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Metrics details. Although all-cause mortality in Sri Lanka decreased significantly from to , subsequent declines have been more modest with divergent trends by age and sex. This study investigates these trends through cause of death analysis for — in adults aged 15—64 years. Adult deaths were categorised by age 15—34 and 35—64 years and sex into: infectious diseases; external-causes; circulatory diseases; cancers; digestive diseases; respiratory diseases; pregnancy-related; ill-defined; and other-causes.
Cause-specific mortality rates were directly age-standardised to the Sri Lankan Census population. All-cause mortality in males 35—64 years has stagnated since , with fluctuating increases. Circulatory diseases were the leading cause of death among adults 35—64 years in —06, with the male rate almost three times higher than females.
Significant disparities are demonstrated in Sri Lankan cause-specific adult mortality by sex and age group for — Female mortality progressively declined while male mortality demonstrated periods of increase and stagnation. Among males aged 15—34 years this coincides with periods of civil conflict over — Sri Lanka is an island nation of 65, square kilometres, with a population of approximately 19 million at the Census, consisting of mainly Sinhalese Provisional data from the Census estimates the population to be around 20,,, with disaggregation by ethnicity yet to be released [ 2 ].
Following significant declines in mortality and increased life expectancy during the second half of the twentieth century, Sri Lanka came to be regarded as an impressive example of the population health improvements that could be achieved in developing countries with limited economic resources [ 3 , 4 ].
These achievements were attributed to social welfare policies and programmes implemented by the Sri Lankan Government, which included: free health care services from primary through to tertiary level; free education, also from primary through to tertiary level; and subsidised food distribution, namely rice [ 5 — 7 ].