Road traffic accidents are the major cause of death among residents aged between 15 and 34, while AIDS is the leading killer for those aged from 35 to 44, according to a confidential Government report.

The report, submitted to a committee conducting Bermuda's Health Care Review, also says the rate of death from heart disease in Bermuda's total population is unacceptably high.

These are three points in a Health Department summary which otherwise concludes Bermudians are in good health and getting the medical care they need.

The report is part of a larger report recently put to a Cabinet committee reviewing health care in Bermuda.

The review was initiated last year by Health Minister the Hon. Quinton Edness following community concerns over escalating health care costs and the quality of health care.

A sub-committee of professionals and health care workers was formed to determine whether the system satisfied the health care needs of the population, whether it was cost-effective and efficient and whether it provided an appropriate level of minimum and affordable care for all residents.

The Health Department report submitted to the sub-committee concluded that "Bermudians enjoy good health as measured by standard indicators''.

Despite that assessment, Mr. Edness last night said the health care review was necessary.

"Even though we do have a good health care system, we've got to watch the signs,'' he said. "More and more people are seeking to get medical treatment abroad. Why did they need to go abroad, particularly when the same care is available here?'' The Heath Department report painted a fairly positive picture of Bermudian health, including maternal and child health.

Fewer children, it said, are dying at birth. The infant mortality rate declined steadily from 31.5 per 1,000 in 1960 to 7.8 in 1990. Last year, the mortality rate was 9.3 deaths per 1,000 births.

In 1993, more than 95 percent of pregnant women received prenatal care, 99 percent were fully immunised against tetanus and all births took place in hospital.

The incidence of vaccine preventable diseases is considered low. The report said immunisation against all five of the common prevantable childhood diseases (measles, rubella, DPT, polio, and mumps) "have been maintained at consistently high levels''.

"Decreases in the incidence of dental decay have been dramatic over the past decade and oral health in children is generally excellent,'' it said. "This is largely attributed to a preventive dental health care programme for infants and children that provides free flouride treatment.'' The report did not paint a comparably good picture of the health of adults.

Chronic disease, accidents and violence were the primary causes of death for people between the ages of 25 and 64.

"Substantial increases in mortality occurred in the population 25-44 years old, between 1985 and the present,'' the Health Department said. "These increases were due primarily to deaths from AIDS, particularly in males. The leading cause of death in 1993 for persons 25-34 years old was accidents. AIDS was the main cause of death in people 35-44 years.'' The Health Department report said the major, current health problems for Bermudians are cancer, heart disease, strokes, HIV infection and AIDS and motor vehicle accidents.

It said death rates from heart disease remained unacceptably high.

"In 1993, one of every five deaths was due to ischaemic heart disease,'' the report said. "Up through 1992, heart disease was the leading cause of death.'' It also said that the frequency of cancer as a cause of death was increasing.

One of every four deaths was now attributable to cancer.

The report said there was little change in the past five years in the incidence rates for sexually transmitted diseases.

AIDS and HIV infection were described as a major public health problem on the Island. By the end of 1993, 247 cases of AIDS were recorded with 213 people dying of it.

Despite the introduction of alcoanalysers and road safety campaigns, deaths from road accidents remained high. In 1994 alone, 10 people have died on Bermuda roads.

Road traffic deaths were the leading cause of deaths among residents 15-34 years of age. "Males are affected disproportionately,'' the report said.

The Department review concluded that the system had enough people to provide health services to meet the country's needs. It did take note of an ongoing shortage in some specialised areas of nursing.

Public health services, it noted, are generally free, or provided at modest costs.