Mortality In Municipalities Research Articles

Spatial–temporal distribution of incidence, mortality, and case-fatality ratios of coronavirus disease 2019 and its social determinants in Brazilian municipalities

The COVID-19 pandemic caused impact on public health worldwide. Brazil gained prominence during the pandemic due to the magnitude of disease. This study aimed to evaluate the spatial–temporal dynamics of incidence, mortality, and case fatality of COVID-19 and its associations with social determinants in Brazilian municipalities and epidemiological week. We modeled incidence, mortality, and case fatality rates using spatial–temporal Bayesian model. “Bolsa Família Programme” (BOLSAFAM) and “proportional mortality ratio” (PMR) were inversely associated with the standardized incidence ratio (SIR), while “health insurance coverage” (HEALTHINSUR) and “Gini index” were directly associated with the SIR. BOLSAFAM and PMR were inversely associated with the standardized mortality ratio (SMR) and standardized case fatality ratio (SCFR). The highest proportion of excess risk for SIR and the SMR started in the North, expanding to the Midwest, Southeast, and South regions. The highest proportion of excess risk for the SCFR outcome was observed in some municipalities in the North region and in the other Brazilian regions. The COVID-19 incidence and mortality in municipalities that most benefited from the cash transfer programme and with better social development decreased. The municipalities with a higher proportion of non-whites had a higher risk of becoming ill and dying from the disease.

DISTRIBUIÇÃO ESPAÇO-TEMPORAL E FATORES ASSOCIADOS À MORTALIDADE POR HIV/AIDS ENTRE JOVENS NO NORDESTE BRASILEIRO

ABSTRACT Objective to analyze the spatial-temporal distribution and factors associated with HIV/AIDS mortality among young people in the Northeast from 2001 to 2020. Method ecological study with 2,509 deaths from HIV/AIDS from northeastern residents aged between 10 and 24 years of age, reported in the Mortality Information System. Temporal analysis techniques (Joinpoint) and detection of spatial clusters (Spatial Autocorrelation, Gets-Ord Gi* and Scan were used. Three spatial error and spatial lag (Spatial Error and Spatial Lag) and non-spatial regression models (Ordinary Least Squares-OLS) were used to identify the factors associated with mortality in northeastern municipalities, considering p<0.05. Results the HIV/AIDS mortality rate among young people in the northeast was 0.4 deaths per 100,000 inhabitants. Maranhão (APC:7.1; CI95%:2.3-12.1), Sergipe (PcA:6.9; CI95%:1.8-12.2), Rio Grande do Norte (PcA:6.4; CI95%:1.8-11.2), Ceará (PcA:4.2; CI95%:1.5-7.0) and Alagoas (APC:3.2; CI95%:0.1-6.4) showed a significant increasing trend of deaths. Cluster detection techniques indicated clusters of deaths mainly on the coast of Pernambuco and north-central Maranhão. The indicators proportion of the population in households with density >2 (β=0.012; p<0.001) and per capita transfer of the continued benefit (β=0.000; p<0.001) showed a positive relationship with the outcome. On the other hand, the proportion of extremely poor people (β=-0.011; p=0.029) and the Brazilian Deprivation Index (β=-0.195; p=0.009) were negatively associated with mortality. Conclusion there was a trend of increased mortality in five of the nine northeastern states. The spatial clusters were located mainly in Pernambuco and North-Central Maranhão. Interventions aimed at socioeconomic factors should be established to prevent HIV infections and deaths among young people.

Evaluation of the national sobriety checkpoints program in Mexico: a difference-in-difference approach with variation in timing of program adoption

BackgroundUp to a third of global road traffic deaths, and one in five in Mexico, are attributable to alcohol. In 2013, Mexico launched a national sobriety checkpoints program designed to reduce drink-driving in municipalities with high rates of alcohol-related collisions. Our study measured the association between the sobriety checkpoints program and road traffic mortality rates in 106 urban municipalities.MethodsWe leveraged data from the Salud Urbana en America Latina (SALURBAL), which compiles health and environmental data from cities with over 100,000 residents. Death data from 2005 to 2019 (i.e., outcome) were from official vital statistics. Among 106 Mexican municipalities defined as priority areas for intervention, 54 adopted the program (i.e., treatment) in 2013, 16 municipalities did so in 2014, 16 in 2015, 10 in 2016, 7 in 2017, and 2 in 2019. We used a difference-in-difference approach with inverse probability weighting adapted to a context where program adoption is staggered over time.ResultsThere was a 12.3% reduction in road traffic fatalities per 10,000 passenger vehicles in the post-treatment period compared to the pre-treatment period (95% Confidence Interval, − 17.8; − 6,5). There was a clear trend of decline in mortality in municipalities that adopted the program (vs. comparison) particularly after year 2 of the program.ConclusionsIn this study of 106 municipalities in Mexico, we found a 12.3% reduction in traffic fatalities associated with the adoption of sobriety checkpoints. There was a clear trend indicating that this association increased over time, which is consistent with sustained changes in drink-driving behavior. These findings provide support and insight for efforts to implement and evaluate the impact of sobriety checkpoint policies across Latin America.

Space-Time Clustering and Socioeconomic Factors Associated with Mortality from Diarrhea in Alagoas, Northeastern Brazil: A 20-Year Population-Based Study.

Acute diarrhea is the second leading cause of death among children in developing countries and is strongly related with the socioeconomic conditions of the population. In Brazil, data show a drop in the diarrhea mortality rate. Nevertheless, the northeastern region still has the most deaths. Considering this, we analyze high-risk areas for diarrhea- and gastroenteritis-related deaths, and their association with social determinants of health (SDH) in the state with one of the worst human development indicators in Brazil (Alagoas) between 2000 and 2019. We applied temporal, spatial, and space–time risk modelling. We used a log-linear regression model to assess temporal trends and the local empirical Bayesian estimator, the global and local Moran indices for spatial analysis. Spearman’s correlation was used to correlate mortality rates with SDH. A total of 3472 diarrhea-related deaths were reported during this period in Alagoas. We observed a decreasing time trend of deaths in the state (9.41/100,000 in 2000 to 2.21 in 2019; APC = −6.7; p-value < 0.001), especially in children under one year of age. However, there was stability among adults and the elderly. We identified two high-risk spatiotemporal clusters of mortality in inland municipalities. Lastly, mortality rates correlated significantly with 90% of SDH. Taken together, these findings indicate that diarrhea diseases remain a serious public health concern in Alagoas, mainly in the poorest and inland municipalities. Thereby, it is urgently necessary to invest in measures to control and prevent cases, and improve the living conditions of the poorest populations and those with the highest social vulnerability index.

Association between racial residential segregation and homicide mortality in municipalities in Minas Gerais, Brazil.

This article aims to evaluate the association between racial residential segregation and homicide mortality in the state of Minas Gerais (MG), Brazil. We conducted an ecological study in which the units of analysis were municipalities in MG. The outcome was homicide deaths between 2008 and 2012 and the exposure variable was residential segregation measured using the racial interaction index, calculated using data from the 2010 Demographic Census. The covariables were per capita family income and the Gini index. The variables were presented in tables and thematic maps and associations were measured using Bayesian hierarchical models. The results of the model adjusted for per capita family income showed a negative association between the racial interaction index and homicide mortality (coefficient=-1.787; 95%CI=-2.459; -1.119). Homicide mortality was lower in municipalities with higher levels of racial interaction.

Factors associated with COVID-19 mortality in municipalities in the state of São Paulo (Brazil): an ecological study.

ABSTRACTBackground: The mortality rate of coronavirus disease (COVID-19) in the state of São Paulo is highly heterogeneous. This study investigated geographic, economic, social, and health-related factors associated with this discrepancy. Methods: An ecological study compared COVID-19 mortality rates according to geographic, economic, social, and health-related variables during initial infection of 2.5% of the population in municipalities with more than 30,000 inhabitants. Results: Mortality was positively associated with demographic density and social inequality (Gini index), and inversely associated with HDI income and longevity of these municipalities, accounting for 33.2% of the variation in mortality. Conclusions: Social determinants influenced COVID-19 outcomes.

Heavy metal toxicity and mortality—association between density of heavy metal bands and cause specific hospital admissions and mortality: population based cohort study

ObjectiveTo assess the association between area level density of heavy metal bands and cause specific hospital admissions and mortality.DesignLongitudinal register based cohort study.Setting311 municipalities in Finland.Participants3 644 944 people aged...

Overview of the Impacts of Pesticides on Human Health in Municipalities with high use and consumption in SPst - Brazil

BACKGROUND AND AIM: The research and activities developed by the São Paulo Forum to Combat Impacts on Pesticides and Transgenics, involve municipalities with higher levels of aerial spraying and where the mortality rate is different. The Forum is composed of members of civil society and public institutions. OBJECTIVE in this symposium: To analyze intoxications, congenital malfomation and the profile of cancer mortality in municipalities where high levels of pesticides were found in water for human consumption. METHODS: Descriptive cross-sectional study based on data from the Ministry of Health/DATASUS on deaths and poisoning by pesticides, domestic use, use in public health and rodenticides in municipalities in the State of São Paulo. RESULTS:Between 2010 and 2019, 113,245 intoxications were reported in Brazil, 60,025 of which were attempted suicides and 39,255 of accidental and habitual use. Of the intoxications in Brazil, 78% were unrelated to work and 3,513 evolved to deaths.In SP state congenital malformations are the third leading cause of child and adolescent deaths (2.41 deaths/1000 inhab) and neoplasms, the fifth leading cause (1.92 deaths/1,000 inhabitants). In 11 municipalities where there is aerial spraying, the rate of neoplasms is 3.49 /100 thousand inhabitants and the second cause of congenital malformation in 5 of these municipalities. The 113,245 cases of poisoning in Brazil, 74.6% of the victims lived in urban areas. In relation to the São Paulo st, 86% lived in urban. Regarding color/race, in Brazil 43.1% were black. Most are between 20 and 39 yo and 26.8% were children under 1 year and 19 yo. CONCLUSIONS:When analyzing the data on the commercialization of pesticides in Brazil, comparing with the incidences of notification of poisoning by pesticides (for agricultural, domestic, public health and rodenticide), a proportional growth is observed, as each product is consumed.We conclude that information is fundamental for society to seek public policies. KEYWORDS: Pesticides,Occupational exposures,Mortality,Toxicology,Water quality

Brazil\u2019s more doctors programme and infant health outcomes: a longitudinal analysis

BackgroundProviding sufficient numbers of human resources for health is essential for effective and accessible health services. Between 2013 and 2018, the Brazilian Ministry of Health implemented the Programa Mais Médicos (PMM) (More Doctors Programme) to increase the supply of primary care doctors in underserved areas of the country. This study investigated the association between PMM and infant health outcomes and assessed if heterogeneity in the impact of PMM varied by municipal socio-economic factors and health indicators.MethodsAn ecological longitudinal (panel) study design was employed to analyse data from 5565 Brazilian municipalities over a 12-year period between 2007 and 2018. A differences-in-differences approach was implemented using longitudinal fixed effect regression models to compare infant health outcomes in municipalities receiving a PMM doctor with those that did not receive a PMM doctor. The impact of PMM was assessed on aggregate and in municipality subgroups.ResultsOn aggregate, the PMM was not significantly associated with changes in infant or neonatal mortality, but the PMM was associated with reductions in infant mortality rate (IMR) (of − 0.21; 95% CI: − 0.38, − 0.03) in municipalities with highest IMR prior to the programme’s implementation (where (IMR) > 25.2 infant deaths per 1000 live births). The PMM was also associated with an increase in the proportion of expectant mothers receiving seven or more prenatal care visits but only in municipalities with a lower IMR at baseline and high density of non-PMM doctors and community health workers before the PMM.ConclusionsThe PMM was associated with reduced infant mortality in municipalities with the highest infant mortality rate prior to the programme. This suggests effectiveness of the PMM was limited only to the areas of greatest need. New programmes to improve the equitable provision of human resources for health should employ comprehensive targeting approaches balancing health needs and socio-economic factors to maximize effectiveness.

Scalable Bayesian modelling for smoothing disease risks in large spatial data sets using INLA

Several methods have been proposed in the spatial statistics literature to analyse big data sets in continuous domains. However, new methods for analysing high-dimensional areal data are still scarce. Here, we propose a scalable Bayesian modelling approach for smoothing mortality (or incidence) risks in high-dimensional data, that is, when the number of small areas is very large. The method is implemented in the R add-on package bigDM and it is based on the idea of “divide and conquer“. Although this proposal could possibly be implemented using any Bayesian fitting technique, we use INLA here (integrated nested Laplace approximations) as it is now a well-known technique, computationally efficient, and easy for practitioners to handle. We analyse the proposal’s empirical performance in a comprehensive simulation study that considers two model-free settings. Finally, the methodology is applied to analyse male colorectal cancer mortality in Spanish municipalities showing its benefits with regard to the standard approach in terms of goodness of fit and computational time.

Patterns of COVID-19 related excess mortality in the municipalities of Northern Italy during the first wave of the pandemic.

The impact of Coronavirus Disease 2019 (COVID-19) on mortality in Italy has been described at the regional level, while less is known about mortality in municipalities, although the spatial distribution of COVID-19 in its first wave has been uneven.We aimed to describe the excess mortality due to COVID-19 from February 23rd to April 30th, 2020 in the three most affected Italian regions, in age and gender subgroups within each municipality.Excess mortality varied widely among municipalities even within the same region; it was higher among the elderly and higher in males except in the ≥75 age group. Thus, nearby municipalities may show a different mortality burden despite being under common regional health policies, possibly as a result of local reinforcements of regional policies.Identifying the municipalities where mortality was higher and the pathways used by the virus to spread may help to concentrate efforts in understanding the reasons why this happened and to identify the frailest areas in light of recurrences of the epidemic.

How Emergency Care Congestion Increases COVID-19 Mortality: Evidence from Lombardy, Italy

Background: The COVID-19 pandemic has caused generous and well-developed healthcare systems to collapse. This paper quantifies how much system congestion may have increased mortality rates, using distance to the ICU as a proxy for access to emergency care.Methods: We match daily death registry data for almost 1,500 municipalities in Lombardy, Italy, to data on geographical location of all ICU beds in the region. We then analyze how system congestion increases mortality in municipalities that are far from the ICU through a differences-in-differences regression model.Findings: We find that COVID-19 mortality is up to 60% higher in the average municipality - which is 15 minutes driving away from the closest ICU - than in a municipality with an ICU in town. This difference is larger in areas and in days characterized by an abnormal number of calls to the emergency line.Interpretation: We interpret these results as suggesting that a sudden surge of critical patients may have congested the healthcare system, forcing emergency medical services to prioritize patients in the most proximate communities in order to maximize the number of lives saved. Through some back-of-the-envelope calculations, we estimate that Lombardy's death toll from the first COVID-19 outbreak could have been 25% lower had all municipalities had ready access to the ICU. Drawing a lesson from Lombardy's tale, governments should strengthen the emergency care response and palliate geographical inequalities to ensure that everyone in need can receive critical care on time during new outbreaks.

The effects of the mining-energy boom on inclusive development in Colombia

This article explores the relationship between mining-energy and inclusive development indicators of local communities. The analysis includes several dimensions of inclusive development: education, health, security, and the quality of the local public management. We study two regions in Colombia which are the main mining-energy producers: Cesar, which produces more than 60% of the nation's coal, and Casanare, which produces 20% of the nation's oil. We use a panel data estimation methodology based on the indicators for all municipalities from 2000 to 2015. The results show that mining-energy municipalities had, in general, better performance in social indicators than in other non mining-energy municipalities. However, when we consider the correlation between trends in social indicators and the interaction between mining-energy activity and time, there is no clear pattern. In Casanare, there is no evidence of better performance in any indicator in oil-producer municipalities. In Cesar, the results are mixed. Child mortality and homicides in mining municipalities exhibit improvements, while education and fiscal performance show setbacks.

Mortalidade por acidentes de transporte terrestre no estado de São Paulo: análise da tendência nos anos de 2000 - 2017

O objetivo deste trabalho foi descrever o perfil da mortalidade por acidentes de transporte terrestre (ATT) no estado de São Paulo e os efeitos da Lei Seca sobre a taxa de mortalidade. Foram selecionados, pelo Sistema de Informações sobre Mortalidade (SIM), os óbitos com os códigos V01-V89 determinados na 10ª revisão da Classificação Internacional de Doenças (CID-10), tendo como causa o ATT. Calculou-se, para 8 anos antes e 9 anos após a Lei, a taxa de mortalidade por ATT de acordo com faixa etária e sexo. Além da distribuição (absoluta e percentual) da mortalidade por ATT relacionados as variáveis: faixa etária, sexo, raça, escolaridade, estado civil, categoria da CID-10 e por departamentos regionais de saúde (DRS). Os resultados mostraram uma tendência de aumento de óbitos por ATT antes da Lei e uma queda nos óbitos após a Lei, além de maior frequência de mortalidade no sexo masculino, entre 20-39 anos, solteiros, brancos, com escolaridade de 4-7 anos antes da Lei e de 8-11 anos após a Lei. Maior mortalidade nos Municípios da Grande São Paulo, Baixada Santista, Registro e Taubaté tanto antes como após a Lei; maior registro de mortalidade por outros ATT antes da Lei e uma maior frequência de pedestres traumatizados por ATT após a Lei. Conclui-se então que a implementação da Lei Seca interferiu positivamente na taxa de mortalidade observada no período e nas variáveis analisadas.

Female motorcycle mortality in Brazilian municipalities, 2005, 2010 and 2015.

To analyze the spatial distribution of female mortality due to motorcycle accidents in Brazilian municipalities between 2005 and 2015, as well as the variation in rates in the same period. Female mortality rates for the years 2005, 2010 and 2015 were estimated considering a three-year moving average around the base year, standardized by the direct method. Rates were standardized using the same pattern (Brazilian females in 2010) for each year. Then, the empirical Bayes estimator was used to reduce the effect of the random fluctuation. The percentage variation of the standardized rates was also analyzed for different population sizes (less than ten thousand, less than 50 thousand, more than 100 thousand and more than one million inhabitants). Bayesian rates showed a clear increase in female mortality due to motorcycle accidents, especially in the North, Northeast and Midwest regions. In the municipalities of the South and Southeast regions, mainly in the period between 2010 and 2015, there was an apparent decrease in mortality. The percentage variation showed a reduction in the indicator analyzed in the period between 2010 and 2015 for the largest municipalities in the South and Southeast regions. For almost all regions and population sizes, the period between 2010 and 2015 showed a deceleration in the growth of rates. The analysis clearly shows concentrations of municipalities with higher mortality, while also showing that the phenomenon has spread to a greater number of municipalities. The studied period allows the identification of different dynamics in female mortality, in a period of significant variation in mortality due to motorcycle accidents.

Infant mortality in the Brazilian countryside: a proposal to overcome epidemiological and demographic invisibility

The study aimed to compare two concepts of rurality, one proposed by the Brazilian Institute of Geography and Statistics (IBGE) and the other by the World Bank, to determine which is better fitted to the territory's reality, besides analyzing the infant mortality profile of rural municipalities (counties) in the state of Paraíba, Brazil, according to the best criterion for rurality. This was an observational epidemiological study conducted in the state of Paraíba. The method for analyzing rural/urban typologies was based on data mining, using the Apriori algorithm of association. Infant mortality was analyzed with descriptive statistics. The data were obtained from the Mortality Information System of the Brazilian Ministry of Health, from 2007 to 2016, and municipal indicators were from IBGE. The World Bank definition of rurality showed kappa = 0.337, compared to the IBGE definition, with kappa = 0.616. Among the 223 municipalities that were analyzed, the World Bank classified 130 (65.66%) correctly, and the IBGE 183 (82.06%). The predominant epidemiological profile of infant mortality in rural municipalities in Paraiba state was male gender (57.4%), brown skin color (61.1%), age from 0 to 7 days (52.4%), low birthweight (44%), and gestational age less than 37 weeks (43.2%). Underlying cause of death was classified as avoidable death via interventions by the Brazilian Unified National Health System (65.2%). The urban/rural typology adopted by the IBGE was better than the World Bank at classifying the municipalities in Paraiba state. This classification allowed studying the infant mortality profile in rural municipalities, which was similar to the overall profile, except for maternal schooling.

Effects of decentralization of primary health care on diabetes mellitus in Brazil

The aim of this study was to investigate the effects of primary healthcare decentralization on type 2 diabetes mellitus mortality and morbidity in different municipalities of a developing country. This was a retrospective study based on a panel of annual data from 5560 Brazilian municipalities from 2000 to 2011. The investigation used the staggered municipal adoption of a federal health information program as a quasi-experiment to identify the treatment effects of health decentralization on diabetes indicators. Using Difference-in-Differences models and instrumental variables, we analyzed the effects of primary healthcare decentralization on diabetes rates (i.e. diabetes deaths and hospitalizations by the number of people with a diabetes diagnosis and by population). Evidence suggests improvements in universal access to primary health care and progress in the average health outcomes related to diabetes mortality (reduction of 30%) and hospitalization (reduction of 2.3%) due to decentralization. Effects are further pronounced in developed regions with higher incomes, while the poorest and less developed regions showed virtually no effect. These results demonstrate that there are particular preconditions for successful primary health decentralization, especially related to returns of scale (big health facilities are associated with low cost per treatment), lack of human and physical capital, and government coordination problems.

Impact of modelled PM2.5, NO2 and O3 annual air concentrations on some causes of mortality in Tuscany municipalities.

In 2014, the European Environment Agency estimated 59 630 premature deaths in Italy attributable to long-term exposure to PM2.5, 17 290 to NO2 and 2900 to O3. The aim of this study was to test an approach for assessing health impact of the above pollutants analyzing possible associations between annual municipal concentrations, estimated by the national dispersion model developed by ENEA, and mortality rates for trachea, bronchus and lung (TBL) cancer, total respiratory diseases (RD) and chronic obstructive pulmonary diseases (COPD). Tuscany was selected as test case. For the 287 municipalities, 2009-13 standardized mortality rates (SMRates) for each cause of death were calculated by the ENEA epidemiological database. The SMRates of municipalities, aggregated on the basis of the 2003 or 2010 estimated pollutant concentration tertiles, were also computed. TBL cancer SMRate in municipalities with 2003 PM2.5 levels >15.2 μg/m3 was significantly higher than the SMRates of the two lowest tertiles and COPD SMRates in the two highest O3 tertiles were significantly higher than that of the lower tertile. No association between PM2.5 or NO2 concentrations and RD and COPD was detected. Approximately 625 TBL cancer deaths attributable to PM2.5 levels above 10 μg/m3 in 2003 were estimated in the region. Smoking habits and deprivation index were homogeneously distributed among municipalities. This methodological approach allowed detecting associations between mortality and specific air pollutants even at levels below the Italian normative limits and could be employed to evaluate the potential health impact of air pollution in areas where direct measures of concentration are unavailable.

Social disorganization and homicide mortality rate trajectories in Brazil between 1991 and 2010

Since the 1990s, researchers have noted declining trends in crime and violence, particularly homicide, in Western countries. Studies have explored national and sub-national trends using latent trajectory analysis techniques and identified several factors associated with declining and/or increasing trajectories. Social disorganization (SD) has been consistently linked to increases in homicide rates over time, explaining at least some of the spatial and temporal heterogeneity of homicide. Similar studies have not yet been carried out in Latin America's cities. In this paper we use Group Based Trajectory models to study homicide mortality rate [HMR] trajectories in Brazilian municipalities between 1991 and 2010. Then, through binary and multinomial logistic regression we investigated the association between SD in 1991, and the likelihood of an increasing HMR trajectory. We carried out an ecological time series study using all Brazilian municipalities in the period between 1991 and 2010 (n = 4491). Data on homicide deaths were collected from the Mortality Information System of the Ministry of Health and standardized by age to calculate HMR per 100,000 population. Socioeconomic and demographic data for 1991 were used to compose the composite measure of SD. Our results highlight the spatial and temporal heterogeneity of homicide mortality in Brazilian municipalities. While national trends are steadily increasing, disaggregating municipal trajectories shows that this is driven by a small proportion of municipalities in the country. We found that SD is associated with an ascending homicide trajectory. This result generally supports the notion that poor social structural conditions can create ‘space’ for criminal behavior and groups and, consequently, violent death.

Residential radon and lung cancer. An ecologic study in Galicia, Spain

Background and objectiveResidential radon is the second cause of lung cancer and the first in never smokers. Galicia is a high radon emission area. The objective of this study is to analyse the relationship between municipal lung cancer mortality and residential radon in Galician municipalities. Material and methodWe performed an ecologic study including 192 municipalities with at least 3 residential radon measurements. The observed number of lung cancer deaths was obtained from the Galician Mortality Registry. Afterwards, we calculated the standardised mortality ratios (SMRs) of lung cancer for males and females for the period comprising 1980–2009. Median municipal residential radon concentrations were correlated with lung cancer SMRs. ResultsMedian residential radon concentration for the included municipalities was 75Bq/m3, with an interquartile range of 40.7–154Bq/m3. The correlation between lung cancer SMRs and municipal radon concentration was statistically significant for males (p=.023) whereas it did not reach statistical significance for females (p=.087). ConclusionThere exists an association between municipal residential radon and lung cancer mortality in Galicia for males, though for women the association is not statistically significant. These results suggest that residential radon could raise the risk of lung cancer in males, though for females no association is evident.