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.

In this paper, we measure the effect of the 2020 COVID-19 pandemic wave at the national and subnational levels in selected Latin American countries that were most affected: Brazil, Chile, Ecuador, Guatemala, Mexico, and Peru. We used publicly available monthly mortality data to measure the impacts of the pandemic using excess mortality for each country and its regions. We compare the mortality, at national and regional levels, in 2020 to the mortality levels of recent trends and provide estimates of the impact of mortality on life expectancy at birth. Our findings indicate that from April 2020 on, mortality exceeded its usual monthly levels in multiple areas of each country. In Mexico and Peru, excess mortality was spreading through many areas by the end of the second half of 2020. To a lesser extent, we observed a similar pattern in Brazil, Chile, and Ecuador. We also found that as the pandemic progressed, excess mortality became more visible in areas with poorer socioeconomic and sanitary conditions. This excess mortality has reduced life expectancy across these countries by 2–10 years. Despite the lack of reliable information on COVID-19 mortality, excess mortality is a useful indicator for measuring the effects of the coronavirus pandemic, especially in the context of Latin American countries, where there is still a lack of good information on causes of death in their vital registration systems.

The observed improvements seem to be related to investments in the public health care system and administrative procedures to improve the recording of vital events.

To determine the variations and spatial patterns of adult mortality across regions, over time, and by sex for 137 small areas in Brazil, we first apply TOPALS to estimate and smooth mortality rates and then use death distribution methods to evaluate the quality of the mortality data. Lastly, we employ spatial autocorrelation statistics and cluster analysis to identify the adult mortality trends and variations in these areas between 1980 and 2010. We find not only that regions in Brazil’s South and Southeast already had complete death registration systems prior to the study period, but that the completeness of death count coverage improved over time across the entire nation—most especially in lesser developed regions—probably because of public investment in health data collection. By also comparing adult mortality by sex and by region, we document a mortality sex differential in favor of women that remains high over the entire study period, most probably as a result of increased morbidity from external causes, especially among males. This increase also explains the concentration of high male mortality levels in some areas.

Resumo: Este trabalho tem por objetivo estimar os diferenciais de mortalidade por nível de escolaridade da população adulta do Brasil e suas regiões, segundo sexo e idade. O artigo utiliza os dados do novo quesito de mortalidade domiciliar do Censo Demográfico de 2010 do Instituto Brasileiro de Geografia e Estatística, combinado com as informações do nível de escolaridade da pessoa de referência do domicílio. Os resultados indicam um considerável diferencial de mortalidade por grau de escolaridade, particularmente entre a população masculina. A expectativa de vida de homens com o ensino superior completo no Brasil era 4,37 anos maior do que a média da população masculina nacional, e 6,27 anos maior do que a da população masculina com menos do que o Ensino Fundamental completo. Entre a população feminina, o gradiente educacional de expectativa de vida é menos acentuado, com um adicional de 2,25 anos na expectativa de vida de mulheres com o Ensino Superior completo em comparação às com menor nível de escolaridade. Os diferenciais de mortalidade por educação aparecem mais acentuados nas regiões Nordeste e Sudeste.

O método de relação de coortes é um método demográfico utilizado para projeções populacionais por sexo e idade para pequenas áreas. Porém, devido a instabilidade dos eventos demográficos em áreas menores, o método produz resultados pouco razoáveis para alguns grupos de idade. Neste artigo aplicamos um estimador contração, bayesiano empírico, para reduzir a instabilidade nas estimativas dos fatores diferenciais de crescimento do método em áreas menores. Ao aplicarmos o método de relação de coortes, ajustado pelo bayesiano empírico, para projeções populacionais municipais no Brasil entre 2000 e 2010, observamos uma redução na variabilidade das estimativas por idade. Além disso, o método reduziu o erro percentual absoluto médio das populações projetadas nesse decênio comparativamente aos resultados obtidos com a aplicação do método original proposto por Duchesne (1989), especialmente nos grupos etários de adultos e idosos.  

BACKGROUNDThe covid-19 pandemic has considerably affected the mortality numbers of many countries in the world, and Latin America is now the epicenter of the diseases. There is a great demand on analyzing the impact of this new disease in the amount of deaths, but available information of deaths by cause is still lacking in most of the countries in the region. OBJECTIVEWe aimed to measure the effects of the disease on mortality, using excess mortality, in two Latin America countries that were most affected by the covid-19 pandemic in the region: Brazil, Chile, Ecuador and Peru. METHODSWe measured the effects of the pandemic by looking at the excess mortality, and comparing estimates of differences in the average number of deaths, variation coefficients and percentages of deaths between the months of March to May for 2019 and 2020. RESULTSOur findings indicated an excess of deaths initially in major cities, but then is spreading towards the least urbanized areas. In the next phase, pandemic will probably affect countries’ cities in worse socioeconomic and sanitary conditions. In Ecuador, we saw that the most affected locations were the less socioeconomic areas of the country. CONCLUSIONDespite the lack of information on causes of death, the excess of deaths is a good indicator for measuring the effects of the coronavirus pandemic, especially in the context Latin America countries. We find strong evidence of the pandemic’s impact and interiorization, especially in Brazilian cases. CONTRIBUTIONThis study provides an initial discussion of the effects of pandemic in small and less urbanized areas of Brazil and Ecuador.

Um grande problema em estimativas demográficas no