Mortality due to acute myocardial infarction in Brazil and its geographical regions: analyzing the effect of age-period-cohort.

Juliano Dos Santos,Taynãna Cesar Simões,Flávio Henrique Miranda De Araújo Freire,Karina Cardoso Meira,Amanda Rodrigues Camacho,Raphael Mendonça Guimarães,Ângela Maria Geraldo Pierin,Pétala Tuani Candido De Oliveira Salvador

doi:10.1590/1413-81232018235.16092016

Abstract

The objective of this study was to analyze the effect of age-period and cohort (APC) of birth on mortality for acute myocardial infarction in Brazil and its geographic regions, according to sex in the period from 1980 to 2009. The data was extracted from the Mortality Information System and was corrected and adjusted by means of proportional redistribution of records with sex and age ignored, ill-defined causes, and corrections were made based on the death sub-register. The APC was calculated using the Poisson regression model with estimable functions. The APC analysis on both sexes and in all regions of the country showed gradual reductions in the risk of death in birth cohorts from the decade of the 1940s, except in the Northeast. In this region, there have been progressive increases in the risk of death from the late 1940s for both sexes. This was up until the 1950s for men and the 1960s for women. It was concluded that the observed differences in the risk of death in Brazilian regions is the result of socio-economic inequalities and poor access to health services within the Brazilian territory, favoring early mortality for this cause especially in poorer areas.

Highlights

Cardiovascular diseases, including acute myocardial infarction (IAM), represents an important problem for public health in Brazil and in the world which has resulted in high rates of incidences of mortality[1]
It was concluded that the observed differences in the risk of death in Brazilian regions is the result of socio -economic inequalities and poor access to health services within the Brazilian territory, favoring early mortality for this cause especially in poorer areas
The main reason for using these is to estimate the effect of each of these factors (APC) separately in the increase or otherwise of the rates[9,10]. Following this line of thought, the objective of this study was to analyze the effect of the age-period and the birth cohort (APC) on the mortality rates for acute myocardial infarction in Brazil and the geographical regions based on sex, during the period from 1980 to 2009

Summary

Introduction

Cardiovascular diseases, including acute myocardial infarction (IAM), represents an important problem for public health in Brazil and in the world which has resulted in high rates of incidences of mortality[1]. The rates of Brazilian mortality for this group of causes[2] (183,3/100.000) are amongst the highest in the world and is similar to that of countries such as China and areas such as the east of Europe[3] This reality can be explained by both the changes in the age structure of the population and the increase in the prevalence of exposure to risk factors that have been recognized as being associated with diseases of the circulatory system such as: sedentarism, increase in the consumption of meat and food that contain a high fat content, a reduction in the consumption of fruits and vegetables, the consumption of alcoholic drinks, smoking, the increase in obesity, as well as socioeconomic inequalities and poor access to health services[3,4,5,6,7,8]. The effects of the period refers to the alterations in the mortality tendencies and incidences that are in themselves related to the changes that occur at certain periods and which influence, simultaneously all of the age ranges (the following must be taken into account: innovations in diagnosis and treatment, access to health care, changes in the certification of deaths and improvements in the mortality information system)[9,10]

Objectives

Methods

Results

Discussion

Conclusion