work on defining the specific cardiovascular causes coded in this group is urgently required. Digestive diseases cause over 5.3 percent of years of life lost in South FSE, with cirrhosis being responsible for more than half of this amount. As a group, injuries are much less important in South than in North FSE. Motor vehicle accidents cause 2.3 percent of deaths, followed by suicides (1.3 percent).

In Central Asia, years of life lost is dominated by child deaths; thus the associated causes are more in Group I. Respiratory infections (29.7 percent), diarrheal diseases (8.6 percent), and perinatal causes (9.5 percent) are the most important. Among cancers, lymphoma/leukemia and cancers of the lung and stomach account for more than 1 percent of years of life lost each. Cardiovascular diseases cause 15.6 percent of deaths; of these, over one-half are attributable to ischemic heart disease and about one-fourth to cerebrovascular disease. The injury pattern is similar to that of South FSE, except for the prominent role of drownings (1.7 percent), suicides (1.1 percent), and homicides (0.8 percent).

Annex Table 6-1 provides estimates of years of life lost by cause for each of the NIS countries, to facilitate more detailed comparisons among states within each of the epidemiological regions.

Excess Years of Life Lost

Table 6-8 shows the distribution by age, sex, and region of excess years of life lost, by disease group and all causes of death. Figures 6-3a, b, and c present the excess years of life lost by age in South FSE, North FSE, and Central Asia, respectively. Total years of life lost in Central Asia is 80 percent higher than expected based on rates of the Established Market Economies, and in North FSE and South FSE is 67 and 50 percent higher, respectively. The excess can be apportioned among different age and sex groups. In Central Asia, 80 percent of the excess is due to child mortality (under age 5). The excess is concentrated among children because of high fertility and a young age structure, combined with moderately high levels of child mortality even by developing world standards. Adult men and women account for 9.9 percent of the excess years of life lost in the region. In South FSE, excess years of life lost is distributed across nearly all age groups, with 28.9 percent being among children under age 5 and 25.3 percent being among adult males. In North FSE, almost half of the excess (44.8 percent) is among adult men aged 15-59, confirming the unique mortality pattern of this region. Just over 15 percent is among children under age 5, and a further 10.6 percent is among women age 15-59. Mortality among the population over age 60 contributes 26 percent to the total excess.

In Central Asia, the major problem is excess mortality in the age group 0-4 years. Figure 6-4 provides the distribution of excess years of life lost among this age group by major causes. Nearly 90 percent is from communicable and perinatal causes. More specifically, 56 percent is due to respiratory infections, a pattern characteristic of a developing country. The second-largest share (17 percent) is



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