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 β in adults aged 15β64 years. Adult deaths were categorised by age 15β34 and 35β64 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 35β64 years has stagnated since , with fluctuating increases. Circulatory diseases were the leading cause of death among adults 35β64 years in β06, 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 β Female mortality progressively declined while male mortality demonstrated periods of increase and stagnation. Among males aged 15β34 years this coincides with periods of civil conflict over β 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 β 7 ].
In recent decades, however, Sri Lanka has experienced an epidemiological transition that has seen morbidity and mortality from non-communicable diseases NCDs , such as cardiovascular disease, increasing to rates higher than observed in many industrialised nations including the United Kingdom, the United States of America, Australia and France [ 9 ]. Despite commendable success in controlling pre-transitional conditions, including infectious disease, under-nutrition, and maternal and child morbidity and mortality, the major health challenge faced by Sri Lanka in the 21st century is developing effective community-based health promotion and disease prevention interventions to address the increasing prevalence and associated premature mortality from NCDs.
