Abstract
BackgroundMonitoring and reducing premature mortality due to non-communicable diseases (NCDs) is a global priority of Agenda 2030. This study aimed to describe the mortality trends and disability-adjusted life years (DALYs) lost due to NCDs between 1990 and 2017 for Brazil and to project those for 2030 as well as the risk factors (RFs) attributed deaths according to estimates of the Global Burden of Disease Study.MethodsWe analyzed cardiovascular diseases, chronic respiratory diseases, neoplasms, and diabetes, and compared the mortality rates in 1990 and 2017 for all of Brazil and states. The study used the definition of premature mortality (30–69 years) that is used by the World Health Organization. The number of deaths, mortality rates, DALYs, and years of life lost (YLL) were used to compare 1990 and 2017. We analyzed the YLL for NCDs attributable to RFs.ResultsThere was a reduction of 35.3% from 509.1 deaths/100,000 inhabitants (1990) to 329.6 deaths/100,000 inhabitants due to NCDs in 2017. The DALY rate decreased by 33.6%, and the YLL rate decreased by 36.0%. There were reductions in NCDs rates in all 27 states. The main RFs related to premature deaths by NCDs in 2017 among women were high body mass index (BMI), dietary risks, high systolic blood pressure, and among men, dietary risks, high systolic blood pressure, tobacco, and high BMI. Trends in mortality rates due to NCDs declined during the study period; however, after 2015, the curve reversed, and rates fluctuated and tended to increase.ConclusionOur findings highlighted a decline in premature mortality rates from NCDs nationwide and in all states. There was a greater reduction in deaths from cardiovascular diseases, followed by respiratory diseases, and we observed a minor reduction for those from diabetes and neoplasms. The observed fluctuations in mortality rates over the last 3 years indicate that if no further action is taken, we may not achieve the NCD Sustainable Development Goals. These findings draw attention to the consequences of austerity measures in a socially unequal setting with great regional disparities in which the majority of the population is dependent on state social policies.
Highlights
Monitoring and reducing premature mortality due to non-communicable diseases (NCDs) is a global priority of Agenda 2030
Our findings highlighted a decline in premature mortality rates from NCDs nationwide and in all states
In 2017, the proportional mortality from NCDs increased to 75.9% (UI 75.6–77.2), and the deaths by external causes decreased to 11.7% (UI 10.8–11.5)
Summary
Monitoring and reducing premature mortality due to non-communicable diseases (NCDs) is a global priority of Agenda 2030. This study aimed to describe the mortality trends and disability-adjusted life years (DALYs) lost due to NCDs between 1990 and 2017 for Brazil and to project those for 2030 as well as the risk factors (RFs) attributed deaths according to estimates of the Global Burden of Disease Study. Non-communicable diseases (NCDs) represent a threat to global health and socioeconomic development. Premature deaths (30 to 69 years) due to NCDs usually affect individuals with lower income and education who are more exposed to risk factors and have reduced access to information and health services, which contributes to even greater social inequality [1, 3,4,5]. Studies of the impact of the financial crisis of 2008 in Europe and the fiscal austerity measures implemented in many countries, including Brazil, showed important effects on public health expenditures and worsening physical health and mental health indicators in addition to an increase in cardiovascular diseases and other NCDs [6,7,8,9]
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