Cause-specific mortality for 249 causes in Brazil and states during 1990–2015: a systematic analysis for the global burden of disease study 2015

Population Health Metrics

Research

Roberto Marini Ladeira¹  Mohsen Naghavi²  Meghan Mooney²  Otaliba L. Morais-Neto³  Maria Tereza Bustamante-Teixeira⁴  Maximiliano R. Guerra⁴  Deborah Carvalho Malta⁵  Bernardo L. Queiroz⁶  Daisy M.X. Abreu⁷  Renato Teixeira⁸  Elisabeth B. França⁸  Mark D. C. Guimarães⁸  Lenice Ishitani⁹  Antonio Luiz P. Ribeiro^1,10  Valéria Maria de Azeredo Passos^1,10  Paulo Camargos^1,11  Ana Paula S. Melo^1,11  Bruce B. Duncan^1,12  Maria Inês Schmidt^1,12  Ana Maria N. Vasconcelos^1,13  Mariângela Carneiro^1,14  Isabela Bensenor^1,15  Paulo Lotufo^1,15 

[1] Fundação Hospitalar do Estado de Minas Gerais, Alameda Alvaro Celso 100/231, 30150-260, Belo Horizonte, Brazil;Institute for Health Metrics and Evaluation, Box 358210, 2301 5th Avenue, Suite 600, 98121, Seattle, WA, USA;Universidade Federal de Goiás, Departamento de Saúde Coletiva. Instituto de Patologia Tropical e Saúde Pública. Rua 235, S/N, Setor Universitário, Goiânia, 74605050, Goiás, Brazil;Universidade Federal de Juiz de Fora, Programa de Pós-graduação em Saúde Coletiva, Campus Universitario da UFJF, Rua José Lourenço Kelmer, S/n, Martelos, 36036-330, Juiz de Fora, Brazil;Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Enfermagem Materno Infantil, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Brazil;Universidade Federal de Minas Gerais, Faculdade de Ciências Econômicas, Departamento de Demografia, Av. Antônio Carlos, 6670, 31270-901, Belo Horizonte, Brazil;Universidade Federal de Minas Gerais, Faculdade de Medicina, Nescon, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Brazil;Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-graduação em Saúde Pública, Av. Prof. Alfredo Balena, 190, 30130-100, Belo Horizonte, Brazil;Universidade Federal de Minas Gerais, Grupo de Pesquisas em Epidemiologia e Avaliação em Saúde-GPEAS, Av. Alfredo Balena, 190, 30130-100, Belo Horizonte, Brazil;Universidade Federal de Minas Gerais, School of Medicine, Av. Alfredo Balena, 190., 30130-100, Belo Horizonte, Brazil;Universidade Federal de São João Del Rei, Faculdade de Medicina. Praça Frei Orlando, 170, Centro, 36307-352, São João del-Rei, Brazil;Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Epidemiologia, R. Ramiro Barcelos 2600/414, 90035-003, Porto Alegre, Brazil;Universidade de Brasília, Programa de Pós-graduação em Desenvolvimento, Sociedade e Cooperação Internacional, Asa Norte, 70910-900, Brasília, Brazil;Universidade de Federal de Minas Gerais, Instituto de Ciências Biológicas, Departamento de Parasitologia. Avenida Antônio Carlos, 6670, 31270-901, Belo Horizonte, MG, Brazil;Universidade de São Paulo. Centro de Pesquisa Clínica e Epidemiológica, Hospital Universitário, Av. Lineu Prestes, 2565 / 3° andar, 05508-000, São Paulo, Brazil;

关键词: Mortality;    Causes of death;    Global burden of disease;    Brazil;   

DOI  :  10.1186/s12963-017-0156-y

 received in 2016-12-27, accepted in 2017-11-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundReliable data on cause of death (COD) are fundamental for planning and resource allocation priorities. We used GBD 2015 estimates to examine levels and trends for the leading causes of death in Brazil from 1990 to 2015.MethodsWe describe the main analytical approaches focused on both overall and specific causes of death for Brazil and Brazilian states.ResultsThere was an overall improvement in life expectancy at birth from 1990 to 2015, but with important heterogeneity among states. Reduced mortality due to diarrhea, lower respiratory infections, and other infectious diseases contributed the most for increasing life expectancy in most states from the North and Northeast regions. Reduced mortality due to cardiovascular diseases was the highest contributor in the South, Southeast, and Center West regions. However, among men, intentional injuries reduced life expectancy in 17 out of 27 states. Although age-standardized rates due to ischemic heart disease (IHD) and cerebrovascular disease declined over time, these remained the leading CODs in the country and states. In contrast, leading causes of premature mortality changed substantially - e.g., diarrheal diseases moved from 1st to 13th and then the 36th position in 1990, 2005, and 2015, respectively, while violence moved from 7th to 1st and to 2nd. Overall, the total age-standardized years of life lost (YLL) rate was reduced from 1990 to 2015, bringing the burden of premature deaths closer to expected rates given the country’s Socio-demographic Index (SDI). In 1990, IHD, stroke, diarrhea, neonatal preterm birth complications, road injury, and violence had ratios higher than the expected, while in 2015 only violence was higher, overall and in all states, according to the SDI.ConclusionsA widespread reduction of mortality levels occurred in Brazil from 1990 to 2015, particularly among children under 5 years old. Major shifts in mortality rates took place among communicable, maternal, neonatal, and nutritional disorders. The mortality profile has shifted to older ages with increases in non-communicable diseases as well as premature deaths due to violence. Policymakers should address health interventions accordingly.

【 授权许可】

CC BY   
© The Author(s). 2017