Potential years of life lost in Campinas-Brazil between 2000-2017 due to external causes of death

Abstract

Abstract The Potential Years of Life Lost indicator is an alternative to the use of traditional indicators to evaluate impacts of external causes of death for its ability to evaluate the magnitude of premature death. This study aims to evaluate the impact in the PYLL of premature deaths due to external causes in Campinas, between 2000 and 2017, and to show selectiveness of violence targeting the poor. We performed a cross-sectional epidemiological study describing the PYLL due to external causes in the city of Campinas between 2000 and 2017. Amongst the variables studied, focus was given to the Human Development Index by Neighborhood (HDIN) of each individual (obtained by relating addresses to the official HDIN census), to evaluate impact of poverty in PYLL, mainly in homicides. A total of 12175 people died from external causes between 2000 and 2017. The distribution of the PYLL in the year 2000 indicated a loss of 35.8 years for every 1000 inhabitants with a high decrease until 2005 to an average of 17.45 from 2005 to 2017. Although we observed this decrease in PYLL, analysis by social strata shows disparities between PYLL of the rich and poor. When all external causes were considered, low and very low-HDI population had the most significant PYLL (27 and 30.3 respectively) compared to high and very high-HDI population (18.3 and 9.9 respectively), and when only homicides were taken into account, an even greater disparity was observed between the lower-HDI and higher-HDI stratas (overall average of 16.55 and 5.55 respectively). Through PYLL analysis, we could observe the selectiveness of violence towards the low and very low-HDI population, which shows that, public policies that aim improve population health cannot be restricted to health sectors, but also include socio-economic actions against social inequalities and income concentration. Key messages Although external causes of death seems to be decreasing in Campinas, violence seems to target the poor. Any policy that aims to prevent violent causes of death must necessarily take into account social disparities.