Diverging Regional Mortality Trends in Selected Avoidable Causes of Death in Poland, 2000–2019: a Fuzzy-Set Qualitative Comparative Analysis

Rok Hrzic , Maastricht University

Regional disparities in avoidable mortality have widened in Poland, reflecting differences in healthcare and public health system performance. While previous studies have linked mortality outcomes to regional economic, social, and healthcare factors, how these conditions interact to shape regional mortality trajectories remains poorly understood. This study is the first to apply fuzzy-set Qualitative Comparative Analysis (fsQCA) to examine combinations of contextual factors associated with mortality outcomes in a Central and Eastern European country. Death and population data from Statistics Poland were used to calculate age-standardised mortality rates (2000–2019) for 16 NUTS-2 and 73 NUTS-3 regions, disaggregated by sex and five causes of death (cerebrovascular disease; breast, lung, and colorectal cancer; and traffic injuries). After applying a cohort-period spline model to stabilise mortality estimates, the smoothed trends were used to classify regions as mortality vanguards or laggards for each cause. fsQCA was then used to assess which combinations of contextual factors, including GDP per capita, unemployment rate, proportion of residents with tertiary education, and nurse density, were associated with each regional classification. No consistent combination of factors was associated with regions being classified as mortality vanguards or laggards across the causes of death examined. The absence of necessary or sufficient configurations suggests that regional mortality disparities in Poland arise from complex, context-dependent interactions that call for tailored, region-specific interventions.

See extended abstract

 Presented in Session P5. Health, Mortality, and Ageing 1