ABSTRACT:
Introduction. Lithuania has some of the largest social and demographic inequalities in mortality within the European Union [1,2]. To address these disparities, the Health Inequalities Reduction Plan was adopted in 2014, and the goal of reducing health inequalities was included in the National Health Strategy [3,4]. This study examines residential inequalities in mortality from the main causes of death for males and females in Lithuania, comparing periods before (1990-2013) and after (2014-2024) the implementation of health policy measures targeting inequality reduction. Methods. Mortality data during 1990-2024 was obtained from the Institute of Hygiene. Age-standardized mortality rates per 100,000 population from cardiovascular diseases, cancer, external causes, and digestive system diseases were calculated for urban and rural residents by sex. Inequalities in mortality were assessed using a rate ratio (rural/urban). The Joinpoint regression analysis was applied to assess trends in inequalities during the periods 1990–2013 and 2014–2024. Results. We found that inequalities in mortality by place of residence from cardiovascular diseases and digestive system diseases for both sexes, and from cancer and external causes for females, increased (P<0.05) during 1990-2013. While during 2014-2024, mortality inequalities increased from cardiovascular diseases and cancers for both sexes, and digestive system diseases for males (P<0.05). A declining trend in inequalities was observed exclusively among females for deaths from external causes. Furthermore, between 2014 and 2024, the inequalities in mortality by place of residence from cardiovascular diseases and cancers for both males and females, and from external causes and digestive system diseases for males, increased faster than between 1990 and 2013. Conclusions. The study showed that despite the introduction of national health policy measures in 2014, inequalities in mortality from the main causes of death did not decrease in Lithuania during 2014-2024.