Background Fiji is experiencing prolonged stagnation in life expectancy (LE) at birth, 7-12-years lower than average LE in upper-middle income countries in 2015. This study examines underlying causes of death (UCoD) over 2013-17 by ICD-10-chapter, age group and sex for the two principle ethnic populations in Fiji: indigenous Fijians (i-Taukei, 63%) and Fijians of Indian descent (FID, 33%). Methods Age-specific proportional mortality was examined to determine the leading causes of death. LE at birth, and age-standardised mortality rates (ASMR) for 15-59-years and all-ages, by sex and ethnicity, were calculated using the Fiji 2017 Census as the standard. Results Over 2013-17, external causes (ICD-10: V01-Y89) were the leading UCoD for those aged 5-34-years: 33% overall; 15% for i-Taukei and 41% for FID females; 32% for i-Taukei and 51% for FID males. Circulatory diseases (I00-I99) were the underlying cause for 38% of all deaths, and for ages 35-59-years comprised 40% of deaths; diabetes (E10-E14) and cancer (C00-D48) each comprised 15% of 35-59-years deaths, followed by respiratory diseases (J00-J98, 5%), external causes (V01-Y89, 5%) and infections (A00-B99, 4%). LE for females was estimated as 66.8 years for i-Taukei, 2.6 years lower than FID (69.4 years); and all-cause 15-59-year ASMR was higher in i-Taukei (4.90/103) than FID (3.42/103). In males, i-Taukei LE was 64.8 years, 0.2 years lower than FID (65.0 years) despite higher 15-59-year ASMR for FID (5.92/103) than i-Taukei (5.63/103). For circulatory diseases, diabetes, cancer, external causes and infections, ASMRs for 15–59-year females were 1.33/103, 0.76/103, 1.36/103, 0.16/103 and 0.26/103 for i-Taukei, and 0.88/103, 0.66/103, 0.51/103, 0.46/103 and 0.11/103, respectively, for FID; in males these were 2.30/103, 0.58/103, 0.62/103, 0.50/103 and 0.31/103 for i-Taukei and 2.80/103, 0.59/103, 0.29/103, 0.90/103 and 0.13/103 for FID. Conclusion LE was higher for FID than i-Taukei females, but similar for males of both ethnicities. CVD was the leading UCoD for both sexes and ethnicities, followed by cancer for i-Taukei males and females, diabetes for FID females and external causes for FID males. Public health interventions aligned with ethnic differences in major causes of death are needed to achieve equitable health outcomes and improved LE in Fiji.

Cause specific mortality across the lifespan for Fiji’s major ethnic sub-populations 2013-17

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2025年8月8日

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Catherine Dearie,
Christine Linhart,
Nashika Sharma,
Timothy Dobbins,
Stephen Morrell,
Richard Taylor

摘要

Background

Fiji is experiencing prolonged stagnation in life expectancy (LE) at birth, 7-12-years lower than average LE in upper-middle income countries in 2015. This study examines underlying causes of death (UCoD) over 2013-17 by ICD-10-chapter, age group and sex for the two principle ethnic populations in Fiji: indigenous Fijians (i-Taukei, 63%) and Fijians of Indian descent (FID, 33%).

Methods

Age-specific proportional mortality was examined to determine the leading causes of death. LE at birth, and age-standardised mortality rates (ASMR) for 15-59-years and all-ages, by sex and ethnicity, were calculated using the Fiji 2017 Census as the standard.

Results

Over 2013-17, external causes (ICD-10: V01-Y89) were the leading UCoD for those aged 5-34-years: 33% overall; 15% for i-Taukei and 41% for FID females; 32% for i-Taukei and 51% for FID males. Circulatory diseases (I00-I99) were the underlying cause for 38% of all deaths, and for ages 35-59-years comprised 40% of deaths; diabetes (E10-E14) and cancer (C00-D48) each comprised 15% of 35-59-years deaths, followed by respiratory diseases (J00-J98, 5%), external causes (V01-Y89, 5%) and infections (A00-B99, 4%). LE for females was estimated as 66.8 years for i-Taukei, 2.6 years lower than FID (69.4 years); and all-cause 15-59-year ASMR was higher in i-Taukei (4.90/10³) than FID (3.42/10³). In males, i-Taukei LE was 64.8 years, 0.2 years lower than FID (65.0 years) despite higher 15-59-year ASMR for FID (5.92/10³) than i-Taukei (5.63/10³). For circulatory diseases, diabetes, cancer, external causes and infections, ASMRs for 15–59-year females were 1.33/10³, 0.76/10³, 1.36/10³, 0.16/10³ and 0.26/10³ for i-Taukei, and 0.88/10³, 0.66/10³, 0.51/10³, 0.46/10³ and 0.11/10³, respectively, for FID; in males these were 2.30/10³, 0.58/10³, 0.62/10³, 0.50/10³ and 0.31/10³ for i-Taukei and 2.80/10³, 0.59/10³, 0.29/10³, 0.90/10³ and 0.13/10³ for FID.

Conclusion

LE was higher for FID than i-Taukei females, but similar for males of both ethnicities. CVD was the leading UCoD for both sexes and ethnicities, followed by cancer for i-Taukei males and females, diabetes for FID females and external causes for FID males. Public health interventions aligned with ethnic differences in major causes of death are needed to achieve equitable health outcomes and improved LE in Fiji.