Death in Transitional Asia: 11-Year All-Cause Mortality in the Thai Cohort Study

OBJECTIVE: Thailand is experiencing a substantial reduction in overall mortality, an ageing society and increasing prevalence of non-communicable diseases. There is an urgent need to understand locally important risk factors for this new disease burden and their distribution. We investigated risk factors for mortality in a large cohort of Thai adults and report on key trends.

PARTICIPANTS: A nationwide cohort of 87,151 Thai adults followed up since 2005 with their data records linked to the Thai civil registration system to monitor mortality up to the end of 2016.

METHODS: We used logistic regression models to measure associations between a large range of socio-demographic, health behaviour and health status variables and all-cause mortality.

RESULTS: 1402 cohort members died between 2005 and 2016. In fully-adjusted models higher income, female sex, and higher education had the strongest protective effects against mortality. Normal body weight also protected (AOR 0.71 [0.52-0.96] with Obese as reference). Heavy smoking (AOR 1.48 [1.29-1.70]), and regular alcohol consumption (AOR 1.37 [1.12-1.68]) were associated with the highest mortality. Experiencing injury in the year proceeding the baseline survey also associated with increased mortality, while urbanising since childhood had a protective effect.

CONCLUSION: This study adds to evidence regarding risks for all-cause mortality in Thailand. Results indicate the need for Thailand to maintain successful tobacco control programs and to address the effects of increased alcohol consumption. The protective effect of higher education is particularly important in Thailand given the growing proportion of the population who are finishing high school and moving to higher education.