 1.152 0.993 0.937 1.024 0.919 1.411 0.740 1.213 1.394 0.837 1.043 1.441 0.961 1.410 1.178 0.717 0.921 0.767 1.056 1.616 1.333 2.160 0.585 1.046 0.393 2.302 0.749 1.588 1.046 1.025 0.815 0.878 0.579 0.957 1.024 1.338 0.942 0.612 0.727 0.858 0.890 0.950 0.901 0.640 1.089 1.133 2.200 0.849 1.870 0.458 1.071 1.670 0.825 0.855 1.016 0.334 0.823 1.274 2.120 1.252 1.013 0.385 0.669 1.391 1.050 1.234 1.153 0.779 0.975 1.170 1.485 1.481 1.012 1.034 bełchatowski kutnowski łaski łęczycki łowicki łódzki wschodni opoczyński pabianicki pajęczański piotrkowski poddębicki radomszczański rawski sieradzki skierniewicki tomaszowski wieluński 1001 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1012 1013 1014 1015 1016 1017 0.822 1.352 1.026 1.077 1.034 1.124 0.976 1.247 0.856 1.138 1.203 1.004 0.869 0.936 0.851 1.032 0.816 0.770 1.305 0.983 1.042 0.960 0.890 0.889 0.961 0.788 0.925 1.003 0.958 0.972 0.995 0.865 0.978 0.876 1.052 1.061 1.206 1.045 1.085 1.330 1.042 1.133 0.891 1.418 1.691 1.026 0.621 1.154 1.051 0.894 0.786 1.081 0.898 1.227 0.715 1.706 0.561 1.240 1.497 0.773 1.674 0.604 1.390 0.530 0.858 0.377 1.004 0.670 0.754 1.255 0.928 1.243 1.169 0.785 1.266 2.073 0.735 1.092 1.011 0.915 0.996 0.557 1.083 0.992 0.237 0.552 2.826 0.797 0.645 0.417 0.900 0.667 1.674 0.974 0.495 1.155 1.568 0.567 0.231 0.204 1.838 0.720 0.911 1.838 0.872 1.698 1.474 2.121 1.425 1.860 1.147 1.773 1.411 1.142 1.646 0.962 1.159 1.045 0.927 Page 240 Respiratory Digestive Ill-defined 0.256 0.551 0.967 0.813 0.509 1.373 0.900 0.594 2.022 0.569 0.985 1.942 0.298 0.142 0.646 0.930 0.886 1.213 0.267 0.505 1.077 0.151 0.933 1.627 1.081 0.512 1.638 2.029 0.689 1.825 0.265 0.383 1.149 0.209 0.599 1.699 0.371 0.707 0.401 0.503 0.579 1.933 1.150 0.874 0.989 0.228 0.750 1.461 0.329 0.624 1.426 0.000 0.446 0.760 1.008 0.157 1.609 0.520 0.496 1.619 0.882 0.593 1.471 0.170 0.700 1.430 1.236 0.980 2.408 0.539 0.326 1.029 External 0.932 0.359 0.837 0.332 0.302 0.939 0.646 0.512 0.791 0.622 1.010 0.580 0.255 0.599 1.386 0.547 0.477 1.008 1.247 0.789 0.579 0.713 0.511 0.796 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Cancer District wieruszowski zduńskowolski zgierski brzeziński m. Łódź m. Piotrków Trybunalski m. Skierniewice TERYT 1018 1019 1020 1021 1061 1062 1063 Total 1.027 1.161 1.122 1.168 1.456 1.273 0.945 1.098 1.080 1.130 1.008 1.150 0.991 1.190 CVD 1.484 1.189 1.113 1.740 1.326 1.440 0.739 bocheński brzeski chrzanowski dąbrowski gorlicki krakowski limanowski miechowski myślenicki nowosądecki nowotarski olkuski oświęcimski proszowicki suski tarnowski tatrzański wadowicki wielicki m. Kraków m. Nowy Sącz m. Tarnów 1201 1202 1203 1204 1205 1206 1207 1208 1209 1210 1211 1212 1213 1214 1215 1216 1217 1218 1219 1261 1262 1263 0.877 0.779 0.912 0.801 0.780 0.802 0.811 0.957 0.813 0.756 0.788 0.870 0.854 0.784 0.842 0.727 0.973 0.945 0.839 0.884 0.760 0.876 0.945 0.757 0.867 0.883 0.817 0.863 0.806 1.125 0.982 0.820 0.863 0.877 1.050 0.858 0.937 0.783 0.922 0.950 0.932 0.928 0.853 0.816 0.867 1.133 1.156 0.843 0.792 0.825 0.898 0.844 0.767 0.823 0.775 0.939 0.832 0.812 0.955 0.834 1.261 0.996 0.825 0.784 0.630 1.083 0.725 0.814 0.974 0.520 0.670 0.727 1.067 0.000 0.266 0.735 0.567 0.885 0.997 0.309 0.364 0.721 0.413 0.637 0.393 0.757 0.441 1.214 0.616 0.540 0.673 0.367 0.503 0.648 0.449 0.614 0.687 0.350 0.461 0.968 0.465 0.147 0.259 0.303 1.353 1.064 0.486 0.909 0.552 0.756 0.695 0.174 0.772 0.139 0.569 0.621 0.716 0.559 0.561 0.653 0.651 1.050 0.531 0.168 0.585 0.342 1.103 0.676 0.622 1.037 0.315 0.651 1.017 0.624 1.051 0.655 0.693 0.757 0.568 1.196 0.735 0.515 0.793 0.648 0.631 1.068 0.939 0.622 0.694 0.740 0.853 0.845 0.758 0.653 białobrzeski ciechanowski garwoliński gostyniński grodziski grójecki kozienicki legionowski lipski łosicki makowski miński mławski nowodworski ostrołęcki ostrowski otwocki piaseczyński płocki płoński pruszkowski przasnyski przysuski pułtuski radomski siedlecki 1401 1402 1403 1404 1405 1406 1407 1408 1409 1410 1411 1412 1413 1414 1415 1416 1417 1418 1419 1420 1421 1422 1423 1424 1425 1426 0.978 1.073 0.835 1.126 1.050 1.100 0.902 0.934 0.751 0.886 0.807 0.906 1.096 1.070 0.753 0.757 0.873 0.822 0.971 1.151 0.933 1.153 0.847 1.022 0.843 0.807 0.799 1.201 0.848 1.281 1.174 1.112 0.985 0.939 0.658 1.186 0.895 0.897 1.286 1.218 0.781 0.738 0.918 0.788 0.938 1.091 0.990 0.990 0.942 1.273 0.886 0.905 1.379 1.090 0.832 0.774 1.020 1.353 0.450 0.841 0.823 0.532 0.619 0.925 1.147 0.972 0.698 0.725 0.857 0.772 0.816 1.167 0.894 1.445 0.915 1.078 0.695 0.747 0.882 1.752 0.976 1.612 1.267 1.365 0.869 0.859 0.748 0.000 1.571 1.447 1.144 0.875 1.204 0.384 0.753 1.286 0.926 1.379 0.872 1.382 0.989 0.851 0.704 0.565 0.632 0.533 0.663 0.502 0.882 0.574 0.502 0.793 0.176 0.818 0.440 0.632 0.534 0.403 0.188 0.991 0.960 0.956 0.686 0.859 1.186 0.649 0.157 0.264 0.659 0.454 0.237 0.533 0.672 1.868 1.095 0.509 1.373 0.976 0.803 0.463 0.332 0.308 0.606 0.552 0.317 0.511 1.096 0.729 1.277 0.815 0.852 1.025 0.535 0.150 1.011 0.409 1.153 1.117 1.080 1.029 1.053 1.083 1.542 1.376 1.298 0.891 0.823 1.070 1.010 1.575 0.904 0.887 0.981 1.027 1.055 1.461 0.863 1.172 1.117 1.567 0.963 0.864 Page 241 Respiratory Digestive Ill-defined 0.630 0.448 0.170 1.084 1.275 1.848 0.851 1.601 0.921 1.198 2.071 0.216 1.710 2.115 4.081 1.679 1.911 1.437 0.944 1.084 0.124 External 1.407 0.892 1.156 1.002 1.245 1.873 1.004 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Cancer District sierpecki sochaczewski sokołowski szydłowiecki warszawski zachodni węgrowski wołomiński wyszkowski zwoleński żuromiński żyrardowski m. Ostrołęka m. Płock m. Radom m. Siedlce m. st. Warszawa TERYT 1427 1428 1429 1430 1432 1433 1434 1435 1436 1437 1438 1461 1462 1463 1464 1465 Total 1.274 1.099 0.673 0.947 0.796 1.013 0.926 0.883 0.835 0.980 1.246 0.800 1.078 0.967 0.927 0.967 1.607 1.135 0.729 1.048 0.734 0.867 0.937 0.849 0.772 1.053 1.193 0.766 1.127 0.901 1.019 1.006 CVD 1.161 1.322 0.664 0.955 0.755 0.907 1.041 0.849 1.077 1.224 1.312 0.670 0.939 0.980 0.962 0.855 brzeski głubczycki kędzierzyńsko-kozielski kluczborski krapkowicki namysłowski nyski oleski opolski prudnicki strzelecki m. Opole 1601 1602 1603 1604 1605 1606 1607 1608 1609 1610 1611 1661 0.983 1.026 1.014 0.883 0.899 0.974 0.957 0.757 0.739 1.031 0.798 0.910 1.039 1.249 0.980 0.965 0.722 1.047 0.975 0.794 0.719 1.174 0.736 0.957 0.644 1.189 1.060 1.154 1.175 0.843 0.943 1.085 0.715 1.141 1.208 0.959 0.991 1.308 1.375 0.761 1.446 0.912 1.323 0.824 1.180 0.915 0.542 1.260 0.848 0.366 1.155 0.705 1.110 0.702 0.729 0.560 0.523 0.316 0.810 0.961 1.718 0.419 1.329 0.202 0.533 1.443 0.931 0.322 0.439 0.844 0.558 0.578 1.103 0.719 0.903 0.697 0.724 1.217 1.173 0.399 0.702 0.834 0.508 0.927 bieszczadzki brzozowski dębicki jarosławski jasielski kolbuszowski krośnieński leżajski lubaczowski łańcucki mielecki niżański przemyski przeworski ropczycko-sędziszowski rzeszowski sanocki stalowowolski strzyżowski tarnobrzeski leski m. Krosno m. Przemyśl m. Rzeszów m. Tarnobrzeg 1801 1802 1803 1804 1805 1806 1807 1808 1809 1810 1811 1812 1813 1814 1815 1816 1817 1818 1819 1820 1821 1861 1862 1863 1864 1.005 0.754 0.810 0.880 0.870 0.678 0.774 0.723 0.689 0.719 0.784 0.666 0.878 0.661 0.699 0.673 0.686 0.726 0.662 0.644 0.580 0.806 0.913 0.760 0.799 0.864 0.849 0.837 0.930 0.965 0.772 0.848 0.756 0.703 0.710 0.813 0.709 0.849 0.768 0.787 0.741 0.741 0.760 0.733 0.642 0.739 0.878 0.887 0.771 0.874 1.176 0.813 0.908 1.032 0.913 0.718 0.731 0.565 0.762 0.616 0.882 0.879 0.710 0.544 0.592 0.610 0.662 0.775 0.713 0.577 0.385 0.748 0.893 0.696 0.745 0.000 0.916 0.327 0.682 0.861 0.757 0.780 0.211 0.772 0.731 0.107 0.230 0.651 0.000 1.041 0.449 0.561 0.587 0.241 0.518 0.548 0.719 1.598 0.675 0.685 0.586 0.436 0.661 0.213 0.516 0.239 0.366 0.492 0.971 0.606 0.447 0.317 0.817 0.436 0.396 0.550 0.519 0.594 0.458 0.722 0.253 0.888 1.150 0.690 0.426 0.000 0.123 0.173 0.968 0.392 0.135 0.138 0.671 0.137 0.589 0.226 0.481 1.729 0.394 0.224 0.192 0.370 0.371 0.130 0.137 0.575 0.255 1.226 0.514 0.613 2.412 0.512 0.760 0.781 0.800 0.549 0.930 1.072 0.576 0.599 0.856 0.634 1.079 0.657 0.793 0.626 0.790 0.752 0.774 0.758 0.174 0.769 0.312 0.701 0.571 augustowski białostocki 2001 2002 0.915 0.805 0.878 0.813 0.775 0.675 0.963 1.137 1.130 0.911 0.514 0.984 1.187 0.747 Page 242 Respiratory Digestive Ill-defined 0.259 0.729 1.518 1.256 0.800 0.415 0.723 0.453 0.387 0.000 0.673 0.382 1.104 0.900 0.905 1.467 1.096 1.353 0.729 0.894 1.051 1.004 0.659 0.213 1.543 0.000 0.208 1.749 0.166 0.564 1.785 0.837 1.741 0.927 0.621 1.068 1.842 1.069 1.560 0.793 0.886 1.380 0.625 0.576 0.659 1.027 1.219 1.224 External 1.113 1.275 0.832 1.527 0.890 1.985 0.980 1.232 0.515 0.936 1.332 1.066 0.904 1.178 1.514 0.824 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Cancer District bielski grajewski hajnowski kolneński łomżyński moniecki sejneński siemiatycki sokólski suwalski wysokomazowiecki zambrowski m. Białystok m. Łomża m. Suwałki TERYT 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2061 2062 2063 Total 0.925 0.719 0.965 0.717 0.794 0.836 0.829 0.918 0.934 0.676 0.741 0.739 0.823 0.954 0.929 1.002 0.870 0.788 0.828 0.810 0.907 0.827 0.785 0.873 0.795 0.864 0.688 0.868 1.056 0.969 CVD 0.922 0.611 0.924 0.390 0.634 0.591 0.951 1.124 1.159 0.778 0.599 0.542 0.645 0.645 0.887 bytowski chojnicki człuchowski gdański kartuski kościerski kwidzyński lęborski malborski nowodworski pucki słupski starogardzki tczewski wejherowski sztumski m. Gdańsk m. Gdynia m. Słupsk m. Sopot 2201 2202 2203 2204 2205 2206 2207 2208 2209 2210 2211 2212 2213 2214 2215 2216 2261 2262 2263 2264 0.934 1.096 1.050 0.917 0.794 1.212 1.060 0.998 1.014 0.976 1.021 1.248 1.250 1.064 0.965 0.984 1.019 0.977 1.054 0.966 0.903 1.080 1.025 0.894 0.898 1.375 1.146 1.096 0.969 1.160 1.211 1.120 1.262 1.146 1.060 1.139 1.084 1.087 0.946 1.064 1.044 1.199 1.001 1.084 0.681 1.142 1.332 0.942 0.961 0.825 0.783 0.948 1.263 1.023 0.825 1.116 0.975 0.852 0.904 1.078 0.564 0.302 0.238 0.973 0.578 1.077 0.515 0.420 0.629 1.567 1.135 2.096 1.714 1.411 1.170 0.342 1.136 1.231 0.576 1.083 0.697 1.266 0.986 0.670 0.744 0.710 0.951 0.483 0.960 1.074 0.614 1.510 1.492 0.769 1.010 0.936 1.225 1.072 1.973 0.776 0.690 1.277 1.988 0.169 0.303 0.457 0.180 0.660 1.096 0.612 0.894 1.636 0.302 0.499 0.735 0.354 0.383 0.420 1.721 0.449 0.888 0.930 0.767 1.329 0.560 0.960 0.937 1.376 1.458 0.757 0.902 1.631 1.545 0.897 0.787 0.959 1.069 1.051 0.796 0.869 będziński bielski cieszyński częstochowski gliwicki kłobucki lubliniecki mikołowski myszkowski pszczyński raciborski rybnicki tarnogórski bieruńsko-lędziński wodzisławski zawierciański żywiecki m. Bielsko-Biała m. Bytom m. Chorzów 2401 2402 2403 2404 2405 2406 2407 2408 2409 2410 2411 2412 2413 2414 2415 2416 2417 2461 2462 2463 1.133 0.842 0.934 0.982 1.082 0.894 0.851 1.039 1.120 0.871 0.953 1.071 1.036 0.999 0.974 1.086 0.935 0.896 1.451 1.540 0.994 0.867 0.952 1.031 0.957 0.929 0.808 1.122 1.003 0.770 0.965 0.926 1.031 1.052 0.829 0.976 0.894 0.886 1.217 1.334 1.228 1.003 1.121 1.002 1.164 0.826 0.983 0.975 1.207 1.121 0.897 1.222 1.192 0.987 1.063 1.045 1.270 1.060 1.554 1.889 1.181 0.261 0.819 0.900 2.141 0.946 0.726 1.132 0.694 0.693 0.748 2.428 0.992 0.504 0.901 1.445 0.926 0.321 0.965 1.538 1.545 0.484 0.623 0.789 1.245 0.669 0.920 0.980 1.366 1.062 1.508 1.204 1.252 1.486 1.265 1.393 1.174 0.934 1.987 2.454 0.871 0.276 0.238 0.478 0.653 0.678 0.478 0.747 0.738 0.142 1.155 0.784 1.007 0.521 0.876 0.413 0.148 0.484 2.558 0.958 1.463 0.729 1.025 1.162 0.874 1.185 0.772 0.957 1.337 0.970 0.716 0.855 0.818 1.109 0.845 0.944 1.045 1.160 1.503 1.612 Page 243 Respiratory Digestive Ill-defined 1.165 0.774 0.252 0.000 0.810 0.306 1.058 1.371 0.570 0.784 0.186 1.680 0.318 0.754 0.340 1.410 0.662 0.376 0.682 0.965 0.365 0.293 0.413 0.314 0.585 1.110 0.631 0.453 0.434 0.000 0.251 0.831 0.134 0.967 0.447 1.016 0.932 1.188 0.692 0.816 0.545 0.938 0.988 0.703 0.201 External 0.978 0.922 1.761 0.737 1.294 0.682 0.453 1.590 1.193 0.858 0.987 1.246 0.747 0.724 1.102 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Cancer District m. Częstochowa m. Dąbrowa Górnicza m. Gliwice m. Jastrzębie-Zdrój m. Jaworzno m. Katowice m. Mysłowice m. Piekary Śląskie m. Ruda Śląska m. Rybnik m. Siemianowice Śląskie m. Sosnowiec m. Świętochłowice m. Tychy m. Zabrze m. Żory TERYT 2464 2465 2466 2467 2468 2469 2470 2471 2472 2473 2474 2475 2476 2477 2478 2479 Total 1.121 1.147 1.147 1.052 1.103 1.286 1.322 1.119 1.524 1.087 1.507 1.259 1.461 1.017 1.251 0.854 1.110 1.119 1.159 1.190 0.968 1.133 1.195 1.143 1.293 1.119 1.338 1.205 1.097 0.980 1.094 0.887 CVD 0.971 1.470 1.002 0.679 1.400 1.330 1.464 0.980 1.767 1.051 1.527 1.333 2.028 1.074 1.286 0.731 buski jędrzejowski kazimierski kielecki konecki opatowski ostrowiecki pińczowski sandomierski skarżyski starachowicki staszowski włoszczowski m. Kielce 2601 2602 2603 2604 2605 2606 2607 2608 2609 2610 2611 2612 2613 2661 0.833 0.887 1.017 0.849 0.812 0.988 0.865 0.838 0.798 1.022 1.029 0.817 0.856 0.838 0.754 0.944 1.109 0.863 0.949 1.070 0.842 0.986 0.833 1.028 1.017 0.928 0.666 0.887 0.975 1.070 1.049 0.787 0.800 0.932 1.029 0.851 0.723 1.332 0.930 0.781 1.135 0.713 0.534 1.191 0.000 0.846 0.920 0.499 0.308 0.312 0.478 0.449 0.394 0.375 0.000 0.588 0.678 0.631 0.726 0.393 0.507 0.464 0.473 0.592 0.981 1.242 1.047 0.525 0.419 0.650 0.290 0.320 0.828 1.052 0.413 0.794 0.652 0.338 0.603 0.159 0.493 0.299 0.158 1.613 0.758 0.926 1.334 0.932 0.760 1.594 0.954 0.889 0.832 0.755 1.685 0.562 1.205 0.672 bartoszycki braniewski działdowski elbląski ełcki giżycki iławski kętrzyński lidzbarski mrągowski nidzicki nowomiejski olecki olsztyński ostródzki piski szczycieński gołdapski węgorzewski m. Elbląg m. Olsztyn 2801 2802 2803 2804 2805 2806 2807 2808 2809 2810 2811 2812 2813 2814 2815 2816 2817 2818 2819 2861 2862 1.077 1.124 1.109 1.229 1.014 0.956 0.983 1.135 1.068 0.982 1.087 0.969 1.084 1.104 1.068 0.934 0.986 1.226 1.186 1.242 0.870 1.021 0.998 1.091 1.263 0.879 0.978 1.029 1.128 1.112 0.954 1.101 1.044 0.943 1.119 1.202 0.917 0.953 1.282 1.035 1.124 0.879 0.983 1.172 0.885 0.852 1.018 0.773 1.011 1.198 0.923 0.948 0.885 0.841 1.343 0.890 0.913 0.849 0.931 1.466 0.785 0.919 0.575 1.761 2.896 2.309 3.655 1.340 2.320 0.610 1.777 1.266 1.895 2.928 1.644 0.000 2.475 1.663 2.258 2.266 1.085 1.711 2.278 1.449 1.814 1.474 0.878 1.319 1.145 0.855 0.706 1.268 1.895 1.110 0.581 0.155 0.964 0.786 0.829 0.234 0.475 1.007 0.788 1.341 1.012 0.803 0.672 0.553 2.576 1.907 0.609 0.800 0.621 1.497 1.824 1.541 0.526 1.306 1.597 0.808 1.327 1.401 1.422 2.697 2.640 1.529 1.436 1.132 1.297 0.734 0.944 1.164 1.335 1.321 0.943 0.608 0.941 1.271 1.332 1.676 1.011 0.963 0.853 0.848 1.341 1.453 1.231 chodzieski czarnkowsko-trzcianecki gnieźnieński gostyński 3001 3002 3003 3004 1.010 1.039 1.087 1.030 1.154 1.210 1.229 1.095 0.796 1.029 0.970 0.572 0.273 0.768 0.544 1.111 0.892 0.288 1.145 1.032 0.727 0.984 0.531 0.977 1.025 0.827 1.079 1.549 Page 244 Respiratory Digestive Ill-defined 1.257 1.612 1.289 0.700 1.351 0.687 1.016 1.353 1.270 1.038 1.125 0.840 1.951 0.955 1.231 1.814 1.924 1.059 2.140 2.499 0.867 2.473 1.800 0.326 1.598 2.893 0.984 0.899 1.159 1.041 2.515 2.415 1.009 1.146 1.631 0.993 1.730 2.413 0.576 1.270 1.229 0.798 1.013 1.634 2.053 1.136 1.375 0.197 External 1.233 0.849 0.989 0.828 0.760 1.325 1.296 0.723 1.119 0.945 1.960 1.512 1.389 0.910 1.252 1.030 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Cancer District grodziski jarociński kaliski kępiński kolski koniński kościański krotoszyński leszczyński międzychodzki nowotomyski obornicki ostrowski ostrzeszowski pilski pleszewski poznański rawicki słupecki szamotulski średzki śremski turecki wągrowiecki wolsztyński wrzesiński złotowski m. Kalisz m. Konin m. Leszno m. Poznań TERYT 3005 3006 3007 3008 3009 3010 3011 3012 3013 3014 3015 3016 3017 3018 3019 3020 3021 3022 3023 3024 3025 3026 3027 3028 3029 3030 3031 3061 3062 3063 3064 Total 1.221 0.990 0.794 0.818 1.114 0.906 0.889 0.934 0.817 1.247 1.033 1.004 0.899 0.862 1.007 0.938 0.889 1.013 0.841 1.112 1.043 1.025 1.106 1.180 0.936 0.876 1.102 1.090 0.860 1.066 0.995 1.147 1.105 0.829 0.960 1.146 0.838 1.039 1.021 0.767 1.271 1.071 1.102 1.109 0.820 1.029 1.099 0.970 1.171 0.965 1.069 1.317 1.011 1.329 1.264 1.057 0.937 1.305 1.095 0.998 1.219 1.079 CVD 1.181 1.115 0.750 0.685 1.080 0.958 0.676 0.918 0.957 1.103 1.014 0.924 0.687 1.194 1.086 0.750 0.944 0.858 0.901 1.354 0.786 1.059 0.754 1.133 1.142 1.016 0.965 1.083 0.794 1.045 0.935 białogardzki choszczeński drawski goleniowski gryficki gryfiński kamieński kołobrzeski koszaliński myśliborski policki pyrzycki sławieński stargardzki szczecinecki świdwiński wałecki łobeski m. Koszalin m. Szczecin m. Świnoujście 3201 3202 3203 3204 3205 3206 3207 3208 3209 3210 3211 3212 3213 3214 3215 3216 3217 3218 3261 3262 3263 1.162 0.986 1.071 1.201 1.005 1.107 0.982 0.940 1.178 1.082 0.938 0.954 1.223 1.092 1.056 0.992 1.104 0.934 0.931 1.054 0.986 1.160 0.936 1.002 1.300 1.010 1.004 0.801 0.872 1.153 0.981 0.907 0.848 1.363 0.992 0.921 1.049 1.135 0.930 1.207 1.001 1.115 1.454 1.110 1.149 1.129 1.217 1.301 1.308 0.654 1.290 1.225 0.856 1.264 1.252 1.051 1.430 0.967 1.303 1.211 0.691 1.090 0.633 1.926 1.858 0.671 1.158 0.874 0.966 2.320 0.636 0.875 0.961 0.816 0.977 0.691 1.819 0.328 1.072 1.173 0.000 0.720 1.175 0.525 0.764 0.615 0.824 1.067 1.001 0.590 0.706 0.438 0.694 1.061 1.263 0.607 1.278 1.078 1.068 0.862 0.542 0.322 0.335 1.330 1.583 0.435 0.981 0.587 1.392 1.028 0.840 0.404 2.013 1.242 1.110 1.450 1.210 0.364 1.291 0.783 0.562 0.124 0.733 0.442 0.675 0.985 1.006 0.530 1.711 1.326 0.866 1.428 1.236 1.605 1.250 1.032 0.905 1.108 1.686 1.118 1.119 1.247 1.181 1.276 1.275 1.158 0.398 1.000 1.000 1.000 1.000 1.000 1.000 1.000 Polska Page 245 Respiratory Digestive Ill-defined 1.181 1.784 0.776 0.558 0.346 0.099 0.691 0.325 0.925 0.489 0.460 0.654 1.013 0.956 0.156 0.592 1.055 0.440 0.519 0.559 1.003 0.520 0.892 0.645 0.843 0.263 0.596 1.790 0.503 1.525 1.109 0.610 0.593 0.236 1.315 0.872 0.407 0.760 0.607 0.244 0.231 0.262 1.305 0.863 0.590 0.214 0.705 0.917 0.891 0.779 0.491 0.219 1.037 0.471 0.462 0.756 0.123 0.769 1.075 0.734 1.224 0.681 0.258 0.446 1.036 0.236 0.957 0.826 0.683 0.805 0.565 0.639 0.246 0.348 0.000 1.217 0.490 0.372 0.807 0.562 0.956 1.117 1.203 1.052 0.958 0.773 0.222 0.546 0.340 0.585 0.688 0.854 1.135 External 2.037 1.241 0.915 0.812 1.648 1.463 0.856 0.635 0.993 1.932 0.983 0.937 0.800 0.742 1.034 0.937 0.888 1.495 0.694 1.180 1.049 1.480 1.069 1.516 0.898 0.825 1.235 0.996 0.759 0.978 0.867 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Table 68. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, total population of age 65 years and more District bolesławiecki dzierżoniowski głogowski górowski jaworski jeleniogórski kamiennogórski kłodzki legnicki lubański lubiński lwówecki milicki oleśnicki oławski polkowicki strzeliński średzki świdnicki trzebnicki wałbrzyski wołowski wrocławski ząbkowicki zgorzelecki złotoryjski m. Jelenia Góra m. Legnica m. Wrocław TERYT 0201 0202 0203 0204 0205 0206 0207 0208 0209 0210 0211 0212 0213 0214 0215 0216 0217 0218 0219 0220 0221 0222 0223 0224 0225 0226 0261 0262 0264 Total 1.036 1.001 1.116 1.025 1.047 1.076 1.092 1.114 1.024 1.087 1.028 1.219 1.015 1.009 1.018 1.085 1.029 1.147 1.056 1.068 1.111 1.104 1.018 1.055 1.077 1.199 0.981 1.030 0.890 Cancer 1.217 0.974 1.161 0.952 1.019 1.120 0.985 1.131 1.016 0.950 1.137 0.995 0.920 1.006 1.114 1.202 1.102 1.128 1.173 1.221 1.120 1.116 1.030 1.039 1.111 1.264 1.079 1.142 0.987 CVD 1.034 1.062 1.115 1.170 1.126 1.045 1.082 1.194 1.103 1.269 1.018 1.285 1.175 1.136 1.062 1.063 1.228 1.257 1.084 1.165 1.163 1.270 1.096 1.114 1.184 1.243 0.899 1.002 0.934 aleksandrowski brodnicki bydgoski chełmiński golubsko-dobrzyński grudziądzki inowrocławski lipnowski mogileński nakielski radziejowski rypiński sępoleński świecki toruński tucholski wąbrzeski włocławski żniński m. Bydgoszcz m. Grudziądz m. Toruń m. Włocławek 0401 0402 0403 0404 0405 0406 0407 0408 0409 0410 0411 0412 0413 0414 0415 0416 0417 0418 0419 0461 0462 0463 0464 1.029 1.084 1.041 1.168 0.957 1.158 1.086 1.136 1.158 1.163 1.105 1.101 1.026 1.142 1.097 1.054 1.078 1.106 1.046 0.944 1.082 0.909 1.017 0.921 1.057 1.133 1.236 0.947 1.148 1.120 1.035 1.246 1.102 1.080 1.159 1.062 1.207 1.209 1.003 1.120 1.062 1.152 1.151 1.090 1.085 1.098 1.227 1.069 1.010 1.105 0.931 1.162 1.150 1.194 1.224 1.351 1.140 1.186 1.078 1.221 0.985 1.122 1.014 1.226 1.006 0.885 1.085 0.773 1.038 0.699 1.215 1.480 1.101 1.366 1.159 1.275 1.451 0.869 0.924 1.706 1.062 1.142 0.958 1.512 1.369 1.237 1.177 0.953 1.093 1.016 1.072 0.861 0.744 1.042 1.189 1.094 0.743 0.975 1.444 0.759 0.916 0.837 0.645 0.868 1.040 1.078 1.065 0.874 0.675 0.844 0.972 0.954 0.902 1.037 1.344 0.454 1.594 0.646 1.521 1.027 1.288 0.438 1.084 1.016 0.727 1.020 0.677 0.844 1.046 1.219 0.916 0.975 0.540 1.188 0.835 1.035 1.271 0.725 0.740 0.514 0.422 0.451 0.232 0.511 0.764 0.742 0.921 0.563 0.551 0.617 0.682 0.560 0.821 0.428 0.475 0.894 0.796 0.486 0.825 0.666 0.781 bialski 0601 1.104 0.729 1.286 0.631 0.900 1.163 1.642 Page 246 Respiratory Digestive Ill-defined 0.917 1.125 0.420 0.884 0.857 1.224 0.888 1.466 1.050 0.724 0.952 0.841 1.010 1.024 0.743 1.058 1.407 0.913 1.079 1.098 2.129 1.060 0.857 1.091 0.834 0.748 1.156 0.753 0.701 1.038 0.810 1.065 1.046 1.155 1.299 1.964 0.492 0.578 1.020 0.943 1.028 0.254 0.557 1.057 1.156 0.926 0.788 1.259 0.477 0.729 0.399 0.969 1.014 1.000 0.683 0.916 1.369 0.783 0.834 0.592 1.122 1.046 1.325 0.797 0.646 0.746 0.869 1.190 0.607 0.879 0.812 1.354 0.987 1.019 0.581 1.288 0.972 0.923 0.903 1.112 1.362 0.730 1.003 1.554 0.631 0.975 0.685 External 1.131 0.835 1.072 0.977 1.210 0.968 0.933 0.806 0.913 0.829 1.105 0.964 0.994 0.956 1.055 0.945 0.674 0.921 1.042 1.073 0.775 0.569 0.992 0.735 0.966 1.246 1.037 1.024 0.792 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District biłgorajski chełmski hrubieszowski janowski krasnostawski kraśnicki lubartowski lubelski łęczyński łukowski opolski parczewski puławski radzyński rycki świdnicki tomaszowski włodawski zamojski m. Biała Podlaska m. Chełm m. Lublin m. Zamość TERYT 0602 0603 0604 0605 0606 0607 0608 0609 0610 0611 0612 0613 0614 0615 0616 0617 0618 0619 0620 0661 0662 0663 0664 Total 1.018 1.119 1.025 1.094 1.084 1.028 1.076 1.066 1.075 1.030 1.074 1.031 0.973 1.083 1.001 0.989 0.999 1.179 1.031 0.929 0.907 0.921 0.882 Cancer 0.776 0.766 0.776 0.746 0.711 0.849 0.899 0.743 0.765 0.759 0.750 0.818 0.928 0.769 0.828 0.863 0.809 0.871 0.821 0.839 0.808 0.902 0.800 CVD 1.012 1.213 0.891 1.209 1.173 1.184 1.204 1.246 1.175 1.207 1.252 1.143 0.956 1.180 1.153 1.097 1.075 1.367 0.958 0.976 0.956 0.937 0.857 gorzowski krośnieński międzyrzecki nowosolski słubicki strzelecko-drezdenecki sulęciński świebodziński zielonogórski żagański żarski wschowski m. Gorzów Wielkopolski m. Zielona Góra 0801 0802 0803 0804 0805 0806 0807 0808 0809 0810 0811 0812 0861 0862 1.035 1.142 1.129 1.007 1.135 1.050 1.209 1.058 1.041 1.084 1.114 1.087 0.957 0.908 0.996 1.026 1.012 0.933 1.119 0.980 1.044 0.866 0.958 1.035 0.997 1.002 1.067 0.975 1.020 1.113 1.099 0.997 1.103 1.008 1.214 1.124 0.948 1.223 1.277 1.015 0.794 0.707 0.841 1.470 1.212 0.739 1.166 0.973 1.249 0.874 0.697 0.654 0.668 0.603 0.829 0.726 1.099 0.733 1.071 1.166 1.501 1.215 1.486 1.185 0.992 0.981 0.947 1.177 0.883 0.905 1.519 1.170 1.869 1.229 1.239 2.154 1.265 1.312 2.481 0.532 0.900 1.533 2.278 2.571 0.978 1.010 1.056 0.880 0.990 0.994 1.164 0.440 0.916 0.809 0.604 1.066 0.622 0.671 bełchatowski kutnowski łaski łęczycki łowicki łódzki wschodni opoczyński pabianicki pajęczański piotrkowski poddębicki radomszczański rawski sieradzki skierniewicki tomaszowski wieluński wieruszowski 1001 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1012 1013 1014 1015 1016 1017 1018 1.064 1.116 1.022 1.184 1.056 1.106 1.063 1.055 1.002 1.104 1.173 1.074 1.000 1.036 1.005 1.043 1.062 1.124 1.084 1.046 0.834 1.019 0.959 0.940 0.784 0.930 0.944 0.791 1.059 0.881 0.926 1.021 0.955 0.909 1.012 0.873 1.102 1.261 1.123 1.376 1.240 1.164 1.308 1.090 1.027 1.239 1.202 1.194 1.032 1.061 1.115 1.094 1.156 1.351 1.255 0.729 1.053 1.296 0.993 1.262 0.907 1.042 1.178 1.139 1.246 1.035 1.500 1.272 0.988 1.124 1.093 0.572 1.277 0.909 1.173 1.216 1.085 1.355 0.899 1.176 0.903 1.241 0.938 0.728 1.103 1.074 0.930 1.011 1.000 0.971 0.754 0.959 0.713 0.258 0.146 1.066 0.347 1.042 0.995 0.926 1.049 1.275 0.521 0.590 0.297 0.781 0.418 0.658 0.869 0.753 1.015 1.183 0.765 0.981 1.092 1.392 0.823 1.240 1.863 0.997 1.194 1.361 1.121 0.970 0.991 1.231 Page 247 Respiratory Digestive Ill-defined 0.954 0.699 2.465 0.920 1.073 1.688 0.834 0.767 3.758 1.055 0.869 1.930 1.338 0.952 1.542 0.898 0.778 0.744 0.837 0.908 0.849 0.779 1.154 0.827 1.612 0.798 0.684 0.740 0.640 1.115 0.823 0.802 0.991 0.941 0.968 1.077 0.672 1.073 1.638 0.970 1.099 1.332 0.728 0.938 0.608 0.418 0.760 1.470 0.558 0.796 1.606 0.616 0.999 1.495 0.844 0.729 2.606 0.686 0.843 0.762 0.665 1.109 0.671 0.812 0.956 0.866 0.728 0.769 1.087 External 0.890 1.185 0.965 0.708 1.042 0.961 1.200 1.004 1.191 0.829 1.084 0.855 0.918 1.311 0.942 0.793 0.867 0.777 1.052 1.296 1.192 0.719 0.750 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District zduńskowolski zgierski brzeziński m. Łódź m. Piotrków Trybunalski m. Skierniewice TERYT 1019 1020 1021 1061 1062 1063 Total 1.047 1.078 1.155 1.045 1.012 1.025 Cancer 1.020 0.950 0.826 0.974 0.830 1.055 CVD 1.106 1.103 1.410 0.942 1.101 1.128 bocheński brzeski chrzanowski dąbrowski gorlicki krakowski limanowski miechowski myślenicki nowosądecki nowotarski olkuski oświęcimski proszowicki suski tarnowski tatrzański wadowicki wielicki m. Kraków m. Nowy Sącz m. Tarnów 1201 1202 1203 1204 1205 1206 1207 1208 1209 1210 1211 1212 1213 1214 1215 1216 1217 1218 1219 1261 1262 1263 1.022 1.024 1.022 0.951 0.987 1.003 0.986 1.016 1.034 0.975 0.942 0.965 0.968 0.985 1.027 0.963 1.008 0.983 0.993 0.884 0.930 0.948 0.815 0.738 1.036 0.925 0.828 0.977 0.924 0.912 0.922 0.879 0.879 0.897 0.993 0.881 1.003 0.903 1.043 0.943 0.932 0.996 1.057 1.034 1.091 1.199 1.036 0.958 1.109 1.082 1.013 1.091 1.167 0.994 1.018 0.980 0.989 1.039 1.088 0.990 1.038 1.091 1.120 0.894 0.848 0.955 1.144 0.782 1.150 0.837 0.879 0.921 1.336 1.110 0.798 1.073 0.782 1.197 1.137 1.898 1.021 1.068 0.789 0.885 0.634 0.725 0.752 0.868 0.909 0.793 1.006 0.735 1.018 0.827 0.563 1.005 1.387 0.935 0.709 0.811 0.893 0.609 0.659 0.840 0.724 0.720 0.946 0.873 1.026 0.863 1.236 1.266 0.926 1.615 0.806 0.657 1.061 0.474 0.544 1.266 0.943 0.735 0.639 0.250 1.038 1.415 0.741 0.563 0.458 0.611 1.276 0.866 0.930 0.794 1.030 0.582 0.715 1.065 0.939 1.078 1.145 1.192 0.841 1.117 0.891 1.103 1.007 0.629 1.354 1.109 1.169 0.733 0.814 0.802 białobrzeski ciechanowski garwoliński gostyniński grodziski grójecki kozienicki legionowski lipski łosicki makowski miński mławski nowodworski ostrołęcki ostrowski otwocki piaseczyński płocki płoński pruszkowski przasnyski przysuski pułtuski radomski siedlecki sierpecki 1401 1402 1403 1404 1405 1406 1407 1408 1409 1410 1411 1412 1413 1414 1415 1416 1417 1418 1419 1420 1421 1422 1423 1424 1425 1426 1427 1.071 1.055 0.977 1.079 1.014 1.061 0.955 0.958 1.010 0.985 1.022 1.004 1.030 1.091 1.041 0.974 0.912 0.997 1.107 1.072 0.891 1.126 0.970 1.060 1.056 1.019 1.034 0.788 1.094 0.717 1.000 1.119 0.894 0.834 1.054 0.824 0.866 0.971 0.956 1.110 1.212 0.955 0.867 0.902 1.012 1.049 0.965 1.040 1.024 0.631 1.072 0.930 0.838 1.028 1.126 0.981 1.123 0.988 1.014 1.159 0.996 0.892 1.066 1.052 1.081 1.032 1.018 1.050 1.025 1.054 0.917 0.980 1.080 1.145 0.857 1.190 1.141 1.068 1.120 1.057 1.052 0.858 1.787 0.857 1.316 1.216 1.150 1.060 1.385 1.044 1.150 0.999 1.410 1.355 1.251 1.688 0.946 0.694 1.191 1.433 1.005 0.942 1.201 1.102 1.204 1.103 1.359 1.074 1.148 1.012 0.981 0.816 0.935 1.055 0.741 1.195 1.116 0.965 0.676 0.971 1.055 1.199 0.761 0.900 1.139 1.038 0.953 1.086 0.878 0.707 0.905 0.750 0.820 1.122 0.900 1.934 0.445 0.742 2.100 0.620 0.807 0.736 0.544 1.065 0.611 0.516 0.540 0.784 0.651 0.976 0.918 1.013 0.735 1.358 0.771 0.497 1.178 0.720 1.330 1.199 0.850 0.715 1.570 1.559 1.194 1.344 1.065 1.100 1.708 1.513 1.633 1.235 1.219 1.252 1.095 1.467 1.095 1.033 0.871 1.209 1.343 1.408 1.057 1.418 0.857 1.281 1.254 1.186 1.083 Page 248 Respiratory Digestive Ill-defined 1.122 0.887 0.764 1.249 1.481 1.103 0.759 0.975 0.818 1.335 1.344 1.993 0.834 1.222 0.783 0.911 0.766 0.476 External 1.022 0.984 1.528 0.910 1.143 0.904 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District sochaczewski sokołowski szydłowiecki warszawski zachodni węgrowski wołomiński wyszkowski zwoleński żuromiński żyrardowski m. Ostrołęka m. Płock m. Radom m. Siedlce m. st. Warszawa TERYT 1428 1429 1430 1432 1433 1434 1435 1436 1437 1438 1461 1462 1463 1464 1465 Total 1.092 0.988 1.016 0.905 0.985 1.049 1.012 1.122 1.023 1.101 1.003 1.010 0.965 0.852 0.828 Cancer 1.066 0.844 0.764 1.011 0.813 1.017 0.874 0.864 1.205 1.145 1.103 1.161 0.986 0.892 0.991 CVD 1.159 1.040 1.106 0.848 1.023 1.027 1.032 1.109 1.035 1.089 0.800 0.882 0.902 0.888 0.705 brzeski głubczycki kędzierzyńsko-kozielski kluczborski krapkowicki namysłowski nyski oleski opolski prudnicki strzelecki m. Opole 1601 1602 1603 1604 1605 1606 1607 1608 1609 1610 1611 1661 0.997 1.134 0.944 1.060 1.020 1.040 1.031 1.002 0.938 1.073 0.988 0.884 0.913 1.121 0.892 0.958 0.805 1.094 1.024 1.008 0.963 0.877 0.804 1.056 1.015 1.285 0.997 1.165 1.136 1.002 1.166 1.112 0.977 1.254 1.197 0.846 0.688 0.737 0.685 0.767 0.986 1.033 0.827 0.358 0.975 0.877 0.759 0.921 0.791 0.970 0.744 0.902 0.930 0.591 0.566 0.732 0.750 0.925 0.752 0.794 1.817 0.549 1.142 0.958 0.738 1.787 0.381 1.113 0.608 0.693 0.443 0.560 1.001 1.096 0.870 1.179 0.821 1.096 1.041 1.008 0.829 0.781 0.683 0.747 bieszczadzki brzozowski dębicki jarosławski jasielski kolbuszowski krośnieński leżajski lubaczowski łańcucki mielecki niżański przemyski przeworski ropczycko-sędziszowski rzeszowski sanocki stalowowolski strzyżowski tarnobrzeski leski m. Krosno m. Przemyśl m. Rzeszów m. Tarnobrzeg 1801 1802 1803 1804 1805 1806 1807 1808 1809 1810 1811 1812 1813 1814 1815 1816 1817 1818 1819 1820 1821 1861 1862 1863 1864 1.072 1.013 0.953 1.031 0.989 0.949 0.950 0.987 1.000 0.955 0.888 0.961 1.006 1.001 0.965 0.969 0.951 1.045 1.010 0.973 0.874 0.921 1.001 0.805 0.870 0.968 0.996 1.036 0.903 0.884 0.802 0.888 0.893 0.940 0.811 0.930 0.853 0.856 0.848 0.828 0.806 0.887 1.002 0.937 0.853 1.043 0.991 1.038 0.919 0.917 1.023 0.946 1.084 1.235 0.999 1.073 0.850 1.050 1.132 1.110 0.739 1.092 1.086 1.137 1.163 1.124 0.871 1.124 0.920 1.145 0.728 0.786 1.074 0.833 0.969 1.506 1.188 0.489 0.390 0.762 0.836 0.913 0.617 0.717 0.588 1.164 0.346 0.528 0.864 0.507 0.738 0.884 0.680 0.907 0.552 1.001 0.704 0.459 0.513 0.420 1.394 0.827 0.488 0.846 1.147 0.588 0.798 0.651 0.517 0.899 0.670 0.532 1.028 0.718 0.856 0.755 1.091 0.693 0.770 0.830 1.028 1.004 0.946 0.635 0.535 1.411 2.005 0.459 1.014 2.054 0.579 2.293 1.465 0.888 0.647 1.558 1.665 1.860 0.882 0.435 0.805 1.833 1.218 2.714 0.444 1.550 2.077 1.062 0.468 0.384 0.539 0.746 0.804 0.787 0.638 1.133 0.765 1.301 0.682 1.185 1.042 0.760 0.870 0.879 0.860 0.845 0.695 0.854 0.776 0.584 0.797 0.654 0.861 0.897 0.443 augustowski białostocki bielski 2001 2002 2003 0.960 0.997 0.908 1.006 0.906 0.782 0.896 0.921 0.923 0.883 1.307 1.060 0.944 0.964 0.797 1.559 1.704 0.935 1.156 1.001 1.572 Page 249 Respiratory Digestive Ill-defined 1.324 0.907 0.469 1.437 0.739 0.393 1.220 0.849 1.027 1.211 1.098 0.730 1.077 1.268 0.738 1.359 1.180 1.088 1.650 0.892 0.682 1.634 1.032 1.672 1.017 0.695 0.513 1.658 1.021 0.706 1.820 1.020 0.865 1.328 1.230 0.771 0.955 1.155 1.584 0.696 1.118 0.422 1.147 1.057 0.774 External 1.241 1.254 1.124 1.181 1.395 1.307 1.348 0.929 0.999 0.997 1.642 1.257 0.786 0.761 0.940 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District grajewski hajnowski kolneński łomżyński moniecki sejneński siemiatycki sokólski suwalski wysokomazowiecki zambrowski m. Białystok m. Łomża m. Suwałki TERYT 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2061 2062 2063 Total 0.976 0.975 1.049 0.959 0.909 1.020 0.975 0.964 0.998 0.961 0.977 0.835 0.944 0.877 Cancer 1.001 0.896 0.854 0.909 0.952 1.212 0.901 0.878 1.028 0.882 0.991 0.995 1.184 1.048 CVD 0.946 0.906 0.923 0.834 0.798 0.863 0.919 0.942 0.904 0.963 0.964 0.712 0.765 0.733 bytowski chojnicki człuchowski gdański kartuski kościerski kwidzyński lęborski malborski nowodworski pucki słupski starogardzki tczewski wejherowski sztumski m. Gdańsk m. Gdynia m. Słupsk m. Sopot 2201 2202 2203 2204 2205 2206 2207 2208 2209 2210 2211 2212 2213 2214 2215 2216 2261 2262 2263 2264 1.096 1.051 1.019 1.005 0.974 1.124 1.088 1.082 1.118 1.142 1.115 1.046 1.090 1.065 1.030 1.241 0.890 0.882 0.931 0.776 1.069 1.239 1.186 1.086 1.019 1.306 1.159 1.324 0.984 1.332 1.342 1.244 1.095 1.244 1.161 1.305 1.110 1.181 1.096 1.158 0.973 0.962 0.889 0.873 0.922 0.961 1.010 0.936 1.100 1.029 0.966 0.820 0.932 0.960 0.802 1.369 0.715 0.719 0.748 0.611 1.530 1.190 0.973 1.344 0.879 1.514 1.281 1.188 1.127 1.189 0.970 0.980 1.831 1.183 1.566 0.729 1.004 0.767 0.785 0.721 1.264 0.983 0.913 1.291 1.005 0.808 1.404 1.275 1.194 1.279 1.087 1.233 0.965 1.028 1.125 0.965 1.103 0.965 1.276 0.765 1.474 1.175 2.030 1.169 1.345 1.491 1.068 1.194 2.345 1.334 1.362 2.369 1.284 0.941 1.679 1.104 1.319 1.194 2.061 1.028 1.114 0.905 0.933 1.314 0.984 0.942 1.175 1.052 0.932 0.909 1.262 0.997 1.320 1.081 1.080 0.604 0.898 0.782 0.776 0.687 będziński bielski cieszyński częstochowski gliwicki kłobucki lubliniecki mikołowski myszkowski pszczyński raciborski rybnicki tarnogórski bieruńsko-lędziński wodzisławski zawierciański żywiecki m. Bielsko-Biała m. Bytom m. Chorzów m. Częstochowa 2401 2402 2403 2404 2405 2406 2407 2408 2409 2410 2411 2412 2413 2414 2415 2416 2417 2461 2462 2463 2464 1.121 0.998 1.026 1.084 1.081 1.032 1.032 1.033 1.082 1.067 1.057 1.127 0.980 1.109 1.078 1.123 1.084 0.899 1.003 1.114 1.010 1.099 0.880 0.925 0.942 1.083 0.876 0.879 0.886 0.939 1.038 1.026 1.071 0.984 1.079 1.158 1.062 0.871 0.893 1.020 1.079 0.973 1.196 1.188 1.107 1.222 1.092 1.171 1.190 1.159 1.208 1.270 0.986 1.122 1.023 1.166 0.981 1.148 1.337 1.031 0.939 1.110 1.090 0.911 0.604 1.183 0.978 1.123 0.963 0.839 1.167 1.037 0.588 1.090 1.610 0.981 1.209 1.318 1.290 0.561 0.441 0.927 1.251 0.878 1.285 0.866 0.846 1.119 1.148 1.043 0.976 1.222 0.845 0.741 1.273 1.233 0.875 1.209 1.657 1.028 1.176 0.688 1.315 1.624 1.106 0.612 0.060 0.111 0.591 0.869 0.382 0.584 0.417 0.970 0.077 1.752 0.827 0.761 0.281 0.768 0.722 0.078 0.086 1.273 0.412 0.535 1.317 1.123 1.173 1.138 1.157 1.245 0.869 0.685 1.086 1.013 0.823 1.308 0.928 1.124 1.034 1.151 1.072 0.971 1.178 1.327 1.040 Page 250 Respiratory Digestive Ill-defined 0.965 0.627 0.912 1.428 1.180 1.238 1.803 0.812 2.049 1.308 0.827 1.834 1.425 0.969 1.199 0.948 0.882 1.600 1.477 0.876 0.947 1.168 0.921 1.046 0.873 1.020 1.535 1.294 0.688 0.973 0.972 0.831 0.673 0.813 1.003 1.171 0.639 0.934 0.970 0.883 0.930 0.781 External 1.066 0.850 0.888 1.132 0.589 1.093 1.493 1.074 1.059 1.128 1.341 0.931 1.435 0.723 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District m. Dąbrowa Górnicza m. Gliwice m. Jastrzębie-Zdrój m. Jaworzno m. Katowice m. Mysłowice m. Piekary Śląskie m. Ruda Śląska m. Rybnik m. Siemianowice Śląskie m. Sosnowiec m. Świętochłowice m. Tychy m. Zabrze m. Żory TERYT 2465 2466 2467 2468 2469 2470 2471 2472 2473 2474 2475 2476 2477 2478 2479 Total 1.086 0.904 1.068 1.044 0.978 1.151 1.076 1.211 0.982 1.174 1.089 1.051 1.003 0.875 1.032 Cancer 1.078 1.035 1.142 1.129 1.055 1.289 0.995 1.148 0.957 1.291 1.131 0.979 1.078 0.952 1.165 CVD 1.116 0.828 0.996 1.087 0.957 1.186 1.209 1.219 0.979 1.180 1.093 1.187 1.006 0.775 0.979 buski jędrzejowski kazimierski kielecki konecki opatowski ostrowiecki pińczowski sandomierski skarżyski starachowicki staszowski włoszczowski m. Kielce 2601 2602 2603 2604 2605 2606 2607 2608 2609 2610 2611 2612 2613 2661 0.988 1.015 1.107 1.017 1.053 1.061 1.052 0.986 0.947 1.023 0.991 1.028 1.052 0.864 0.869 0.802 0.994 0.898 0.921 0.878 0.984 0.805 0.932 0.874 0.901 0.928 0.758 0.851 0.877 1.066 1.097 1.006 1.164 1.139 1.169 1.018 0.957 1.139 1.024 1.097 1.186 0.787 1.116 1.290 1.357 1.371 0.894 0.852 0.514 0.736 0.630 0.828 1.107 0.644 0.913 1.131 0.735 0.708 0.714 0.862 1.032 0.774 0.854 0.838 1.066 0.792 0.868 0.854 0.825 0.997 2.629 0.959 1.306 1.128 0.567 1.382 0.413 1.809 0.934 0.461 0.418 1.267 0.714 1.073 0.895 1.060 0.904 1.126 0.926 1.131 1.094 1.005 0.779 1.110 1.091 0.869 0.853 0.916 bartoszycki braniewski działdowski elbląski ełcki giżycki iławski kętrzyński lidzbarski mrągowski nidzicki nowomiejski olecki olsztyński ostródzki piski szczycieński gołdapski węgorzewski m. Elbląg m. Olsztyn 2801 2802 2803 2804 2805 2806 2807 2808 2809 2810 2811 2812 2813 2814 2815 2816 2817 2818 2819 2861 2862 1.073 1.112 1.088 1.077 0.991 1.014 0.989 1.077 1.061 1.083 1.092 1.009 1.063 1.072 0.976 1.002 1.023 1.043 1.021 0.996 0.814 0.997 1.052 1.405 1.003 1.009 0.919 1.029 1.189 1.177 1.216 1.201 1.119 0.942 1.120 1.048 1.041 0.899 0.932 0.947 1.188 0.988 0.992 1.150 0.941 0.962 0.885 0.979 0.920 0.985 1.046 0.944 0.903 0.849 1.214 0.927 0.904 0.930 0.936 0.972 0.927 0.843 0.626 1.771 1.352 1.493 1.718 1.078 1.607 1.344 1.711 1.148 1.508 2.707 1.590 1.161 2.139 1.425 1.682 1.836 1.277 1.655 1.473 1.394 1.546 1.181 0.750 0.833 0.873 1.100 0.879 0.810 1.396 1.077 1.182 0.704 0.585 0.684 1.094 0.713 0.888 0.766 0.977 0.904 0.803 0.779 0.932 0.924 2.069 1.826 0.922 1.261 0.962 0.855 1.210 1.312 1.362 0.285 1.340 0.957 0.863 1.741 2.035 1.636 1.232 1.296 0.855 0.557 0.527 0.354 0.591 0.891 0.618 0.849 0.708 1.055 0.538 0.971 0.838 0.899 0.644 0.652 0.758 0.928 0.645 0.454 0.703 chodzieski czarnkowsko-trzcianecki gnieźnieński gostyński grodziski 3001 3002 3003 3004 3005 1.074 1.100 1.054 1.099 1.176 1.060 1.172 1.128 1.133 0.939 0.943 0.963 0.975 1.024 1.352 1.101 0.894 0.657 0.904 0.842 0.575 0.837 1.020 1.073 1.246 2.036 1.907 1.301 1.377 0.675 1.360 1.604 1.298 1.751 1.039 Page 251 Respiratory Digestive Ill-defined 1.203 1.223 0.497 0.832 1.186 0.787 1.043 1.469 0.888 0.743 0.991 0.644 0.995 1.275 0.473 0.998 1.436 0.347 0.755 1.282 0.451 1.103 1.600 0.777 1.217 0.939 0.479 1.193 1.676 0.263 1.130 1.295 0.507 0.485 1.248 0.466 1.192 1.086 0.270 0.910 1.298 0.879 0.864 1.419 0.357 External 1.091 0.923 1.072 1.063 1.218 1.398 0.828 1.184 1.164 1.050 1.237 1.305 0.720 0.968 1.293 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District jarociński kaliski kępiński kolski koniński kościański krotoszyński leszczyński międzychodzki nowotomyski obornicki ostrowski ostrzeszowski pilski pleszewski poznański rawicki słupecki szamotulski średzki śremski turecki wągrowiecki wolsztyński wrzesiński złotowski m. Kalisz m. Konin m. Leszno m. Poznań TERYT 3006 3007 3008 3009 3010 3011 3012 3013 3014 3015 3016 3017 3018 3019 3020 3021 3022 3023 3024 3025 3026 3027 3028 3029 3030 3031 3061 3062 3063 3064 Total 1.053 1.039 1.050 1.052 0.994 1.030 1.134 1.101 1.199 1.097 1.166 0.995 1.142 1.065 1.143 1.069 1.101 1.077 1.101 1.067 1.194 1.105 1.066 1.133 1.065 1.060 0.945 0.881 0.985 0.919 Cancer 1.111 0.947 1.015 1.053 1.108 1.066 1.090 1.120 0.910 1.099 1.267 1.116 0.922 1.162 1.059 1.189 1.052 1.195 1.249 0.952 1.232 1.073 1.028 1.035 1.133 1.060 1.038 1.092 1.116 1.088 CVD 1.096 0.964 1.088 1.149 0.953 0.897 1.185 1.066 1.112 1.047 1.044 0.916 1.289 0.959 1.242 1.015 1.152 1.017 1.029 1.067 1.085 1.098 0.916 1.206 1.000 1.057 0.929 0.759 0.899 0.842 białogardzki choszczeński drawski goleniowski gryficki gryfiński kamieński kołobrzeski koszaliński myśliborski policki pyrzycki sławieński stargardzki szczecinecki świdwiński wałecki łobeski m. Koszalin m. Szczecin m. Świnoujście 3201 3202 3203 3204 3205 3206 3207 3208 3209 3210 3211 3212 3213 3214 3215 3216 3217 3218 3261 3262 3263 1.085 1.114 1.120 1.012 1.139 1.073 1.064 0.968 1.161 1.082 1.003 1.051 1.014 1.039 1.192 1.034 1.139 1.045 0.883 0.966 1.072 1.058 1.079 1.026 0.981 1.014 1.034 1.002 1.097 1.235 0.951 1.072 1.022 1.139 1.036 0.967 1.099 1.131 0.909 1.197 1.112 0.996 1.224 1.132 1.183 1.046 1.146 1.146 1.062 0.852 1.133 1.175 0.934 1.054 1.077 1.029 1.296 1.043 1.184 1.077 0.789 0.917 1.165 0.912 1.483 0.954 1.090 1.385 0.884 0.935 0.626 1.027 1.406 1.071 0.994 0.524 1.239 0.846 1.031 1.044 1.238 0.718 0.822 0.906 1.142 1.035 0.967 1.239 1.435 0.813 1.249 1.004 0.896 1.102 1.252 1.260 1.081 1.094 1.226 1.342 1.277 1.158 1.061 1.095 1.019 0.538 0.543 1.097 0.749 1.724 0.744 1.185 1.938 1.525 0.684 0.919 1.067 0.654 0.830 1.273 0.801 0.599 0.827 0.645 0.797 1.287 0.913 1.133 1.157 0.819 0.775 1.104 0.825 0.809 0.897 1.022 1.096 0.942 0.986 1.068 0.892 0.756 1.905 1.423 0.852 1.002 0.943 1.000 1.000 1.000 1.000 1.000 1.000 1.000 Polska Page 252 Respiratory Digestive Ill-defined 0.594 0.890 0.633 1.040 0.927 2.176 1.114 0.907 0.642 0.573 1.034 0.583 0.910 0.947 0.983 0.608 1.169 2.082 0.908 0.982 0.479 0.690 1.165 1.215 0.816 1.766 2.534 0.631 1.409 1.258 0.670 0.844 1.210 0.927 0.940 0.581 0.656 1.060 0.313 1.064 0.981 1.272 0.785 1.162 0.717 0.766 1.144 0.950 0.948 1.045 0.530 1.471 0.999 0.542 0.667 0.707 1.813 0.842 1.135 0.468 1.172 1.029 1.414 1.063 1.096 1.375 1.151 1.054 0.874 0.777 1.412 0.684 1.207 1.201 0.533 0.742 0.764 1.151 0.760 0.837 0.983 0.829 0.807 0.884 0.683 1.160 1.027 0.703 0.972 0.762 External 1.504 1.236 1.659 1.289 0.939 1.725 1.680 1.622 1.920 1.779 2.313 1.658 1.656 1.251 1.870 1.268 1.741 1.346 1.185 1.365 1.616 1.257 2.484 1.264 1.634 2.014 1.041 1.323 1.097 1.179 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Table 69. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, males of age 65 years and more District bolesławiecki dzierżoniowski głogowski górowski jaworski jeleniogórski kamiennogórski kłodzki legnicki lubański lubiński lwówecki milicki oleśnicki oławski polkowicki strzeliński średzki świdnicki trzebnicki wałbrzyski wołowski wrocławski ząbkowicki zgorzelecki złotoryjski m. Jelenia Góra m. Legnica m. Wrocław TERYT 0201 0202 0203 0204 0205 0206 0207 0208 0209 0210 0211 0212 0213 0214 0215 0216 0217 0218 0219 0220 0221 0222 0223 0224 0225 0226 0261 0262 0264 Total 1.045 1.027 1.183 1.053 1.065 1.092 1.150 1.135 1.069 1.128 1.043 1.309 0.987 1.108 1.067 1.148 1.079 1.249 1.079 1.114 1.090 1.091 1.085 1.022 1.131 1.305 0.994 1.081 0.877 Cancer 1.206 0.971 1.153 1.055 1.096 1.130 0.956 1.183 1.036 1.105 1.198 1.209 0.980 1.102 1.212 1.353 1.197 1.334 1.198 1.250 1.112 1.111 1.049 1.014 1.169 1.394 1.045 1.120 0.936 CVD 1.053 1.097 1.248 1.236 1.082 1.022 1.147 1.219 1.157 1.272 1.003 1.462 1.118 1.260 1.091 1.043 1.275 1.361 1.139 1.227 1.093 1.301 1.210 1.047 1.272 1.307 0.952 1.082 0.937 aleksandrowski brodnicki bydgoski chełmiński golubsko-dobrzyński grudziądzki inowrocławski lipnowski mogileński nakielski radziejowski rypiński sępoleński świecki toruński tucholski wąbrzeski włocławski żniński m. Bydgoszcz m. Grudziądz m. Toruń m. Włocławek 0401 0402 0403 0404 0405 0406 0407 0408 0409 0410 0411 0412 0413 0414 0415 0416 0417 0418 0419 0461 0462 0463 0464 1.034 1.088 1.049 1.163 1.032 1.224 1.108 1.176 1.156 1.156 1.173 1.031 1.115 1.114 1.107 1.083 1.145 1.169 1.014 0.952 1.056 0.937 1.023 0.940 1.132 1.117 1.193 1.138 1.299 1.139 1.083 1.443 1.088 1.072 1.099 1.126 1.214 1.381 1.025 1.309 1.211 1.085 1.089 1.009 1.093 1.046 1.194 1.027 1.029 1.097 0.968 1.209 1.162 1.201 1.148 1.346 1.234 1.067 1.251 1.153 0.894 1.129 0.922 1.244 0.989 0.903 1.081 0.787 1.051 0.904 1.571 1.457 1.275 1.582 1.202 1.378 1.665 0.717 1.000 1.809 1.272 1.263 0.935 1.527 1.333 1.211 1.436 1.063 0.933 0.911 0.988 0.882 0.612 0.855 0.883 1.109 0.817 0.660 1.417 0.816 0.720 0.852 0.683 0.845 0.826 1.380 0.956 1.137 1.260 0.986 0.861 0.897 0.801 1.043 1.228 0.590 1.247 0.919 1.338 1.129 1.648 0.499 1.088 1.038 0.699 1.021 0.409 0.304 0.795 1.233 1.027 1.274 0.296 1.071 1.114 1.186 1.373 0.708 1.053 0.488 0.473 0.427 0.088 0.589 0.955 0.943 1.286 0.696 0.983 0.744 0.984 0.760 0.922 0.609 0.792 1.146 0.808 0.546 1.046 0.770 0.999 bialski 0601 1.122 0.716 1.345 0.692 0.947 1.358 1.656 Page 253 Respiratory Digestive Ill-defined 0.816 1.090 0.425 0.963 1.109 1.072 1.055 1.869 0.657 0.737 1.448 0.207 1.171 1.031 0.587 1.106 1.380 0.958 1.123 1.379 2.366 1.212 0.724 0.940 0.910 0.794 1.467 0.831 1.061 0.968 0.850 1.214 0.753 1.213 1.126 1.489 0.667 0.740 0.868 1.138 1.113 0.348 0.588 1.007 1.420 1.076 0.774 1.185 0.586 0.701 0.568 1.038 1.007 1.040 0.775 0.929 1.162 0.890 0.829 0.595 1.365 1.286 1.265 0.781 0.569 0.559 0.891 1.085 0.814 0.935 0.893 1.062 0.996 0.870 0.659 1.526 1.299 0.436 0.844 1.101 1.173 0.736 1.102 1.546 0.556 0.942 0.761 External 1.172 1.068 1.360 0.673 1.418 1.363 1.409 0.887 0.625 1.073 1.070 0.970 0.796 0.978 0.894 1.316 0.592 1.086 1.025 1.227 0.640 0.614 1.045 0.910 1.013 1.804 1.192 1.143 0.780 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District biłgorajski chełmski hrubieszowski janowski krasnostawski kraśnicki lubartowski lubelski łęczyński łukowski opolski parczewski puławski radzyński rycki świdnicki tomaszowski włodawski zamojski m. Biała Podlaska m. Chełm m. Lublin m. Zamość TERYT 0602 0603 0604 0605 0606 0607 0608 0609 0610 0611 0612 0613 0614 0615 0616 0617 0618 0619 0620 0661 0662 0663 0664 Total 1.029 1.179 1.062 1.103 1.127 1.009 1.104 1.103 1.149 1.040 1.118 1.084 0.996 1.075 1.029 1.021 1.003 1.218 1.049 0.954 0.961 0.907 0.888 Cancer 0.847 0.770 0.829 0.797 0.802 0.823 0.973 0.865 0.823 0.765 0.865 0.825 0.984 0.793 0.885 0.959 0.912 0.967 0.864 0.723 0.869 0.918 0.736 CVD 0.987 1.296 0.903 1.152 1.198 1.166 1.202 1.251 1.212 1.231 1.245 1.222 0.962 1.197 1.136 1.106 1.093 1.400 0.957 1.011 0.983 0.908 0.872 gorzowski krośnieński międzyrzecki nowosolski słubicki strzelecko-drezdenecki sulęciński świebodziński zielonogórski żagański żarski wschowski m. Gorzów Wielkopolski m. Zielona Góra 0801 0802 0803 0804 0805 0806 0807 0808 0809 0810 0811 0812 0861 0862 1.012 1.211 1.182 1.014 1.227 1.085 1.287 1.069 1.115 1.108 1.068 1.092 0.943 0.890 0.947 1.146 1.115 0.912 1.332 1.069 1.112 0.874 1.016 1.091 0.923 0.956 0.966 0.910 0.989 1.126 1.144 1.032 1.163 1.020 1.345 1.169 1.057 1.260 1.269 1.051 0.816 0.719 0.821 1.679 1.254 0.862 1.238 1.138 1.316 0.853 0.693 0.729 0.770 0.905 0.749 0.772 1.302 0.914 1.031 1.036 1.281 1.104 1.362 1.703 0.936 1.104 0.862 0.963 1.010 0.927 1.755 0.956 2.010 0.881 1.315 2.214 0.980 1.295 2.585 0.546 0.816 1.413 2.255 2.394 1.123 1.150 1.107 1.209 1.056 1.271 1.711 0.532 1.320 0.882 0.662 1.374 0.753 0.697 bełchatowski kutnowski łaski łęczycki łowicki łódzki wschodni opoczyński pabianicki pajęczański piotrkowski poddębicki radomszczański rawski sieradzki skierniewicki tomaszowski wieluński wieruszowski 1001 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1012 1013 1014 1015 1016 1017 1018 1.077 1.146 1.014 1.160 1.114 1.119 1.020 1.086 0.993 1.094 1.116 1.114 0.974 1.026 1.020 1.097 1.125 1.089 1.113 1.153 0.884 1.038 1.018 0.938 0.874 1.023 0.990 0.769 1.130 0.968 0.939 1.023 1.030 0.918 1.131 0.882 1.077 1.207 1.113 1.305 1.280 1.169 1.195 1.119 0.921 1.234 1.098 1.211 1.000 1.042 1.058 1.143 1.178 1.314 1.233 0.784 1.096 1.551 1.219 1.248 1.202 0.996 1.226 1.284 1.288 1.185 1.389 1.433 1.050 1.228 1.361 0.643 1.566 1.065 0.911 1.111 1.168 1.628 0.651 1.004 1.090 1.121 0.758 0.769 1.048 0.917 0.949 1.183 1.031 0.777 0.895 1.639 0.741 0.298 0.162 1.292 0.348 1.219 1.304 1.010 0.836 1.426 0.641 0.421 0.312 0.947 0.478 0.638 0.927 0.685 1.179 1.312 1.110 1.074 0.924 1.357 0.955 1.177 1.707 1.066 1.069 1.181 1.240 1.139 0.984 1.427 Page 254 Respiratory Digestive Ill-defined 1.013 0.730 2.458 1.233 1.219 1.657 1.006 0.879 3.916 1.496 1.477 1.829 1.593 0.772 1.524 1.134 0.622 0.651 1.030 0.814 0.991 0.914 1.231 1.214 1.832 0.470 1.076 0.934 0.558 1.396 1.052 0.644 1.072 0.921 1.194 1.199 0.738 1.088 1.739 0.869 1.140 1.352 0.884 1.322 0.739 0.481 0.644 1.827 0.647 0.714 1.358 0.796 1.265 1.469 1.035 0.788 2.423 0.773 0.928 1.207 0.686 1.141 0.863 0.830 0.904 0.956 0.734 1.032 1.248 External 1.043 1.251 0.994 0.738 1.069 1.082 1.397 0.865 1.017 0.732 1.545 0.891 0.872 1.390 0.881 0.785 0.738 0.770 1.200 1.716 1.408 0.559 0.686 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District zduńskowolski zgierski brzeziński m. Łódź m. Piotrków Trybunalski m. Skierniewice TERYT 1019 1020 1021 1061 1062 1063 Total 0.996 1.101 1.089 1.077 1.001 0.997 Cancer 0.990 1.066 0.849 0.960 0.830 1.071 CVD 0.998 1.103 1.380 0.985 1.092 1.071 bocheński brzeski chrzanowski dąbrowski gorlicki krakowski limanowski miechowski myślenicki nowosądecki nowotarski olkuski oświęcimski proszowicki suski tarnowski tatrzański wadowicki wielicki m. Kraków m. Nowy Sącz m. Tarnów 1201 1202 1203 1204 1205 1206 1207 1208 1209 1210 1211 1212 1213 1214 1215 1216 1217 1218 1219 1261 1262 1263 1.008 1.042 0.999 0.863 0.975 1.009 0.972 0.968 1.064 0.976 0.959 0.958 0.924 1.029 1.079 0.960 1.047 0.985 1.032 0.838 0.924 0.935 0.882 0.761 1.029 0.867 0.779 1.002 1.000 0.858 0.979 0.988 0.872 0.866 1.002 1.047 1.054 0.959 1.101 1.006 1.014 0.910 1.035 0.978 1.069 1.232 1.062 0.865 1.095 1.075 0.976 1.010 1.229 0.969 1.027 0.950 0.925 0.941 1.177 1.005 1.098 1.062 1.158 0.862 0.885 0.987 1.099 1.011 1.000 0.970 1.022 0.886 1.131 1.224 0.870 1.027 0.918 1.168 1.129 2.122 1.006 1.042 0.728 0.865 0.473 0.616 0.701 0.773 0.873 0.748 0.657 0.748 0.886 0.775 0.522 1.044 1.066 0.764 0.770 0.904 0.722 0.668 0.801 0.785 0.455 0.611 0.973 0.818 0.893 0.619 1.256 1.014 0.822 1.188 0.902 0.790 0.965 0.464 0.524 1.204 0.883 0.814 0.577 0.344 0.905 1.171 0.661 0.675 0.530 0.662 1.149 0.633 1.097 1.144 0.886 0.518 0.817 1.225 0.825 1.186 1.144 1.179 0.933 1.206 0.840 1.226 0.906 0.606 1.251 1.186 1.311 0.640 0.669 0.844 białobrzeski ciechanowski garwoliński gostyniński grodziski grójecki kozienicki legionowski lipski łosicki makowski miński mławski nowodworski ostrołęcki ostrowski otwocki piaseczyński płocki płoński pruszkowski przasnyski przysuski pułtuski radomski siedlecki sierpecki 1401 1402 1403 1404 1405 1406 1407 1408 1409 1410 1411 1412 1413 1414 1415 1416 1417 1418 1419 1420 1421 1422 1423 1424 1425 1426 1427 1.055 1.080 0.991 1.112 1.042 1.016 0.985 0.967 1.013 0.971 1.082 1.008 1.093 1.078 1.053 0.986 0.891 0.984 1.117 1.107 0.868 1.186 0.974 1.058 1.070 0.970 1.082 0.801 1.124 0.772 1.176 1.148 0.831 0.903 1.035 0.762 0.870 1.044 1.001 1.206 1.255 1.044 0.940 0.867 0.935 1.120 1.066 0.966 1.179 0.648 1.146 0.944 0.807 1.176 1.143 0.977 1.137 0.969 1.018 1.121 0.968 0.929 1.104 1.048 1.151 1.014 1.038 0.984 0.938 1.047 0.883 0.954 1.053 1.176 0.825 1.240 1.145 1.022 1.122 0.998 1.050 0.995 1.867 0.850 1.297 1.053 1.203 1.269 1.213 1.123 0.971 1.095 1.403 1.531 1.272 1.993 1.114 0.675 1.183 1.548 0.978 0.935 1.234 1.232 1.350 1.256 1.331 1.223 1.351 0.786 0.850 0.564 0.927 1.144 0.697 1.077 1.201 1.015 0.547 1.104 1.251 1.317 0.984 0.928 1.239 1.119 0.745 0.969 0.892 0.788 0.960 0.684 0.885 1.160 0.968 1.568 0.311 0.921 2.061 0.752 0.667 0.841 0.526 1.054 0.549 0.424 0.479 0.764 0.534 1.054 0.911 1.218 0.803 1.307 0.763 0.559 0.743 0.845 1.384 1.406 0.858 0.957 1.366 1.866 1.306 1.360 1.317 1.106 1.899 1.200 1.973 1.502 1.254 1.270 1.262 1.272 0.989 0.886 0.831 1.202 1.510 1.743 0.979 1.771 0.851 1.074 1.279 1.088 0.850 Page 255 Respiratory Digestive Ill-defined 0.863 0.881 1.129 1.313 1.538 1.125 0.888 0.941 0.410 1.212 1.370 2.385 0.801 1.172 0.788 0.808 0.672 0.634 External 1.267 0.708 1.236 0.931 1.400 0.898 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District sochaczewski sokołowski szydłowiecki warszawski zachodni węgrowski wołomiński wyszkowski zwoleński żuromiński żyrardowski m. Ostrołęka m. Płock m. Radom m. Siedlce m. st. Warszawa TERYT 1428 1429 1430 1432 1433 1434 1435 1436 1437 1438 1461 1462 1463 1464 1465 Total 1.113 0.952 1.074 0.891 0.945 1.062 1.037 1.061 1.008 1.132 1.009 1.045 0.979 0.883 0.794 Cancer 1.180 0.861 0.881 0.946 0.723 1.040 0.841 0.886 1.269 1.210 1.231 1.174 0.983 0.841 0.907 CVD 1.115 1.013 1.168 0.849 1.002 1.013 1.069 1.087 0.940 1.062 0.801 0.884 0.919 0.938 0.675 brzeski głubczycki kędzierzyńsko-kozielski kluczborski krapkowicki namysłowski nyski oleski opolski prudnicki strzelecki m. Opole 1601 1602 1603 1604 1605 1606 1607 1608 1609 1610 1611 1661 1.075 1.234 0.934 1.091 0.993 1.122 1.018 0.969 0.913 1.115 0.951 0.845 1.006 1.184 0.818 1.002 0.749 1.180 1.039 1.005 0.941 0.892 0.821 0.951 1.076 1.452 1.024 1.250 1.131 1.108 1.118 1.113 0.953 1.341 1.168 0.807 0.828 0.823 0.719 0.740 1.165 1.194 0.929 0.435 0.977 0.925 0.630 0.887 0.840 0.985 0.941 0.881 0.934 0.592 0.648 0.744 0.640 1.281 0.679 0.839 1.968 0.562 1.241 0.708 0.771 1.611 0.423 0.864 0.755 0.599 0.461 0.602 1.378 0.982 0.892 1.407 0.815 1.362 1.212 0.842 0.859 0.912 0.885 0.788 bieszczadzki brzozowski dębicki jarosławski jasielski kolbuszowski krośnieński leżajski lubaczowski łańcucki mielecki niżański przemyski przeworski ropczycko-sędziszowski rzeszowski sanocki stalowowolski strzyżowski tarnobrzeski leski m. Krosno m. Przemyśl m. Rzeszów m. Tarnobrzeg 1801 1802 1803 1804 1805 1806 1807 1808 1809 1810 1811 1812 1813 1814 1815 1816 1817 1818 1819 1820 1821 1861 1862 1863 1864 1.150 1.008 0.986 1.001 1.007 0.931 0.929 0.947 1.030 0.908 0.856 0.989 1.031 0.962 1.028 0.951 0.924 0.985 1.012 0.936 0.852 0.909 1.001 0.775 0.869 1.088 1.058 1.041 0.915 0.992 0.911 0.929 0.919 0.957 0.781 0.941 0.910 0.923 0.890 0.868 0.845 0.840 0.991 0.978 1.039 0.959 1.078 1.040 0.900 0.927 1.194 0.919 1.134 1.205 1.037 1.038 0.870 0.987 1.185 1.049 0.724 1.171 1.075 1.045 1.280 1.114 0.930 1.054 0.923 0.997 0.754 0.831 1.053 0.791 1.002 1.437 1.288 0.631 0.461 0.967 0.836 0.958 0.642 0.810 0.711 1.021 0.387 0.684 0.977 0.700 0.849 0.792 0.783 0.966 0.704 0.992 0.612 0.559 0.450 0.478 1.377 1.008 0.494 0.859 1.156 0.584 0.657 0.603 0.536 0.688 0.617 0.661 1.114 0.661 0.656 0.747 1.053 0.644 0.561 0.743 1.087 0.841 0.827 0.560 0.731 0.958 1.349 0.447 0.980 1.415 0.357 1.547 1.338 0.833 0.759 1.134 1.289 2.307 0.963 0.276 0.658 1.200 0.860 2.439 0.370 1.099 1.138 1.291 0.449 0.386 0.553 0.936 0.823 0.772 0.841 0.974 0.870 1.246 0.578 1.270 0.991 0.992 0.955 0.925 1.029 0.783 0.770 0.798 1.151 0.580 0.782 0.734 0.887 0.941 0.257 augustowski białostocki bielski 2001 2002 2003 0.974 1.019 0.855 1.009 0.927 0.715 0.945 0.978 0.859 0.898 1.274 1.106 1.046 1.035 0.871 1.360 1.427 0.827 1.388 0.852 1.466 Page 256 Respiratory Digestive Ill-defined 1.386 1.087 0.637 1.355 0.416 0.310 1.442 0.658 1.035 0.959 0.924 0.908 0.990 1.303 0.757 1.351 1.104 1.236 1.707 0.848 0.629 1.562 1.060 1.383 1.108 0.569 0.413 1.492 1.323 0.973 1.631 1.268 0.436 1.322 1.506 0.975 0.970 1.215 1.725 0.818 0.801 0.726 0.948 0.997 0.865 External 1.260 1.226 1.162 1.242 1.419 1.533 1.501 0.742 0.614 0.934 1.821 1.043 0.733 0.673 0.844 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District grajewski hajnowski kolneński łomżyński moniecki sejneński siemiatycki sokólski suwalski wysokomazowiecki zambrowski m. Białystok m. Łomża m. Suwałki TERYT 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2061 2062 2063 Total 1.021 0.949 1.081 0.978 0.903 0.991 0.957 0.983 0.993 0.916 0.968 0.847 0.979 0.856 Cancer 1.087 0.910 0.882 0.967 0.916 1.348 0.904 0.902 1.118 0.795 0.985 0.966 1.214 0.935 CVD 0.961 0.884 0.998 0.857 0.812 0.764 0.899 0.968 0.938 0.906 0.942 0.757 0.825 0.762 bytowski chojnicki człuchowski gdański kartuski kościerski kwidzyński lęborski malborski nowodworski pucki słupski starogardzki tczewski wejherowski sztumski m. Gdańsk m. Gdynia m. Słupsk m. Sopot 2201 2202 2203 2204 2205 2206 2207 2208 2209 2210 2211 2212 2213 2214 2215 2216 2261 2262 2263 2264 1.111 1.041 1.063 1.025 0.987 0.980 1.197 1.138 1.156 1.289 1.078 1.105 1.058 1.076 0.991 1.351 0.881 0.839 0.928 0.738 1.067 1.226 1.276 1.075 1.109 1.155 1.343 1.440 1.052 1.564 1.252 1.304 1.047 1.249 1.108 1.674 1.051 1.079 1.006 1.144 0.974 0.939 0.892 0.925 0.915 0.865 1.098 0.945 1.129 1.112 0.997 0.835 0.920 0.989 0.754 1.419 0.736 0.725 0.785 0.591 1.483 1.268 1.011 1.238 0.923 1.402 1.263 1.150 0.962 1.270 0.871 1.145 1.702 1.124 1.317 0.733 0.881 0.678 0.671 0.469 1.506 0.811 1.093 1.305 1.183 0.840 2.063 1.491 1.553 1.646 1.029 1.440 1.127 0.925 1.355 1.063 1.030 0.802 1.114 0.793 1.513 1.005 2.277 0.953 1.093 1.072 0.728 0.975 3.001 1.344 0.714 2.337 0.823 0.642 1.429 0.917 1.149 0.907 2.173 0.636 1.026 1.095 1.005 1.391 0.870 0.641 1.495 1.137 0.903 0.756 1.540 1.169 1.496 0.984 0.987 0.633 0.825 0.667 0.655 0.574 będziński bielski cieszyński częstochowski gliwicki kłobucki lubliniecki mikołowski myszkowski pszczyński raciborski rybnicki tarnogórski bieruńsko-lędziński wodzisławski zawierciański żywiecki m. Bielsko-Biała m. Bytom m. Chorzów m. Częstochowa 2401 2402 2403 2404 2405 2406 2407 2408 2409 2410 2411 2412 2413 2414 2415 2416 2417 2461 2462 2463 2464 1.144 0.946 0.960 1.089 1.074 1.032 0.979 0.979 1.084 1.046 1.028 1.139 0.922 1.097 1.051 1.109 1.069 0.898 0.992 1.088 0.994 1.073 0.839 0.894 0.982 1.044 0.940 0.816 0.922 1.007 0.941 1.020 1.092 0.931 1.014 1.064 1.084 0.921 0.850 0.962 1.025 0.946 1.219 1.167 1.058 1.186 1.104 1.123 1.165 1.113 1.222 1.339 0.970 1.148 0.944 1.177 0.964 1.120 1.374 1.090 0.947 1.114 1.067 1.027 0.490 1.001 1.178 1.203 1.204 0.878 0.950 1.076 0.489 1.168 1.613 0.970 1.278 1.172 1.354 0.485 0.321 0.954 1.076 0.786 1.360 0.758 0.924 1.176 1.117 1.156 1.304 1.123 1.083 0.638 1.311 1.214 0.968 1.191 1.955 0.781 1.181 0.647 1.312 1.758 1.139 0.725 0.079 0.149 0.783 0.894 0.263 0.439 0.396 0.626 0.151 1.598 0.815 0.730 0.442 0.783 0.573 0.108 0.172 1.346 0.443 0.722 1.415 1.157 0.918 1.201 0.959 1.359 0.949 0.593 1.166 1.075 0.353 1.025 0.882 1.179 0.978 1.095 0.957 0.888 1.117 1.125 1.103 Page 257 Respiratory Digestive Ill-defined 1.091 0.663 0.754 1.300 1.034 0.961 1.979 1.056 1.825 1.444 0.545 1.498 1.281 0.985 1.044 1.053 1.047 0.994 1.353 0.934 0.705 1.213 1.046 0.729 0.811 0.697 1.179 1.377 0.623 0.899 1.069 0.888 0.544 0.693 0.977 0.933 0.684 0.784 0.877 0.793 1.022 0.507 External 1.221 0.723 0.817 1.297 0.777 1.144 1.115 1.172 1.092 1.270 1.404 0.856 0.991 0.733 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District m. Dąbrowa Górnicza m. Gliwice m. Jastrzębie-Zdrój m. Jaworzno m. Katowice m. Mysłowice m. Piekary Śląskie m. Ruda Śląska m. Rybnik m. Siemianowice Śląskie m. Sosnowiec m. Świętochłowice m. Tychy m. Zabrze m. Żory TERYT 2465 2466 2467 2468 2469 2470 2471 2472 2473 2474 2475 2476 2477 2478 2479 Total 1.112 0.869 1.008 1.053 0.930 1.123 1.094 1.175 0.942 1.097 1.086 1.026 0.973 0.861 1.013 Cancer 1.101 0.943 1.056 1.165 0.975 1.138 0.998 1.085 0.894 1.296 1.109 0.940 1.132 0.838 1.151 CVD 1.146 0.797 0.958 1.097 0.919 1.175 1.270 1.221 0.973 1.044 1.075 1.152 0.932 0.779 1.027 buski jędrzejowski kazimierski kielecki konecki opatowski ostrowiecki pińczowski sandomierski skarżyski starachowicki staszowski włoszczowski m. Kielce 2601 2602 2603 2604 2605 2606 2607 2608 2609 2610 2611 2612 2613 2661 0.968 0.996 1.184 1.066 1.088 1.092 1.046 1.045 0.993 1.027 1.010 1.016 0.986 0.840 0.893 0.866 1.045 0.963 0.960 0.991 1.027 0.864 0.919 0.900 0.942 0.930 0.750 0.817 0.871 1.023 1.196 1.017 1.138 1.146 1.150 1.126 1.041 1.157 1.001 1.080 1.113 0.777 1.142 1.182 1.649 1.427 1.246 0.979 0.598 0.762 0.630 0.813 1.189 0.760 0.782 0.952 0.689 0.794 0.729 0.980 1.200 0.607 0.882 1.017 1.307 0.940 1.024 0.837 0.692 0.972 2.504 0.773 1.238 1.227 0.612 1.123 0.475 1.680 0.799 0.467 0.549 1.193 0.550 1.091 0.930 1.127 0.718 1.347 1.143 1.577 1.009 0.975 0.977 1.176 0.908 0.911 0.814 0.961 bartoszycki braniewski działdowski elbląski ełcki giżycki iławski kętrzyński lidzbarski mrągowski nidzicki nowomiejski olecki olsztyński ostródzki piski szczycieński gołdapski węgorzewski m. Elbląg m. Olsztyn 2801 2802 2803 2804 2805 2806 2807 2808 2809 2810 2811 2812 2813 2814 2815 2816 2817 2818 2819 2861 2862 1.131 1.154 1.113 1.123 1.063 1.098 1.029 1.197 1.096 1.178 1.118 1.069 1.056 1.121 1.049 1.042 1.080 1.077 1.002 1.046 0.824 1.043 1.204 1.447 1.101 1.073 0.946 1.159 1.347 1.194 1.381 1.292 1.158 1.060 1.215 1.190 1.064 0.967 0.833 0.900 1.182 0.943 1.015 1.139 0.896 0.903 0.945 1.035 0.872 1.073 1.040 0.955 0.809 0.920 1.162 0.917 0.929 0.935 0.940 1.085 0.882 0.871 0.599 1.898 1.222 1.566 1.906 0.957 1.500 1.307 1.477 1.241 1.609 2.736 1.756 1.070 2.079 1.319 1.756 2.084 1.365 1.743 1.364 1.208 1.248 0.754 0.792 0.942 0.931 1.405 0.985 0.987 1.329 1.228 1.408 0.435 0.787 0.738 1.416 0.863 0.936 0.863 0.983 1.065 0.939 0.937 1.384 0.765 2.667 2.196 1.071 1.360 0.937 1.163 1.273 1.386 1.268 0.226 1.280 1.069 0.777 1.695 1.960 1.792 1.502 1.576 1.334 0.610 0.655 0.235 0.722 1.361 0.655 1.058 1.074 1.490 0.628 1.120 0.965 1.159 0.697 0.780 0.942 1.395 0.454 0.459 0.833 chodzieski czarnkowsko-trzcianecki gnieźnieński gostyński grodziski 3001 3002 3003 3004 3005 1.044 1.090 1.029 1.052 1.215 0.980 1.179 1.113 1.080 0.996 0.954 0.969 0.971 1.010 1.461 1.223 0.898 0.676 1.045 0.922 0.815 0.616 1.183 1.192 1.599 1.593 2.085 0.840 0.854 0.381 1.162 1.418 1.233 1.434 1.178 Page 258 Respiratory Digestive Ill-defined 1.111 1.357 0.543 0.706 1.204 0.867 0.887 1.588 1.070 0.733 0.904 0.673 0.886 1.166 0.491 1.171 1.546 0.439 0.796 1.566 0.587 1.116 1.336 0.649 1.212 0.721 0.446 1.113 1.397 0.132 1.046 1.375 0.591 0.545 1.432 0.496 1.233 1.082 0.157 0.890 1.414 1.011 0.504 1.353 0.147 External 1.029 0.806 0.714 1.038 1.092 1.083 0.766 1.064 0.927 1.122 1.298 1.359 0.559 0.973 1.071 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District jarociński kaliski kępiński kolski koniński kościański krotoszyński leszczyński międzychodzki nowotomyski obornicki ostrowski ostrzeszowski pilski pleszewski poznański rawicki słupecki szamotulski średzki śremski turecki wągrowiecki wolsztyński wrzesiński złotowski m. Kalisz m. Konin m. Leszno m. Poznań TERYT 3006 3007 3008 3009 3010 3011 3012 3013 3014 3015 3016 3017 3018 3019 3020 3021 3022 3023 3024 3025 3026 3027 3028 3029 3030 3031 3061 3062 3063 3064 Total 1.000 1.009 1.038 1.095 1.043 1.070 1.087 1.124 1.204 1.131 1.130 1.015 1.132 1.094 1.057 1.042 1.050 1.068 1.095 1.067 1.156 1.151 1.048 1.054 1.090 1.120 0.942 0.895 0.997 0.890 Cancer 1.044 0.947 1.054 1.095 1.210 1.054 0.981 1.185 0.843 1.083 1.179 1.180 0.927 1.196 1.006 1.171 1.087 1.130 1.313 0.932 1.329 1.133 0.948 0.937 1.107 1.150 1.012 0.999 1.104 1.004 CVD 1.059 0.889 1.025 1.260 0.963 1.006 1.137 1.087 1.208 1.124 1.042 0.918 1.290 1.011 1.135 1.010 1.068 0.990 1.010 1.126 0.994 1.157 0.865 1.131 1.081 1.089 0.930 0.828 0.911 0.837 białogardzki choszczeński drawski goleniowski gryficki gryfiński kamieński kołobrzeski koszaliński myśliborski policki pyrzycki sławieński stargardzki szczecinecki świdwiński wałecki łobeski m. Koszalin m. Szczecin m. Świnoujście 3201 3202 3203 3204 3205 3206 3207 3208 3209 3210 3211 3212 3213 3214 3215 3216 3217 3218 3261 3262 3263 1.201 1.124 1.180 1.071 1.153 1.071 1.075 0.978 1.273 1.135 1.026 1.125 1.074 1.046 1.220 1.105 1.177 1.147 0.870 0.967 1.052 1.034 1.106 1.053 1.014 1.028 1.117 0.995 1.106 1.329 1.019 1.030 1.209 1.235 1.076 1.046 1.106 1.232 0.960 1.057 1.036 0.988 1.388 1.115 1.288 1.099 1.163 1.166 1.114 0.833 1.253 1.212 0.986 1.051 1.100 1.032 1.312 1.155 1.199 1.159 0.823 0.952 1.143 1.186 1.810 0.951 1.140 1.369 0.890 0.900 0.585 1.153 1.388 1.317 0.985 0.668 1.163 0.831 1.061 0.994 1.599 0.634 0.744 0.701 1.720 0.786 1.068 1.346 0.999 0.591 1.178 1.086 0.811 1.279 1.149 1.595 0.997 1.027 1.666 1.623 1.676 1.402 1.194 1.106 1.162 0.345 0.632 0.718 0.923 2.028 0.444 1.053 2.556 1.835 0.796 0.846 1.607 0.737 0.901 1.528 0.692 0.373 0.762 0.618 0.841 1.637 1.107 0.757 1.760 1.025 0.693 1.153 0.724 0.388 0.948 1.062 1.222 1.179 1.297 1.068 1.137 0.964 2.228 1.944 0.577 0.976 0.756 1.000 1.000 1.000 1.000 1.000 1.000 1.000 Polska Page 259 Respiratory Digestive Ill-defined 0.657 0.820 0.507 1.185 0.791 2.285 1.364 1.097 0.819 0.674 0.725 0.651 1.134 1.094 1.007 0.573 1.137 2.206 1.109 0.981 0.460 0.808 1.233 1.360 1.065 1.668 2.325 0.713 1.500 1.175 0.730 0.891 1.202 1.028 0.958 0.646 0.913 1.059 0.372 1.141 0.989 1.141 0.871 1.084 0.773 0.749 1.035 0.809 1.073 0.711 0.556 1.587 1.181 0.420 0.686 0.369 1.565 0.886 0.878 0.302 1.099 1.139 1.102 1.294 1.060 1.420 1.280 1.194 0.882 0.839 1.090 0.881 1.225 1.047 0.265 0.906 0.754 1.159 0.776 0.765 1.105 0.899 0.759 0.911 0.804 1.257 0.902 0.577 0.924 0.910 External 1.323 1.533 1.175 1.191 0.920 1.383 1.479 1.149 1.407 1.677 1.834 1.228 1.965 0.992 1.547 0.859 1.530 1.213 1.090 1.259 1.464 0.999 2.249 1.335 1.537 2.015 1.048 1.153 1.085 0.929 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 Table 70. Age-standardized mortality ratio (SMR) by main groups of causes of deaths, district of residence in 2006–2008, females of age 65 years and more District bolesławiecki dzierżoniowski głogowski górowski jaworski jeleniogórski kamiennogórski kłodzki legnicki lubański lubiński lwówecki milicki oleśnicki oławski polkowicki strzeliński średzki świdnicki trzebnicki wałbrzyski wołowski wrocławski ząbkowicki zgorzelecki złotoryjski m. Jelenia Góra m. Legnica m. Wrocław TERYT 0201 0202 0203 0204 0205 0206 0207 0208 0209 0210 0211 0212 0213 0214 0215 0216 0217 0218 0219 0220 0221 0222 0223 0224 0225 0226 0261 0262 0264 Total 1.042 1.020 1.066 1.016 1.048 1.105 1.085 1.127 1.020 1.097 0.991 1.184 1.043 0.948 0.970 1.038 1.013 1.093 1.066 1.049 1.151 1.128 0.975 1.105 1.056 1.168 0.988 1.010 0.905 Cancer 1.258 1.046 1.184 0.856 0.961 1.194 1.077 1.129 1.049 0.859 1.010 0.820 0.859 0.926 0.977 1.032 1.043 0.942 1.204 1.224 1.171 1.146 1.031 1.115 1.087 1.220 1.156 1.210 1.054 CVD 1.030 1.067 1.027 1.136 1.166 1.083 1.066 1.198 1.089 1.300 1.016 1.197 1.215 1.067 1.037 1.082 1.216 1.208 1.067 1.136 1.226 1.259 1.028 1.173 1.142 1.234 0.876 0.962 0.935 aleksandrowski brodnicki bydgoski chełmiński golubsko-dobrzyński grudziądzki inowrocławski lipnowski mogileński nakielski radziejowski rypiński sępoleński świecki toruński tucholski wąbrzeski włocławski żniński m. Bydgoszcz m. Grudziądz m. Toruń m. Włocławek 0401 0402 0403 0404 0405 0406 0407 0408 0409 0410 0411 0412 0413 0414 0415 0416 0417 0418 0419 0461 0462 0463 0464 1.034 1.082 1.018 1.175 0.897 1.099 1.075 1.117 1.158 1.167 1.052 1.158 0.950 1.161 1.086 1.015 1.029 1.050 1.058 0.935 1.114 0.895 1.025 0.915 0.969 1.121 1.295 0.715 0.950 1.110 1.003 0.999 1.114 1.094 1.233 0.976 1.187 0.988 0.952 0.902 0.871 1.209 1.225 1.208 1.093 1.188 1.254 1.098 0.986 1.110 0.906 1.125 1.146 1.198 1.276 1.354 1.078 1.266 0.958 1.263 1.045 1.108 1.078 1.211 1.009 0.872 1.094 0.767 1.037 0.457 0.762 1.459 0.898 1.102 1.107 1.159 1.230 1.070 0.807 1.599 0.784 0.986 0.992 1.490 1.390 1.292 0.819 0.773 1.305 1.179 1.209 0.879 0.846 1.184 1.426 1.083 0.684 1.219 1.470 0.723 1.069 0.822 0.617 0.883 1.200 0.831 1.143 0.653 0.237 0.731 1.051 0.999 0.986 1.040 1.439 0.371 1.817 0.439 1.634 0.957 1.034 0.397 1.088 1.000 0.748 1.018 0.853 1.192 1.211 1.204 0.831 0.783 0.703 1.254 0.651 0.942 1.214 0.740 0.419 0.544 0.347 0.479 0.393 0.416 0.555 0.540 0.496 0.395 0.088 0.468 0.333 0.317 0.697 0.205 0.126 0.602 0.757 0.417 0.592 0.564 0.561 bialski 0601 1.072 0.725 1.231 0.508 0.855 1.012 1.593 Page 260 Respiratory Digestive Ill-defined 1.080 1.166 0.421 0.861 0.714 1.356 0.696 1.149 1.318 0.729 0.601 1.264 0.838 1.029 0.853 1.115 1.459 0.909 1.104 0.936 2.036 0.935 0.966 1.214 0.799 0.731 0.989 0.727 0.481 1.114 0.708 0.908 1.281 1.155 1.440 2.330 0.281 0.462 1.121 0.746 0.976 0.198 0.511 1.090 0.956 0.754 0.799 1.315 0.366 0.760 0.297 0.928 1.034 0.988 0.612 0.923 1.528 0.678 0.845 0.596 0.853 0.884 1.389 0.830 0.712 0.894 0.862 1.274 0.471 0.868 0.769 1.555 1.025 1.144 0.536 1.134 0.784 1.240 1.017 1.136 1.504 0.756 0.945 1.585 0.733 1.007 0.636 External 1.114 0.661 0.736 1.325 1.022 0.663 0.508 0.759 1.248 0.641 1.109 0.999 1.211 0.954 1.235 0.500 0.786 0.780 1.105 0.934 0.957 0.531 0.951 0.589 0.948 0.781 0.910 0.931 0.816 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District biłgorajski chełmski hrubieszowski janowski krasnostawski kraśnicki lubartowski lubelski łęczyński łukowski opolski parczewski puławski radzyński rycki świdnicki tomaszowski włodawski zamojski m. Biała Podlaska m. Chełm m. Lublin m. Zamość TERYT 0602 0603 0604 0605 0606 0607 0608 0609 0610 0611 0612 0613 0614 0615 0616 0617 0618 0619 0620 0661 0662 0663 0664 Total 1.008 1.086 0.992 1.076 1.050 1.032 1.060 1.032 1.023 1.010 1.040 0.981 0.940 1.075 0.971 0.950 0.997 1.146 1.010 0.913 0.868 0.940 0.885 Cancer 0.688 0.779 0.707 0.665 0.604 0.859 0.822 0.588 0.709 0.736 0.615 0.800 0.831 0.715 0.745 0.719 0.686 0.754 0.754 0.990 0.740 0.895 0.889 CVD 1.030 1.170 0.882 1.246 1.157 1.188 1.209 1.241 1.158 1.182 1.258 1.086 0.943 1.158 1.161 1.082 1.065 1.344 0.955 0.956 0.940 0.961 0.851 gorzowski krośnieński międzyrzecki nowosolski słubicki strzelecko-drezdenecki sulęciński świebodziński zielonogórski żagański żarski wschowski m. Gorzów Wielkopolski m. Zielona Góra 0801 0802 0803 0804 0805 0806 0807 0808 0809 0810 0811 0812 0861 0862 1.064 1.110 1.092 1.012 1.089 1.038 1.174 1.062 0.988 1.099 1.179 1.090 0.974 0.921 1.072 0.928 0.899 0.979 0.929 0.906 1.009 0.877 0.902 1.035 1.128 1.070 1.200 1.052 1.048 1.119 1.073 0.982 1.082 1.010 1.148 1.104 0.879 1.226 1.304 0.996 0.782 0.696 0.887 1.257 1.185 0.590 1.135 0.801 1.243 0.926 0.717 0.600 0.577 0.230 0.945 0.640 0.957 0.612 1.105 1.273 1.695 1.307 1.590 0.804 1.038 0.919 1.026 1.337 0.784 0.888 1.372 1.335 1.778 1.487 1.211 2.137 1.456 1.337 2.419 0.537 0.976 1.615 2.305 2.710 0.838 0.895 1.011 0.526 0.963 0.723 0.634 0.344 0.472 0.779 0.569 0.741 0.470 0.640 bełchatowski kutnowski łaski łęczycki łowicki łódzki wschodni opoczyński pabianicki pajęczański piotrkowski poddębicki radomszczański rawski sieradzki skierniewicki tomaszowski wieluński wieruszowski 1001 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 1012 1013 1014 1015 1016 1017 1018 1.049 1.102 1.025 1.197 1.005 1.099 1.102 1.049 1.000 1.114 1.209 1.039 1.009 1.034 0.980 1.012 1.024 1.149 1.042 0.938 0.764 0.979 0.882 0.948 0.681 0.854 0.865 0.818 0.939 0.769 0.879 0.998 0.831 0.919 0.893 0.855 1.118 1.301 1.127 1.422 1.211 1.163 1.391 1.083 1.098 1.244 1.270 1.182 1.048 1.069 1.150 1.068 1.149 1.373 1.271 0.683 0.976 0.899 0.689 1.293 0.511 1.142 1.066 0.928 1.130 0.823 1.582 1.002 0.848 1.014 0.795 0.469 1.052 0.798 1.375 1.297 1.020 1.151 1.092 1.314 0.747 1.336 1.079 0.694 1.140 1.194 0.908 0.894 0.982 1.117 0.659 0.543 0.694 0.231 0.136 0.918 0.347 0.941 0.770 0.872 1.196 1.170 0.427 0.703 0.285 0.679 0.382 0.670 0.799 0.835 0.821 1.023 0.381 0.881 1.291 1.470 0.655 1.314 2.015 0.912 1.321 1.546 0.958 0.807 1.010 1.010 Page 261 Respiratory Digestive Ill-defined 0.865 0.675 2.471 0.548 0.982 1.722 0.592 0.679 3.648 0.378 0.370 1.996 0.997 1.086 1.556 0.504 0.902 0.810 0.606 0.978 0.762 0.586 1.094 0.560 1.346 1.048 0.420 0.447 0.700 0.912 0.525 0.922 0.942 0.952 0.793 0.992 0.564 1.048 1.552 1.072 1.055 1.307 0.495 0.635 0.515 0.317 0.849 1.203 0.435 0.860 1.778 0.365 0.795 1.515 0.566 0.681 2.721 0.585 0.780 0.464 0.645 1.089 0.546 0.803 1.003 0.812 0.743 0.576 0.990 External 0.715 1.144 0.928 0.662 1.016 0.790 1.000 1.156 1.401 0.925 0.592 0.805 0.948 1.183 1.002 0.787 1.013 0.785 0.879 0.829 0.962 0.911 0.827 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District zduńskowolski zgierski brzeziński m. Łódź m. Piotrków Trybunalski m. Skierniewice TERYT 1019 1020 1021 1061 1062 1063 Total 1.088 1.066 1.215 1.056 1.031 1.054 Cancer 1.049 0.825 0.797 1.053 0.845 1.047 CVD 1.181 1.107 1.435 0.936 1.113 1.170 bocheński brzeski chrzanowski dąbrowski gorlicki krakowski limanowski miechowski myślenicki nowosądecki nowotarski olkuski oświęcimski proszowicki suski tarnowski tatrzański wadowicki wielicki m. Kraków m. Nowy Sącz m. Tarnów 1201 1202 1203 1204 1205 1206 1207 1208 1209 1210 1211 1212 1213 1214 1215 1216 1217 1218 1219 1261 1262 1263 1.033 1.007 1.034 1.018 0.995 0.992 0.991 1.042 1.013 0.963 0.913 0.951 0.995 0.941 0.978 0.954 0.981 0.985 0.965 0.920 0.926 0.961 0.731 0.709 1.030 0.974 0.887 0.934 0.814 0.953 0.859 0.716 0.865 0.903 0.952 0.657 0.931 0.809 0.983 0.873 0.840 1.098 1.065 1.105 1.103 1.175 1.010 1.021 1.116 1.081 1.036 1.136 1.126 1.004 1.002 0.989 1.028 1.097 1.022 0.972 1.000 1.114 1.096 0.915 0.816 0.932 1.212 0.477 1.347 0.602 0.684 0.959 1.600 0.915 0.728 1.109 0.544 1.171 1.106 1.573 1.027 1.076 0.874 0.924 0.854 0.866 0.811 0.999 0.934 0.825 1.286 0.717 1.118 0.861 0.593 0.966 1.626 1.068 0.649 0.721 1.032 0.558 0.544 0.877 0.937 0.807 0.927 0.915 1.128 1.059 1.219 1.438 0.993 1.928 0.739 0.565 1.122 0.477 0.554 1.299 0.981 0.666 0.681 0.189 1.131 1.578 0.801 0.486 0.412 0.576 1.354 1.028 0.738 0.389 1.189 0.645 0.592 0.866 1.059 0.937 1.147 1.181 0.702 0.966 0.934 0.946 1.121 0.642 1.489 1.027 1.019 0.838 0.975 0.753 białobrzeski ciechanowski garwoliński gostyniński grodziski grójecki kozienicki legionowski lipski łosicki makowski miński mławski nowodworski ostrołęcki ostrowski otwocki piaseczyński płocki płoński pruszkowski przasnyski przysuski pułtuski radomski siedlecki sierpecki 1401 1402 1403 1404 1405 1406 1407 1408 1409 1410 1411 1412 1413 1414 1415 1416 1417 1418 1419 1420 1421 1422 1423 1424 1425 1426 1427 1.067 1.039 0.953 1.055 0.998 1.089 0.926 0.945 1.006 0.975 0.959 0.994 0.977 1.096 1.017 0.949 0.929 0.998 1.089 1.037 0.902 1.077 0.970 1.051 1.036 1.034 1.002 0.743 1.067 0.629 0.793 1.101 0.956 0.742 1.066 0.895 0.819 0.854 0.885 0.988 1.142 0.814 0.745 0.945 1.091 0.940 0.829 1.113 0.834 0.612 0.957 0.898 0.829 0.865 1.103 0.986 1.106 1.002 1.014 1.180 1.012 0.862 1.040 1.041 1.024 1.040 1.004 1.094 1.083 1.050 0.939 0.992 1.095 1.121 0.873 1.155 1.141 1.097 1.114 1.086 1.058 0.600 1.691 0.832 1.360 1.449 1.038 0.767 1.602 0.933 1.329 0.819 1.383 1.094 1.188 1.165 0.656 0.720 1.178 1.235 1.026 0.930 1.161 0.913 0.957 0.870 1.274 0.896 0.967 1.186 1.077 1.005 0.944 0.978 0.772 1.283 1.054 0.909 0.776 0.864 0.905 1.101 0.571 0.869 1.065 0.966 1.111 1.173 0.860 0.646 0.868 0.799 0.765 1.069 0.854 2.194 0.535 0.616 2.124 0.541 0.900 0.668 0.554 1.072 0.650 0.580 0.581 0.800 0.733 0.911 0.916 0.883 0.684 1.387 0.774 0.451 1.455 0.638 1.285 1.052 0.832 0.563 1.765 1.225 1.042 1.329 0.813 1.077 1.490 1.860 1.278 0.862 1.152 1.220 0.905 1.689 1.201 1.178 0.917 1.195 1.122 1.014 1.129 1.023 0.873 1.501 1.209 1.248 1.349 Page 262 Respiratory Digestive Ill-defined 1.460 0.892 0.507 1.193 1.446 1.093 0.568 1.005 1.128 1.585 1.358 1.815 0.897 1.269 0.785 1.063 0.842 0.374 External 0.734 1.299 1.884 0.944 0.872 0.921 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District sochaczewski sokołowski szydłowiecki warszawski zachodni węgrowski wołomiński wyszkowski zwoleński żuromiński żyrardowski m. Ostrołęka m. Płock m. Radom m. Siedlce m. st. Warszawa TERYT 1428 1429 1430 1432 1433 1434 1435 1436 1437 1438 1461 1462 1463 1464 1465 Total 1.063 0.998 0.981 0.905 1.004 1.037 0.982 1.162 1.027 1.091 0.993 0.974 0.963 0.834 0.854 Cancer 0.897 0.779 0.646 1.065 0.901 0.987 0.901 0.818 1.103 1.101 0.929 1.132 1.006 0.965 1.090 CVD 1.184 1.046 1.073 0.839 1.029 1.036 1.000 1.116 1.097 1.115 0.796 0.875 0.896 0.859 0.725 brzeski głubczycki kędzierzyńsko-kozielski kluczborski krapkowicki namysłowski nyski oleski opolski prudnicki strzelecki m. Opole 1601 1602 1603 1604 1605 1606 1607 1608 1609 1610 1611 1661 0.958 1.075 0.946 1.029 1.036 0.998 1.058 1.025 0.955 1.064 1.011 0.917 0.843 1.088 0.981 0.895 0.872 1.039 1.038 1.002 0.982 0.895 0.765 1.186 0.990 1.190 0.970 1.100 1.131 0.946 1.209 1.105 0.988 1.214 1.208 0.874 0.555 0.661 0.645 0.809 0.745 0.889 0.731 0.254 0.983 0.885 0.944 0.964 0.768 0.970 0.567 0.914 0.914 0.598 0.512 0.716 0.834 0.683 0.805 0.759 1.746 0.548 1.055 1.131 0.702 1.919 0.356 1.275 0.497 0.758 0.422 0.531 0.639 1.255 0.826 0.890 0.810 0.855 0.880 1.194 0.777 0.668 0.395 0.702 bieszczadzki brzozowski dębicki jarosławski jasielski kolbuszowski krośnieński leżajski lubaczowski łańcucki mielecki niżański przemyski przeworski ropczycko-sędziszowski rzeszowski sanocki stalowowolski strzyżowski tarnobrzeski leski m. Krosno m. Przemyśl m. Rzeszów m. Tarnobrzeg 1801 1802 1803 1804 1805 1806 1807 1808 1809 1810 1811 1812 1813 1814 1815 1816 1817 1818 1819 1820 1821 1861 1862 1863 1864 0.974 1.003 0.913 1.059 0.972 0.945 0.970 1.016 0.959 0.994 0.896 0.935 0.977 1.027 0.903 0.978 0.963 1.086 1.004 1.001 0.855 0.929 1.011 0.823 0.859 0.768 0.884 1.010 0.893 0.746 0.622 0.843 0.849 0.894 0.846 0.869 0.777 0.759 0.782 0.762 0.747 0.929 0.991 0.878 0.617 1.080 0.880 1.058 0.920 0.879 0.872 0.958 1.040 1.259 0.970 1.084 0.838 1.092 1.084 1.151 0.739 1.035 1.089 1.196 1.073 1.126 0.821 1.168 0.916 1.243 0.682 0.753 1.094 0.860 0.935 1.538 0.991 0.274 0.295 0.478 0.795 0.858 0.571 0.541 0.414 1.304 0.290 0.300 0.691 0.239 0.581 0.991 0.504 0.820 0.352 0.891 0.836 0.344 0.580 0.324 1.390 0.670 0.479 0.838 1.140 0.581 0.907 0.685 0.497 1.062 0.706 0.432 0.956 0.759 1.007 0.755 1.113 0.727 0.933 0.894 0.939 1.128 1.043 0.698 0.357 1.760 2.467 0.464 1.039 2.495 0.730 2.796 1.550 0.928 0.571 1.878 1.910 1.545 0.824 0.539 0.899 2.267 1.475 2.893 0.491 1.889 2.644 0.925 0.480 0.378 0.500 0.500 0.764 0.808 0.400 1.280 0.649 1.350 0.796 1.087 1.068 0.497 0.760 0.815 0.640 0.904 0.590 0.903 0.324 0.585 0.755 0.559 0.852 0.827 0.677 augustowski białostocki bielski 2001 2002 2003 0.928 0.961 0.930 0.962 0.850 0.825 0.848 0.871 0.960 0.805 1.292 0.869 0.846 0.895 0.717 1.692 1.889 1.011 0.829 1.149 1.632 Page 263 Respiratory Digestive Ill-defined 1.189 0.755 0.347 1.442 0.995 0.449 0.983 0.989 1.029 1.514 1.227 0.603 1.140 1.228 0.720 1.368 1.240 0.986 1.540 0.920 0.714 1.688 1.003 1.858 0.870 0.788 0.579 1.928 0.815 0.546 2.091 0.809 1.151 1.342 0.997 0.624 0.949 1.120 1.504 0.562 1.358 0.236 1.397 1.106 0.716 External 1.198 1.236 1.105 1.079 1.330 1.043 1.140 1.123 1.426 1.085 1.396 1.499 0.864 0.864 1.051 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District grajewski hajnowski kolneński łomżyński moniecki sejneński siemiatycki sokólski suwalski wysokomazowiecki zambrowski m. Białystok m. Łomża m. Suwałki TERYT 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2061 2062 2063 Total 0.921 0.987 0.995 0.913 0.884 1.015 0.967 0.939 0.973 0.964 0.967 0.830 0.906 0.901 Cancer 0.857 0.855 0.776 0.773 0.933 0.937 0.848 0.830 0.841 0.931 0.961 1.041 1.127 1.198 CVD 0.926 0.916 0.851 0.803 0.771 0.925 0.921 0.920 0.861 0.985 0.970 0.683 0.717 0.717 bytowski chojnicki człuchowski gdański kartuski kościerski kwidzyński lęborski malborski nowodworski pucki słupski starogardzki tczewski wejherowski sztumski m. Gdańsk m. Gdynia m. Słupsk m. Sopot 2201 2202 2203 2204 2205 2206 2207 2208 2209 2210 2211 2212 2213 2214 2215 2216 2261 2262 2263 2264 1.074 1.050 0.990 0.979 0.934 1.229 1.018 1.053 1.110 1.044 1.127 1.003 1.113 1.049 1.046 1.171 0.892 0.906 0.940 0.804 1.058 1.234 1.092 1.084 0.836 1.447 0.978 1.229 0.944 1.106 1.415 1.187 1.147 1.225 1.192 0.911 1.169 1.279 1.220 1.170 0.969 0.972 0.891 0.829 0.909 1.017 0.961 0.938 1.095 0.985 0.928 0.813 0.936 0.935 0.827 1.350 0.697 0.706 0.725 0.623 1.584 1.063 0.943 1.482 0.770 1.584 1.362 1.299 1.403 1.147 1.080 0.782 2.008 1.271 1.881 0.763 1.156 0.865 0.953 1.028 1.050 1.116 0.779 1.268 0.823 0.759 0.933 1.127 0.947 1.022 1.117 1.074 0.828 1.103 0.903 0.900 1.155 1.091 1.407 0.745 1.433 1.284 1.867 1.309 1.494 1.777 1.299 1.337 1.938 1.336 1.820 2.397 1.596 1.136 1.839 1.250 1.428 1.377 1.995 1.260 1.203 0.661 0.862 1.195 1.073 1.290 0.852 0.980 0.996 1.093 0.844 0.804 1.097 1.182 1.159 0.589 0.972 0.903 0.925 0.800 będziński bielski cieszyński częstochowski gliwicki kłobucki lubliniecki mikołowski myszkowski pszczyński raciborski rybnicki tarnogórski bieruńsko-lędziński wodzisławski zawierciański żywiecki m. Bielsko-Biała m. Bytom m. Chorzów m. Częstochowa 2401 2402 2403 2404 2405 2406 2407 2408 2409 2410 2411 2412 2413 2414 2415 2416 2417 2461 2462 2463 2464 1.109 1.036 1.075 1.082 1.065 1.028 1.068 1.073 1.077 1.078 1.080 1.107 1.012 1.107 1.087 1.139 1.097 0.906 1.000 1.147 1.040 1.144 0.920 0.953 0.900 1.099 0.792 0.949 0.828 0.849 1.154 1.034 1.031 1.019 1.147 1.256 1.042 0.810 0.955 1.075 1.166 1.037 1.185 1.196 1.135 1.249 1.066 1.201 1.198 1.184 1.197 1.213 0.993 1.095 1.068 1.145 0.982 1.170 1.311 0.995 0.924 1.112 1.116 0.783 0.756 1.429 0.719 0.972 0.639 0.792 1.469 0.971 0.731 1.016 1.599 0.956 1.119 1.516 1.216 0.673 0.605 0.887 1.529 1.031 1.233 0.948 0.775 1.078 1.154 0.951 0.696 1.292 0.655 0.819 1.234 1.238 0.776 1.207 1.370 1.216 1.171 0.721 1.299 1.528 1.098 0.539 0.046 0.084 0.468 0.830 0.460 0.674 0.427 1.206 0.022 1.844 0.828 0.769 0.160 0.743 0.822 0.056 0.032 1.204 0.393 0.423 1.220 1.061 1.455 1.073 1.382 1.103 0.751 0.786 0.986 0.912 1.404 1.647 0.945 1.022 1.070 1.218 1.205 1.071 1.222 1.579 1.009 Page 264 Respiratory Digestive Ill-defined 0.751 0.591 1.010 1.554 1.291 1.443 1.416 0.588 2.190 0.985 1.049 2.066 1.482 0.936 1.311 0.681 0.720 2.036 1.544 0.811 1.130 1.039 0.818 1.289 0.896 1.281 1.774 1.002 0.728 1.009 0.755 0.773 0.766 0.978 1.032 1.354 0.567 1.050 1.027 1.019 0.866 0.957 External 0.849 0.987 0.940 0.869 0.311 0.974 1.908 0.946 0.961 0.865 1.227 1.036 1.947 0.723 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District m. Dąbrowa Górnicza m. Gliwice m. Jastrzębie-Zdrój m. Jaworzno m. Katowice m. Mysłowice m. Piekary Śląskie m. Ruda Śląska m. Rybnik m. Siemianowice Śląskie m. Sosnowiec m. Świętochłowice m. Tychy m. Zabrze m. Żory TERYT 2465 2466 2467 2468 2469 2470 2471 2472 2473 2474 2475 2476 2477 2478 2479 Total 1.068 0.922 1.072 1.025 1.012 1.167 1.066 1.241 1.003 1.234 1.104 1.068 1.026 0.874 1.019 Cancer 1.060 1.129 1.172 1.060 1.147 1.472 1.002 1.232 1.018 1.269 1.183 1.026 0.996 1.077 1.127 CVD 1.097 0.844 0.985 1.071 0.979 1.185 1.171 1.215 0.972 1.269 1.111 1.205 1.059 0.763 0.922 buski jędrzejowski kazimierski kielecki konecki opatowski ostrowiecki pińczowski sandomierski skarżyski starachowicki staszowski włoszczowski m. Kielce 2601 2602 2603 2604 2605 2606 2607 2608 2609 2610 2611 2612 2613 2661 0.996 1.017 1.035 0.974 1.033 1.036 1.062 0.935 0.897 1.028 0.971 1.023 1.099 0.875 0.823 0.697 0.915 0.815 0.888 0.741 0.942 0.728 0.929 0.855 0.842 0.897 0.750 0.876 0.877 1.090 1.026 0.998 1.185 1.135 1.186 0.945 0.892 1.133 1.040 1.101 1.233 0.788 1.046 1.380 0.936 1.284 0.463 0.682 0.411 0.697 0.613 0.861 0.970 0.441 1.061 1.353 0.766 0.633 0.699 0.771 0.913 0.899 0.835 0.704 0.868 0.684 0.740 0.861 0.929 1.013 2.699 1.085 1.345 1.062 0.540 1.549 0.374 1.882 1.018 0.460 0.320 1.314 0.831 1.054 0.844 0.956 1.091 0.878 0.702 0.654 1.202 1.028 0.537 1.052 1.310 0.803 0.885 0.847 bartoszycki braniewski działdowski elbląski ełcki giżycki iławski kętrzyński lidzbarski mrągowski nidzicki nowomiejski olecki olsztyński ostródzki piski szczycieński gołdapski węgorzewski m. Elbląg m. Olsztyn 2801 2802 2803 2804 2805 2806 2807 2808 2809 2810 2811 2812 2813 2814 2815 2816 2817 2818 2819 2861 2862 1.055 1.080 1.068 1.064 0.942 0.963 0.960 1.012 1.041 1.016 1.079 0.961 1.080 1.034 0.928 0.960 0.978 1.022 1.043 0.976 0.805 0.992 0.870 1.355 0.932 0.954 0.916 0.878 1.074 1.176 1.043 1.107 1.074 0.818 1.013 0.901 1.001 0.821 1.069 1.016 1.239 1.041 0.992 1.163 0.974 1.012 0.849 0.952 0.954 0.946 1.057 0.943 0.975 0.802 1.259 0.936 0.893 0.924 0.936 0.895 0.963 0.836 0.646 1.736 1.539 1.393 1.571 1.268 1.812 1.419 2.116 1.046 1.426 2.700 1.410 1.316 2.264 1.606 1.531 1.490 1.161 1.556 1.679 1.630 1.784 1.538 0.718 0.769 0.835 0.887 0.799 0.700 1.455 0.967 1.012 0.902 0.433 0.642 0.859 0.579 0.853 0.696 0.978 0.800 0.696 0.688 0.598 1.036 1.721 1.576 0.832 1.197 0.997 0.649 1.174 1.269 1.415 0.330 1.382 0.888 0.934 1.784 2.116 1.535 1.070 1.104 0.377 0.500 0.380 0.492 0.450 0.395 0.580 0.664 0.304 0.557 0.441 0.806 0.703 0.591 0.595 0.475 0.540 0.378 0.874 0.466 0.552 chodzieski czarnkowsko-trzcianecki gnieźnieński gostyński grodziski 3001 3002 3003 3004 3005 1.110 1.115 1.075 1.129 1.131 1.179 1.177 1.150 1.178 0.847 0.941 0.963 0.978 1.028 1.266 0.994 0.906 0.641 0.663 0.702 0.400 1.006 0.895 0.965 0.953 2.328 1.791 1.593 1.763 0.877 1.594 1.823 1.369 2.113 0.856 Page 265 Respiratory Digestive Ill-defined 1.349 1.121 0.466 0.984 1.157 0.722 1.220 1.242 0.635 0.743 1.058 0.614 1.144 1.354 0.457 0.777 1.329 0.279 0.729 1.058 0.360 1.132 1.805 0.858 1.216 1.107 0.494 1.317 1.895 0.353 1.290 1.240 0.454 0.425 1.089 0.440 1.119 1.084 0.360 0.918 1.179 0.773 1.364 1.428 0.502 External 1.164 1.043 1.579 1.074 1.354 1.767 0.905 1.321 1.424 0.939 1.186 1.220 0.928 0.931 1.502 Colours reflect ranking of the districts sorted from the lowest value of SMR (1) to the highest value (379) 1 District jarociński kaliski kępiński kolski koniński kościański krotoszyński leszczyński międzychodzki nowotomyski obornicki ostrowski ostrzeszowski pilski pleszewski poznański rawicki słupecki szamotulski średzki śremski turecki wągrowiecki wolsztyński wrzesiński złotowski m. Kalisz m. Konin m. Leszno m. Poznań TERYT 3006 3007 3008 3009 3010 3011 3012 3013 3014 3015 3016 3017 3018 3019 3020 3021 3022 3023 3024 3025 3026 3027 3028 3029 3030 3031 3061 3062 3063 3064 Total 1.087 1.053 1.058 1.019 0.953 1.000 1.172 1.070 1.203 1.081 1.195 0.972 1.145 1.042 1.206 1.084 1.142 1.072 1.110 1.061 1.219 1.059 1.073 1.198 1.044 1.015 0.961 0.861 0.973 0.947 Cancer 1.172 0.925 0.959 1.004 0.982 1.088 1.222 1.013 1.001 1.141 1.375 1.021 0.909 1.122 1.106 1.194 1.007 1.250 1.185 0.969 1.090 0.984 1.115 1.154 1.164 0.960 1.098 1.194 1.126 1.200 CVD 1.115 1.011 1.132 1.075 0.946 0.825 1.216 1.043 1.053 1.005 1.044 0.910 1.284 0.924 1.310 1.014 1.209 1.028 1.045 1.021 1.145 1.051 0.946 1.257 0.944 1.037 0.937 0.703 0.890 0.848 białogardzki choszczeński drawski goleniowski gryficki gryfiński kamieński kołobrzeski koszaliński myśliborski policki pyrzycki sławieński stargardzki szczecinecki świdwiński wałecki łobeski m. Koszalin m. Szczecin m. Świnoujście 3201 3202 3203 3204 3205 3206 3207 3208 3209 3210 3211 3212 3213 3214 3215 3216 3217 3218 3261 3262 3263 1.025 1.108 1.087 0.977 1.158 1.085 1.065 0.969 1.089 1.046 0.993 1.009 0.982 1.040 1.181 0.998 1.129 0.989 0.889 0.966 1.089 1.134 1.052 1.021 0.966 1.047 0.955 1.026 1.105 1.161 0.885 1.141 0.836 1.065 0.999 0.891 1.131 1.054 0.889 1.367 1.210 1.002 1.142 1.146 1.123 1.019 1.155 1.140 1.032 0.872 1.066 1.156 0.904 1.068 1.075 1.032 1.296 0.984 1.189 1.039 0.760 0.893 1.181 0.655 1.060 0.996 1.069 1.491 0.906 0.997 0.691 0.923 1.455 0.786 1.047 0.355 1.359 0.885 1.042 1.153 0.863 0.823 0.929 1.221 0.763 1.229 0.899 1.169 1.770 0.987 1.312 0.948 0.964 0.972 1.332 1.026 1.157 1.152 0.897 1.158 0.999 1.001 0.947 1.087 0.888 0.661 0.480 1.365 0.638 1.554 0.958 1.294 1.500 1.331 0.610 0.973 0.717 0.605 0.785 1.105 0.886 0.760 0.880 0.666 0.766 0.976 0.750 1.573 0.511 0.604 0.900 1.065 0.958 1.329 0.860 0.990 0.956 0.707 0.674 1.081 0.627 0.560 1.609 0.921 1.200 1.036 1.201 1.000 1.000 1.000 1.000 1.000 1.000 1.000 Polska Page 266 Respiratory Digestive Ill-defined 0.479 0.943 0.723 0.809 1.026 2.088 0.755 0.756 0.517 0.442 1.267 0.538 0.624 0.835 0.965 0.661 1.196 2.006 0.640 0.981 0.491 0.520 1.100 1.108 0.516 1.844 2.674 0.553 1.352 1.311 0.596 0.806 1.212 0.772 0.920 0.535 0.342 1.054 0.276 0.967 0.974 1.364 0.642 1.215 0.673 0.778 1.224 1.042 0.777 1.302 0.512 1.266 0.844 0.619 0.654 0.959 1.972 0.778 1.334 0.578 1.262 0.934 1.625 0.727 1.120 1.338 0.965 0.937 0.864 0.689 1.664 0.544 1.196 1.317 0.703 0.543 0.772 1.143 0.771 0.896 0.918 0.721 0.841 0.857 0.520 1.080 1.109 0.873 1.013 0.673 External 1.699 0.870 2.209 1.398 0.955 2.113 1.902 2.129 2.490 1.913 2.846 2.137 1.303 1.554 2.209 1.734 1.975 1.469 1.293 1.475 1.783 1.548 2.722 1.176 1.742 2.013 1.061 1.514 1.106 1.463 Table 71. Infant mortality rates by age and district of residence in 2001–2003 and 2006–2008, per 1000 live births District TERYT 2001–2003 0-27 28+ Total days days 2006–2008 0-27 28+ Total days days Total change (%) bolesławiecki 0201 6.8 2.8 9.6 4.8 1.1 5.9 -38.7 dzierżoniowski 0202 6.1 3.8 9.9 4.6 1.4 6.1 -38.7 głogowski 0203 4.6 4.2 8.8 4.9 1.3 6.2 -30.1 górowski 0204 7.8 0.0 7.8 2.4 0.0 2.4 -69.0 jaworski 0205 5.9 5.1 11.0 3.3 1.3 4.6 -58.3 jeleniogórski 0206 7.4 1.9 9.3 2.8 2.8 5.5 -40.3 kamiennogórski 0207 6.3 2.8 9.1 3.6 2.2 5.8 -36.1 kłodzki 0208 6.5 2.6 9.1 4.3 1.8 6.0 -33.5 legnicki 0209 2.7 2.7 5.4 4.2 3.0 7.1 33.2 lubański 0210 6.9 3.8 10.6 4.9 1.2 6.1 -42.4 lubiński 0211 2.5 2.8 5.3 3.9 1.8 5.8 9.6 lwówecki 0212 3.8 3.0 6.8 5.1 4.4 9.5 39.7 milicki 0213 6.4 2.4 8.8 5.2 0.7 6.0 -32.3 oleśnicki 0214 6.2 4.2 10.4 5.8 1.8 7.6 -27.1 oławski 0215 7.4 1.1 8.5 5.3 4.8 10.1 19.3 polkowicki 0216 5.8 2.1 7.9 6.7 0.5 7.1 -9.2 strzeliński 0217 6.5 1.6 8.1 8.7 1.6 10.3 26.5 średzki 0218 3.7 6.6 10.3 5.7 1.3 7.0 -32.2 świdnicki 0219 5.0 2.9 7.9 5.3 2.4 7.7 -3.3 trzebnicki 0220 9.0 4.0 13.0 8.9 1.2 10.1 -22.4 wałbrzyski 0221 4.4 4.2 8.6 5.4 2.1 7.5 -13.0 wołowski 0222 6.2 4.6 10.8 3.7 1.5 5.2 -52.1 wrocławski 0223 9.2 2.0 11.2 7.4 1.5 8.8 -20.9 ząbkowicki 0224 11.1 2.7 13.8 6.6 2.2 8.8 -36.3 zgorzelecki 0225 7.2 3.0 10.2 6.7 1.9 8.5 -16.9 złotoryjski 0226 9.9 1.6 11.5 4.1 2.8 6.9 -39.9 m. Jelenia Góra 0261 7.8 3.1 10.9 4.3 1.4 5.8 -46.7 m. Legnica m. Wrocław 0262 0264 3.8 6.8 3.8 2.9 7.5 9.7 4.3 5.4 3.3 1.4 7.7 6.8 2.2 -29.9 aleksandrowski 0401 6.7 1.2 7.9 4.1 3.0 7.1 -10.5 brodnicki 0402 6.4 3.6 9.9 3.6 1.1 4.6 -53.5 bydgoski 0403 4.5 3.8 8.2 5.9 2.1 8.0 -2.6 chełmiński 0404 6.6 7.8 14.4 4.6 3.4 8.0 -44.6 golubsko-dobrzyński 0405 5.8 2.6 8.3 4.1 0.7 4.8 -42.5 grudziądzki 0406 9.3 5.0 14.3 3.8 2.5 6.3 -55.9 inowrocławski 0407 6.1 1.7 7.8 3.9 1.7 5.6 -28.8 lipnowski 0408 5.7 2.6 8.3 5.8 3.7 9.5 15.5 mogileński 0409 5.1 2.9 7.9 4.0 1.3 5.3 -32.9 nakielski 0410 5.6 2.5 8.1 5.1 1.6 6.8 -16.4 radziejowski 0411 8.0 1.6 9.7 5.3 0.8 6.1 -37.1 rypiński 0412 4.7 0.7 5.4 4.9 1.8 6.7 24.9 sępoleński 0413 7.3 0.7 8.0 4.3 2.5 6.8 -15.1 Page 267 District TERYT 2001–2003 0-27 28+ Total days days 2006–2008 0-27 28+ Total days days Total change (%) świecki 0414 7.3 1.6 8.9 5.4 2.1 7.5 -15.8 toruński 0415 3.7 2.4 6.1 3.8 1.2 5.0 -18.7 tucholski 0416 5.5 4.3 9.7 2.3 0.6 2.8 -70.8 wąbrzeski 0417 5.9 3.4 9.3 3.4 1.7 5.1 -45.1 włocławski 0418 5.5 2.4 7.8 6.5 0.8 7.3 -7.2 żniński 0419 4.9 1.3 6.3 3.0 0.4 3.5 -44.6 m. Bydgoszcz 0461 5.3 2.1 7.4 4.1 1.1 5.2 -29.7 m. Grudziądz 0462 3.7 3.3 7.0 5.5 1.6 7.1 2.4 m. Toruń 0463 4.8 3.3 8.1 2.3 2.0 4.3 -46.5 m. Włocławek 0464 7.0 1.5 8.6 3.1 1.9 5.0 -41.3 bialski 0601 4.5 1.9 6.4 2.4 1.3 3.7 -42.1 biłgorajski 0602 5.3 2.5 7.8 3.1 1.6 4.7 -39.5 chełmski 0603 3.1 4.4 7.4 5.2 1.6 6.9 -8.0 hrubieszowski 0604 3.4 2.9 6.3 3.0 3.0 6.0 -3.8 janowski 0605 8.3 3.8 12.2 6.1 1.4 7.5 -38.3 krasnostawski 0606 5.4 1.5 6.9 5.5 2.2 7.7 11.3 kraśnicki 0607 8.3 2.8 11.0 3.8 1.4 5.2 -52.7 lubartowski 0608 5.8 2.7 8.5 4.6 1.0 5.6 -33.6 lubelski 0609 5.5 1.8 7.3 6.6 1.7 8.4 15.1 łęczyński 0610 4.6 1.7 6.3 4.4 2.7 7.1 13.5 łukowski 0611 3.7 2.7 6.4 3.5 2.5 6.1 -5.0 opolski 0612 7.6 3.2 10.8 4.0 3.0 7.0 -35.3 parczewski 0613 4.3 1.7 6.0 4.5 0.9 5.4 -9.4 puławski 0614 4.7 1.2 5.8 3.6 2.1 5.7 -2.3 radzyński 0615 6.2 1.4 7.6 4.3 1.4 5.8 -24.0 rycki 0616 7.4 2.7 10.1 4.9 1.6 6.6 -34.8 świdnicki 0617 5.4 3.4 8.9 4.2 4.2 8.4 -5.5 tomaszowski 0618 4.3 1.4 5.8 3.8 1.9 5.7 -1.3 włodawski 0619 4.3 2.6 6.9 4.7 0.0 4.7 -31.6 zamojski 0620 4.6 2.7 7.3 5.6 2.8 8.4 14.4 m. Biała Podlaska 0661 5.9 3.0 8.9 4.0 2.9 6.9 -22.9 m. Chełm 0662 5.3 1.8 7.0 4.8 0.5 5.3 -24.6 m. Lublin 0663 6.9 2.6 9.5 4.4 2.2 6.5 -31.4 m. Zamość 0664 1.7 3.4 5.2 6.5 0.0 6.5 25.6 gorzowski 0801 5.0 4.0 9.0 3.7 0.9 4.6 -48.9 krośnieński 0802 4.7 4.1 8.8 1.7 1.7 3.3 -62.2 międzyrzecki 0803 3.7 2.4 6.1 4.3 1.6 5.9 -2.5 nowosolski 0804 6.4 3.0 9.4 5.2 1.7 6.9 -26.7 słubicki 0805 5.0 2.2 7.2 3.1 0.6 3.7 -49.2 strzelecko-drezdenecki 0806 3.8 2.5 6.3 2.8 2.8 5.7 -9.8 sulęciński 0807 5.5 1.8 7.3 3.3 3.3 6.5 -11.0 świebodziński 0808 7.8 1.2 9.0 3.7 1.6 5.3 -40.5 zielonogórski 0809 4.4 1.6 6.0 3.8 2.1 5.9 -2.1 Page 268 District TERYT 2001–2003 0-27 28+ Total days days 2006–2008 0-27 28+ Total days days Total change (%) żagański 0810 5.7 1.2 6.9 4.4 3.7 8.1 17.3 żarski 0811 3.8 4.8 8.6 4.3 0.3 4.6 -45.8 wschowski 0812 4.7 0.8 5.5 5.3 2.3 7.5 36.2 m. Gorzów Wielkopolski 0861 6.7 1.3 7.9 6.3 2.4 8.7 8.9 m. Zielona Góra 0862 4.1 3.0 7.0 2.7 2.1 4.7 -32.9 bełchatowski 1001 4.7 1.3 6.0 2.8 0.3 3.0 -49.7 kutnowski 1002 2.7 2.3 5.1 5.5 2.5 8.0 58.3 łaski 1003 4.4 2.9 7.3 0.0 3.5 3.5 -52.2 łęczycki 1004 3.4 2.7 6.0 4.4 3.1 7.5 24.2 łowicki 1005 3.1 3.9 7.0 1.7 1.3 3.0 -57.6 łódzki wschodni 1006 8.1 2.5 10.6 3.2 1.6 4.8 -55.0 opoczyński 1007 7.3 1.1 8.4 1.8 1.8 3.7 -56.4 pabianicki 1008 6.8 1.9 8.7 3.1 2.2 5.3 -38.2 pajęczański 1009 3.9 0.7 4.6 5.0 0.6 5.7 22.8 piotrkowski 1010 4.6 2.1 6.7 3.7 0.7 4.4 -34.8 poddębicki 1011 6.9 2.6 9.5 3.3 0.0 3.3 -65.4 radomszczański 1012 5.4 2.3 7.7 5.1 1.1 6.2 -19.2 rawski 1013 4.1 3.4 7.6 3.2 0.0 3.2 -58.3 sieradzki 1014 3.4 2.0 5.5 2.5 0.5 3.0 -44.7 skierniewicki 1015 2.6 0.9 3.4 4.8 0.8 5.6 62.7 tomaszowski 1016 5.8 2.3 8.2 3.4 1.5 4.9 -40.0 wieluński 1017 2.7 0.9 3.5 4.2 1.3 5.4 53.6 wieruszowski 1018 3.5 2.1 5.7 2.2 0.7 2.9 -48.2 zduńskowolski 1019 3.1 3.1 6.2 5.2 0.5 5.7 -8.2 zgierski 1020 6.9 1.0 7.9 4.1 0.9 5.0 -37.0 brzeziński 1021 6.2 0.0 6.2 3.4 1.1 4.5 -26.7 m. Łódź 1061 6.3 2.5 8.8 4.0 2.1 6.1 -31.2 m. Piotrków Trybunalski 1062 3.6 2.7 6.4 5.0 2.5 7.6 18.6 m. Skierniewice 1063 6.2 0.8 7.0 3.8 3.2 7.0 0.5 bocheński 1201 4.5 1.8 6.4 3.3 0.8 4.2 -34.3 brzeski 1202 3.7 2.0 5.7 3.6 1.3 5.0 -13.5 chrzanowski 1203 4.2 3.6 7.7 4.6 2.6 7.1 -7.8 dąbrowski 1204 4.8 3.0 7.7 6.7 1.2 7.9 2.2 gorlicki 1205 3.1 2.5 5.6 3.5 0.8 4.3 -22.3 krakowski 1206 5.7 0.9 6.6 3.8 1.5 5.2 -20.1 limanowski 1207 6.0 1.9 7.9 4.8 2.2 7.0 -11.1 miechowski 1208 2.0 1.4 3.4 4.7 3.4 8.1 138.7 myślenicki 1209 6.9 1.2 8.1 2.6 0.7 3.3 -59.9 nowosądecki 1210 3.5 1.9 5.3 4.6 2.5 7.1 33.5 nowotarski 1211 3.3 1.7 5.0 3.0 2.8 5.8 15.3 olkuski 1212 7.5 2.2 9.6 5.5 1.5 7.1 -26.6 oświęcimski 1213 3.8 1.4 5.3 2.0 1.5 3.5 -34.2 proszowicki 1214 8.0 0.8 8.8 3.9 0.0 3.9 -55.7 Page 269 District TERYT 2001–2003 0-27 28+ Total days days 2006–2008 0-27 28+ Total days days Total change (%) suski 1215 2.9 1.4 4.3 5.3 2.1 7.4 72.7 tarnowski 1216 3.9 1.7 5.6 3.6 2.1 5.7 0.2 tatrzański 1217 0.5 2.5 3.0 3.0 1.5 4.6 54.7 wadowicki 1218 5.3 1.6 6.9 4.6 2.7 7.2 4.6 wielicki 1219 6.6 1.3 7.9 3.7 0.6 4.2 -46.1 m. Kraków 1261 4.8 2.1 6.8 3.9 1.4 5.3 -22.4 m. Nowy Sącz 1262 3.9 2.7 6.7 5.1 0.7 5.8 -12.4 m. Tarnów 1263 5.3 1.3 6.6 3.0 0.7 3.7 -44.4 białobrzeski 1401 4.0 0.8 4.8 7.1 4.0 11.1 131.9 ciechanowski 1402 4.5 2.1 6.6 5.3 0.4 5.6 -14.8 garwoliński 1403 4.6 1.1 5.6 2.8 1.3 4.0 -28.3 gostyniński 1404 7.3 1.5 8.7 3.5 0.0 3.5 -59.6 grodziski 1405 5.6 1.5 7.1 2.0 1.6 3.6 -48.6 grójecki 1406 6.0 2.3 8.3 2.6 1.9 4.5 -45.7 kozienicki 1407 5.2 1.6 6.8 3.7 0.0 3.7 -46.0 legionowski 1408 4.7 1.7 6.4 3.1 1.6 4.7 -26.8 lipski 1409 2.9 2.9 5.7 7.1 0.0 7.1 23.0 łosicki 1410 4.8 3.9 8.7 2.0 3.0 5.1 -41.7 makowski 1411 3.1 3.1 6.2 3.6 0.0 3.6 -41.3 miński 1412 3.2 1.2 4.4 2.5 0.8 3.3 -25.5 mławski 1413 5.9 2.1 8.0 5.1 1.7 6.8 -15.9 nowodworski 1414 4.0 0.9 4.8 1.9 0.8 2.7 -44.1 ostrołęcki 1415 6.3 1.3 7.6 3.3 1.3 4.6 -38.9 ostrowski 1416 4.1 2.1 6.2 2.0 2.0 4.1 -34.2 otwocki 1417 3.2 1.0 4.2 3.5 1.3 4.8 14.7 piaseczyński 1418 5.4 0.9 6.3 3.0 2.1 5.1 -19.8 płocki 1419 3.0 1.8 4.8 5.9 3.5 9.5 95.2 płoński 1420 6.3 1.0 7.3 4.8 1.0 5.8 -19.9 pruszkowski 1421 4.0 0.8 4.8 3.8 0.2 4.0 -16.1 przasnyski 1422 5.5 2.5 7.9 2.1 2.1 4.1 -48.2 przysuski 1423 10.2 2.9 13.1 1.6 3.3 4.9 -62.8 pułtuski 1424 6.1 2.4 8.5 2.9 2.3 5.3 -38.4 radomski 1425 7.6 1.9 9.5 2.8 2.0 4.8 -49.4 siedlecki 1426 3.3 1.5 4.8 5.1 1.8 6.9 43.7 sierpecki 1427 5.5 0.6 6.1 2.3 2.3 4.6 -24.0 sochaczewski 1428 5.8 0.8 6.6 3.4 0.4 3.7 -43.3 sokołowski 1429 3.5 2.9 6.4 1.1 1.1 2.3 -64.3 szydłowiecki 1430 3.1 0.8 3.8 8.1 0.8 9.0 134.9 warszawski zachodni 1432 2.7 0.0 2.7 3.5 0.7 4.2 52.6 węgrowski 1433 6.9 2.8 9.7 2.7 2.2 4.9 -49.6 wołomiński 1434 3.6 3.2 6.8 2.6 1.6 4.1 -39.1 wyszkowski 1435 4.6 1.7 6.3 2.3 3.1 5.4 -13.6 zwoleński 1436 2.6 3.5 6.0 8.4 4.2 12.5 107.7 Page 270 District TERYT 2001–2003 0-27 28+ Total days days 2006–2008 0-27 28+ Total days days Total change (%) żuromiński 1437 8.9 0.7 9.6 2.2 0.7 2.9 -69.3 żyrardowski 1438 3.7 3.7 7.4 3.3 1.6 4.9 -34.2 m. Ostrołęka 1461 6.9 1.3 8.1 4.8 0.6 5.4 -33.1 m. Płock 1462 9.2 1.5 10.6 4.8 1.0 5.9 -44.9 m. Radom 1463 6.3 2.6 8.9 4.2 0.9 5.1 -42.8 m. Siedlce 1464 5.7 0.9 6.6 1.2 2.4 3.6 -46.5 m. st. Warszawa 1465 4.7 1.9 6.6 3.8 1.1 4.8 -27.0 brzeski 1601 4.8 1.6 6.3 5.0 2.5 7.5 18.5 głubczycki 1602 2.2 0.7 3.0 0.7 3.0 3.7 25.5 kędzierzyńsko-kozielski 1603 5.7 0.8 6.6 2.0 0.8 2.8 -57.0 kluczborski 1604 5.6 2.8 8.4 4.1 2.3 6.5 -22.7 krapkowicki 1605 4.3 1.2 5.6 6.8 1.2 8.0 43.8 namysłowski 1606 2.5 0.0 2.5 3.9 0.8 4.7 86.1 nyski 1607 3.7 1.3 5.1 5.1 1.6 6.7 32.6 oleski 1608 5.7 0.6 6.3 4.2 0.6 4.8 -22.9 opolski 1609 4.4 2.7 7.0 2.3 0.7 3.0 -57.6 prudnicki 1610 3.3 2.0 5.3 1.3 0.7 2.0 -63.0 strzelecki 1611 1.6 1.1 2.7 2.7 1.6 4.3 62.2 m. Opole 1661 4.8 2.6 7.3 3.8 2.9 6.7 -8.2 bieszczadzki 1801 4.4 1.5 5.8 6.0 1.5 7.5 29.1 brzozowski 1802 4.3 1.7 6.0 3.6 1.3 4.9 -17.9 dębicki 1803 2.8 1.4 4.3 4.5 1.7 6.2 45.3 jarosławski 1804 5.6 2.1 7.7 4.6 2.2 6.8 -10.9 jasielski 1805 3.3 1.1 4.4 6.0 0.9 6.9 55.5 kolbuszowski 1806 5.0 0.5 5.5 4.6 1.1 5.7 4.9 krośnieński 1807 6.1 2.6 8.8 4.7 0.8 5.6 -36.7 leżajski 1808 8.1 1.8 9.8 6.2 2.4 8.6 -13.0 lubaczowski 1809 2.7 1.1 3.8 5.3 0.0 5.3 38.6 łańcucki 1810 3.6 1.2 4.9 7.6 0.8 8.4 72.4 mielecki 1811 5.3 1.8 7.0 4.2 1.2 5.4 -22.9 niżański 1812 4.2 2.6 6.8 5.8 0.0 5.8 -15.1 przemyski 1813 5.3 1.2 6.5 2.6 1.3 3.8 -41.1 przeworski 1814 7.5 0.8 8.3 6.6 0.8 7.4 -10.9 ropczycko-sędziszowski 1815 9.4 3.3 12.7 6.7 1.2 7.9 -37.7 rzeszowski 1816 7.2 3.1 10.3 3.2 1.9 5.1 -50.6 sanocki 1817 2.5 1.4 3.9 4.6 1.1 5.6 42.7 stalowowolski 1818 2.7 2.3 5.0 2.5 2.1 4.6 -8.2 strzyżowski 1819 7.1 1.5 8.6 3.7 0.5 4.2 -50.8 tarnobrzeski 1820 2.5 3.1 5.6 6.7 1.3 8.0 44.7 leski 1821 9.8 2.4 12.2 7.8 2.6 10.4 -14.5 m. Krosno 1861 2.5 2.5 4.9 3.8 0.8 4.6 -6.4 m. Przemyśl 1862 3.3 1.7 5.0 2.8 4.4 7.2 43.3 m. Rzeszów 1863 6.4 1.8 8.2 4.4 1.5 5.8 -28.9 Page 271 District TERYT 2001–2003 0-27 28+ Total days days 2006–2008 0-27 28+ Total days days Total change (%) m. Tarnobrzeg 1864 11.3 1.5 12.9 3.8 2.3 6.0 -53.2 augustowski 2001 4.3 2.1 6.4 1.7 0.6 2.3 -64.5 białostocki 2002 3.0 1.1 4.0 4.0 1.6 5.5 36.9 bielski 2003 2.5 1.3 3.8 5.8 0.6 6.4 67.9 grajewski 2004 3.1 1.3 4.4 5.2 0.6 5.8 32.4 hajnowski 2005 0.9 2.6 3.5 0.9 1.9 2.8 -20.0 kolneński 2006 5.0 4.3 9.3 3.8 0.8 4.6 -50.2 łomżyński 2007 5.9 3.6 9.5 6.2 3.1 9.3 -2.2 moniecki 2008 8.3 4.1 12.4 1.8 2.6 4.4 -64.4 sejneński 2009 6.5 1.6 8.1 1.6 4.9 6.5 -20.3 siemiatycki 2010 5.4 3.1 8.4 3.6 1.8 5.3 -36.6 sokólski 2011 4.5 3.6 8.2 1.5 1.0 2.6 -68.5 suwalski 2012 2.3 2.3 4.6 1.6 2.4 3.9 -14.0 wysokomazowiecki 2013 3.3 2.2 5.5 1.6 0.5 2.1 -61.2 zambrowski 2014 4.4 2.2 6.5 2.2 3.6 5.7 -12.3 m. Białystok 2061 4.6 1.7 6.3 5.3 0.6 5.9 -6.7 m. Łomża 2062 7.8 1.2 9.0 6.3 1.7 8.1 -10.1 m. Suwałki 2063 6.3 1.0 7.3 5.6 3.3 8.9 21.2 bytowski 2201 5.4 2.9 8.2 6.6 1.0 7.6 -7.3 chojnicki 2202 2.5 1.3 3.8 3.3 1.7 5.0 31.6 człuchowski 2203 4.1 2.1 6.2 6.0 0.5 6.5 5.2 gdański 2204 1.6 3.6 5.2 3.4 1.8 5.2 1.0 kartuski 2205 2.0 0.7 2.7 3.4 1.6 5.0 84.2 kościerski 2206 2.3 2.3 4.6 3.4 0.7 4.1 -9.7 kwidzyński 2207 3.9 1.4 5.3 3.3 1.3 4.6 -12.8 lęborski 2208 1.4 2.3 3.6 6.0 1.7 7.7 112.2 malborski 2209 4.8 2.6 7.4 4.8 2.4 7.3 -2.0 nowodworski 2210 3.4 3.4 6.8 4.2 0.8 5.1 -25.3 pucki 2211 1.9 1.5 3.4 6.0 2.3 8.3 141.8 słupski 2212 6.6 0.9 7.6 5.0 2.1 7.1 -7.1 starogardzki 2213 4.9 1.2 6.1 4.5 1.9 6.4 5.6 tczewski 2214 3.9 1.6 5.5 5.3 1.2 6.5 18.4 wejherowski 2215 4.2 1.3 5.5 3.2 1.7 4.9 -9.7 sztumski 2216 1.4 1.4 2.8 2.0 1.3 3.3 20.0 m. Gdańsk 2261 16.1 2.6 18.7 4.3 1.5 5.8 -68.7 m. Gdynia 2262 1.6 2.2 3.8 4.3 1.1 5.4 42.8 m. Słupsk 2263 3.7 2.1 5.8 5.9 1.1 7.0 20.3 m. Sopot 2264 1.3 2.7 4.0 2.4 0.0 2.4 -41.0 będziński 2401 4.9 3.4 8.3 6.3 1.3 7.6 -8.9 bielski 2402 4.8 1.9 6.7 4.0 1.0 5.0 -25.4 cieszyński 2403 4.4 1.2 5.6 4.6 1.7 6.3 13.2 częstochowski 2404 6.4 2.9 9.3 5.0 1.4 6.4 -31.2 gliwicki 2405 5.5 4.8 10.2 5.2 1.2 6.4 -37.2 Page 272 District TERYT 2001–2003 0-27 28+ Total days days 2006–2008 0-27 28+ Total days days Total change (%) kłobucki 2406 6.4 3.8 10.3 3.7 2.5 6.2 -39.6 lubliniecki 2407 6.2 2.4 8.5 3.8 0.5 4.2 -50.4 mikołowski 2408 4.7 2.6 7.3 4.5 1.4 5.9 -19.5 myszkowski 2409 6.0 4.0 9.9 2.6 4.7 7.3 -26.6 pszczyński 2410 6.9 3.1 10.0 5.5 2.5 8.0 -20.2 raciborski 2411 2.5 1.4 4.0 2.9 3.3 6.2 57.4 rybnicki 2412 4.6 2.1 6.7 3.8 2.9 6.7 0.6 tarnogórski 2413 5.6 2.5 8.1 3.4 1.1 4.5 -44.2 bieruńsko-lędziński 2414 6.9 1.3 8.2 5.2 2.3 7.6 -7.2 wodzisławski 2415 4.9 2.3 7.3 3.9 2.5 6.4 -12.3 zawierciański 2416 5.3 2.7 8.0 7.2 1.2 8.4 5.2 żywiecki 2417 6.1 2.0 8.1 3.1 2.3 5.3 -34.0 m. Bielsko-Biała 2461 5.4 2.5 7.9 2.9 0.8 3.7 -53.8 m. Bytom 2462 7.4 3.8 11.3 6.2 3.7 9.9 -11.9 m. Chorzów 2463 5.9 5.2 11.1 5.3 2.4 7.7 -30.4 m. Częstochowa 2464 5.3 2.4 7.6 4.2 1.6 5.8 -24.2 m. Dąbrowa Górnicza 2465 5.7 2.0 7.8 4.0 2.0 6.0 -23.4 m. Gliwice 2466 5.4 2.2 7.6 3.7 1.3 5.0 -34.1 m. Jastrzębie-Zdrój 2467 6.1 2.1 8.2 6.3 2.0 8.3 1.2 m. Jaworzno 2468 3.8 3.4 7.1 2.7 4.3 7.0 -1.3 m. Katowice 2469 7.2 4.8 12.0 6.1 3.2 9.3 -22.3 m. Mysłowice 2470 5.7 4.2 9.9 3.6 3.6 7.2 -27.1 m. Piekary Śląskie 2471 6.1 1.4 7.4 4.4 1.9 6.2 -16.3 m. Ruda Śląska 2472 7.3 4.0 11.3 5.2 1.6 6.8 -39.3 m. Rybnik 2473 7.2 3.1 10.4 6.6 3.2 9.8 -5.7 m. Siemianowice Śląskie 2474 6.2 4.5 10.7 5.0 3.5 8.5 -20.6 m. Sosnowiec 2475 7.5 2.6 10.1 5.4 1.6 7.0 -30.4 m. Świętochłowice 2476 9.5 2.7 12.2 6.6 1.8 8.4 -31.0 m. Tychy 2477 2.9 0.9 3.8 5.2 2.5 7.7 100.1 m. Zabrze 2478 8.8 3.0 11.8 4.4 4.4 8.9 -24.5 m. Żory 2479 3.1 2.6 5.7 4.2 0.5 4.6 -18.4 buski 2601 4.4 2.4 6.8 4.0 2.5 6.5 -3.8 jędrzejowski 2602 4.9 1.9 6.7 1.5 1.8 3.3 -51.1 kazimierski 2603 4.4 3.3 7.6 2.2 1.1 3.3 -56.4 kielecki 2604 6.4 2.3 8.7 2.8 1.2 4.0 -54.2 konecki 2605 4.2 2.5 6.7 3.2 2.0 5.3 -21.9 opatowski 2606 6.0 1.2 7.2 3.3 1.3 4.6 -35.9 ostrowiecki 2607 5.0 2.7 7.7 3.7 1.4 5.1 -33.7 pińczowski 2608 9.1 3.3 12.4 1.8 0.9 2.7 -78.0 sandomierski 2609 7.5 2.1 9.6 3.1 0.9 4.0 -58.4 skarżyski 2610 5.8 1.6 7.4 4.6 1.0 5.7 -23.3 starachowicki 2611 6.5 1.9 8.4 3.7 1.9 5.6 -33.8 staszowski 2612 3.0 1.3 4.3 5.5 2.3 7.7 79.3 Page 273 District TERYT 2001–2003 0-27 28+ Total days days 2006–2008 0-27 28+ Total days days Total change (%) włoszczowski 2613 4.0 0.7 4.7 2.7 2.7 5.5 16.1 m. Kielce 2661 4.8 1.6 6.4 3.4 1.9 5.2 -17.9 bartoszycki 2801 6.2 2.1 8.2 1.5 1.0 2.5 -69.4 braniewski 2802 5.4 3.4 8.8 6.7 2.2 8.9 0.8 działdowski 2803 3.9 2.2 6.0 3.8 0.4 4.2 -29.8 elbląski 2804 5.1 1.0 6.1 5.6 4.6 10.2 67.7 ełcki 2805 7.0 1.1 8.1 4.2 2.1 6.3 -22.6 giżycki 2806 4.1 1.2 5.3 5.0 0.6 5.6 4.9 iławski 2807 4.7 1.9 6.6 4.2 1.5 5.7 -13.9 kętrzyński 2808 5.6 2.0 7.7 4.4 2.0 6.4 -16.7 lidzbarski 2809 2.2 1.5 3.7 2.2 1.5 3.7 0.0 mrągowski 2810 3.8 0.6 4.4 3.6 2.4 5.9 33.9 nidzicki 2811 2.4 0.0 2.4 5.9 1.7 7.5 214.8 nowomiejski 2812 2.5 2.5 4.9 4.2 1.8 6.0 21.2 olecki 2813 5.0 2.5 7.5 2.4 1.6 4.1 -45.5 olsztyński 2814 4.4 2.0 6.4 2.8 1.3 4.1 -36.1 ostródzki 2815 3.3 0.9 4.2 2.5 0.8 3.3 -20.5 piski 2816 7.6 0.5 8.1 3.1 0.5 3.7 -55.0 szczycieński 2817 7.9 2.5 10.3 5.0 0.4 5.4 -47.6 gołdapski 2818 7.1 3.6 10.7 4.0 2.0 6.0 -43.6 węgorzewski 2819 5.9 4.5 10.4 5.9 1.5 7.4 -28.6 m. Elbląg 2861 3.2 2.4 5.6 2.3 2.5 4.8 -14.5 m. Olsztyn 2862 2.1 1.4 3.5 2.7 1.2 3.9 11.1 chodzieski 3001 3.4 1.3 4.7 6.7 1.2 7.9 67.5 czarnkowsko-trzcianecki 3002 2.8 1.1 3.9 5.0 1.9 6.8 77.8 gnieźnieński 3003 6.8 2.3 9.1 4.6 0.6 5.2 -43.1 gostyński 3004 6.2 1.2 7.4 3.4 2.6 6.0 -18.2 grodziski 3005 4.8 1.2 5.9 3.7 3.2 6.9 16.4 jarociński 3006 5.9 2.3 8.2 4.9 0.4 5.3 -34.9 kaliski 3007 6.5 1.9 8.4 2.7 2.7 5.5 -35.4 kępiński 3008 6.9 1.2 8.1 3.1 1.6 4.7 -42.1 kolski 3009 4.1 2.2 6.3 2.8 1.7 4.5 -27.6 koniński 3010 3.6 1.9 5.6 3.9 1.1 5.0 -10.2 kościański 3011 3.8 0.8 4.7 4.7 0.0 4.7 1.0 krotoszyński 3012 5.7 2.4 8.1 1.9 1.9 3.8 -53.7 leszczyński 3013 6.4 0.0 6.4 2.6 4.2 6.9 6.4 międzychodzki 3014 5.1 0.8 5.9 6.0 2.3 8.3 40.4 nowotomyski 3015 6.3 1.3 7.5 5.8 2.2 8.0 6.9 obornicki 3016 6.2 1.5 7.7 3.7 0.5 4.1 -46.2 ostrowski 3017 3.6 1.5 5.1 4.3 1.6 5.9 14.8 ostrzeszowski 3018 6.6 0.6 7.2 4.2 0.5 4.7 -34.1 pilski 3019 4.7 2.8 7.4 4.2 1.3 5.5 -26.0 pleszewski 3020 3.4 1.0 4.4 5.4 1.3 6.7 53.8 Page 274 District TERYT 2001–2003 0-27 28+ Total days days 2006–2008 0-27 28+ Total days days Total change (%) poznański 3021 4.4 1.3 5.7 4.7 1.9 6.6 16.9 rawicki 3022 1.5 1.5 3.0 4.1 0.0 4.1 33.0 słupecki 3023 5.4 0.5 6.0 2.6 1.5 4.1 -31.1 szamotulski 3024 6.4 1.5 7.9 3.8 1.3 5.1 -35.1 średzki 3025 5.3 1.2 6.5 5.2 3.1 8.3 26.9 śremski 3026 5.7 2.6 8.3 6.0 2.8 8.8 6.2 turecki 3027 4.6 1.5 6.1 5.3 2.8 8.1 32.8 wągrowiecki 3028 7.0 2.2 9.2 6.1 1.1 7.3 -20.9 wolsztyński 3029 3.1 1.0 4.2 1.9 2.9 4.8 15.0 wrzesiński 3030 6.1 1.3 7.5 2.2 1.9 4.1 -44.8 złotowski 3031 3.9 2.6 6.5 5.8 1.7 7.4 15.3 m. Kalisz 3061 6.0 2.5 8.5 3.9 0.7 4.6 -45.9 m. Konin 3062 8.6 1.0 9.5 3.0 2.2 5.2 -45.2 m. Leszno 3063 6.1 3.9 10.0 5.0 3.0 8.0 -20.4 m. Poznań 3064 4.6 1.5 6.1 5.4 1.8 7.2 18.9 białogardzki 3201 7.2 0.7 7.9 4.9 3.0 7.9 0.0 choszczeński 3202 3.8 3.2 7.0 2.4 1.8 4.2 -39.7 drawski 3203 3.3 3.3 6.6 8.6 2.7 11.2 71.1 goleniowski 3204 3.7 2.0 5.7 2.7 3.4 6.1 7.0 gryficki 3205 4.7 2.6 7.3 3.4 3.0 6.4 -12.0 gryfiński 3206 3.8 2.7 6.5 4.7 1.5 6.2 -5.1 kamieński 3207 7.8 2.8 10.7 4.8 1.4 6.2 -42.0 kołobrzeski 3208 6.7 2.9 9.5 3.1 1.8 4.9 -48.7 koszaliński 3209 7.5 4.0 11.4 3.4 1.0 4.3 -62.1 myśliborski 3210 3.4 3.9 7.4 6.5 1.8 8.3 12.7 policki 3211 5.0 1.7 6.7 4.1 1.4 5.4 -18.6 pyrzycki 3212 2.5 3.3 5.7 3.7 1.5 5.2 -9.2 sławieński 3213 7.6 2.2 9.8 2.1 3.1 5.2 -46.6 stargardzki 3214 5.6 3.1 8.7 4.1 2.2 6.2 -28.3 szczecinecki 3215 5.4 3.7 9.1 6.0 1.2 7.3 -20.6 świdwiński 3216 7.1 1.3 8.3 6.3 1.3 7.5 -9.5 wałecki 3217 3.2 2.1 5.4 3.4 1.7 5.1 -5.2 łobeski 3218 5.8 1.7 7.5 6.1 4.6 10.6 42.7 m. Koszalin 3261 6.1 2.0 8.2 4.0 1.1 5.1 -37.7 m. Szczecin 3262 5.5 2.2 7.7 4.0 2.2 6.1 -19.9 m. Świnoujście 3263 6.7 0.0 6.7 4.9 1.0 5.9 -11.7 5.2 2.2 7.4 4.2 1.7 5.9 -20.9 Polska Page 275 Table 72. Life expectancy at birth (in years) of males and females in 2001–2003 and 2006–2008 Males District Females TERYT 2001–2003 2006–2008 change 2001–2003 2006–2008 change bolesławiecki dzierżoniowski głogowski górowski jaworski jeleniogórski kamiennogórski kłodzki legnicki lubański lubiński lwówecki milicki oleśnicki oławski polkowicki strzeliński średzki świdnicki trzebnicki wałbrzyski wołowski wrocławski ząbkowicki zgorzelecki złotoryjski m. Jelenia Góra m. Legnica m. Wrocław 0201 0202 0203 0204 0205 0206 0207 0208 0209 0210 0211 0212 0213 0214 0215 0216 0217 0218 0219 0220 0221 0222 0223 0224 0225 0226 0261 0262 0264 69.4 69.3 69.9 69.6 68.6 69.3 68.6 68.5 69.1 67.9 70.8 67.7 70.1 69.9 70.8 68.2 68.3 68.5 69.4 68.7 68.5 68.6 69.9 68.4 68.0 68.9 70.4 69.7 71.9 70.8 70.0 71.2 71.7 69.5 69.2 69.3 69.2 70.4 69.8 71.5 67.6 71.2 70.0 70.8 70.2 69.6 68.3 69.6 69.3 68.5 70.8 70.4 69.3 68.4 69.0 71.4 70.2 72.5 1.4 0.7 1.3 2.1 0.9 -0.2 0.7 0.7 1.3 1.9 0.7 -0.1 1.1 0.0 0.0 2.1 1.4 -0.2 0.2 0.6 0.0 2.2 0.5 0.9 0.4 0.1 1.0 0.6 0.6 78.0 77.7 78.6 77.8 78.1 77.1 78.3 77.0 76.9 77.8 78.7 77.7 79.5 78.4 79.1 78.4 78.8 77.9 77.9 77.9 77.0 78.5 78.7 76.9 77.4 77.4 78.1 77.5 79.5 80.0 79.2 79.3 79.2 79.0 78.4 78.2 78.3 78.9 78.9 80.0 78.2 79.5 80.1 79.8 79.2 78.9 78.4 78.6 78.9 77.4 78.3 79.6 78.5 78.4 78.3 79.3 78.8 80.4 1.9 1.5 0.7 1.4 0.8 1.3 -0.1 1.3 2.0 1.1 1.3 0.5 0.0 1.7 0.8 0.8 0.2 0.5 0.7 1.1 0.3 -0.2 0.9 1.6 1.0 0.9 1.2 1.2 0.9 aleksandrowski brodnicki bydgoski chełmiński golubsko-dobrzyński grudziądzki inowrocławski lipnowski mogileński nakielski radziejowski rypiński sępoleński świecki toruński tucholski wąbrzeski włocławski żniński m. Bydgoszcz m. Grudziądz 0401 0402 0403 0404 0405 0406 0407 0408 0409 0410 0411 0412 0413 0414 0415 0416 0417 0418 0419 0461 0462 68.9 69.9 70.4 68.9 70.9 68.4 69.8 68.3 69.0 69.6 69.3 69.1 70.8 69.9 69.6 69.6 70.0 69.1 69.3 71.5 69.4 68.9 70.7 71.3 68.9 70.8 69.7 69.8 68.2 70.1 69.5 69.7 69.8 71.6 70.8 70.2 70.9 70.3 68.4 71.0 72.4 69.9 0.1 0.8 0.9 0.0 -0.1 1.3 0.0 -0.1 1.1 -0.1 0.3 0.7 0.8 0.9 0.6 1.4 0.3 -0.6 1.7 0.9 0.5 77.1 78.1 78.7 75.6 79.0 76.6 78.3 77.0 76.9 77.7 78.4 78.8 79.4 76.8 77.3 78.0 78.7 77.7 78.3 79.1 77.5 78.9 78.8 79.1 78.2 80.6 79.0 79.0 78.3 78.8 78.2 79.1 78.9 80.1 78.0 79.1 79.7 78.8 79.2 79.9 80.0 78.4 1.8 0.7 0.5 2.5 1.6 2.3 0.7 1.2 1.9 0.5 0.7 0.2 0.7 1.2 1.8 1.7 0.2 1.5 1.6 0.9 0.9 Page 276 Males District Females TERYT 2001–2003 2006–2008 change 2001–2003 2006–2008 change m. Toruń 0463 71.6 72.4 0.8 79.5 80.6 1.1 m. Włocławek 0464 70.3 70.4 0.0 78.4 78.5 0.0 bialski biłgorajski chełmski hrubieszowski janowski krasnostawski kraśnicki lubartowski lubelski łęczyński łukowski opolski parczewski puławski radzyński rycki świdnicki tomaszowski włodawski zamojski m. Biała Podlaska m. Chełm m. Lublin 0601 0602 0603 0604 0605 0606 0607 0608 0609 0610 0611 0612 0613 0614 0615 0616 0617 0618 0619 0620 0661 0662 0663 68.5 70.6 66.5 67.7 70.7 68.3 70.2 68.8 69.0 69.9 69.4 68.5 69.1 69.9 69.8 68.6 70.1 69.9 67.3 69.5 69.8 70.1 71.1 68.9 71.4 66.5 68.5 71.2 69.7 71.1 69.2 69.3 69.0 69.7 69.3 69.8 70.7 69.7 69.6 70.6 70.5 68.7 69.6 71.3 70.7 71.9 0.4 0.8 0.0 0.9 0.5 1.4 0.9 0.4 0.4 -0.9 0.3 0.8 0.7 0.8 -0.1 1.0 0.5 0.6 1.4 0.1 1.6 0.6 0.8 78.1 79.7 78.0 78.8 79.0 79.5 78.7 78.9 79.1 77.9 79.7 78.7 78.9 79.8 78.4 78.4 79.8 79.8 78.3 79.4 78.0 79.2 79.4 79.8 81.1 79.0 80.3 80.5 79.6 80.6 80.2 80.0 80.1 80.4 79.6 80.0 80.9 79.2 80.2 80.6 80.7 79.4 80.6 80.7 81.8 80.2 1.6 1.4 1.0 1.6 1.4 0.1 1.9 1.3 1.0 2.2 0.8 0.9 1.1 1.1 0.8 1.8 0.8 0.9 1.2 1.2 2.7 2.6 0.8 m. Zamość 0664 71.7 72.8 1.1 81.0 81.8 0.9 gorzowski krośnieński międzyrzecki nowosolski słubicki strzelecko-drezdenecki sulęciński świebodziński zielonogórski żagański żarski wschowski m. Gorzów Wielkopolski 0801 0802 0803 0804 0805 0806 0807 0808 0809 0810 0811 0812 0861 69.2 68.0 70.3 70.2 69.4 69.2 68.9 68.1 70.2 68.2 67.7 70.1 71.7 70.5 69.4 69.7 71.1 68.4 69.5 68.7 69.8 70.1 69.1 69.3 70.3 72.2 1.3 1.4 -0.7 1.0 -1.0 0.3 -0.3 1.7 -0.1 0.9 1.7 0.3 0.6 78.2 77.7 77.9 77.9 78.9 78.9 78.9 78.0 78.3 77.6 77.2 79.4 79.0 78.9 79.4 79.1 78.8 77.9 78.8 78.3 78.9 79.9 78.5 78.3 78.5 79.5 0.7 1.7 1.2 0.9 -1.0 -0.1 -0.7 1.0 1.7 0.8 1.0 -0.9 0.5 m. Zielona Góra 0862 71.6 72.9 1.2 79.4 80.5 1.1 bełchatowski kutnowski łaski łęczycki łowicki łódzki wschodni opoczyński pabianicki pajęczański piotrkowski poddębicki 1001 1002 1003 1004 1005 1006 1007 1008 1009 1010 1011 69.6 67.6 69.1 68.5 68.7 68.0 68.3 68.6 70.1 68.3 69.2 70.2 66.5 69.7 68.4 69.7 68.8 69.3 69.3 70.5 68.5 67.2 0.6 -1.1 0.6 -0.1 1.0 0.9 1.0 0.7 0.4 0.3 -2.0 78.9 77.6 78.4 77.7 78.3 76.9 78.6 77.5 79.6 77.9 77.3 80.3 77.4 80.1 78.1 79.7 78.4 79.3 78.5 80.2 78.7 77.8 1.4 -0.2 1.7 0.4 1.3 1.5 0.7 0.9 0.6 0.7 0.5 Page 277 Males District Females TERYT 2001–2003 2006–2008 change 2001–2003 2006–2008 change radomszczański rawski sieradzki skierniewicki tomaszowski wieluński wieruszowski zduńskowolski zgierski brzeziński m. Łódź m. Piotrków Trybunalski m. Skierniewice 1012 1013 1014 1015 1016 1017 1018 1019 1020 1021 1061 1062 1063 68.6 69.4 69.5 69.0 67.8 70.2 68.6 69.6 68.4 66.9 67.7 68.7 69.9 69.2 70.0 70.5 69.4 67.3 69.5 69.4 69.1 68.4 67.0 68.0 69.1 71.4 0.6 0.6 1.0 0.4 -0.5 -0.7 0.8 -0.4 0.1 0.1 0.3 0.5 1.4 77.8 79.3 79.3 79.7 77.5 79.5 78.2 78.7 77.4 76.5 77.1 77.9 77.6 79.5 80.3 79.9 80.9 79.6 80.4 79.0 78.7 79.0 78.3 77.7 78.8 79.6 1.7 1.0 0.6 1.2 2.1 0.9 0.7 0.0 1.6 1.8 0.6 0.9 2.0 bocheński brzeski chrzanowski dąbrowski gorlicki krakowski limanowski miechowski myślenicki nowosądecki nowotarski olkuski oświęcimski proszowicki suski tarnowski tatrzański wadowicki wielicki m. Kraków m. Nowy Sącz m. Tarnów 1201 1202 1203 1204 1205 1206 1207 1208 1209 1210 1211 1212 1213 1214 1215 1216 1217 1218 1219 1261 1262 1263 71.1 72.1 71.0 71.1 72.2 70.9 72.0 70.2 71.2 71.6 72.6 70.5 71.3 69.3 70.8 72.1 71.5 70.6 71.0 72.9 72.8 72.7 72.6 72.5 71.6 73.3 73.0 71.8 72.4 70.7 71.9 72.2 72.8 71.8 72.7 70.2 70.9 72.8 71.5 72.0 72.0 73.9 73.7 72.6 1.6 0.4 0.6 2.2 0.8 0.9 0.5 0.5 0.8 0.5 0.2 1.3 1.3 0.9 0.1 0.7 0.0 1.4 1.0 0.9 0.9 -0.1 79.6 79.5 79.0 79.5 79.2 79.2 79.6 80.5 78.3 79.7 79.5 78.8 79.3 79.1 78.9 79.8 80.4 79.3 78.5 79.6 79.7 78.8 80.2 80.8 79.9 80.3 80.8 80.7 80.6 79.6 80.8 81.0 81.2 80.7 80.5 81.2 80.6 81.2 80.2 80.1 80.8 80.9 81.3 80.5 0.6 1.3 0.9 0.8 1.6 1.4 1.0 -0.8 2.4 1.3 1.7 1.9 1.2 2.1 1.7 1.4 -0.2 0.8 2.3 1.3 1.6 1.7 białobrzeski ciechanowski garwoliński gostyniński grodziski grójecki kozienicki legionowski lipski łosicki makowski miński mławski nowodworski ostrołęcki ostrowski 1401 1402 1403 1404 1405 1406 1407 1408 1409 1410 1411 1412 1413 1414 1415 1416 69.2 69.7 69.6 68.8 69.2 67.7 70.3 70.6 69.4 71.0 68.7 68.8 69.3 69.1 68.3 70.2 69.1 69.8 70.0 70.5 70.7 69.4 71.2 72.1 69.9 70.3 68.8 69.4 68.3 69.0 69.5 70.2 -0.1 0.1 0.3 1.7 1.5 1.7 0.8 1.5 0.5 -0.6 0.2 0.6 -1.0 -0.1 1.2 0.1 78.4 78.7 79.2 78.7 78.4 77.7 79.9 80.0 79.0 78.6 78.1 79.2 78.3 78.4 79.7 79.6 78.9 79.2 80.8 79.1 79.8 78.8 80.7 80.7 80.5 80.5 80.9 80.4 79.4 79.2 80.7 81.2 0.5 0.5 1.7 0.4 1.3 1.1 0.8 0.7 1.4 1.9 2.8 1.2 1.1 0.8 1.0 1.6 Page 278 Males District Females TERYT 2001–2003 2006–2008 change 2001–2003 2006–2008 change otwocki piaseczyński płocki płoński pruszkowski przasnyski przysuski pułtuski radomski siedlecki sierpecki sochaczewski sokołowski szydłowiecki warszawski zachodni węgrowski wołomiński wyszkowski zwoleński żuromiński żyrardowski m. Ostrołęka m. Płock m. Radom m. Siedlce 1417 1418 1419 1420 1421 1422 1423 1424 1425 1426 1427 1428 1429 1430 1432 1433 1434 1435 1436 1437 1438 1461 1462 1463 1464 69.4 70.6 69.4 68.7 71.6 67.9 69.7 68.0 68.9 70.4 68.3 68.9 71.3 69.1 70.8 70.0 69.4 69.3 69.5 69.9 68.5 71.0 70.8 70.0 71.2 71.2 71.5 69.0 68.3 72.9 67.8 69.9 69.8 70.2 69.7 69.5 69.5 71.2 68.9 72.8 69.9 69.9 69.7 68.8 71.2 68.9 71.6 70.0 70.8 72.7 1.9 1.0 -0.4 -0.4 1.2 -0.1 0.1 1.7 1.2 -0.7 1.2 0.6 -0.1 -0.3 1.9 0.0 0.5 0.4 -0.7 1.3 0.5 0.6 -0.8 0.8 1.5 78.8 78.3 78.6 77.7 79.7 77.7 79.2 78.4 79.0 79.8 78.6 78.4 78.9 79.7 80.6 79.1 79.0 79.4 78.6 79.5 76.8 79.0 78.5 79.0 80.3 81.1 80.7 79.1 78.9 80.9 78.4 80.6 79.2 80.1 80.2 78.9 79.4 81.3 80.2 81.3 79.8 79.9 80.3 79.0 79.8 78.4 80.8 79.8 80.1 81.3 2.3 2.4 0.5 1.2 1.2 0.7 1.3 0.8 1.1 0.5 0.3 1.0 2.4 0.5 0.8 0.7 0.9 0.9 0.3 0.3 1.6 1.8 1.3 1.1 1.0 m. st. Warszawa 1465 72.4 74.0 1.6 79.6 81.2 1.5 brzeski głubczycki kędzierzyńsko-kozielski kluczborski krapkowicki namysłowski nyski oleski opolski prudnicki strzelecki 1601 1602 1603 1604 1605 1606 1607 1608 1609 1610 1611 70.2 69.7 70.4 70.2 71.7 69.6 70.1 70.7 72.1 70.3 72.0 70.4 69.5 72.7 70.5 72.1 70.8 71.4 72.4 73.9 70.4 72.4 0.2 -0.3 2.3 0.3 0.4 1.2 1.3 1.7 1.8 0.1 0.4 78.6 77.3 78.6 78.4 78.8 79.0 78.9 79.2 79.8 78.7 78.6 80.0 78.9 80.3 80.3 79.9 80.1 79.3 80.8 81.2 79.5 80.5 1.4 1.7 1.8 1.9 1.1 1.1 0.4 1.7 1.4 0.8 1.9 m. Opole 1661 73.0 74.5 1.5 80.1 80.9 0.8 bieszczadzki brzozowski dębicki jarosławski jasielski kolbuszowski krośnieński leżajski lubaczowski łańcucki mielecki niżański przemyski 1801 1802 1803 1804 1805 1806 1807 1808 1809 1810 1811 1812 1813 72.1 72.5 72.5 70.5 71.1 72.5 71.1 71.1 71.6 71.7 72.4 70.1 69.2 71.1 72.8 72.7 71.8 72.2 73.6 72.8 72.7 71.0 73.0 74.2 71.7 71.9 -1.0 0.3 0.2 1.3 1.1 1.1 1.7 1.6 -0.6 1.3 1.9 1.6 2.7 81.0 78.7 79.7 78.9 79.9 80.9 80.0 79.9 80.5 79.7 79.7 80.0 79.2 80.1 81.0 81.3 79.8 80.4 81.4 81.0 80.7 81.4 80.6 81.2 81.7 80.6 -0.8 2.3 1.6 1.0 0.5 0.4 0.9 0.8 0.9 0.9 1.5 1.7 1.4 Page 279 Males District Females TERYT 2001–2003 2006–2008 change 2001–2003 2006–2008 change przeworski ropczycko-sędziszowski rzeszowski sanocki stalowowolski strzyżowski tarnobrzeski leski m. Krosno m. Przemyśl m. Rzeszów m. Tarnobrzeg 1814 1815 1816 1817 1818 1819 1820 1821 1861 1862 1863 1864 71.3 71.0 71.3 71.4 71.6 70.2 70.8 72.8 72.5 70.1 72.9 72.3 72.5 71.9 72.9 73.2 73.0 73.1 71.9 72.7 73.7 71.6 75.3 73.6 1.1 0.9 1.7 1.8 1.3 2.8 1.2 -0.1 1.2 1.5 2.4 1.4 79.5 79.2 79.4 79.7 79.7 78.5 80.2 80.4 79.9 77.7 80.0 79.8 80.9 81.5 81.3 81.3 80.2 81.3 81.2 82.5 80.9 80.0 82.1 81.5 1.4 2.3 1.9 1.6 0.5 2.8 1.0 2.1 1.0 2.3 2.1 1.7 augustowski białostocki bielski grajewski hajnowski kolneński łomżyński moniecki sejneński siemiatycki sokólski suwalski wysokomazowiecki zambrowski m. Białystok m. Łomża 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2061 2062 70.0 69.9 70.8 70.3 67.9 70.0 70.5 69.9 70.2 69.8 68.5 69.9 71.3 70.9 71.7 72.4 71.6 70.6 71.3 70.0 69.7 70.7 70.7 72.5 69.5 70.2 69.7 70.2 71.5 71.6 73.6 72.3 1.6 0.6 0.4 -0.3 1.7 0.8 0.2 2.7 -0.6 0.5 1.2 0.3 0.2 0.7 1.9 -0.1 79.1 79.2 80.0 79.8 79.3 80.3 80.0 79.9 81.0 78.7 79.6 80.9 80.9 80.9 80.7 80.0 80.5 80.8 80.5 81.5 79.8 80.8 81.1 81.3 80.6 80.4 80.8 81.4 81.3 80.7 81.8 80.2 1.5 1.6 0.5 1.7 0.5 0.5 1.1 1.4 -0.4 1.7 1.2 0.5 0.4 -0.1 1.1 0.2 m. Suwałki 2063 70.8 72.4 1.5 79.3 80.5 1.2 bytowski chojnicki człuchowski gdański kartuski kościerski kwidzyński lęborski malborski nowodworski pucki słupski starogardzki tczewski wejherowski sztumski m. Gdańsk m. Gdynia m. Słupsk 2201 2202 2203 2204 2205 2206 2207 2208 2209 2210 2211 2212 2213 2214 2215 2216 2261 2262 2263 70.6 71.6 70.2 70.5 71.2 71.4 69.6 70.6 69.0 68.8 71.1 68.6 70.3 69.9 71.0 69.1 71.0 73.7 71.3 71.4 72.0 70.6 71.5 72.6 72.7 70.0 69.5 69.8 69.1 71.3 69.7 70.8 70.6 71.9 68.4 72.8 73.9 70.8 0.8 0.5 0.4 1.0 1.4 1.3 0.5 -1.1 0.7 0.3 0.3 1.1 0.5 0.7 0.8 -0.6 1.8 0.2 -0.5 78.4 79.1 78.9 79.5 79.8 79.4 77.9 78.0 77.4 77.9 78.2 77.7 77.5 77.4 78.5 77.1 78.9 80.0 79.0 79.4 79.0 79.7 80.2 81.1 77.7 79.2 79.5 79.0 79.8 78.5 78.6 78.1 79.3 79.7 78.8 80.6 80.7 80.0 1.0 0.0 0.8 0.6 1.3 -1.7 1.3 1.5 1.5 2.0 0.3 0.9 0.5 1.9 1.2 1.7 1.7 0.7 1.0 m. Sopot 2264 74.2 74.5 0.2 79.8 82.1 2.3 będziński bielski 2401 2402 69.0 70.9 68.6 73.0 -0.4 2.1 77.8 78.5 78.4 80.2 0.6 1.7 Page 280 Males District Females TERYT 2001–2003 2006–2008 change 2001–2003 2006–2008 change cieszyński częstochowski gliwicki kłobucki lubliniecki mikołowski myszkowski pszczyński raciborski rybnicki tarnogórski bieruńsko-lędziński wodzisławski zawierciański żywiecki m. Bielsko-Biała m. Bytom m. Chorzów m. Częstochowa m. Dąbrowa Górnicza m. Gliwice m. Jastrzębie-Zdrój m. Jaworzno m. Katowice m. Mysłowice m. Piekary Śląskie m. Ruda Śląska m. Rybnik m. Siemianowice Śląskie m. Sosnowiec m. Świętochłowice m. Tychy m. Zabrze 2403 2404 2405 2406 2407 2408 2409 2410 2411 2412 2413 2414 2415 2416 2417 2461 2462 2463 2464 2465 2466 2467 2468 2469 2470 2471 2472 2473 2474 2475 2476 2477 2478 70.9 69.6 70.3 70.4 70.4 69.8 69.1 70.2 71.2 70.8 71.1 71.0 70.3 68.9 69.9 71.9 69.3 67.0 69.5 69.4 71.1 70.0 70.2 69.8 69.0 68.5 67.7 70.8 68.5 69.1 66.6 71.6 70.7 72.2 69.6 70.6 71.1 72.6 72.2 69.6 71.4 72.3 71.2 72.4 70.8 71.5 69.3 70.5 73.3 69.7 67.4 70.4 69.6 72.7 71.7 70.5 70.8 70.0 69.8 68.1 72.0 68.9 69.7 68.1 72.0 72.1 1.3 0.0 0.3 0.7 2.2 2.3 0.5 1.2 1.0 0.4 1.3 -0.1 1.3 0.5 0.5 1.4 0.4 0.3 0.9 0.2 1.5 1.7 0.3 0.9 0.9 1.3 0.4 1.2 0.5 0.6 1.5 0.4 1.4 78.6 78.5 77.9 79.1 78.3 77.5 77.6 78.7 79.1 78.6 78.6 78.4 78.6 77.5 78.4 79.2 77.0 75.6 78.6 78.1 78.8 77.7 77.8 77.3 77.7 77.1 75.7 78.3 76.1 77.2 75.5 78.0 77.8 79.6 79.4 79.0 79.9 80.0 79.3 79.0 79.7 79.4 78.7 79.8 79.0 79.3 78.1 79.5 81.1 78.0 77.1 79.1 78.8 79.8 79.0 79.1 78.4 77.8 78.9 76.5 79.4 76.3 78.0 77.6 79.5 80.0 1.0 0.9 1.1 0.8 1.7 1.8 1.3 1.0 0.3 0.0 1.2 0.7 0.6 0.6 1.1 1.9 1.0 1.5 0.5 0.7 1.0 1.4 1.3 1.1 0.1 1.8 0.9 1.0 0.2 0.7 2.1 1.5 2.2 m. Żory 2479 71.9 72.6 0.7 78.9 80.4 1.5 buski jędrzejowski kazimierski kielecki konecki opatowski ostrowiecki pińczowski sandomierski skarżyski starachowicki staszowski włoszczowski m. Kielce 2601 2602 2603 2604 2605 2606 2607 2608 2609 2610 2611 2612 2613 2661 70.2 70.3 69.9 70.1 69.3 68.5 69.1 68.6 70.2 70.7 70.6 71.4 70.5 72.7 70.9 71.1 69.3 70.3 69.9 69.6 70.6 70.7 72.2 69.6 70.2 71.0 71.2 73.5 0.7 0.8 -0.6 0.2 0.6 1.1 1.5 2.1 2.1 -1.2 -0.4 -0.5 0.7 0.9 79.6 78.1 78.3 79.6 79.0 78.4 78.6 78.7 79.4 79.0 79.2 79.8 79.5 79.9 80.5 79.9 79.7 80.6 80.6 80.0 79.9 80.7 81.4 79.8 79.7 80.1 79.6 81.4 0.9 1.8 1.4 1.0 1.6 1.6 1.3 2.1 2.0 0.8 0.5 0.3 0.2 1.5 bartoszycki braniewski działdowski 2801 2802 2803 67.2 67.3 69.5 68.2 68.8 69.7 1.0 1.5 0.2 77.3 77.1 78.9 79.4 78.5 79.0 2.2 1.4 0.1 Page 281 Males District Females TERYT 2001–2003 2006–2008 change 2001–2003 2006–2008 change elbląski ełcki giżycki iławski kętrzyński lidzbarski mrągowski nidzicki nowomiejski olecki olsztyński ostródzki piski szczycieński gołdapski węgorzewski m. Elbląg 2804 2805 2806 2807 2808 2809 2810 2811 2812 2813 2814 2815 2816 2817 2818 2819 2861 69.0 68.0 69.0 70.5 67.1 67.9 69.1 68.1 71.2 68.8 68.8 69.4 69.4 68.1 70.1 66.5 70.4 68.7 69.5 69.3 71.2 67.9 68.7 70.1 68.4 71.5 69.9 69.5 70.4 70.0 69.6 69.5 69.0 70.6 -0.3 1.4 0.3 0.7 0.8 0.8 1.0 0.3 0.3 1.1 0.7 1.0 0.6 1.5 -0.6 2.5 0.3 79.4 78.9 79.1 78.9 78.2 78.5 78.9 79.8 78.4 78.9 77.8 78.7 78.3 78.7 77.4 78.0 78.2 78.3 80.2 80.2 80.2 78.9 79.5 80.0 78.8 79.9 79.0 79.0 80.2 80.4 79.8 79.1 78.2 79.1 -1.0 1.4 1.1 1.3 0.7 1.0 1.1 -1.0 1.5 0.1 1.1 1.5 2.1 1.0 1.7 0.2 0.9 m. Olsztyn 2862 72.5 74.1 1.5 80.9 82.1 1.1 chodzieski czarnkowsko-trzcianecki gnieźnieński gostyński grodziski jarociński kaliski kępiński kolski koniński kościański krotoszyński leszczyński międzychodzki nowotomyski obornicki ostrowski ostrzeszowski pilski pleszewski poznański rawicki słupecki szamotulski średzki śremski turecki wągrowiecki wolsztyński wrzesiński złotowski m. Kalisz m. Konin 3001 3002 3003 3004 3005 3006 3007 3008 3009 3010 3011 3012 3013 3014 3015 3016 3017 3018 3019 3020 3021 3022 3023 3024 3025 3026 3027 3028 3029 3030 3031 3061 3062 69.7 69.8 70.0 71.6 69.7 70.4 69.4 70.2 68.6 70.1 70.3 70.3 71.9 69.2 69.6 69.3 70.8 68.4 70.2 69.3 70.5 69.8 70.6 69.4 71.2 70.4 69.3 70.0 71.1 70.0 70.2 69.4 71.1 71.0 70.9 71.3 71.7 71.1 71.9 70.4 72.0 70.0 71.1 71.6 70.9 72.0 70.2 70.6 69.9 71.6 70.6 70.5 71.1 72.1 71.6 70.9 71.2 70.5 71.1 69.8 70.8 71.7 70.6 70.5 71.2 73.1 1.3 1.0 1.3 0.2 1.4 1.5 1.0 1.8 1.4 1.0 1.3 0.7 0.1 1.1 1.1 0.6 0.8 2.2 0.3 1.8 1.6 1.9 0.3 1.8 -0.7 0.8 0.6 0.8 0.6 0.6 0.2 1.8 2.0 77.8 77.6 77.9 77.5 77.7 78.2 79.0 79.2 77.8 80.2 78.6 77.8 78.5 75.3 78.4 77.2 78.3 77.4 78.2 77.8 78.5 78.5 78.5 78.3 78.6 77.0 78.0 78.0 78.2 77.5 78.3 77.8 80.0 79.0 78.7 79.1 78.7 78.1 79.3 80.1 80.1 79.2 80.3 80.0 79.1 79.8 77.2 78.7 78.3 80.4 79.3 79.6 78.9 79.6 78.9 79.9 78.7 79.0 78.1 78.9 78.7 78.8 80.1 79.2 79.8 81.2 1.2 1.1 1.2 1.2 0.3 1.1 1.1 0.9 1.3 0.1 1.4 1.3 1.3 1.9 0.4 1.1 2.1 2.0 1.3 1.1 1.1 0.4 1.3 0.3 0.4 1.1 0.9 0.6 0.6 2.6 0.9 1.9 1.3 Page 282 Males District Females TERYT 2001–2003 2006–2008 change 2001–2003 2006–2008 change m. Leszno 3063 71.8 72.4 0.6 78.9 79.5 0.6 m. Poznań 3064 71.7 72.8 1.1 78.9 80.1 1.2 białogardzki choszczeński drawski goleniowski gryficki gryfiński kamieński kołobrzeski koszaliński myśliborski policki pyrzycki sławieński stargardzki szczecinecki świdwiński wałecki łobeski m. Koszalin m. Szczecin m. Świnoujście 3201 3202 3203 3204 3205 3206 3207 3208 3209 3210 3211 3212 3213 3214 3215 3216 3217 3218 3261 3262 3263 68.6 69.3 69.8 69.3 67.8 69.8 68.2 70.8 69.1 69.0 69.2 69.4 69.0 70.2 70.0 68.8 69.5 69.1 72.8 70.6 69.4 68.1 70.5 69.0 69.9 68.9 70.7 70.5 71.9 69.8 69.6 71.6 69.4 69.8 70.7 69.0 68.6 69.0 68.2 73.7 71.7 71.5 -0.6 1.2 -0.8 0.7 1.1 0.9 2.3 1.1 0.7 0.6 2.4 0.0 0.9 0.6 -0.9 -0.2 -0.4 -0.9 1.0 1.1 2.1 78.0 79.1 78.2 78.9 77.6 76.8 77.3 78.3 77.6 77.6 78.2 78.6 78.8 78.6 78.0 79.3 76.9 79.0 79.8 78.2 77.5 78.8 79.2 78.6 79.0 78.8 78.5 79.1 80.0 78.7 79.3 80.3 80.3 78.9 78.8 78.1 80.0 78.7 80.0 81.2 79.9 79.1 0.7 0.1 0.5 0.1 1.1 1.7 1.8 1.7 1.0 1.7 2.1 1.8 0.1 0.2 0.1 0.7 1.8 1.0 1.3 1.7 1.6 70.2 71.0 0.8 78.6 79.8 1.1 Polska (TERYT -National Official Register of Territorial Division of the Country ) Page 283 4. Association of health status of districts population with socio-economic characteristic of districts Bogdan Wojtyniak, Daniel Rabczenko – National Institute of Public Health-National Institute of Hygiene, Warsaw Agnieszka Chłoń-Domińczak - Demography Unit, Institute of Statistics and Demography, Warsaw School of Economics In this Chapter results of statistical analysis of an association of health status of districts population measured by standardised mortality ratios (SMRs) for selected main causes of deaths, infant mortality rates and life expectancy at birth, with social and economic district characteristics described in Chapter 2. Since SMR is a ratio type measure, and thus the same value above or below 1 (which means, for instance, 20% above or 20% below national average) should be taken into account as equally different from 1 but the sign, all analyses were carried out after logarithmic transformation of each SMR. Infant mortality rate and life expectancy were not transformed. The analysis was carried out in three steps; in the first one, bivariate (pairwise) associations between each of the health and socio-economic indicators were tested by applying Spearman correlation coefficient (rho) and relative concentration index (RCI)39. The RCI summarizes relative inequality in a given health parameter across the entire distribution of a given socioeconomic, district characteristic. It shows whether an elevated mortality level accumulates faster amongst the districts with worse socio-economic situation (which is the case when the index has a negative value). If all the values of an examined health variable are positive, RCI varies between -1 and 1. However, if there are some negative values present, the limits of RCI are not defined, and RCI interpretation is difficult. Since the analysed values of SMR logarithm were positive as well as negative, negative values were changed to zeros, as advised by Konigs et al1. Therefore, RCI calculated can be interpreted as a measure of concentration of districts with unfavourable mortality situation. At the second step, analysis was carried out by blocks – groups of socio-economic variables as presented in Chapter 2. For each group we built a multivariate, linear regression model weighted by district population, applying backward elimination procedure and retaining in the 39 Konings P, Harper S, Lynch J, Hosseinpoor AR, Berkvens B, Lorant V, Geckova A, Speybroeck N; Analysis of socioeconomic health inequalities using the concentration index; Int J Public Health; Volume 55, Number 1, 71-74 Page 284 block model those variables that were statistically significant (p<.05) or were at the borderline of significance (p<.1). At the third step, we allowed all the variables that remained in the block models to enter the pre-final model and, once again applying backward elimination according to the same rules, we have built a final model that shows which variables contribute significantly to the explanation of differences in district mortality level or life expectancy. In the tables below, final model standardized regression coefficients and the values of determination coefficient (R2) are presented. The former ones indicate the importance of individual variables in explaining variability of the dependent variable across districts (health indicator), while the latter one shows what proportion of a given health indicator variability is explained by socio-economic variables in the model. For easy identification of whether the variables show an expected association with mortality, those variables that have a negative association (i.e. reduce mortality or increase life expectancy) are highlighted in green, and those that have positive association are highlighted in red. In tables 82–149 in Annex 4, for each mortality indicator and life expectancy, as well as for each socio-economic variable, unweighted simple Spearman correlation coefficient (rho) is presented, together with its significance level and relative concentration index (RCI). Regular, not standardised regression coefficients are also presented (with their significance level), and coefficients of determination (R2) for each block model and for the final model. 4.1. Overall mortality All cause total population SMR (actually, its logarithmic transformation) was significantly correlated with almost all factors taken into consideration (Table 82 in Annex 4). The strongest bivariate association was observed in the case of lower secondary school literacy exams results, the non-significant factors were old-age demographic dependency rate and the share of employment in hazardous conditions. All but two factors which were significantly associated with all causes SMR in individual blocks models retained their statistical significance in the final regression model (Table 82). This model explained 37% of variation in district mortality levels from all causes (SMRs). It may be noticed that while the association of district budget revenue with mortality was Page 285 inverse (negative) in the block model, it turned out to be positive in the final model, indicating that, when controlling for other factors, district’s income does not necessarily contribute to the reduction of total mortality risk. The opposite change in association is observed in the case of the number of district residents per one physician – the positive (and expected) association in the block model changes to the negative in the final model, which is difficult to explain. Standardized regression coefficient of the number of households equipped with a bathroom, which is higher than almost all of the others, indicates that conditions represented by this variable have relatively stronger association with total mortality than those represented by other variables (see Table 73). Table 73 Standardized regression coefficients from the final multiple regression models for mortality due to all causes for each age and sex group Variables feminization rate population density old-age demographic dependency rate revenue of district budget per capita share of employment in hazardous conditions unemployment rate share of employment in agriculture library members per 1000 inhabitants local governments election turnout share of households equipped with bathroom pre-school participation rate of children aged 3-5 number of inhabitants per 1 medical doctor number of inhabitants per 1 health care institution average lower secondary school exam results (literacy) baccalaureate results - Polish language (basic level) R2 Total Total Males Females -0.16 Total 0–64 Males Females 0.35 0.28 0.15 0.17 0.11 0.16 0.10 0.21 -0.25 -0.49 -0.09 -0.09 -0.38 0.37 65+ Males -0.27 -0.14 -0.22 -0.20 0.10 0.16 0.21 -0.57 -0.31 -0.51 Total Females -0.36 0.11 0.12 -0.93 -0.17 -0.65 -0.29 -0.57 -0.30 -0.49 -0.17 -0.69 -0.20 -0.34 -0.19 -0.33 -0.21 -0.29 0.19 -0.31 -0.55 -0.35 -0.15 -0.51 -0.33 -0.29 -0.38 0.40 0.30 0.34 0.35 0.40 0.38 0.42 0.25 The association of male and female total mortality with socio-economic variables taken into account is somewhat different. In females, the strongest bivariate correlation is clearly observed for the results of lower secondary school exams, while in males several variables are associated with mortality with similar strength (Tables 83–90 in Annex 4). Final models of mortality explain to a greater extent the variation in district male SMR (40%) than in female SMR (30%) (Table 73). Three factors (households equipped with bathrooms, local government election participation, lower secondary school exam results) were significant in explaining variation in mortality of males as well as females, two factors (unemployment rate, inhabitants per one physician) were significant in male model only, and two (employment in agriculture and employment in hazardous conditions) were significant in explaining differences only in female mortality. Page 286 Models explaining mortality differentials in younger (below 65 years of age) and older (65 years and above) sub-populations show some similarities and discrepancies. In males and females from both groups there is significant, negative association of district mortality level with three factors: local government election participation, share of households equipped with bathrooms, and lower secondary school exam results. Interestingly, population density and old-age demographic dependency rate demonstrated some positive association with mortality of the younger sub-population, and negative association with mortality of the elderly people. Unemployment rate was significantly associated with mortality of males in younger and older age groups. 4.2. Mortality from cancer Cancer mortality was significantly correlated with most of the factors taken into consideration (Tables 91–99 in Annex 4). However, only four factors that were significant in individual blocks models retained their statistical significance in the final regression model for male mortality, and only three factors remained significant in the female mortality model (Table 74). Table 74. Standardized regression coefficients from the final multiple regression models for cancer mortality for each age and sex group Variables feminization rate population density old-age demographic dependency rate revenue of district budget per capita share of employment in hazardous conditions unemployment rate share of employment in agriculture library members per 1000 inhabitants local governments election turnout share of households equipped with bathroom pre-school participation rate of children aged 3-5 number of inhabitants per 1 medical doctor number of inhabitants per 1 health care institution average lower secondary school exam results (literacy) baccalaureate results - Polish language (basic level) R2 Total Total Males Females Total 0–64 Males Females -0.19 -0.12 Total 65+ Males Females 0.19 -0.14 -0.12 -0.68 -0.54 -0.21 -0.36 -0.55 0.09 -0.48 0.36 0.31 -0.61 -0.13 -0.10 0.34 -0.42 -0.14 -0.44 -0.34 -0.45 -0.23 0.39 -0.26 0.24 -0.34 0.23 -0.66 -0.13 0.09 -0.51 -0.47 -0.49 -0.43 -0.35 0.26 0.21 0.25 0.38 0.29 Nevertheless, these models explained more than 30% of variation in district mortality from cancer. There was only one variable, the share of employment in agriculture, which was present in the models of male and female mortality and was negatively associated with mortality level. This variable has the strongest association (largest standardized regression Page 287 0.37 coefficient) with cancer mortality in both gender groups, and it is significant in younger and older population. Another variable that is significantly (and negatively) associated with cancer mortality of the younger and older population (except older women) is the average lower secondary school exam results. The share of households equipped with a bathroom plays a significant role in explaining differences in district mortality in older population and, rather surprisingly, the association observed is positive. Overall, created models better describe mortality differential of the elderly population than of the younger age group. 4.3. Mortality from circulatory system diseases Mortality caused by cardiovascular diseases (CVD) was significantly correlated with most of the factors taken into consideration (Tables 100–108 in Annex 4). Six factors which were significant in individual blocks models retained their statistical significance in the final regression model for male mortality, and only five factors remained significant in the female mortality model (see Table 75). These models explained more than 20% of variation in district mortality from CVD, and this proportion was lower than the one explained by cancer mortality models. There were three variables that played a significant role in the models of male as well as female mortality: population density and the share of households equipped with a bathroom (the strongest association), and local government election participation. All three variables were negatively associated with mortality level. Models explaining CVD mortality differentials in younger (below 65 years of age) and older (65 years and above) sub-populations show some similarities and discrepancies. The share of households equipped with a bathroom is the only variable that is significantly associated with district mortality level of males and females in both age groups. Local government election participation and average lower secondary school examination results represent significant factors in younger age group mortality model, while district budget revenue and population density play a significant role in explaining mortality of the elderly population, the association being negative. Overall, developed models better describe CVD mortality differential of the elderly population (coefficients of determination R2 0.29, 0.23, 0.27 in total, males and females, respectively) than of the younger age group (respective coefficients of determination R2 0.17, 0.15, 0.21). Page 288 Table 75. Standardized regression coefficients from the final multiple regression models for mortality due to circulatory system diseases for each age and sex group Total Total Males Females feminization rate population density old-age demographic dependency rate revenue of district budget per capita share of employment in hazardous conditions unemployment rate share of employment in agriculture library members per 1000 inhabitants local governments election turnout share of households equipped with bathroom pre-school participation rate of children aged 3-5 number of inhabitants per 1 medical doctor number of inhabitants per 1 health care institution average lower secondary school exam results (literacy) baccalaureate results - Polish language (basic level) -0.16 -0.53 -0.17 -0.44 R2 0.29 Variables Total 0–64 Males Females -0.20 -0.18 -0.58 Total 65+ Males Females -0.48 -0.50 -0.47 -0.24 -0.18 -0.19 0.14 0.19 0.15 -0.41 -0.16 -0.56 -0.23 -0.36 0.21 0.22 0.14 -0.38 0.10 -0.16 -0.62 0.26 -0.79 -0.28 -0.41 -0.19 -0.28 -0.19 -0.66 -0.27 -0.20 -0.33 0.17 0.15 0.21 -0.38 0.09 -0.38 0.11 -0.49 -0.17 -0.29 0.21 -0.52 0.29 0.23 0.27 4.4. Mortality from respiratory system diseases Mortality from respiratory diseases was significantly associated with fewer variables than cancer and CVD, although bivariate associations were often significant (Tables 109–117 in Annex 4). Of the nine variables which were significant in individual blocks models of male mortality, five retained their statistical significance in the final regression model, and only three out of seven variables remained significant in the female mortality model (see Table 76). Table 76. Standardized regression coefficients from the final multiple regression models for mortality due to respiratory system diseases for each age and sex group Variables feminization rate population density old-age demographic dependency rate revenue of district budget per capita share of employment in hazardous conditions unemployment rate share of employment in agriculture library members per 1000 inhabitants local governments election turnout share of households equipped with bathroom pre-school participation rate of children aged 3-5 number of inhabitants per 1 medical doctor number of inhabitants per 1 health care institution average lower secondary school exam results (literacy) baccalaureate results - Polish language (basic level) R2 Total Total Males Females 0.41 0.34 0.32 0.16 0.23 0.20 -0.13 -0.13 -0.37 Total 0–64 Males Females 0.46 0.16 -0.59 0.24 -0.15 -0.50 -0.37 -0.38 Total 65+ Males Females 0.41 0.26 0.37 0.20 0.15 0.18 -0.36 -0.28 -0.18 -0.29 -0.26 -0.32 0.11 0.20 0.06 -0.16 -0.17 0.16 0.14 0.08 -0.27 -0.33 0.10 0.20 Explanatory power of the final model of female mortality was very low, since it explained only 6% of the variation in district SMRs, while the model of male mortality explained 20% Page 289 0.05 of district SMR differences. There were two variables which played significant role in the models of male as well as female mortality: district budget revenue and district unemployment rate. These variables were positively associated with mortality level. The models explaining respiratory mortality differentials in younger (below 65 years of age) and older (65 years and over) sub-populations show some similarities and differences. Unemployment rate is a significant variable in both age groups, while district budget revenue was important in older population. Share of households equipped with a bathroom and lower secondary school exam results were important predictors of male mortality regardless of the age group, however, they were insignificant predictors in female models. Created models better explain district respiratory mortality differentials in the case of men than women (only two variables retained their significance in younger and in older women final models). However, there is no clear difference in the explained variation of district SMRs in the elderly population and in the younger age group. Overall, differences in district respiratory diseases SMR are explained to a lesser extent than the differences in SMRs for cancer and CVD. 4.5. Mortality from digestive system diseases Mortality from digestive system diseases was significantly associated with fewer variables than cancer and CVD mortality ( Tables 118–126 in Annex4). Only three variables retained their statistical significance in the final regression mortality model for males as well as females (see Table 77). Two variables were significant in both gender- specific models: the share of employment in agriculture and local government election participation. Both variables were negatively associated with mortality from digestive diseases. The share of households equipped with a bathrooms was a significant factor in models for total population and for males, but not so for females. Explanatory power of final regression model of female mortality was lower than that of the male mortality model (respective R2: 28% and 16%). Page 290 Table 77. Standardized regression coefficients from the final multiple regression models for mortality due to digestive system diseases for each age and sex group Variables feminization rate population density old-age demographic dependency rate revenue of district budget per capita share of employment in hazardous conditions unemployment rate share of employment in agriculture library members per 1000 inhabitants local governments election turnout share of households equipped with bathroom pre-school participation rate of children aged 3-5 number of inhabitants per 1 medical doctor number of inhabitants per 1 health care institution average lower secondary school exam results (literacy) baccalaureate results - Polish language (basic level) R2 Total Total Males Females Total 0–64 Males Females 0.15 0.24 -1.05 -0.32 -1.09 -1.04 -0.15 -0.83 -0.15 -0.90 -0.13 -0.12 -0.72 -0.12 -0.78 -0.19 -0.11 -0.24 0.33 0.31 0.22 0.28 0.16 65+ Males Females -0.27 0.13 -0.24 -0.33 -0.13 -0.13 0.09 0.07 0.27 0.25 -1.06 0.29 Total -0.48 The models explaining respiratory mortality differentials in younger (below 65 years of age) and older (65 years and over) sub-populations are different. While the share of employment in agriculture and local government election participation play a significant role in explaining mortality differentials in both age groups, the share of households equipped with a bathroom, average lower secondary school examination results, and old-age dependency rate were significant factors in the younger population only. It may be noticed that, just like in the case of respiratory diseases mortality models, in digestive diseases mortality models the share of households equipped with a bathroom was an important predictor of male mortality in both age groups, however, it was an insignificant predictor in female models. Created models better explain the differences in district mortality from digestive system diseases in the younger age group than in the elderly population, and in the younger population the differences in district digestive diseases SMR are better explained by the models than the differences in SMRs for respiratory diseases. 4.6. Mortality from ill-defined causes (symptoms, signs and abnormal clinical and laboratory findings) As mentioned in the previous chapter, ill-defined causes of deaths like symptoms, signs, abnormal findings etc. without designation of any specific disease as a cause, are an indicator of the quality of the system of assigning and coding cases of deaths. It is interesting to notice that the level of district mortality due to ill-defined causes has a weak correlation with socioeconomic variables taken into account ( Tables 127–135 in Annex 4). The developed Page 291 0.06 regression models explain only a small proportion of the differences in district SMRs (see Table 78). Table 78. Standardized regression coefficients from the final multiple regression models for mortality due to ill-defined causes for each age and sex group Variables feminization rate population density old-age demographic dependency rate revenue of district budget per capita share of employment in hazardous conditions unemployment rate share of employment in agriculture library members per 1000 inhabitants local governments election turnout share of households equipped with bathroom pre-school participation rate of children aged 3-5 number of inhabitants per 1 medical doctor number of inhabitants per 1 health care institution average lower secondary school exam results (literacy) baccalaureate results - Polish language (basic level) R2 Total Total Males Females 0.20 0.40 Total 0–64 Males Females 0.29 0.28 0.28 0.21 0.20 0.22 0.28 -0.14 0.22 0.24 0.25 0.25 0.16 -0.32 -0.21 -0.27 -0.41 -0.15 -0.54 0.22 -0.13 -0.55 0.25 -0.17 -0.44 -0.14 0.08 0.07 65+ Males -0.14 0.11 0.11 0.10 -0.16 0.08 0.12 -0.20 0.04 It may be pointed out that in the total population and in the elderly group no variable was significant jointly in male and female models. However, in the younger age group there were several variables that revealed significant association consistently in males and in females. For example, as it was observed in mortality models dedicated to specific diseases, in this case as well the share of households equipped with bathrooms and local government election participation play a significant role in explaining mortality differentials in both gender groups, being negatively associated with mortality level. The variables: population density, district budget revenue and unemployment rate, which were less significant in previous models, were significantly associated with increased mortality from ill-defined causes of younger males and females. It should be underlined, however, that despite the five/six factors in the younger age group regression models, only 10-11% of the differences in district SMR are explained by these models. 4.7. Mortality from the external causes of death Analysis of the relationship between mortality caused by external causes and socio-economic factors taken into account reveals two interesting phenomena. One is an almost non-existing association of district female mortality with these factors, while the association of male mortality is quite strong and the final regression model explains 39% of the variation in district SMRs (Tables 136–144 in Annex 4, Table 79). The second interesting finding is that Page 292 Females 0.15 0.11 -0.19 -0.18 0.07 Total 0.09 such relatively strong determination of male mortality differential by socio-economic factors is observed only in the younger age group (41% of the explained variation), while in the elderly men the factors taken into account are almost non-significant – the final model has only two variables and explains only 3% of the differences in district SMRs. Table 79. Standardized regression coefficients from the final multiple regression models for mortality due to external causes for each age and sex group Total Total Males Females Total 0–64 Males Females Total 65+ Males feminization rate population density old-age demographic dependency rate revenue of district budget per capita share of employment in hazardous conditions unemployment rate share of employment in agriculture library members per 1000 inhabitants local governments election turnout share of households equipped with bathroom pre-school participation rate of children aged 3-5 number of inhabitants per 1 medical doctor number of inhabitants per 1 health care institution average middle chool exam results (literacy) baccalaureate results - Polish language (basic level) -0.19 -0.15 -0.17 -0.25 -0.21 -0.21 -0.17 -0.22 -0.23 -0.19 0.16 0.14 R2 Variables 0.17 Females 0.13 -0.31 0.15 -0.30 0.14 -0.36 0.16 -0.33 -0.66 -0.53 -0.58 -0.60 -0.60 -0.51 -0.23 -0.18 -0.23 -0.19 -0.29 0.32 0.39 0.41 0.41 0.09 0.01 -0.26 -0.28 -0.13 -0.18 0.08 0.03 Similarly like in some of the models of mortality from other causes of deaths, among the variables that were significantly associated with the lower mortality from the external causes were employment in agriculture, share of households applied with bathrooms, gymnasium examination results. Lower mortality is also associated with higher population density, and interestingly in younger population with lower unemployment while in older age group with higher unemployment. 4.8. Infant mortality The association between district levels of infant mortality and socio-economic factors taken into consideration is weak (Tables 145–147 in Annex 4). Only 10% of the differences observed between district infant mortality rates (IMR) can be explained by the analysed variables, even though six variable are in the final regression model (see Table 80). Three of them are associated with IMR decrease, and three with IMR increase. Of the latter group, the share of employment in hazardous conditions played a significant role in total IMR, neonatal and post-neonatal models. It is interesting to note that when post-neonatal infant mortality (infants 28 days old and above) was analyzed, and such mortality is more contingent on Page 293 0.12 exogenous factors, the explained proportion of inter-district differences was only 2%, and only three variables were significant: the one mentioned above, and local government election participation and pre-school participation rate of children, which were associated with a decrease in post-neonatal mortality. Table 80. Standardized regression coefficients for infant mortality rate, total and in age groups Variables feminization rate population density old-age demographic dependency rate revenue of district budget per capita share of employment in hazardous conditions unemployment rate share of employment in agriculture library members per 1000 inhabitants local governments election turnout share of households equipped with bathroom pre-school participation rate of children aged 3-5 number of inhabitants per 1 medical doctor number of inhabitants per 1 health care institution average lower secondary school exam results (literacy) baccalaureate results - Polish language (basic level) R2 Total 0-27 days 0.28 0.16 0.18 0.19 0.20 28 days and more 0.15 0.16 -0.18 -0.23 -0.32 -0.19 -0.18 0.10 0.08 0.02 4.9. Life expectancy at birth The association between life expectancy in districts and socio-economic factors taken into consideration is moderate, stronger in men than in women (Tables 148–149 in Annex4). As much as 43% of the differences observed between district male life expectancy, and 36% of differences in female life expectancy, can be explained by the analysed variables (see Table 81). More variables (7) played a significant role in the male regression model than in the female one (4); however, three of them: the share of households equipped with bathrooms, local governments election participation, and lower secondary school exam results, were positively associated with life expectancy of both males and females. District unemployment rate and, quite surprisingly, revenue of district budget per capita were the only variables that were significantly associated with shorter life expectancy, and only in the case of males. Page 294 Table 81. Standardized regression coefficients for life expectancy at birth of males and females Variables Males feminization rate population density old-age demographic dependency rate revenue of district budgets per capita share of employment in hazardous conditions unemployment rate share of employment in agriculture library members per 1000 inhabitants local governments election turnout share of households equipped with bathroom pre-school participation rate of children aged 3-5 number of inhabitants per 1 medical doctor number of inhabitants per 1 health care institution average lower secondary school exam results (literacy) baccalaureate results - Polish language (basic level) 0.16 R2 Females -0.21 -0.23 0.79 0.31 0.55 0.21 0.68 0.09 0.27 0.57 0.43 0.36 Summary Regression models results show that social determinants are significantly associated with the mortality outcomes of the district population. The analysis of the outcomes of final models for standardized mortality ratios (SMRs) and life expectancy as dependent variables, with the use of proposed groups of indicators representing demographic, economic and labour market, social, access to health care and education-related factors as explanatory variables, confirms that in some cases these indicators can explain a significant part of district variation in mortality level and life expectancy. Explanatory power is particularly strong in the case of overall mortality and life expectancy at birth. Socio-economic determinants also explain some 30 to 40 percent of variation in the case of cancer mortality and mortality from external causes in younger men. Selected indicators also explain some 20 percent of variation in mortality due to cardiovascular diseases in total population, and digestive system diseases in the younger age group of districts inhabitants. However, indicators taken into consideration do not explain a meaningful portion of differences in districts mortality from diseases of the respiratory system, diseases of the digestive system in elderly population, or in infant mortality. Page 295 The analysis of final models reveals that in the case of all groups of selected indicators, with the exception of access to health care, there are some that play a significant role in explaining mortality differentials more frequently than others. These include: • share of households equipped with a bathroom, • local government elections turnout, • lower secondary school exam results from humanities, • share of employment in agriculture, • population density, • unemployment rate. On the other hand, high school (baccalaureate) exams never appear as explanatory variable in the final models; access to health care indicators and library membership are also less frequent. There are three variables which are almost always associated with decreased mortality outcomes in districts. These are: the share of employment in agriculture, local elections turnout, and humanities exam results. Some hypotheses on those results can be proposed. First, employment in agriculture, which also represents residence in rural areas, is related to living and working in a less polluted physical environment, leading a life that is more physically active, with better lifestyles of rural women who smoke tobacco less frequently and drink less alcohol than urban women4041. Local elections turnout, as a proxy of social activity, can indicate that in those districts where participation is higher people are more active in various fields, and the social network, a well-known factor contributing to better health, is stronger. Exam results (which are also correlated with the education structure, as explained in the previous chapter) confirm positive impact of education on health and mortality reduction. Another variable which is associated with lower mortality level is the share of households equipped with bathroom. Only in the case of cancer mortality for the elderly population of age 65 years and over, the association was reversed. Share of households equipped with bathroom 40 Globalny sondaż dotyczący używania tytoniu przez osoby dorosłe (GATS) Polska 2009-2010. Ministerstwo Zdrowia, World Health Organization Regional Office for Europe, Warszawa 2010. 41 Sierosławski J. Substancje psychoaktywne – postawy i zachowania Polaków. W: Postawy i zachowania Polaków wobec alkoholu i problemów alkoholowych. [Psychoactive substances: attitides and behaviour of Poles. In: Attitudes and behavior of Poles related to alcohol and alcohol abuse.] Państwowa Agencja Rozwiązywania Problemów Alkoholowych, Warszawa 2004, s. 33. Page 296 is an indicator of living conditions – sanitary-hygienic situation and economic status therefore, as could be expected, its higher level was associated with lower mortality from several diseases and longer life expectancy. Unemployment rate, as expected, is associated with increase in SMRs, especially in men, in particular for overall mortality and mortality caused by respiratory diseases, which may be related to overall stress as well as lifestyles of the unemployed. We do not have information on the risk of death from respiratory diseases in the unemployed population however, as we presented earlier, respiratory diseases mortality exhibits strong social gradient, which is also very strong in the case of unemployment. Similar situation takes place in the case of mortality from ill-defined conditions so there is coherence in these findings. Surprisingly, the population density, revenue of local budgets per inhabitant, as well as share of children in pre-school education seem to have a smaller and mixed impact on mortality outcomes when other variables/factors are taken into account. Higher population density is associated with lower overall mortality, which is due to its negative association with mortality in elderly population especially due to the cardiovascular diseases and also negative association with mortality from external causes in both the age groups. This may be a reflection of lower mortality from CVD and external causes in the bigger towns than in smaller communities42. On the other hand positive association with higher infant mortality may at least partly result from high infant mortality in Śląskie towns. Own revenue of districts budgets is associated with increased overall mortality, but looking more thorough this association is present in the case of respiratory diseases and mortality from external causes which may be related to higher mortality in regions with heavy industry and pollution (such as Silesia region). On the other hand in districts with higher budget revenue there was significantly lower CVD mortality in the elderly population which could result from better health care and more common preventive programmes in those districts however, we have no data to substantiate this presumption. 42 B. Wojtyniak: Zdrowie mieszkańców polskich miast. Wyniki analizy prezentowane na konferencji „Człowiek i Miasto” organizowanej przez Biuro WHO w Polsce z okazji Światowego Dnia Zdrowia, Warszawa 7 kwietnia 2010. Page 297 Higher participation in pre-school education has the expected direction of association in the case of cancer mortality and infant mortality, which may again be linked to the overall structure of education of population (as this indicator is strongly correlated with the share of population with higher education, which is not used in the model). However, it is difficult to explain why this association is observed in the case of these two health indicators only. Finally, it should be stressed that the socio-economic variables taken into consideration in our analysis are not narrow, very specific risk factors for a particular cause of death or other health outcome. Each of them belongs to the up-stream level indicators and represents several more specific factors more directly affecting population health. Therefore, the associations observed should be interpreted with due caution. Page 298 Annex 4 Table 82. Association between district SMR for all causes and socio-economic variables, total population, all ages Variable Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) 2 p-value R 0.14 Demographics feminization rate -0.336 0.00 -0.143 -6.29 0.00 population density -0.377 0.00 -0.162 -0.02 0.00 old-age demographic dependency rate -0.049 0.34 -0.014 revenue of district budget per capita -0.142 0.01 -0.042 -0.03 0.00 share of employment in hazardous conditions -0.052 0.31 -0.031 2.35 0.02 unemployment rate 0.390 0.00 0.209 5.29 0.00 share of employment in agriculture 0.167 0.00 0.042 library members per 1000 inhabitants -0.143 0.01 -0.036 local governments election turnout 0.121 0.02 0.034 -6.20 0.00 share of households applied with bathroom -0.347 0.00 -0.176 -4.47 0.00 pre-school participation rate of children aged 3-5 -0.304 0.00 -0.133 -1.75 0.00 number of inhabitants per 1 medical doctor 0.254 0.00 0.104 0.03 0.00 0.02 number of inhabitants per 1 health care institution 0.123 0.02 0.054 average gymnasium exams results (literacy) -0.462 0.00 -0.227 -32.99 0.00 0.26 baccalaureate results - Polish language (basic level) -0.210 0.00 -0.103 population density -0.02 0.02 0.37 revenue of district budget per capita 0.02 0.02 unemployment rate 2.50 0.00 share of employment in hazardous conditions 2.49 0.01 share of households applied with bathroom -5.72 0.00 local governments election turnout -5.44 0.00 number of inhabitants per 1 medical doctor -0.01 0.02 average gymnasium exams results (literacy) -19.82 0.00 Economic and labour market situation 0.16 Social cohesion 0.19 Access to health care Education Final model Page 299 Table 83. Association between district SMR for all causes and socio-economic variables, males, all ages Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.413 0.00 -0.204 -8.84 0.00 0.18 population density -0.407 0.00 -0.199 -0.01 0.04 old-age demographic dependency rate 0.049 0.35 0.048 revenue of district budget per capita -0.198 0.00 -0.087 -0.04 0.00 share of employment in hazardous conditions -0.160 0.00 -0.105 unemployment rate 0.449 0.00 0.258 7.16 0.00 share of employment in agriculture 0.235 0.00 0.095 library members per 1000 inhabitants -0.175 0.00 -0.058 local governments election turnout 0.166 0.00 0.066 -6.97 0.00 share of households equipped with a bathroom -0.442 0.00 -0.236 -6.50 0.00 pre-school participation rate of children aged 3-5 -0.374 0.00 -0.185 -1.84 0.00 number of inhabitants per 1 medical doctor 0.244 0.00 0.105 0.03 0.00 0.02 number of inhabitants per 1 health care institution 0.109 0.03 0.044 average lower secondary school exams results (literacy) -0.400 0.00 -0.196 -37.30 0.00 0.21 baccalaureate results - Polish language (basic level) -0.226 0.00 -0.119 unemployment rate 3.97 0.00 0.40 share of households equipped with a bathroom -6.65 0.00 local governments election turnout -5.43 0.00 number of inhabitants per 1 medical doctor average lower secondary school exams results (literacy) -0.01 0.02 -19.75 0.00 Variable 2 Demographics Economic and labour market situation 0.21 Social cohesion 0.24 Access to health care Education Final model Page 300 Table 84. Association between district SMR for all causes and socio-economic variables, females, all ages Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.097 0.06 -0.010 -4.67 0.00 0.04 population density -0.178 0.00 -0.048 old-age demographic dependency rate -0.176 0.00 -0.111 -3.33 0.00 revenue of district budget per capita 0.028 0.59 0.065 -0.03 0.00 share of employment in hazardous conditions 0.142 0.01 0.106 3.30 0.00 unemployment rate 0.223 0.00 0.109 3.34 0.00 share of employment in agriculture -0.043 0.41 -0.091 -0.61 0.03 library members per 1000 inhabitants -0.032 0.53 0.026 local governments election turnout -0.036 0.49 -0.073 -6.03 0.00 share of households equipped with a bathroom -0.102 0.05 -0.036 -2.38 0.00 pre-school participation rate of children aged 3-5 -0.070 0.18 0.002 -1.23 0.00 number of inhabitants per 1 medical doctor 0.161 0.00 0.044 0.01 0.02 0.00 number of inhabitants per 1 health care institution 0.090 0.08 0.034 average lower secondary school exams results (literacy) -0.426 0.00 -0.254 -25.13 0.00 0.19 baccalaureate results - Polish language (basic level) -0.120 0.02 -0.047 share of employment in agriculture -2.28 0.00 0.30 share of employment in hazardous conditions 2.04 0.03 share of households equipped with a bathroom -6.49 0.00 local governments election turnout average lower secondary school exams results (literacy) -2.63 0.00 -25.36 0.00 Variable 2 Demographics Economic and labour market situation 0.07 Social cohesion 0.04 Access to health care Education Final model Page 301 Table 85. Association between district SMR for all causes and socio-economic variables, total population, aged 0–64 years Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.379 0.00 -0.177 -12.73 0.00 0.13 population density -0.330 0.00 -0.122 0.03 0.00 old-age demographic dependency rate 0.161 0.00 0.170 revenue of district budget per capita -0.103 0.05 -0.043 share of employment in hazardous conditions -0.154 0.00 -0.111 unemployment rate 0.376 0.00 0.216 share of employment in agriculture 0.149 0.00 0.048 Variable 2 Demographics Economic and labour market situation 0.11 9.53 0.00 Social cohesion library members per 1000 inhabitants -0.171 0.00 -0.058 local governments election turnout 0.103 0.05 0.009 -10.24 0.00 0.20 share of households equipped with a bathroom -0.428 0.00 -0.283 -10.97 0.00 pre-school participation rate of children aged 3-5 -0.303 0.00 -0.156 number of inhabitants per 1 medical doctor 0.152 0.00 0.040 number of inhabitants per 1 health care institution 0.040 0.44 -0.016 average lower secondary school exams results (literacy) -0.355 0.00 -0.160 -34.34 0.00 0.13 baccalaureate results - Polish language (basic level) -0.213 0.00 -0.081 population density 0.05 0.00 0.34 unemployment rate 3.82 0.00 share of households equipped with a bathroom -9.93 0.00 local governments election turnout average lower secondary school exams results (literacy) -7.93 0.00 -28.53 0.00 Access to health care Education Final model Page 302 Table 86. Association between district SMR for all causes and socio-economic variables, males, aged 0–64 years Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.444 0.00 -0.243 -11.60 0.00 0.19 population density -0.338 0.00 -0.154 old-age demographic dependency rate 0.269 0.00 0.243 7.09 0.00 revenue of district budget per capita -0.186 0.00 -0.118 share of employment in hazardous conditions -0.253 0.00 -0.197 unemployment rate 0.357 0.00 0.199 share of employment in agriculture 0.243 0.00 0.138 Variable 2 Demographics Economic and labour market situation 0.12 11.00 0.00 Social cohesion library members per 1000 inhabitants -0.198 0.00 -0.079 local governments election turnout 0.175 0.00 0.072 -9.70 0.00 0.28 share of households equipped with a bathroom -0.524 0.00 -0.357 -13.14 0.00 pre-school participation rate of children aged 3-5 -0.346 0.00 -0.196 number of inhabitants per 1 medical doctor 0.145 0.00 0.045 number of inhabitants per 1 health care institution 0.039 0.44 -0.015 average lower secondary school exams results (literacy) -0.275 0.00 -0.119 -34.39 0.00 0.09 baccalaureate results - Polish language (basic level) -0.197 0.00 -0.083 old-age demographic dependency rate 6.38 0.00 0.35 unemployment rate 5.34 0.00 share of households equipped with a bathroom -9.27 0.00 local governments election turnout average lower secondary school exams results (literacy) -8.96 0.00 -13.16 0.01 Access to health care Education Final model Page 303 Table 87. Association between district SMR for all causes and socio-economic variables, females, aged 0– 64 years Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R 0.097 0.06 0.111 -4.94 0.01 0.06 population density 0.017 0.74 0.114 0.07 0.00 old-age demographic dependency rate -0.182 0.00 -0.014 -5.28 0.03 revenue of district budget per capita 0.331 0.00 0.236 share of employment in hazardous conditions 0.236 0.00 0.175 unemployment rate 0.166 0.00 0.107 7.20 0.00 share of employment in agriculture -0.344 0.00 -0.280 -3.97 0.00 Variable 2 Demographics feminization rate Economic and labour market situation 0.18 Social cohesion library members per 1000 inhabitants 0.040 0.44 0.037 local governments election turnout -0.275 0.00 -0.244 -13.17 0.00 0.09 share of households equipped with a bathroom 0.121 0.02 -0.009 -3.41 0.01 pre-school participation rate of children aged 3-5 0.106 0.04 0.087 1.10 0.04 number of inhabitants per 1 medical doctor -0.042 0.41 -0.116 -0.04 0.00 0.00 number of inhabitants per 1 health care institution -0.021 0.69 -0.061 average lower secondary school exams results (literacy) -0.308 0.00 -0.188 -15.68 0.00 0.07 baccalaureate results - Polish language (basic level) -0.063 0.22 -0.018 population density 0.05 0.00 0.40 share of employment in agriculture -7.24 0.00 share of households equipped with a bathroom -13.22 0.00 local governments election turnout average lower secondary school exams results (literacy) -5.11 0.00 -46.13 0.00 Access to health care Education Final model Page 304 Table 88. Association between district SMR for all causes and socio-economic variables, total population, aged 65 years and over Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.225 0.00 -0.089 -4.39 0.00 0.25 population density -0.339 0.00 -0.163 -0.03 0.00 old-age demographic dependency rate -0.228 0.00 -0.147 -3.86 0.00 revenue of district budget per capita -0.135 0.01 -0.038 -0.04 0.00 share of employment in hazardous conditions 0.053 0.30 0.043 3.11 0.00 unemployment rate 0.293 0.00 0.138 3.50 0.00 share of employment in agriculture 0.147 0.00 0.037 Variable 2 Demographics Economic and labour market situation 0.17 Social cohesion library members per 1000 inhabitants -0.100 0.05 -0.023 local governments election turnout 0.112 0.03 0.038 -4.22 0.00 0.14 share of households equipped with a bathroom -0.196 0.00 -0.062 -1.46 0.01 pre-school participation rate of children aged 3-5 -0.234 0.00 -0.083 -2.53 0.00 number of inhabitants per 1 medical doctor 0.302 0.00 0.139 0.03 0.00 0.03 number of inhabitants per 1 health care institution 0.168 0.00 0.089 average lower secondary school exams results (literacy) -0.455 0.00 -0.239 -32.46 0.00 0.27 baccalaureate results - Polish language (basic level) -0.159 0.00 -0.085 old-age demographic dependency rate -3.27 0.00 0.38 population density -0.02 0.00 share of employment in hazardous conditions 2.08 0.01 share of households equipped with a bathroom -3.50 0.00 local governments election turnout average lower secondary school exams results (literacy) -3.17 0.00 -15.79 0.00 Access to health care Education Final model Page 305 Table 89. Association between district SMR for all causes and socio-economic variables, males, aged 65 years and over Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.282 0.00 -0.132 -6.16 0.00 0.30 population density -0.418 0.00 -0.231 -0.03 0.00 old-age demographic dependency rate -0.256 0.00 -0.168 -6.03 0.00 revenue of district budget per capita -0.156 0.00 -0.051 -0.05 0.00 share of employment in hazardous conditions 0.009 0.86 0.014 2.59 0.01 unemployment rate 0.409 0.00 0.221 5.77 0.00 share of employment in agriculture 0.176 0.00 0.059 Variable 2 Demographics Economic and labour market situation 0.23 Social cohesion library members per 1000 inhabitants -0.130 0.01 -0.046 local governments election turnout 0.118 0.02 0.051 -4.80 0.00 0.18 share of households equipped with a bathroom -0.220 0.00 -0.070 -1.47 0.04 pre-school participation rate of children aged 3-5 -0.315 0.00 -0.138 -3.27 0.00 number of inhabitants per 1 medical doctor 0.331 0.00 0.172 0.04 0.00 0.05 number of inhabitants per 1 health care institution 0.175 0.00 0.101 average lower secondary school exams results (literacy) -0.470 0.00 -0.253 -39.81 0.00 0.28 baccalaureate results - Polish language (basic level) -0.209 0.00 -0.139 old-age demographic dependency rate -5.55 0.00 0.42 population density -0.02 0.00 unemployment rate 2.02 0.01 share of households equipped with a bathroom -4.02 0.00 local governments election turnout average lower secondary school exams results (literacy) -3.68 0.00 -16.43 0.00 Access to health care Education Final model Page 306 Table 90. Association between district SMR for all causes and socio-economic variables, females, aged 65 years and over Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.141 0.01 -0.041 -3.08 0.00 0.12 population density -0.212 0.00 -0.088 -0.03 0.00 old-age demographic dependency rate -0.164 0.00 -0.123 -2.31 0.03 revenue of district budget per capita -0.086 0.09 -0.007 -0.04 0.00 share of employment in hazardous conditions 0.100 0.05 0.082 3.38 0.00 unemployment rate 0.195 0.00 0.076 2.43 0.00 share of employment in agriculture 0.072 0.16 -0.011 Variable 2 Demographics Economic and labour market situation 0.09 Social cohesion library members per 1000 inhabitants -0.046 0.37 0.013 local governments election turnout 0.060 0.24 -0.002 -4.23 0.00 0.05 share of households equipped with a bathroom -0.152 0.00 -0.043 -1.74 0.01 pre-school participation rate of children aged 3-5 -0.112 0.03 -0.016 -1.78 0.00 number of inhabitants per 1 medical doctor 0.222 0.00 0.085 0.02 0.00 0.01 number of inhabitants per 1 health care institution 0.121 0.02 0.055 average lower secondary school exams results (literacy) -0.386 0.00 -0.229 -26.81 0.00 0.18 baccalaureate results - Polish language (basic level) -0.118 0.02 -0.046 population density -0.03 0.00 0.25 share of employment in hazardous conditions 2.31 0.01 pre-school participation rate of children aged 3-5 0.76 0.03 Access to health care Education Final model Page 307 Table 91. Association between district SMR for malignant neoplasms and socio-economic variables, total population, all ages Spearman correlation coefficient p-value RCI feminization rate 0.157 0.00 0.047 population density -0.022 0.67 -0.062 0.02 0.00 old-age demographic dependency rate -0.410 0.00 -0.280 -11.22 0.00 revenue of district budget per capita 0.330 0.00 0.133 share of employment in hazardous conditions 0.264 0.00 0.134 3.75 0.01 unemployment rate 0.129 0.01 0.143 4.55 0.00 share of employment in agriculture -0.308 0.00 -0.138 -1.91 0.00 Variable Regression coefficient (x 1000) p-value 2 R Demographics 0.16 Economic and labour market situation 0.15 Social cohesion library members per 1000 inhabitants 0.023 0.66 0.010 -0.29 0.02 local governments election turnout -0.245 0.00 -0.103 -4.05 0.00 share of households equipped with a bathroom 0.286 0.00 0.119 6.32 0.00 pre-school participation rate of children aged 3-5 0.075 0.15 -0.034 -1.75 0.00 number of inhabitants per 1 medical doctor 0.048 0.36 0.074 number of inhabitants per 1 health care institution 0.090 0.08 0.055 average lower secondary school exams results (literacy) -0.388 0.00 -0.309 -21.37 0.00 baccalaureate results - Polish language (basic level) -0.023 0.65 -0.038 5.90 0.02 unemployment rate -2.09 0.04 share of employment in agriculture -3.52 0.00 pre-school participation rate of children aged 3-5 average lower secondary school exams results (literacy) -1.08 0.02 -32.40 0.00 0.21 Access to health care Education 0.14 Final model Page 308 0.36 Table 92. Association between district SMR for malignant neoplasms and socio-economic variables, males, all ages Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.034 0.51 -0.076 -3.21 0.00 0.12 population density -0.180 0.00 -0.196 old-age demographic dependency rate -0.359 0.00 -0.268 -11.72 0.00 revenue of district budget per capita 0.139 0.01 0.022 -0.02 0.04 share of employment in hazardous conditions 0.131 0.01 0.044 2.99 0.05 unemployment rate 0.268 0.00 0.243 6.32 0.00 share of employment in agriculture -0.104 0.04 -0.015 -1.16 0.00 library members per 1000 inhabitants -0.066 0.20 -0.039 local governments election turnout -0.109 0.03 -0.017 -3.67 0.00 share of households equipped with a bathroom 0.097 0.06 0.029 5.03 0.00 pre-school participation rate of children aged 3-5 -0.116 0.02 -0.148 -3.40 0.00 number of inhabitants per 1 medical doctor 0.177 0.00 0.170 number of inhabitants per 1 health care institution 0.159 0.00 0.115 0.01 0.00 average lower secondary school exams results (literacy) -0.458 0.00 -0.364 -31.36 0.00 0.20 baccalaureate results - Polish language (basic level) -0.094 0.07 -0.099 share of employment in agriculture -2.93 0.00 0.31 pre-school participation rate of children aged 3-5 -1.99 0.00 number of inhabitants per 1 health care institution average lower secondary school exams results (literacy) 0.01 0.04 -30.29 0.00 Variable 2 Demographics Economic and labour market situation 0.10 Social cohesion 0.15 Access to health care 0.02 Education Final model Page 309 Table 93. Association between district SMR for malignant neoplasms and socio-economic variables, females, all ages Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R 0.374 0.00 0.224 3.00 0.05 0.23 population density 0.212 0.00 0.159 0.05 0.00 old-age demographic dependency rate -0.380 0.00 -0.206 -11.80 0.00 0.521 0.00 0.298 share of employment in hazardous conditions 0.376 0.00 0.241 unemployment rate -0.048 0.35 -0.028 share of employment in agriculture -0.529 0.00 -0.323 -4.17 0.00 Variable 2 Demographics feminization rate Economic and labour market situation revenue of district budget per capita 0.30 Social cohesion library members per 1000 inhabitants 0.141 0.01 0.102 -0.31 0.03 local governments election turnout -0.384 0.00 -0.236 -5.72 0.00 share of households equipped with a bathroom 0.462 0.00 0.235 8.08 0.00 pre-school participation rate of children aged 3-5 0.321 0.00 0.167 number of inhabitants per 1 medical doctor -0.148 0.00 -0.111 -0.05 0.00 number of inhabitants per 1 health care institution -0.045 0.38 -0.064 average lower secondary school exams results (literacy) -0.197 0.00 -0.154 baccalaureate results - Polish language (basic level) 0.064 0.21 0.041 0.30 Access to health care 0.01 Education 0.00 7.39 0.02 share of employment in agriculture -4.17 0.00 library members per 1000 inhabitants -0.39 0.00 local governments election turnout -2.58 0.05 Final model Page 310 0.34 Table 94. Association between district SMR for malignant neoplasms and socio-economic variables, total population, aged 0–64 years Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.094 0.07 -0.073 -4.01 0.00 0.05 population density -0.181 0.00 -0.150 old-age demographic dependency rate -0.210 0.00 -0.149 -6.40 0.00 revenue of district budget per capita 0.094 0.07 0.007 share of employment in hazardous conditions 0.096 0.06 0.032 3.63 0.03 unemployment rate 0.238 0.00 0.225 7.16 0.00 share of employment in agriculture -0.079 0.13 -0.026 -0.81 0.03 -6.26 0.00 -1.85 0.00 Variable 2 Demographics Economic and labour market situation 0.07 Social cohesion library members per 1000 inhabitants -0.086 0.09 -0.037 local governments election turnout -0.086 0.09 -0.063 0.04 share of households equipped with a bathroom -0.028 0.58 -0.052 pre-school participation rate of children aged 3-5 -0.091 0.08 -0.120 number of inhabitants per 1 medical doctor 0.185 0.00 0.156 number of inhabitants per 1 health care institution 0.140 0.01 0.093 0.01 0.01 average lower secondary school exams results (literacy) -0.470 0.00 -0.343 -32.20 0.00 0.20 baccalaureate results - Polish language (basic level) -0.115 0.03 -0.084 feminization rate -3.87 0.01 0.26 share of employment in agriculture -2.59 0.00 number of inhabitants per 1 health care institution average lower secondary school exams results (literacy) 0.01 0.04 -36.20 0.00 Access to health care 0.03 Education Final model Page 311 Table 95. Association between district SMR for malignant neoplasms and socio-economic variables, males, aged 0–64 years Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.203 0.00 -0.157 -7.89 0.00 0.05 population density -0.272 0.00 -0.210 old-age demographic dependency rate -0.105 0.04 -0.079 -6.71 0.00 revenue of district budget per capita -0.046 0.38 -0.078 -0.03 0.00 share of employment in hazardous conditions -0.015 0.77 -0.037 3.61 0.03 unemployment rate 0.267 0.00 0.231 6.46 0.00 share of employment in agriculture 0.087 0.09 0.072 -5.66 0.00 Variable 2 Demographics Economic and labour market situation 0.06 Social cohesion library members per 1000 inhabitants -0.142 0.01 -0.078 local governments election turnout 0.034 0.51 0.004 0.06 share of households equipped with a bathroom -0.163 0.00 -0.118 pre-school participation rate of children aged 3-5 -0.197 0.00 -0.179 -3.13 0.00 number of inhabitants per 1 medical doctor 0.290 0.00 0.218 0.04 0.00 0.05 number of inhabitants per 1 health care institution 0.191 0.00 0.118 average lower secondary school exams results (literacy) -0.464 0.00 -0.342 -41.17 0.00 0.20 baccalaureate results - Polish language (basic level) -0.145 0.00 -0.082 feminization rate -2.65 0.04 0.21 local governments election turnout average lower secondary school exams results (literacy) -3.35 0.01 -36.89 0.00 Access to health care Education Final model Page 312 Table 96. Association between district SMR for malignant neoplasms and socio-economic variables, females, aged 0–64 years Spearman correlation coefficient p-value RCI 0.120 0.02 0.050 population density 0.054 0.29 -0.021 0.04 0.00 old-age demographic dependency rate -0.247 0.00 -0.146 -8.94 0.00 revenue of district budget per capita 0.292 0.00 0.126 share of employment in hazardous conditions 0.217 0.00 0.099 unemployment rate 0.083 0.11 0.105 5.28 0.00 share of employment in agriculture -0.314 0.00 -0.136 -3.50 0.00 Variable Regression coefficient (x 1000) p-value 2 R Demographics feminization rate 0.08 Economic and labour market situation 0.13 Social cohesion library members per 1000 inhabitants 0.019 0.71 0.002 -0.36 0.05 local governments election turnout -0.248 0.00 -0.134 -7.04 0.00 0.08 share of households equipped with a bathroom 0.180 0.00 0.034 3.24 0.00 pre-school participation rate of children aged 3-5 0.132 0.01 -0.005 number of inhabitants per 1 medical doctor -0.040 0.44 0.022 -0.03 0.00 0.00 number of inhabitants per 1 health care institution 0.020 0.70 0.020 average lower secondary school exams results (literacy) -0.287 0.00 -0.243 -13.68 0.00 0.07 baccalaureate results - Polish language (basic level) -0.018 0.73 -0.062 population density 0.03 0.01 0.25 share of employment in agriculture -4.98 0.00 share of households equipped with a bathroom average lower secondary school exams results (literacy) -4.27 0.01 -42.29 0.00 Access to health care Education Final model Page 313 Table 97. Association between district SMR for malignant neoplasms and socio-economic variables, total population, aged 65 years and over Spearman correlation coefficient p-value RCI 0.285 0.00 0.135 population density 0.097 0.06 0.025 0.03 0.00 old-age demographic dependency rate -0.469 0.00 -0.333 -14.93 0.00 revenue of district budget per capita 0.432 0.00 0.225 share of employment in hazardous conditions 0.321 0.00 0.188 4.07 0.01 unemployment rate 0.017 0.74 0.051 2.99 0.00 share of employment in agriculture -0.401 0.00 -0.208 -2.49 0.00 Variable Regression coefficient (x 1000) p-value 2 R Demographics feminization rate 0.22 Economic and labour market situation 0.20 Social cohesion library members per 1000 inhabitants 0.095 0.06 0.051 -0.27 0.03 local governments election turnout -0.297 0.00 -0.132 -2.95 0.01 0.31 share of households equipped with a bathroom 0.440 0.00 0.240 9.46 0.00 pre-school participation rate of children aged 3-5 0.180 0.00 0.053 -1.81 0.00 number of inhabitants per 1 medical doctor -0.049 0.34 0.014 -0.02 0.02 0.00 number of inhabitants per 1 health care institution 0.036 0.49 0.035 average lower secondary school exams results (literacy) -0.245 0.00 -0.228 -14.04 0.00 0.07 baccalaureate results - Polish language (basic level) 0.041 0.43 -0.014 7.20 0.01 unemployment rate -2.74 0.01 share of employment in agriculture -2.51 0.00 pre-school participation rate of children aged 3-5 -1.52 0.00 share of households equipped with a bathroom average lower secondary school exams results (literacy) 5.48 0.00 -27.76 0.00 Access to health care Education Final model Page 314 0.38 Table 98. Association between district SMR for malignant neoplasms and socio-economic variables, males, aged 65 years and over Spearman correlation coefficient p-value RCI feminization rate 0.072 0.16 -0.025 population density -0.084 0.10 -0.149 old-age demographic dependency rate -0.448 0.00 -0.339 revenue of district budget per capita 0.231 0.00 0.089 share of employment in hazardous conditions 0.200 0.00 0.082 3.76 0.02 unemployment rate 0.197 0.00 0.192 6.91 0.00 share of employment in agriculture -0.200 0.00 -0.063 -1.36 0.00 Variable Regression coefficient (x 1000) p-value 2 R Demographics 0.18 -15.27 0.00 Economic and labour market situation 0.11 Social cohesion library members per 1000 inhabitants 0.002 0.96 -0.015 local governments election turnout -0.171 0.00 -0.021 -2.39 0.05 0.22 share of households equipped with a bathroom 0.242 0.00 0.114 8.71 0.00 pre-school participation rate of children aged 3-5 -0.036 0.49 -0.096 -3.81 0.00 number of inhabitants per 1 medical doctor 0.079 0.13 0.112 number of inhabitants per 1 health care institution 0.097 0.06 0.094 0.01 0.04 average lower secondary school exams results (literacy) -0.340 0.00 -0.311 -25.87 0.00 0.11 baccalaureate results - Polish language (basic level) -0.054 0.29 -0.101 old-age demographic dependency rate -4.67 0.02 0.29 share of employment in agriculture -2.05 0.00 pre-school participation rate of children aged 3-5 -2.06 0.00 share of households equipped with a bathroom average lower secondary school exams results (literacy) 3.58 0.01 -24.02 0.00 Access to health care 0.01 Education Final model Page 315 Table 99. Association between district SMR for malignant neoplasms and socio-economic variables, females aged 65 years and over Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate 0.460 0.00 0.303 6.20 0.00 0.28 population density 0.293 0.00 0.236 0.05 0.00 old-age demographic dependency rate -0.386 0.00 -0.234 -12.99 0.00 revenue of district budget per capita 0.577 0.00 0.366 share of employment in hazardous conditions 0.402 0.00 0.280 unemployment rate -0.131 0.01 -0.105 share of employment in agriculture -0.576 0.00 -0.384 library members per 1000 inhabitants 0.185 0.00 0.146 local governments election turnout -0.407 0.00 -0.253 -4.98 0.00 share of households equipped with a bathroom 0.557 0.00 0.341 10.07 0.00 pre-school participation rate of children aged 3-5 0.395 0.00 0.241 number of inhabitants per 1 medical doctor -0.207 0.00 -0.148 -0.06 0.00 number of inhabitants per 1 health care institution -0.075 0.14 -0.085 average lower secondary school exams results (literacy) -0.086 0.10 -0.067 baccalaureate results - Polish language (basic level) 0.119 0.02 0.098 Variable 2 Demographics Economic and labour market situation 0.33 -4.91 0.00 Social cohesion 0.35 Access to health care 0.02 Education 0.01 11.33 0.00 share of employment in agriculture -3.45 0.00 share of households equipped with a bathroom 4.26 0.00 Final model Page 316 0.37 Table 100. Association between district SMR for circulatory system diseases and socio-economic variables, total population, all ages Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.258 0.00 -0.122 -7.41 0.00 0.17 population density -0.204 0.00 -0.100 -0.06 0.00 old-age demographic dependency rate 0.136 0.01 0.091 revenue of district budget per capita -0.265 0.00 -0.131 -0.07 0.00 share of employment in hazardous conditions -0.043 0.40 -0.025 4.61 0.01 unemployment rate 0.224 0.00 0.116 3.84 0.00 share of employment in agriculture 0.261 0.00 0.119 1.13 0.01 Variable 2 Demographics Economic and labour market situation 0.16 Social cohesion library members per 1000 inhabitants -0.106 0.04 -0.047 local governments election turnout 0.174 0.00 0.082 -5.99 0.00 0.16 share of households equipped with a bathroom -0.385 0.00 -0.209 -6.75 0.00 pre-school participation rate of children aged 3-5 -0.207 0.00 -0.096 -2.78 0.00 number of inhabitants per 1 medical doctor 0.230 0.00 0.110 0.05 0.00 0.01 number of inhabitants per 1 health care institution 0.073 0.16 0.026 average lower secondary school exams results (literacy) -0.184 0.00 -0.088 -40.84 0.00 0.07 baccalaureate results - Polish language (basic level) -0.183 0.00 -0.085 feminization rate -3.90 0.01 0.29 population density -0.08 0.00 share of employment in agriculture -3.06 0.00 share of households equipped with a bathroom -10.27 0.00 local governments election turnout -4.53 0.00 Access to health care Education Final model Page 317 Table 101. Association between district SMR for circulatory system diseases and socio-economic variables, males, all ages Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.271 0.00 -0.136 -8.76 0.00 0.15 population density -0.224 0.00 -0.123 -0.05 0.00 old-age demographic dependency rate 0.132 0.01 0.083 revenue of district budget per capita -0.234 0.00 -0.116 -0.09 0.00 share of employment in hazardous conditions -0.077 0.14 -0.044 unemployment rate 0.253 0.00 0.149 4.40 0.00 share of employment in agriculture 0.236 0.00 0.104 Variable 2 Demographics Economic and labour market situation 0.14 Social cohesion library members per 1000 inhabitants -0.112 0.03 -0.048 local governments election turnout 0.160 0.00 0.076 -6.96 0.00 0.14 share of households equipped with a bathroom -0.373 0.00 -0.208 -7.17 0.00 pre-school participation rate of children aged 3-5 -0.214 0.00 -0.107 -2.81 0.00 number of inhabitants per 1 medical doctor 0.211 0.00 0.104 0.05 0.00 0.01 number of inhabitants per 1 health care institution 0.051 0.32 0.013 average lower secondary school exams results (literacy) -0.177 0.00 -0.089 -42.05 0.00 0.06 baccalaureate results - Polish language (basic level) -0.188 0.00 -0.105 feminization rate -4.25 0.01 0.22 population density -0.07 0.00 unemployment rate 3.87 0.00 pre-school participation rate of children aged 3-5 1.61 0.01 share of households equipped with a bathroom -6.83 0.00 local governments election turnout -6.90 0.00 Access to health care Education Final model Page 318 Table 102. Association between district SMR for circulatory system diseases and socio-economic variables, females, all ages Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.214 0.00 -0.102 -6.14 0.00 0.14 population density -0.155 0.00 -0.070 -0.06 0.00 old-age demographic dependency rate 0.127 0.01 0.091 revenue of district budget per capita -0.255 0.00 -0.132 -0.07 0.00 share of employment in hazardous conditions -0.006 0.91 -0.004 4.93 0.01 unemployment rate 0.185 0.00 0.094 3.44 0.01 share of employment in agriculture 0.241 0.00 0.116 1.17 0.01 Variable 2 Demographics Economic and labour market situation 0.13 Social cohesion library members per 1000 inhabitants -0.085 0.10 -0.033 0.36 0.03 local governments election turnout 0.154 0.00 0.071 -5.50 0.00 0.13 share of households equipped with a bathroom -0.359 0.00 -0.199 -7.07 0.00 pre-school participation rate of children aged 3-5 -0.170 0.00 -0.075 -2.68 0.00 number of inhabitants per 1 medical doctor 0.218 0.00 0.099 0.05 0.00 0.01 number of inhabitants per 1 health care institution 0.083 0.11 0.031 average lower secondary school exams results (literacy) -0.175 0.00 -0.091 -37.66 0.00 0.06 baccalaureate results - Polish language (basic level) -0.163 0.00 -0.069 population density -0.09 0.00 0.26 share of employment in agriculture -2.79 0.00 library members per 1000 inhabitants 0.32 0.02 share of households equipped with a bathroom -11.41 0.00 local governments election turnout -4.52 0.00 Access to health care Education Final model Page 319 Table 103. Association between district SMR for circulatory system diseases and socio-economic variables, total population, aged 0–64 Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.241 0.00 -0.124 -9.49 0.00 0.06 population density -0.206 0.00 -0.081 -0.03 0.03 old-age demographic dependency rate 0.178 0.00 0.155 7.07 0.01 revenue of district budget per capita -0.123 0.02 -0.050 -0.04 0.00 share of employment in hazardous conditions -0.058 0.26 -0.037 unemployment rate 0.223 0.00 0.130 7.05 0.00 share of employment in agriculture 0.134 0.01 0.040 Variable 2 Demographics Economic and labour market situation 0.05 Social cohesion library members per 1000 inhabitants -0.125 0.02 -0.047 local governments election turnout 0.087 0.09 0.027 -9.74 0.00 0.11 share of households equipped with a bathroom -0.335 0.00 -0.239 -9.93 0.00 pre-school participation rate of children aged 3-5 -0.189 0.00 -0.095 -1.41 0.02 number of inhabitants per 1 medical doctor 0.120 0.02 0.042 number of inhabitants per 1 health care institution -0.015 0.77 -0.030 average lower secondary school exams results (literacy) -0.247 0.00 -0.105 -43.08 0.00 0.07 baccalaureate results - Polish language (basic level) -0.183 0.00 -0.089 feminization rate -6.00 0.01 0.17 revenue of district budget per capita 0.04 0.01 share of households equipped with a bathroom -9.32 0.00 local governments election turnout average lower secondary school exams results (literacy) -9.97 0.00 -28.61 0.00 Access to health care Education Final model Page 320 Table 104. Association between district SMR for circulatory system diseases and socio-economic variables, males, aged 0–64 Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.272 0.00 -0.161 -10.18 0.00 0.09 population density -0.185 0.00 -0.083 -0.03 0.04 old-age demographic dependency rate 0.237 0.00 0.203 9.45 0.00 revenue of district budget per capita -0.152 0.00 -0.090 -0.04 0.00 share of employment in hazardous conditions -0.118 0.02 -0.089 unemployment rate 0.207 0.00 0.127 6.28 0.00 share of employment in agriculture 0.169 0.00 0.082 Variable 2 Demographics Economic and labour market situation 0.05 Social cohesion library members per 1000 inhabitants -0.120 0.02 -0.054 local governments election turnout 0.130 0.01 0.064 -7.41 0.00 0.13 share of households equipped with a bathroom -0.372 0.00 -0.278 -12.23 0.00 pre-school participation rate of children aged 3-5 -0.194 0.00 -0.108 number of inhabitants per 1 medical doctor 0.093 0.07 0.032 number of inhabitants per 1 health care institution -0.043 0.41 -0.043 average lower secondary school exams results (literacy) -0.181 0.00 -0.077 -36.99 0.00 0.04 baccalaureate results - Polish language (basic level) -0.150 0.00 -0.075 feminization rate -5.51 0.01 0.15 old-age demographic dependency rate 7.13 0.01 share of households equipped with a bathroom -6.31 0.00 local governments election turnout average lower secondary school exams results (literacy) -6.78 0.00 -21.57 0.00 Access to health care Education Final model Page 321 Table 105. Association between district SMR for circulatory system diseases and socio-economic variables, females, aged 0–64 Spearman correlation coefficient p-value RCI feminization rate 0.071 0.17 0.038 population density -0.005 0.93 0.005 old-age demographic dependency rate -0.038 0.46 0.021 revenue of district budget per capita 0.149 0.00 0.097 share of employment in hazardous conditions 0.192 0.00 0.108 8.00 0.01 unemployment rate 0.104 0.04 0.101 9.51 0.00 share of employment in agriculture -0.187 0.00 -0.129 -2.56 0.00 Variable Regression coefficient (x 1000) p-value 2 R Demographics Economic and labour market situation 0.06 Social cohesion library members per 1000 inhabitants -0.014 0.79 0.003 local governments election turnout -0.182 0.00 -0.127 -17.17 0.00 0.05 share of households equipped with a bathroom 0.007 0.90 -0.076 -6.12 0.00 pre-school participation rate of children aged 3-5 0.055 0.29 0.005 number of inhabitants per 1 medical doctor 0.027 0.60 -0.002 number of inhabitants per 1 health care institution -0.001 0.99 0.010 average lower secondary school exams results (literacy) -0.215 0.00 -0.152 -30.01 0.00 0.04 baccalaureate results - Polish language (basic level) -0.114 0.03 -0.094 share of employment in agriculture -8.96 0.00 0.21 share of households equipped with a bathroom -18.55 0.00 local governments election turnout average lower secondary school exams results (literacy) -8.50 0.00 -43.93 0.00 Access to health care Education Final model Page 322 Table 106. Association between district SMR for circulatory system diseases and socio-economic variables, total population, aged 65 years and over Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.244 0.00 -0.118 -6.43 0.00 0.19 population density -0.195 0.00 -0.098 -0.07 0.00 old-age demographic dependency rate 0.109 0.03 0.072 revenue of district budget per capita -0.289 0.00 -0.153 -0.08 0.00 share of employment in hazardous conditions -0.035 0.49 -0.023 4.85 0.01 unemployment rate 0.203 0.00 0.098 3.08 0.01 share of employment in agriculture 0.283 0.00 0.141 1.31 0.00 Variable 2 Demographics Economic and labour market situation 0.17 Social cohesion library members per 1000 inhabitants -0.101 0.05 -0.046 0.34 0.03 local governments election turnout 0.182 0.00 0.095 -5.08 0.00 0.14 share of households equipped with a bathroom -0.364 0.00 -0.193 -6.27 0.00 pre-school participation rate of children aged 3-5 -0.197 0.00 -0.090 -3.32 0.00 number of inhabitants per 1 medical doctor 0.251 0.00 0.120 0.06 0.00 0.02 number of inhabitants per 1 health care institution 0.093 0.07 0.043 average lower secondary school exams results (literacy) -0.162 0.00 -0.076 -40.21 0.00 0.06 baccalaureate results - Polish language (basic level) -0.166 0.00 -0.080 population density -0.07 0.00 0.29 revenue of district budget per capita -0.04 0.00 share of employment in agriculture -2.88 0.00 library members per 1000 inhabitants 0.31 0.02 share of households equipped with a bathroom -9.04 0.00 Access to health care Education Final model Page 323 Table 107. Association between district SMR for circulatory system diseases and socio-economic variables, males, aged 65 years and over Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.235 0.00 -0.117 -7.00 0.00 0.18 population density -0.232 0.00 -0.138 -0.07 0.00 old-age demographic dependency rate 0.037 0.47 0.016 revenue of district budget per capita -0.247 0.00 -0.129 -0.10 0.00 share of employment in hazardous conditions -0.032 0.53 -0.019 unemployment rate 0.243 0.00 0.134 3.71 0.00 share of employment in agriculture 0.243 0.00 0.117 Variable 2 Demographics Economic and labour market situation 0.15 Social cohesion library members per 1000 inhabitants -0.102 0.05 -0.048 local governments election turnout 0.158 0.00 0.078 -6.42 0.00 0.10 share of households equipped with a bathroom -0.307 0.00 -0.153 -5.43 0.00 pre-school participation rate of children aged 3-5 -0.197 0.00 -0.094 -3.55 0.00 number of inhabitants per 1 medical doctor 0.256 0.00 0.136 0.06 0.00 0.02 number of inhabitants per 1 health care institution 0.093 0.07 0.049 average lower secondary school exams results (literacy) -0.169 0.00 -0.096 -43.86 0.00 0.06 baccalaureate results - Polish language (basic level) -0.184 0.00 -0.117 population density -0.08 0.00 0.23 revenue of district budget per capita -0.03 0.02 unemployment rate 3.68 0.00 pre-school participation rate of children aged 3-5 1.68 0.01 share of households equipped with a bathroom -5.65 0.00 local governments election turnout -5.14 0.00 Access to health care Education Final model Page 324 Table 108. Association between district SMR for circulatory system diseases and socio-economic variables, females, aged 65 years and over Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.237 0.00 -0.117 -5.16 0.00 0.17 population density -0.165 0.00 -0.076 -0.08 0.00 old-age demographic dependency rate 0.140 0.01 0.096 3.85 0.04 revenue of district budget per capita -0.294 0.00 -0.160 -0.07 0.00 share of employment in hazardous conditions -0.032 0.54 -0.021 4.68 0.01 unemployment rate 0.180 0.00 0.089 3.03 0.02 share of employment in agriculture 0.285 0.00 0.145 1.47 0.00 Variable 2 Demographics Economic and labour market situation 0.15 Social cohesion library members per 1000 inhabitants -0.090 0.08 -0.040 0.40 0.01 local governments election turnout 0.183 0.00 0.096 -4.40 0.00 0.14 share of households equipped with a bathroom -0.381 0.00 -0.209 -6.92 0.00 pre-school participation rate of children aged 3-5 -0.185 0.00 -0.085 -2.91 0.00 number of inhabitants per 1 medical doctor 0.235 0.00 0.108 0.05 0.00 0.01 number of inhabitants per 1 health care institution 0.092 0.07 0.038 average lower secondary school exams results (literacy) -0.159 0.00 -0.076 -37.89 0.00 0.05 baccalaureate results - Polish language (basic level) -0.152 0.00 -0.060 population density -0.07 0.00 0.27 revenue of district budget per capita -0.03 0.00 share of employment in agriculture -2.88 0.00 library members per 1000 inhabitants 0.38 0.01 share of households equipped with a bathroom -9.81 0.00 Access to health care Education Final model Page 325 Table 109. Association between district SMR for respiratory system diseases and socio-economic variables, total population, all ages Spearman correlation coefficient p-value RCI feminization rate -0.207 0.00 -0.212 population density -0.238 0.00 -0.241 old-age demographic dependency rate -0.011 0.83 -0.084 revenue of district budget per capita -0.052 0.31 -0.101 share of employment in hazardous conditions -0.136 0.01 -0.177 unemployment rate 0.210 0.00 0.226 share of employment in agriculture 0.111 0.03 0.115 Variable Regression coefficient (x 1000) p-value R 0.06 0.00 0.05 14.74 0.00 2 Demographics Economic and labour market situation Social cohesion library members per 1000 inhabitants -0.161 0.00 -0.136 local governments election turnout 0.058 0.26 0.029 share of households equipped with a bathroom -0.175 0.00 -0.146 pre-school participation rate of children aged 3-5 -0.271 0.00 -0.265 number of inhabitants per 1 medical doctor 0.092 0.07 0.076 number of inhabitants per 1 health care institution 0.063 0.22 0.056 average lower secondary school exams results (literacy) -0.228 0.00 -0.219 baccalaureate results - Polish language (basic level) -0.016 0.76 -0.006 0.06 -1.93 0.01 -36.48 0.00 0.06 revenue of district budget per capita 0.12 0.00 0.11 unemployment rate 7.19 0.02 pre-school participation rate of children aged 3-5 average lower secondary school exams results (literacy) -2.50 0.03 -40.13 0.00 Access to health care Education Final model Page 326 Table 110. Association between district SMR for respiratory system diseases and socio-economic variables, males, all ages Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.314 0.00 -0.283 -12.04 0.00 0.07 population density -0.323 0.00 -0.289 old-age demographic dependency rate 0.037 0.47 -0.014 revenue of district budget per capita -0.200 0.00 -0.187 0.05 0.03 0.14 share of employment in hazardous conditions -0.169 0.00 -0.169 unemployment rate 0.301 0.00 0.268 17.69 0.00 share of employment in agriculture 0.250 0.00 0.200 2.75 0.00 Variable 2 Demographics Economic and labour market situation Social cohesion library members per 1000 inhabitants -0.191 0.00 -0.151 local governments election turnout 0.131 0.01 0.076 -6.26 0.03 0.15 share of households equipped with a bathroom -0.317 0.00 -0.233 -7.73 0.00 pre-school participation rate of children aged 3-5 -0.379 0.00 -0.329 -3.14 0.00 number of inhabitants per 1 medical doctor 0.173 0.00 0.135 0.06 0.00 0.02 number of inhabitants per 1 health care institution 0.099 0.05 0.086 average lower secondary school exams results (literacy) -0.302 0.00 -0.246 -63.24 0.00 0.11 baccalaureate results - Polish language (basic level) -0.081 0.12 -0.043 revenue of district budget per capita 0.10 0.00 0.20 unemployment rate 10.57 0.00 share of households equipped with a bathroom -12.38 0.00 local governments election turnout average lower secondary school exams results (literacy) -7.01 0.01 -51.05 0.00 Access to health care Education Final model Page 327 Table 111. Association between district SMR for respiratory system diseases and socio-economic variables, females, all ages Spearman correlation coefficient p-value RCI feminization rate 0.001 0.98 -0.061 population density -0.053 0.31 -0.099 old-age demographic dependency rate -0.107 0.04 -0.164 revenue of district budget per capita 0.198 0.00 0.066 share of employment in hazardous conditions -0.039 0.44 -0.124 unemployment rate 0.069 0.18 share of employment in agriculture -0.148 0.00 Variable Regression coefficient (x 1000) p-value 2 R Demographics 0.00 0.08 0.00 0.12 0.00 0.144 11.61 0.00 -0.066 -2.28 0.04 Economic and labour market situation 0.06 Social cohesion library members per 1000 inhabitants -0.069 0.18 -0.079 local governments election turnout -0.103 0.04 -0.048 share of households equipped with a bathroom 0.089 0.08 0.020 pre-school participation rate of children aged 3-5 -0.031 0.55 -0.102 number of inhabitants per 1 medical doctor -0.059 0.25 -0.043 number of inhabitants per 1 health care institution -0.010 0.84 -0.014 average lower secondary school exams results (literacy) -0.093 0.07 -0.135 baccalaureate results - Polish language (basic level) 0.068 0.18 0.067 0.01 7.72 0.00 -0.06 0.02 Access to health care 0.00 Education 0.00 15.54 0.04 revenue of district budget per capita 0.12 0.00 unemployment rate 11.61 0.00 share of employment in agriculture -2.28 0.04 Final model Page 328 0.06 Table 112. Association between district SMR for respiratory system diseases and socio-economic variables, total population, aged 0–64 Spearman correlation coefficient p-value RCI feminization rate -0.083 0.10 -0.137 population density -0.098 0.06 -0.136 old-age demographic dependency rate 0.027 0.60 0.009 revenue of district budget per capita 0.075 0.15 0.036 share of employment in hazardous conditions -0.018 0.72 -0.078 unemployment rate 0.272 0.00 0.289 17.71 0.00 share of employment in agriculture -0.059 0.25 -0.045 -4.00 0.00 Variable Regression coefficient (x 1000) p-value 2 R Demographics Economic and labour market situation 0.08 Social cohesion library members per 1000 inhabitants -0.090 0.08 -0.046 local governments election turnout -0.098 0.06 -0.114 -19.11 0.00 0.04 share of households equipped with a bathroom -0.095 0.07 -0.098 -8.24 0.00 pre-school participation rate of children aged 3-5 -0.088 0.09 -0.115 number of inhabitants per 1 medical doctor 0.061 0.24 0.017 number of inhabitants per 1 health care institution 0.005 0.92 0.009 average lower secondary school exams results (literacy) -0.224 0.00 -0.210 -36.88 0.00 0.04 baccalaureate results - Polish language (basic level) -0.074 0.15 -0.054 unemployment rate 9.22 0.01 0.16 share of employment in agriculture -9.90 0.00 share of households equipped with a bathroom -20.53 0.00 local governments election turnout average lower secondary school exams results (literacy) -9.52 0.01 -31.76 0.01 Access to health care Education Final model Page 329 Table 113. Association between district SMR for respiratory system diseases and socio-economic variables, males, aged 0–64 Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.114 0.03 -0.155 -10.96 0.01 0.02 population density -0.095 0.06 -0.124 0.08 0.00 old-age demographic dependency rate 0.104 0.04 0.092 revenue of district budget per capita 0.016 0.76 -0.006 0.08 0.00 share of employment in hazardous conditions -0.064 0.21 -0.088 unemployment rate 0.232 0.00 0.259 18.00 0.00 share of employment in agriculture -0.005 0.92 -0.011 Variable 2 Demographics Economic and labour market situation 0.05 Social cohesion library members per 1000 inhabitants -0.114 0.03 -0.058 local governments election turnout -0.069 0.18 -0.095 -19.80 0.00 0.05 share of households equipped with a bathroom -0.148 0.00 -0.156 -10.88 0.00 pre-school participation rate of children aged 3-5 -0.102 0.05 -0.116 number of inhabitants per 1 medical doctor 0.064 0.21 0.022 number of inhabitants per 1 health care institution 0.013 0.81 0.022 average lower secondary school exams results (literacy) -0.180 0.00 -0.181 -32.15 0.00 0.02 baccalaureate results - Polish language (basic level) -0.060 0.24 -0.064 revenue of district budget per capita 0.18 0.00 0.14 unemployment rate 14.41 0.00 share of households equipped with a bathroom -16.60 0.00 local governments election turnout average lower secondary school exams results (literacy) -24.93 0.00 -33.78 0.01 Access to health care Education Final model Page 330 Table 114. Association between district SMR for respiratory system diseases and socio-economic variables, females, aged 0–64 Spearman correlation coefficient p-value RCI 0.076 0.14 -0.056 population density 0.023 0.66 -0.109 0.14 0.00 old-age demographic dependency rate -0.109 0.03 -0.140 -22.81 0.01 revenue of district budget per capita 0.222 0.00 0.090 share of employment in hazardous conditions 0.091 0.08 0.008 unemployment rate 0.169 0.00 0.256 17.30 0.00 share of employment in agriculture -0.210 0.00 -0.115 -10.14 0.00 -25.86 0.00 unemployment rate 17.30 0.00 share of employment in agriculture -10.14 0.00 Variable Regression coefficient (x 1000) p-value 2 R Demographics feminization rate 0.04 Economic and labour market situation 0.08 Social cohesion library members per 1000 inhabitants 0.024 0.64 0.006 local governments election turnout -0.192 0.00 -0.097 share of households equipped with a bathroom 0.108 0.04 0.027 pre-school participation rate of children aged 3-5 0.069 0.18 -0.064 number of inhabitants per 1 medical doctor -0.032 0.53 0.013 number of inhabitants per 1 health care institution -0.013 0.80 -0.056 average lower secondary school exams results (literacy) -0.120 0.02 -0.254 baccalaureate results - Polish language (basic level) -0.009 0.86 -0.077 0.04 Access to health care Education Final model Page 331 0.08 Table 115. Association between district SMR for respiratory system diseases and socio-economic variables, total population, aged 65 years and over Spearman correlation coefficient p-value RCI feminization rate -0.215 0.00 -0.202 population density -0.261 0.00 -0.233 old-age demographic dependency rate -0.040 0.44 -0.097 revenue of district budget per capita -0.084 0.10 -0.114 share of employment in hazardous conditions -0.155 0.00 -0.179 unemployment rate 0.181 0.00 share of employment in agriculture 0.148 Variable Regression coefficient (x 1000) p-value R 0.09 0.00 0.06 0.182 13.23 0.00 0.00 0.132 2.31 0.01 2 Demographics Economic and labour market situation Social cohesion library members per 1000 inhabitants -0.173 0.00 -0.140 local governments election turnout 0.094 0.07 0.059 share of households equipped with a bathroom -0.165 0.00 -0.142 pre-school participation rate of children aged 3-5 -0.294 0.00 -0.264 number of inhabitants per 1 medical doctor 0.102 0.05 0.075 number of inhabitants per 1 health care institution 0.080 0.12 0.057 average lower secondary school exams results (literacy) -0.218 0.00 -0.199 baccalaureate results - Polish language (basic level) -0.001 0.99 0.008 0.07 -2.24 0.00 -35.45 0.00 0.05 revenue of district budget per capita 0.13 0.00 0.10 pre-school participation rate of children aged 3-5 average lower secondary school exams results (literacy) -4.14 0.00 -44.27 0.00 Access to health care Education Final model Page 332 Table 116. Association between district SMR for respiratory system diseases and socio-economic variables, males, aged 65 years and over Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.339 0.00 -0.278 -8.14 0.02 0.11 population density -0.381 0.00 -0.294 -0.05 0.01 old-age demographic dependency rate -0.021 0.68 -0.050 revenue of district budget per capita -0.250 0.00 -0.204 0.05 0.02 share of employment in hazardous conditions -0.186 0.00 -0.159 unemployment rate 0.286 0.00 0.232 18.07 0.00 share of employment in agriculture 0.312 0.00 0.224 4.04 0.00 Variable 2 Demographics Economic and labour market situation 0.15 Social cohesion library members per 1000 inhabitants -0.201 0.00 -0.152 local governments election turnout 0.195 0.00 0.115 0.16 share of households equipped with a bathroom -0.315 0.00 -0.224 -5.19 0.04 pre-school participation rate of children aged 3-5 -0.427 0.00 -0.339 -4.29 0.00 number of inhabitants per 1 medical doctor 0.206 0.00 0.148 0.08 0.00 0.03 number of inhabitants per 1 health care institution 0.129 0.01 0.092 average lower secondary school exams results (literacy) -0.317 0.00 -0.245 -70.98 0.00 0.11 baccalaureate results - Polish language (basic level) -0.082 0.11 -0.038 revenue of district budget per capita 0.08 0.00 0.20 unemployment rate 9.94 0.00 -10.14 0.00 -55.94 0.00 Access to health care Education Final model share of households equipped with a bathroom average lower secondary school exams results (literacy) Page 333 Table 117. Association between district SMR for respiratory system diseases and socio-economic variables, females, aged 65 years and over Spearman correlation coefficient p-value RCI feminization rate -0.012 0.81 -0.052 population density -0.067 0.20 -0.087 old-age demographic dependency rate -0.097 0.06 -0.160 revenue of district budget per capita 0.161 0.00 0.065 share of employment in hazardous conditions -0.074 0.15 -0.121 unemployment rate 0.043 0.41 0.109 share of employment in agriculture -0.115 0.02 -0.062 Variable Regression coefficient (x 1000) p-value 2 R Demographics 0.00 0.09 0.00 0.15 0.00 9.06 0.02 Economic and labour market situation 0.04 Social cohesion library members per 1000 inhabitants -0.080 0.12 -0.085 local governments election turnout -0.075 0.15 -0.036 share of households equipped with a bathroom 0.077 0.13 0.023 pre-school participation rate of children aged 3-5 -0.051 0.32 -0.092 number of inhabitants per 1 medical doctor -0.053 0.31 -0.047 number of inhabitants per 1 health care institution 0.003 0.95 -0.013 average lower secondary school exams results (literacy) -0.075 0.15 -0.105 baccalaureate results - Polish language (basic level) 0.086 0.09 0.081 0.00 7.82 0.00 -0.06 0.02 Access to health care 0.00 Education 0.00 19.68 0.02 revenue of district budget per capita 0.15 0.00 unemployment rate 9.06 0.02 Final model Page 334 0.05 Table 118. Association between district SMR for digestive system diseases and socio-economic variables, total population, all ages Spearman correlation coefficient p-value RCI 0.142 0.01 0.215 population density 0.205 0.00 0.333 old-age demographic dependency rate -0.023 0.65 0.091 0.419 0.00 0.365 share of employment in hazardous conditions 0.174 0.00 0.229 unemployment rate -0.082 0.11 -0.033 share of employment in agriculture -0.399 0.00 -0.431 Variable Regression coefficient (x 1000) p-value 2 R Demographics feminization rate 0.09 0.08 0.00 Economic and labour market situation revenue of district budget per capita 0.15 -4.76 0.00 Social cohesion library members per 1000 inhabitants 0.129 0.01 0.169 local governments election turnout -0.221 0.00 -0.355 -14.23 0.00 0.11 share of households equipped with a bathroom 0.153 0.00 0.061 -8.09 0.00 pre-school participation rate of children aged 3-5 0.273 0.00 0.319 4.47 0.00 number of inhabitants per 1 medical doctor -0.214 0.00 -0.294 -0.07 0.00 0.03 number of inhabitants per 1 health care institution -0.144 0.01 -0.173 average lower secondary school exams results (literacy) 0.024 0.65 0.018 baccalaureate results - Polish language (basic level) 0.029 0.58 0.040 share of employment in agriculture -11.47 0.00 0.29 share of households equipped with a bathroom -22.12 0.00 local governments election turnout -6.43 0.00 Access to health care Education Final model Page 335 Table 119. Association between district SMR for digestive system diseases and socio-economic variables, males, all ages Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate 0.086 0.09 0.151 -6.39 0.02 0.08 population density 0.198 0.00 0.257 0.11 0.00 old-age demographic dependency rate 0.065 0.21 0.103 0.348 0.00 0.281 share of employment in hazardous conditions 0.126 0.01 0.154 unemployment rate -0.030 0.56 0.038 5.28 0.01 share of employment in agriculture -0.346 0.00 -0.345 -5.18 0.00 Variable 2 Demographics Economic and labour market situation revenue of district budget per capita 0.11 Social cohesion library members per 1000 inhabitants 0.103 0.05 0.140 local governments election turnout -0.210 0.00 -0.301 -15.74 0.00 0.10 share of households equipped with a bathroom 0.082 0.11 -0.006 -11.37 0.00 pre-school participation rate of children aged 3-5 0.242 0.00 0.241 5.08 0.00 number of inhabitants per 1 medical doctor -0.222 0.00 -0.237 -0.08 0.00 0.03 number of inhabitants per 1 health care institution -0.146 0.00 -0.149 average lower secondary school exams results (literacy) 0.056 0.28 0.018 baccalaureate results - Polish language (basic level) -0.003 0.95 0.016 share of employment in agriculture -12.70 0.00 0.28 share of households equipped with a bathroom -26.70 0.00 local governments election turnout -7.16 0.00 Access to health care Education Final model Page 336 Table 120. Association between district SMR for digestive system diseases and socio-economic variables, females, all ages Spearman correlation coefficient p-value RCI 0.241 0.00 0.222 population density 0.256 0.00 0.287 old-age demographic dependency rate -0.121 0.02 0.006 0.459 0.00 0.382 share of employment in hazardous conditions 0.228 0.00 0.262 unemployment rate -0.176 0.00 -0.098 share of employment in agriculture -0.429 0.00 -0.439 Variable Regression coefficient (x 1000) p-value 2 R Demographics feminization rate 0.09 0.11 0.00 Economic and labour market situation revenue of district budget per capita 0.16 -6.05 0.00 -11.63 0.00 Social cohesion library members per 1000 inhabitants 0.177 0.00 0.141 local governments election turnout -0.247 0.00 -0.318 0.10 share of households equipped with a bathroom 0.255 0.00 0.152 pre-school participation rate of children aged 3-5 0.317 0.00 0.313 3.65 0.00 number of inhabitants per 1 medical doctor -0.200 0.00 -0.263 -0.08 0.00 number of inhabitants per 1 health care institution -0.118 0.02 -0.173 average lower secondary school exams results (literacy) 0.033 0.52 -0.017 baccalaureate results - Polish language (basic level) 0.099 0.05 0.054 Access to health care 0.02 Education 0.00 15.16 0.01 population density 0.04 0.01 share of employment in agriculture -3.92 0.00 local governments election turnout -6.32 0.01 Final model Page 337 0.16 Table 121. Association between district SMR for digestive system diseases and socio-economic variables, total population, aged 0–64 Spearman correlation coefficient p-value RCI feminization rate -0.083 0.10 -0.137 population density -0.098 0.06 -0.136 old-age demographic dependency rate 0.027 0.60 0.009 revenue of district budget per capita 0.075 0.15 0.036 share of employment in hazardous conditions -0.018 0.72 -0.078 unemployment rate 0.272 0.00 0.289 17.71 0.00 share of employment in agriculture -0.059 0.25 -0.045 -4.00 0.00 Variable Regression coefficient (x 1000) p-value 2 R Demographics Economic and labour market situation 0.08 Social cohesion library members per 1000 inhabitants -0.090 0.08 -0.046 local governments election turnout -0.098 0.06 -0.114 -19.11 0.00 0.04 share of households equipped with a bathroom -0.095 0.07 -0.098 -8.24 0.00 pre-school participation rate of children aged 3-5 -0.088 0.09 -0.115 number of inhabitants per 1 medical doctor 0.061 0.24 0.017 number of inhabitants per 1 health care institution 0.005 0.92 0.009 average lower secondary school exams results (literacy) -0.224 0.00 -0.210 -36.88 0.00 0.04 baccalaureate results - Polish language (basic level) -0.074 0.15 -0.054 unemployment rate 9.22 0.01 0.16 share of employment in agriculture -9.90 0.00 share of households equipped with a bathroom -20.53 0.00 local governments election turnout average lower secondary school exams results (literacy) -9.52 0.01 -31.76 0.01 Access to health care Education Final model Page 338 Table 122. Association between district SMR for digestive system diseases and socio-economic variables, males, aged 0–64 Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.114 0.03 -0.155 -10.96 0.01 0.02 population density -0.095 0.06 -0.124 0.08 0.00 old-age demographic dependency rate 0.104 0.04 0.092 revenue of district budget per capita 0.016 0.76 -0.006 0.08 0.00 share of employment in hazardous conditions -0.064 0.21 -0.088 unemployment rate 0.232 0.00 0.259 18.00 0.00 share of employment in agriculture -0.005 0.92 -0.011 Variable 2 Demographics Economic and labour market situation 0.05 Social cohesion library members per 1000 inhabitants -0.114 0.03 -0.058 local governments election turnout -0.069 0.18 -0.095 -19.80 0.00 0.05 share of households equipped with a bathroom -0.148 0.00 -0.156 -10.88 0.00 pre-school participation rate of children aged 3-5 -0.102 0.05 -0.116 number of inhabitants per 1 medical doctor 0.064 0.21 0.022 number of inhabitants per 1 health care institution 0.013 0.81 0.022 average lower secondary school exams results (literacy) -0.180 0.00 -0.181 -32.15 0.00 0.02 baccalaureate results - Polish language (basic level) -0.060 0.24 -0.064 revenue of district budget per capita 0.18 0.00 0.14 unemployment rate 14.41 0.00 share of households equipped with a bathroom -16.60 0.00 local governments election turnout average lower secondary school exams results (literacy) -24.93 0.00 -33.78 0.01 Access to health care Education Final model Page 339 Table 123. Association between district SMR for digestive system diseases and socio-economic variables, females, aged 0–64 Spearman correlation coefficient p-value RCI 0.076 0.14 -0.056 population density 0.023 0.66 -0.109 0.14 0.00 old-age demographic dependency rate -0.109 0.03 -0.140 -22.81 0.01 revenue of district budget per capita 0.222 0.00 0.090 share of employment in hazardous conditions 0.091 0.08 0.008 unemployment rate 0.169 0.00 0.256 17.30 0.00 share of employment in agriculture -0.210 0.00 -0.115 -10.14 0.00 -25.86 0.00 unemployment rate 17.30 0.00 share of employment in agriculture -10.14 0.00 Variable Regression coefficient (x 1000) p-value 2 R Demographics feminization rate 0.04 Economic and labour market situation 0.08 Social cohesion library members per 1000 inhabitants 0.024 0.64 0.006 local governments election turnout -0.192 0.00 -0.097 share of households equipped with a bathroom 0.108 0.04 0.027 pre-school participation rate of children aged 3-5 0.069 0.18 -0.064 number of inhabitants per 1 medical doctor -0.032 0.53 0.013 number of inhabitants per 1 health care institution -0.013 0.80 -0.056 average lower secondary school exams results (literacy) -0.120 0.02 -0.254 baccalaureate results - Polish language (basic level) -0.009 0.86 -0.077 0.04 Access to health care Education Final model Page 340 0.08 Table 124. Association between district SMR for digestive system diseases and socio-economic variables, total population, aged 65 years and over Spearman correlation coefficient p-value RCI 0.169 0.00 0.165 population density 0.098 0.06 0.091 0.06 0.00 old-age demographic dependency rate -0.220 0.00 -0.198 -8.40 0.00 0.370 0.00 0.304 share of employment in hazardous conditions 0.183 0.00 0.204 unemployment rate -0.101 0.05 -0.048 share of employment in agriculture -0.329 0.00 -0.312 Variable Regression coefficient (x 1000) p-value 2 R Demographics feminization rate 0.07 Economic and labour market situation revenue of district budget per capita 0.09 -3.40 0.00 -8.71 0.00 Social cohesion library members per 1000 inhabitants 0.075 0.14 0.060 local governments election turnout -0.162 0.00 -0.174 0.04 share of households equipped with a bathroom 0.228 0.00 0.200 pre-school participation rate of children aged 3-5 0.216 0.00 0.201 1.30 0.02 number of inhabitants per 1 medical doctor -0.113 0.03 -0.095 -0.03 0.01 0.00 number of inhabitants per 1 health care institution -0.110 0.03 -0.122 average lower secondary school exams results (literacy) -0.018 0.73 -0.062 baccalaureate results - Polish language (basic level) 0.051 0.32 0.034 share of employment in agriculture -2.70 0.00 0.09 local governments election turnout -4.93 0.03 Access to health care Education Final model Page 341 Table 125. Association between district SMR for digestive system diseases and socio-economic variables, males, aged 65 years and over Spearman correlation coefficient p-value RCI 0.110 0.03 0.087 population density 0.036 0.48 0.009 0.05 0.00 old-age demographic dependency rate -0.174 0.00 -0.179 -10.45 0.01 0.290 0.00 0.221 share of employment in hazardous conditions 0.149 0.00 0.161 unemployment rate -0.003 0.95 0.054 5.94 0.01 share of employment in agriculture -0.269 0.00 -0.224 -3.99 0.00 -11.85 0.00 unemployment rate 5.46 0.02 share of employment in agriculture -3.03 0.00 local governments election turnout -6.32 0.03 Variable Regression coefficient (x 1000) p-value 2 R Demographics feminization rate 0.04 Economic and labour market situation revenue of district budget per capita 0.07 Social cohesion library members per 1000 inhabitants -0.002 0.97 0.009 local governments election turnout -0.158 0.00 -0.107 share of households equipped with a bathroom 0.161 0.00 0.138 pre-school participation rate of children aged 3-5 0.152 0.00 0.122 number of inhabitants per 1 medical doctor -0.079 0.12 -0.062 number of inhabitants per 1 health care institution -0.101 0.05 -0.088 average lower secondary school exams results (literacy) -0.071 0.17 -0.098 baccalaureate results - Polish language (basic level) -0.020 0.70 -0.013 0.03 Access to health care Education Final model Page 342 0.07 Table 126. Association between district SMR for digestive system diseases and socio-economic variables, females, aged 65 years and over Spearman correlation coefficient p-value RCI 0.172 0.00 0.126 population density 0.147 0.00 0.083 old-age demographic dependency rate -0.152 0.00 -0.157 0.330 0.00 0.244 share of employment in hazardous conditions 0.164 0.00 0.154 unemployment rate -0.159 0.00 -0.076 share of employment in agriculture -0.288 0.00 -0.255 Variable Regression coefficient (x 1000) p-value 2 R Demographics feminization rate 0.03 0.07 0.00 Economic and labour market situation revenue of district budget per capita 0.06 -3.86 0.00 -7.39 0.00 Social cohesion library members per 1000 inhabitants 0.138 0.01 0.088 local governments election turnout -0.137 0.01 -0.142 0.03 share of households equipped with a bathroom 0.194 0.00 0.153 pre-school participation rate of children aged 3-5 0.216 0.00 0.172 2.30 0.00 number of inhabitants per 1 medical doctor -0.099 0.05 -0.099 -0.04 0.01 number of inhabitants per 1 health care institution -0.094 0.07 -0.109 average lower secondary school exams results (literacy) 0.054 0.30 -0.057 baccalaureate results - Polish language (basic level) 0.111 0.03 0.043 Access to health care 0.00 Education 0.01 12.80 0.01 -3.86 0.00 Final model share of employment in agriculture Page 343 0.06 Table 127. Association between district SMR for ill-defined causes and socio-economic variables, total population, all ages Spearman correlation coefficient p-value RCI feminization rate -0.164 0.00 -0.176 population density -0.193 0.00 -0.162 old-age demographic dependency rate 0.029 0.58 0.076 revenue of district budget per capita -0.096 0.06 share of employment in hazardous conditions -0.151 unemployment rate 0.196 share of employment in agriculture 0.108 Variable Regression coefficient (x 1000) p-value R -0.120 0.07 0.03 0.05 0.00 -0.126 -18.89 0.00 0.00 0.127 16.82 0.00 0.04 0.110 2 Demographics Economic and labour market situation Social cohesion library members per 1000 inhabitants 0.000 1.00 0.010 local governments election turnout 0.110 0.03 0.075 -11.80 0.02 0.03 share of households equipped with a bathroom -0.159 0.00 -0.158 -12.58 0.00 pre-school participation rate of children aged 3-5 -0.168 0.00 -0.144 number of inhabitants per 1 medical doctor 0.062 0.23 0.081 number of inhabitants per 1 health care institution 0.158 0.00 0.117 average lower secondary school exams results (literacy) -0.156 0.00 -0.084 baccalaureate results - Polish language (basic level) -0.128 0.01 -0.090 Access to health care Education 0.02 -21.67 0.04 revenue of district budget per capita 0.15 0.00 unemployment rate 17.24 0.00 share of employment in hazardous conditions -16.39 0.01 share of households equipped with a bathroom -15.50 0.00 local governments election turnout -19.04 0.00 Final model Page 344 0.07 Table 128. Association between district SMR for ill-defined causes and socio-economic variables, males, all ages Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.146 0.00 -0.164 -13.54 0.02 0.01 population density -0.121 0.02 -0.080 0.16 0.00 old-age demographic dependency rate 0.090 0.08 0.106 revenue of district budget per capita -0.026 0.61 -0.069 0.12 0.00 share of employment in hazardous conditions -0.151 0.00 -0.154 -22.63 0.00 unemployment rate 0.165 0.00 0.108 15.63 0.00 share of employment in agriculture 0.074 0.15 0.078 Variable 2 Demographics Economic and labour market situation 0.04 Social cohesion library members per 1000 inhabitants -0.011 0.83 0.038 local governments election turnout 0.092 0.07 0.048 -10.85 0.05 0.04 share of households equipped with a bathroom -0.173 0.00 -0.166 -26.53 0.00 pre-school participation rate of children aged 3-5 -0.123 0.02 -0.102 7.98 0.00 number of inhabitants per 1 medical doctor 0.042 0.42 0.024 number of inhabitants per 1 health care institution 0.125 0.01 0.084 average lower secondary school exams results (literacy) -0.067 0.20 0.011 baccalaureate results - Polish language (basic level) -0.092 0.07 -0.042 feminization rate 16.83 0.01 population density 0.21 0.00 unemployment rate 20.63 0.00 share of households equipped with a bathroom -25.33 0.00 Access to health care Education Final model Page 345 0.08 Table 129. Association between district SMR for ill-defined causes and socio-economic variables, females, all ages Spearman correlation coefficient p-value RCI feminization rate -0.105 0.04 -0.126 population density -0.234 0.00 -0.195 old-age demographic dependency rate -0.075 0.14 0.012 revenue of district budget per capita -0.119 0.02 -0.142 share of employment in hazardous conditions -0.095 0.07 -0.060 -14.88 0.03 unemployment rate 0.190 0.00 0.103 14.93 0.00 share of employment in agriculture 0.088 0.09 0.097 Variable Regression coefficient (x 1000) p-value 2 R Demographics Economic and labour market situation 0.04 Social cohesion library members per 1000 inhabitants -0.011 0.83 0.007 local governments election turnout 0.072 0.16 0.062 0.00 share of households equipped with a bathroom -0.069 0.18 -0.089 pre-school participation rate of children aged 3-5 -0.168 0.00 -0.139 number of inhabitants per 1 medical doctor 0.086 0.10 0.066 number of inhabitants per 1 health care institution 0.178 0.00 0.102 0.04 0.01 average lower secondary school exams results (literacy) -0.248 0.00 -0.167 -54.80 0.00 0.05 baccalaureate results - Polish language (basic level) -0.141 0.01 -0.096 -19.06 0.01 0.07 -55.17 0.00 -6.65 0.05 Access to health care 0.02 Education Final model share of employment in hazardous conditions average lower secondary school exams results (literacy) Page 346 Table 130. Association between district SMR for ill-defined causes and socio-economic variables, total population, aged 0–64 Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.132 0.01 -0.172 -20.45 0.00 0.03 population density -0.058 0.26 -0.035 0.25 0.00 old-age demographic dependency rate 0.118 0.02 0.174 revenue of district budget per capita 0.050 0.33 -0.065 0.18 0.00 share of employment in hazardous conditions -0.114 0.03 -0.180 -23.26 0.00 unemployment rate 0.143 0.01 0.106 16.99 0.01 share of employment in agriculture 0.015 0.77 0.086 Variable 2 Demographics Economic and labour market situation 0.04 Social cohesion library members per 1000 inhabitants -0.010 0.85 0.058 local governments election turnout 0.038 0.46 0.036 -15.51 0.01 0.05 share of households equipped with a bathroom -0.150 0.00 -0.218 -37.28 0.00 pre-school participation rate of children aged 3-5 -0.067 0.19 -0.099 13.45 0.00 number of inhabitants per 1 medical doctor -0.008 0.87 -0.012 number of inhabitants per 1 health care institution 0.091 0.08 0.045 average lower secondary school exams results (literacy) -0.011 0.83 0.063 40.78 0.02 0.00 baccalaureate results - Polish language (basic level) -0.071 0.17 0.012 population density 0.17 0.00 0.11 revenue of district budget per capita 0.14 0.03 unemployment rate 24.55 0.00 pre-school participation rate of children aged 3-5 6.68 0.03 share of households equipped with a bathroom -38.79 0.00 local governments election turnout -17.54 0.01 Access to health care Education Final model Page 347 Table 131. Association between district SMR for ill-defined causes and socio-economic variables, males, aged 0–64 Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.144 0.00 -0.178 -21.05 0.00 0.03 population density -0.054 0.29 -0.015 0.25 0.00 old-age demographic dependency rate 0.142 0.01 0.195 revenue of district budget per capita 0.036 0.49 -0.071 0.18 0.00 share of employment in hazardous conditions -0.137 0.01 -0.196 -27.69 0.00 unemployment rate 0.137 0.01 0.086 16.60 0.01 share of employment in agriculture 0.032 0.53 0.093 Variable 2 Demographics Economic and labour market situation 0.04 Social cohesion library members per 1000 inhabitants -0.021 0.69 0.069 local governments election turnout 0.052 0.31 0.045 -13.89 0.03 0.06 share of households equipped with a bathroom -0.172 0.00 -0.229 -39.60 0.00 pre-school participation rate of children aged 3-5 -0.073 0.16 -0.091 14.31 0.00 number of inhabitants per 1 medical doctor -0.012 0.81 -0.030 number of inhabitants per 1 health care institution 0.080 0.12 0.037 average lower secondary school exams results (literacy) 0.013 0.80 0.091 46.65 0.01 0.00 baccalaureate results - Polish language (basic level) -0.061 0.24 0.024 population density 0.18 0.00 0.11 revenue of district budget per capita 0.13 0.04 unemployment rate 25.02 0.00 pre-school participation rate of children aged 3-5 7.79 0.01 share of households equipped with a bathroom -40.92 0.00 local governments election turnout -15.38 0.03 Access to health care Education Final model Page 348 Table 132. Association between district SMR for ill-defined causes and socio-economic variables, females, aged 0–64 Spearman correlation coefficient p-value RCI 0.065 0.21 0.023 population density 0.066 0.20 0.037 old-age demographic dependency rate -0.040 0.43 0.052 revenue of district budget per capita 0.224 0.00 0.134 share of employment in hazardous conditions 0.069 0.18 -0.019 unemployment rate 0.089 0.08 share of employment in agriculture -0.202 0.00 Variable Regression coefficient (x 1000) p-value 2 R Demographics feminization rate 0.04 0.28 0.00 0.20 0.00 0.126 16.83 0.02 -0.130 -6.27 0.00 Economic and labour market situation 0.07 Social cohesion library members per 1000 inhabitants 0.118 0.02 0.073 local governments election turnout -0.133 0.01 -0.146 -25.46 0.00 0.03 share of households equipped with a bathroom 0.097 0.06 -0.017 -22.91 0.00 pre-school participation rate of children aged 3-5 0.101 0.05 0.022 14.58 0.00 number of inhabitants per 1 medical doctor -0.081 0.11 -0.079 -0.17 0.00 0.00 number of inhabitants per 1 health care institution 0.069 0.18 -0.015 average lower secondary school exams results (literacy) -0.011 0.83 -0.008 69.58 0.00 0.00 baccalaureate results - Polish language (basic level) -0.026 0.61 0.002 population density 0.20 0.00 0.10 revenue of district budget per capita 0.16 0.02 unemployment rate 18.33 0.01 share of employment in agriculture -10.71 0.00 share of households equipped with a bathroom -37.05 0.00 local governments election turnout -22.23 0.01 Access to health care Education Final model Page 349 Table 133. Association between district SMR for ill-defined causes and socio-economic variables, total population, aged 65 years and over Spearman correlation coefficient p-value RCI feminization rate -0.116 0.02 -0.121 population density -0.251 0.00 -0.201 old-age demographic dependency rate -0.093 0.07 -0.022 revenue of district budget per capita -0.137 0.01 -0.137 share of employment in hazardous conditions -0.108 0.04 -0.057 -14.93 0.04 unemployment rate 0.189 0.00 0.098 17.31 0.00 share of employment in agriculture 0.114 0.03 0.100 Variable Regression coefficient (x 1000) p-value 2 R Demographics Economic and labour market situation 0.04 Social cohesion library members per 1000 inhabitants -0.030 0.56 -0.001 local governments election turnout 0.108 0.04 0.078 0.03 share of households equipped with a bathroom -0.081 0.12 -0.073 pre-school participation rate of children aged 3-5 -0.190 0.00 -0.141 number of inhabitants per 1 medical doctor 0.118 0.02 0.094 number of inhabitants per 1 health care institution 0.197 0.00 0.123 0.05 0.00 average lower secondary school exams results (literacy) -0.253 0.00 -0.166 -66.05 0.00 0.05 baccalaureate results - Polish language (basic level) -0.145 0.00 -0.105 -19.61 0.00 0.08 0.04 0.03 -58.85 0.00 -4.00 0.01 Access to health care 0.03 Education Final model share of employment in hazardous conditions number of inhabitants per 1 health care institution average lower secondary school exams results (literacy) Page 350 Table 134. Association between district SMR for ill-defined causes and socio-economic variables, males, aged 65 years and over Spearman correlation coefficient p-value RCI feminization rate -0.097 0.06 -0.121 population density -0.196 0.00 -0.188 old-age demographic dependency rate -0.069 0.18 -0.043 revenue of district budget per capita -0.091 0.08 -0.079 share of employment in hazardous conditions -0.106 0.04 -0.071 unemployment rate 0.171 0.00 0.133 share of employment in agriculture 0.090 0.08 0.070 Variable Regression coefficient (x 1000) p-value 2 R Demographics Economic and labour market situation 0.03 13.27 0.00 Social cohesion library members per 1000 inhabitants -0.009 0.87 -0.017 local governments election turnout 0.110 0.03 0.076 share of households equipped with a bathroom -0.092 0.08 -0.059 pre-school participation rate of children aged 3-5 -0.155 0.00 -0.127 number of inhabitants per 1 medical doctor 0.109 0.03 0.122 number of inhabitants per 1 health care institution 0.186 0.00 0.139 average lower secondary school exams results (literacy) -0.186 0.00 -0.149 baccalaureate results - Polish language (basic level) -0.128 0.01 -0.124 0.00 -6.87 0.04 Access to health care 0.02 0.04 0.02 Education 0.02 -29.84 0.01 13.27 0.00 Final model unemployment rate Page 351 0.04 Table 135. Association between district SMR for ill-defined causes and socio-economic variables, females, aged 65 years and over Spearman correlation coefficient p-value RCI feminization rate -0.121 0.02 -0.116 population density -0.270 0.00 -0.195 old-age demographic dependency rate -0.094 0.07 -0.015 revenue of district budget per capita -0.164 0.00 -0.154 share of employment in hazardous conditions -0.106 0.04 -0.053 -19.50 0.02 unemployment rate 0.191 0.00 0.085 20.95 0.00 share of employment in agriculture 0.129 0.01 0.105 Variable Regression coefficient (x 1000) p-value 2 R Demographics 0.00 -19.49 0.03 Economic and labour market situation 0.05 Social cohesion library members per 1000 inhabitants -0.040 0.44 0.008 local governments election turnout 0.105 0.04 0.068 0.03 share of households equipped with a bathroom -0.081 0.11 -0.075 pre-school participation rate of children aged 3-5 -0.198 0.00 -0.139 number of inhabitants per 1 medical doctor 0.124 0.02 0.068 number of inhabitants per 1 health care institution 0.187 0.00 0.098 0.07 0.00 average lower secondary school exams results (literacy) -0.269 0.00 -0.176 -82.68 0.00 0.06 baccalaureate results - Polish language (basic level) -0.151 0.00 -0.095 -25.18 0.00 0.09 0.05 0.02 -74.11 0.00 -5.36 0.00 Access to health care 0.03 Education Final model share of employment in hazardous conditions number of inhabitants per 1 health care institution average lower secondary school exams results (literacy) Page 352 Table 136. Association between district SMR for external causes and socio-economic variables, total population, all ages Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.456 0.00 -0.314 -15.72 0.00 0.24 population density -0.490 0.00 -0.313 -0.05 0.00 old-age demographic dependency rate 0.096 0.06 0.156 revenue of district budget per capita -0.271 0.00 -0.206 share of employment in hazardous conditions -0.242 0.00 -0.213 6.08 0.02 unemployment rate 0.253 0.00 0.111 11.07 0.00 share of employment in agriculture 0.388 0.00 0.294 4.30 0.00 Variable 2 Demographics Economic and labour market situation 0.19 Social cohesion library members per 1000 inhabitants -0.335 0.00 -0.211 local governments election turnout 0.309 0.00 0.224 0.26 share of households equipped with a bathroom -0.478 0.00 -0.347 -9.74 0.00 pre-school participation rate of children aged 3-5 -0.403 0.00 -0.281 -3.21 0.00 number of inhabitants per 1 medical doctor 0.262 0.00 0.143 0.07 0.00 0.01 number of inhabitants per 1 health care institution 0.066 0.20 0.005 average lower secondary school exams results (literacy) -0.303 0.00 -0.137 -59.17 0.00 0.11 baccalaureate results - Polish language (basic level) -0.205 0.00 -0.093 -9.51 0.04 feminization rate -6.61 0.01 population density -0.03 0.02 share of employment in agriculture -3.37 0.00 share of households equipped with a bathroom average lower secondary school exams results (literacy) -14.08 0.00 -28.98 0.00 Access to health care Education Final model Page 353 0.32 Table 137. Association between district SMR for external causes and socio-economic variables, males, all ages Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.487 0.00 -0.334 -18.02 0.00 0.28 population density -0.526 0.00 -0.339 -0.06 0.00 old-age demographic dependency rate 0.133 0.01 0.169 revenue of district budget per capita -0.331 0.00 -0.234 -0.03 0.04 share of employment in hazardous conditions -0.305 0.00 -0.252 unemployment rate 0.339 0.00 0.172 13.30 0.00 share of employment in agriculture 0.430 0.00 0.313 3.69 0.00 Variable 2 Demographics Economic and labour market situation 0.26 Social cohesion library members per 1000 inhabitants -0.348 0.00 -0.222 local governments election turnout 0.332 0.00 0.230 -4.19 0.04 0.33 share of households equipped with a bathroom -0.533 0.00 -0.364 -12.12 0.00 pre-school participation rate of children aged 3-5 -0.471 0.00 -0.320 -4.41 0.00 number of inhabitants per 1 medical doctor 0.262 0.00 0.138 0.08 0.00 0.01 number of inhabitants per 1 health care institution 0.082 0.11 0.012 average lower secondary school exams results (literacy) -0.312 0.00 -0.147 -67.67 0.00 0.13 baccalaureate results - Polish language (basic level) -0.235 0.00 -0.124 -13.74 0.01 feminization rate -6.87 0.01 population density -0.06 0.00 revenue of district budget per capita 0.04 0.01 unemployment rate 6.10 0.00 share of employment in agriculture -3.62 0.00 share of households equipped with a bathroom average lower secondary school exams results (literacy) -17.32 0.00 -24.93 0.00 Access to health care Education Final model Page 354 0.39 Table 138. Association between district SMR for external causes and socio-economic variables, females, all ages Spearman correlation coefficient p-value RCI -0.025 0.63 -0.021 population density 0.016 0.76 -0.021 old-age demographic dependency rate -0.040 0.44 -0.063 0.173 0.00 0.054 share of employment in hazardous conditions 0.098 0.06 0.080 unemployment rate -0.185 0.00 -0.142 share of employment in agriculture -0.061 0.24 0.012 Variable Regression coefficient (x 1000) p-value 2 R Demographics feminization rate Economic and labour market situation revenue of district budget per capita 0.01 7.78 0.01 7.78 0.01 Social cohesion library members per 1000 inhabitants -0.056 0.28 -0.021 local governments election turnout 0.006 0.90 -0.004 share of households equipped with a bathroom -0.002 0.96 -0.029 pre-school participation rate of children aged 3-5 0.104 0.04 0.072 number of inhabitants per 1 medical doctor 0.031 0.55 0.078 number of inhabitants per 1 health care institution -0.065 0.21 0.006 average lower secondary school exams results (literacy) -0.012 0.81 -0.057 baccalaureate results - Polish language (basic level) 0.063 0.22 0.106 Access to health care Education Final model share of employment in hazardous conditions Page 355 0.01 Table 139. Association between district SMR for external causes and socio-economic variables, total population, aged 0–64 Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.499 0.00 -0.346 -20.45 0.00 0.28 population density -0.547 0.00 -0.346 -0.05 0.00 old-age demographic dependency rate 0.136 0.01 0.185 revenue of district budget per capita -0.318 0.00 -0.229 -0.04 0.02 share of employment in hazardous conditions -0.302 0.00 -0.256 unemployment rate 0.361 0.00 0.181 14.65 0.00 share of employment in agriculture 0.424 0.00 0.315 3.46 0.00 Variable 2 Demographics Economic and labour market situation 0.27 Social cohesion library members per 1000 inhabitants -0.359 0.00 -0.221 local governments election turnout 0.314 0.00 0.222 -6.56 0.00 0.33 share of households equipped with a bathroom -0.540 0.00 -0.378 -12.68 0.00 pre-school participation rate of children aged 3-5 -0.498 0.00 -0.335 -5.02 0.00 number of inhabitants per 1 medical doctor 0.274 0.00 0.137 0.09 0.00 0.02 number of inhabitants per 1 health care institution 0.084 0.10 -0.003 average lower secondary school exams results (literacy) -0.352 0.00 -0.166 -75.97 0.00 0.15 baccalaureate results - Polish language (basic level) -0.238 0.00 -0.122 -13.08 0.01 feminization rate -8.77 0.00 population density -0.06 0.00 revenue of district budget per capita 0.04 0.02 unemployment rate 5.89 0.01 share of employment in agriculture -4.58 0.00 share of households equipped with a bathroom average lower secondary school exams results (literacy) -19.04 0.00 -33.47 0.00 Access to health care Education Final model Page 356 0.41 Table 140. Association between district SMR for external causes and socio-economic variables, males, aged 0–64 Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.501 0.00 -0.351 -20.39 0.00 0.29 population density -0.545 0.00 -0.351 -0.06 0.00 old-age demographic dependency rate 0.155 0.00 0.196 revenue of district budget per capita -0.345 0.00 -0.249 -0.04 0.02 share of employment in hazardous conditions -0.325 0.00 -0.276 unemployment rate 0.372 0.00 0.191 15.25 0.00 share of employment in agriculture 0.440 0.00 0.330 3.81 0.00 Variable 2 Demographics Economic and labour market situation 0.29 Social cohesion library members per 1000 inhabitants -0.355 0.00 -0.222 local governments election turnout 0.330 0.00 0.237 -6.02 0.01 0.35 share of households equipped with a bathroom -0.553 0.00 -0.387 -13.36 0.00 pre-school participation rate of children aged 3-5 -0.507 0.00 -0.349 -5.18 0.00 number of inhabitants per 1 medical doctor 0.263 0.00 0.135 0.09 0.00 0.02 number of inhabitants per 1 health care institution 0.092 0.07 0.006 average lower secondary school exams results (literacy) -0.330 0.00 -0.162 -75.88 0.00 0.14 baccalaureate results - Polish language (basic level) -0.246 0.00 -0.138 -14.97 0.01 feminization rate -7.28 0.01 population density -0.06 0.00 revenue of district budget per capita 0.04 0.03 unemployment rate 7.28 0.00 share of employment in agriculture -4.36 0.00 share of households equipped with a bathroom average lower secondary school exams results (literacy) -19.81 0.00 -28.42 0.00 Access to health care Education Final model Page 357 0.41 Table 141. Association between district SMR for external causes and socio-economic variables, females, aged 0–64 Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.077 0.13 -0.088 -5.30 0.03 0.00 population density -0.110 0.03 -0.104 old-age demographic dependency rate -0.062 0.23 0.005 revenue of district budget per capita 0.161 0.00 0.067 share of employment in hazardous conditions 0.045 0.38 0.004 unemployment rate 0.062 0.23 0.081 8.60 0.00 share of employment in agriculture -0.076 0.14 0.006 -2.51 0.00 Variable 2 Demographics Economic and labour market situation 0.01 Social cohesion library members per 1000 inhabitants -0.099 0.05 -0.089 local governments election turnout -0.054 0.29 -0.032 -11.84 0.00 0.01 share of households equipped with a bathroom -0.065 0.21 -0.115 -5.69 0.00 pre-school participation rate of children aged 3-5 -0.023 0.65 -0.049 number of inhabitants per 1 medical doctor 0.036 0.48 0.020 number of inhabitants per 1 health care institution -0.061 0.24 -0.084 average lower secondary school exams results (literacy) -0.165 0.00 -0.117 -33.79 0.00 0.02 baccalaureate results - Polish language (basic level) -0.006 0.91 0.047 share of employment in agriculture -9.55 0.00 0.09 share of households equipped with a bathroom average lower secondary school exams results (literacy) -18.06 0.00 -48.50 0.00 Access to health care Education Final model Page 358 Table 142. Association between district SMR for external causes and socio-economic variables, total population, aged 65 years and over Spearman correlation coefficient p-value RCI feminization rate -0.081 0.11 -0.076 population density -0.009 0.86 -0.070 old-age demographic dependency rate 0.007 0.89 -0.127 revenue of district budget per capita -0.004 0.94 -0.042 share of employment in hazardous conditions -0.007 0.90 0.036 8.06 0.03 unemployment rate -0.220 0.00 -0.153 -7.23 0.00 share of employment in agriculture 0.094 0.07 0.087 3.51 0.00 Variable Regression coefficient (x 1000) p-value 2 R Demographics 0.00 -0.04 0.00 Economic and labour market situation 0.06 Social cohesion library members per 1000 inhabitants -0.120 0.02 -0.024 local governments election turnout 0.138 0.01 0.081 share of households equipped with a bathroom -0.086 0.09 -0.024 pre-school participation rate of children aged 3-5 0.043 0.41 0.044 number of inhabitants per 1 medical doctor 0.090 0.08 0.121 number of inhabitants per 1 health care institution 0.001 0.98 0.042 average lower secondary school exams results (literacy) 0.060 0.24 -0.044 baccalaureate results - Polish language (basic level) 0.019 0.72 0.066 0.01 -4.72 0.00 population density -0.06 0.00 unemployment rate -11.07 0.00 share of households equipped with a bathroom -4.23 0.03 Access to health care Education Final model Page 359 0.08 Table 143. Association between district SMR for external causes and socio-economic variables, males, aged 65 years and over Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate -0.154 0.00 -0.155 -7.75 0.02 0.02 population density -0.146 0.00 -0.168 -0.05 0.02 old-age demographic dependency rate -0.024 0.65 -0.084 revenue of district budget per capita -0.105 0.04 -0.077 share of employment in hazardous conditions -0.060 0.24 -0.056 unemployment rate -0.012 0.82 0.038 share of employment in agriculture 0.163 0.00 0.119 Variable 2 Demographics Economic and labour market situation 0.01 3.71 0.00 Social cohesion library members per 1000 inhabitants -0.171 0.00 -0.104 local governments election turnout 0.159 0.00 0.117 share of households equipped with a bathroom -0.175 0.00 -0.099 pre-school participation rate of children aged 3-5 -0.078 0.13 -0.079 number of inhabitants per 1 medical doctor 0.137 0.01 0.107 number of inhabitants per 1 health care institution 0.005 0.92 0.038 average lower secondary school exams results (literacy) -0.058 0.26 -0.085 baccalaureate results - Polish language (basic level) -0.050 0.34 -0.027 0.03 -9.90 0.00 -35.32 0.00 0.00 population density -0.06 0.00 0.03 share of households equipped with a bathroom -6.35 0.00 Access to health care Education Final model Page 360 Table 144. Association between district SMR for external causes and socio-economic variables, females, aged 65 years and over Spearman correlation coefficient p-value RCI feminization rate 0.024 0.64 0.023 population density 0.141 0.01 0.006 old-age demographic dependency rate 0.057 0.27 -0.172 0.099 0.05 0.020 share of employment in hazardous conditions 0.042 0.42 0.141 unemployment rate -0.325 0.00 -0.237 share of employment in agriculture -0.018 0.73 0.008 Variable Regression coefficient (x 1000) p-value 2 R Demographics Economic and labour market situation revenue of district budget per capita 0.11 -17.25 0.00 Social cohesion library members per 1000 inhabitants 0.005 0.92 0.058 local governments election turnout 0.052 0.32 -0.004 0.05 share of households equipped with a bathroom 0.029 0.57 0.083 -6.45 0.05 pre-school participation rate of children aged 3-5 0.171 0.00 0.145 4.74 0.00 number of inhabitants per 1 medical doctor 0.005 0.92 0.108 number of inhabitants per 1 health care institution -0.004 0.94 0.052 average lower secondary school exams results (literacy) 0.160 0.00 -0.046 24.40 0.02 0.02 baccalaureate results - Polish language (basic level) 0.090 0.08 0.098 -17.25 0.00 0.12 Access to health care Education Final model unemployment rate Page 361 Table 145. Association between district infant mortality rate and socio-economic variables Spearman correlation coefficient p-value RCI 0.116 0.02 -0.283 population density 0.102 0.05 -0.276 0.17 0.05 old-age demographic dependency rate -0.160 0.00 0.105 -63.98 0.01 revenue of district budget per capita 0.106 0.04 -0.207 share of employment in hazardous conditions 0.188 0.00 -0.207 101.25 0.00 unemployment rate 0.117 0.02 0.298 35.88 0.01 share of employment in agriculture -0.186 0.00 0.241 Variable Regression coefficient (x 1000) p-value 2 R Demographics feminization rate 0.04 Economic and labour market situation 0.06 Social cohesion library members per 1000 inhabitants 0.191 0.00 -0.235 5.44 0.00 local governments election turnout -0.138 0.01 0.246 -82.73 0.00 0.04 share of households equipped with a bathroom 0.124 0.02 -0.287 pre-school participation rate of children aged 3-5 0.011 0.83 -0.385 -16.17 0.00 number of inhabitants per 1 medical doctor -0.002 0.98 0.325 number of inhabitants per 1 health care institution -0.014 0.78 0.303 average lower secondary school exams results (literacy) -0.096 0.06 -0.366 -108.29 0.01 0.01 baccalaureate results - Polish language (basic level) -0.008 0.88 -0.225 population density 0.44 0.00 0.10 share of employment in hazardous conditions 68.80 0.00 pre-school participation rate of children aged 3-5 -24.13 0.00 5.39 0.00 -53.39 0.00 -158.00 0.01 Access to health care Education Final model library members per 1000 inhabitants local governments election turnout average lower secondary school exams results (literacy) Page 362 Table 146. Association between districts infant neonatal (0-27 days) mortality rate and socio-economic variables Spearman correlation coefficient p-value RCI feminization rate 0.078 0.13 0.005 population density 0.086 0.09 -0.134 0.17 0.02 old-age demographic dependency rate -0.164 0.00 -0.086 -53.41 0.00 revenue of district budget per capita 0.094 0.07 -0.014 share of employment in hazardous conditions 0.140 0.01 -0.024 42.53 0.02 unemployment rate 0.124 0.02 0.217 33.66 0.00 share of employment in agriculture -0.162 0.00 0.063 -8.54 0.02 library members per 1000 inhabitants 0.209 0.00 -0.116 3.81 0.02 local governments election turnout -0.112 0.03 0.120 -39.37 0.00 share of households equipped with a bathroom 0.123 0.02 -0.059 pre-school participation rate of children aged 3-5 0.008 0.87 -0.183 -7.46 0.05 number of inhabitants per 1 medical doctor 0.000 0.99 0.073 number of inhabitants per 1 health care institution -0.014 0.79 0.167 average lower secondary school exams results (literacy) -0.067 0.19 -0.203 baccalaureate results - Polish language (basic level) 0.060 0.24 -0.125 population density 0.21 0.01 unemployment rate 41.44 0.00 share of employment in hazardous conditions 58.84 0.00 Variable Regression coefficient (x 1000) p-value 2 R Demographics 0.04 Economic and labour market situation 0.05 Social cohesion 0.03 Access to health care Education Final model Page 363 0.08 Table 147. Association between districts infant postneonatal (28–365 days) mortality rate and socioeconomic variables Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate 0.052 0.31 0.004 population density 0.049 0.35 -0.015 old-age demographic dependency rate -0.042 0.42 0.009 revenue of district budget per capita 0.046 0.37 0.001 -0.13 0.00 0.01 share of employment in hazardous conditions 0.118 0.02 0.073 43.03 0.00 unemployment rate -0.003 0.96 0.068 share of employment in agriculture -0.084 0.10 -0.037 library members per 1000 inhabitants 0.027 0.60 0.006 local governments election turnout -0.075 0.15 -0.064 share of households equipped with a bathroom 0.021 0.69 -0.024 pre-school participation rate of children aged 3-5 -0.009 0.87 -0.035 number of inhabitants per 1 medical doctor -0.012 0.82 0.058 number of inhabitants per 1 health care institution -0.016 0.75 0.024 average lower secondary school exams results (literacy) -0.074 0.15 -0.113 baccalaureate results - Polish language (basic level) -0.053 0.31 -0.145 Variable 2 Demographics Economic and labour market situation Social cohesion 0.01 -43.91 0.00 -7.02 0.00 -61.14 0.01 0.01 share of employment in hazardous conditions 30.92 0.01 0.02 pre-school participation rate of children aged 3-5 -7.73 0.00 local governments election turnout -36.58 0.00 Access to health care Education Final model Page 364 Table 148. Association between districts life expectancy and socio-economic variables, males Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate 0.444 0.00 0.425 150.59 0.00 0.20 population density 0.421 0.00 0.443 old-age demographic dependency rate -0.111 0.03 0.039 revenue of district budget per capita 0.209 0.00 0.289 0.45 0.00 0.20 share of employment in hazardous conditions 0.214 0.00 0.096 unemployment rate -0.437 0.00 -0.387 -106.42 0.00 share of employment in agriculture -0.260 0.00 -0.349 library members per 1000 inhabitants 0.196 0.00 0.320 local governments election turnout -0.186 0.00 -0.122 101.88 0.00 share of households equipped with a bathroom 0.482 0.00 0.457 109.26 0.00 pre-school participation rate of children aged 3-5 0.397 0.00 0.420 20.56 0.00 number of inhabitants per 1 medical doctor -0.236 0.00 -0.317 -0.40 0.00 0.02 number of inhabitants per 1 health care institution -0.091 0.08 -0.213 average lower secondary school exams results (literacy) 0.375 0.00 0.446 508.65 0.00 0.18 baccalaureate results - Polish language (basic level) 0.243 0.00 0.186 0.43 Variable 2 Demographics Economic and labour market situation Social cohesion 0.27 Access to health care Education Final model feminization rate 42.03 0.01 revenue of district budget per capita -0.38 0.00 unemployment rate -62.97 0.00 share of households equipped with a bathroom 109.79 0.00 local governments election turnout 97.30 0.00 number of inhabitants per 1 medical doctor average lower secondary school exams results (literacy) 0.19 0.02 255.70 0.00 Page 365 Table 149. Association between districts life expectancy and socio-economic variables, females Spearman correlation coefficient p-value RCI Regression coefficient (x 1000) p-value R feminization rate 0.035 0.50 0.074 36.87 0.00 0.04 population density 0.126 0.01 0.096 old-age demographic dependency rate 0.223 0.00 0.095 33.04 0.02 revenue of district budget per capita -0.153 0.00 -0.030 0.29 0.00 share of employment in hazardous conditions -0.193 0.00 -0.092 -34.12 0.01 unemployment rate -0.216 0.00 -0.105 -47.26 0.00 share of employment in agriculture 0.163 0.00 0.023 15.12 0.00 Variable 2 Demographics Economic and labour market situation 0.10 Social cohesion library members per 1000 inhabitants 0.003 0.95 0.068 local governments election turnout 0.138 0.01 0.069 87.71 0.00 0.05 share of households equipped with a bathroom 0.006 0.90 0.053 25.79 0.00 pre-school participation rate of children aged 3-5 0.014 0.79 0.030 10.24 0.00 number of inhabitants per 1 medical doctor -0.105 0.04 -0.101 number of inhabitants per 1 health care institution -0.056 0.28 -0.051 average lower secondary school exams results (literacy) 0.428 0.00 0.234 270.29 0.00 0.17 baccalaureate results - Polish language (basic level) 0.105 0.04 0.053 share of employment in agriculture 39.87 0.00 0.36 share of households equipped with a bathroom 84.89 0.00 local governments election turnout average lower secondary school exams results (literacy) 41.50 0.00 329.01 0.00 Access to health care Education Final model Page 366 Page 367