Abstract

Background: What is the spatial pattern of mortality by cause and sex in Brazil? Even considering the main causes of death, such as neoplasms, cardiovascular diseases, external causes, respiratory diseases, and infectious diseases, there are still important debate regarding the spatial pattern of mortality by causes in Brazil. Evidence shows that there is an overlap in transitional health states, due to the persistence of infectious diseases (e.g., dengue, cholera, malaria, etc.,) in parallel with the increase in chronic degenerative diseases. The main objective of this paper is to analyze the spatio-temporal evolution of three groups of causes of death in Brazil across small areas from 1998 to 2017, by sex.Methods: We use publicly available data from the System Data Mortality Information (SIM-DATASUS) from 1998 to 2017. We focus on this period due to the better quality of information, in addition to all deaths are registered following the Tenth Revision of the International Classification of Diseases (ICD-10). We estimate standardized mortality rates by sex and cause aggregated into three main groups. We use a ternary color scheme to maximize all the information in a three-dimensional array of compositional data.Results: We find improvements in mortality from chronic degenerative diseases; faster declines are observed in the Southern regions of the country; but the persistence of high levels of mortality due to infectious diseases remained in the northern parts of the country. We also find impressive differences in external causes of deaths between males and females and an increase in mortality from these causes in the interior part of the country.Conclusions: This study provides useful information for policy makers in establishing effective measures for the prevention of deaths and public health planning for deaths from external and non-communicable causes. We observed how the distribution of causes of death varies across regions and how the patterns of mortality also vary by gender.

Highlights

  • In the last several decades, Brazil has experienced an accelerated decline in infant, child, and adult mortality [1]

  • The “Obs” column indicates the number of micro-regions in each state

  • We observed an increase in the percentage of deaths from chronic degenerative diseases (CDDs) and external causes in the first three periods, with a stabilization in the most recent one

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Summary

Introduction

In the last several decades, Brazil has experienced an accelerated decline in infant, child, and adult mortality [1]. The median gain in life expectancy at birth between 1940 and 2015 was about 30 years [2]. This change occurred much more quickly than any increase in life expectancy in developed countries over the same period. In 1940, life expectancy at birth in Brazil was around 45.5 years. What is the spatial pattern of mortality by cause and sex in Brazil? Even considering the main causes of death, such as neoplasms, cardiovascular diseases, external causes, respiratory diseases, and infectious diseases, there are still important debate regarding the spatial pattern of mortality by causes in Brazil. The main objective of this paper is to analyze the spatio-temporal evolution of three groups of causes of death in Brazil across small areas from 1998 to 2017, by sex

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