Decomposition of mortality rates from cardiovascular disease in the adult population: a study for Brazilian micro-regions between 1996 and 2015

Abstract

<jats:p>Cardiovascular disease (CVD) is one of the most serious health issues and the leading cause of death worldwide, causing 30% of deaths in Brazil alone in recent years. However, CVD mortality rates are not uniformly distributed across the country. Brazil is marked by important regional differences resulting from socioeconomic inequality and limited access to health services. Given the spatial distribution of causes and heterogeneity of deaths from cardiovascular disease in Brazil, both at macro and micro levels, the goal of this paper is to investigate how age composition effects and age-specific mortality rates are related to the observed difference in deaths from cardiovascular disease in the adult population (over 30 years of age), by sex, in Brazilian micro-regions from 1996 to 2015. The results suggest there has been a decrease in mortality rates resulting from cardiovascular disease, and that both the effects of age structure and level may have influenced the variation of these deaths in Brazil over the period analyzed. These findings indicate that the Brazilian epidemiological transition is not uniform across and within regions of the country.</jats:p>

The relation between cardiovascular mortality and development: Study for small areas in Brazil, 2001–2015

“…Meanwhile, the less developed North and Northeast regions observed an increase in CVD mortality overtime (see Figures A-1 and B-1 in the supplementary material). This spatial heterogeneity over the period appears to be associated with access to proper healthcare and strongly related to socioeconomic factors (Mansur and Favarato 2016;Baptista, Queiroz, and Rigotti 2018;Lotufo 2019). In addition, males have higher mortality rates than females in approximately 72% of micro-regions.…”

“…The decline was higher in the southeastern and southern regions of the country and in the Federal District, while the lowest reductions occurred in the northern and northeastern regions where the socioeconomic conditions are the worst. Baptista, Queiroz, and Rigotti (2018) analyze the recent evolution of mortality due to cardiovascular disease and decompose the effects of changes in the levels of mortality rates and age structure of the population. They note an increased concentration of high mortality rates from this disease in the Northeast.…”

“…While the number of deaths from CVD in Brazil increased from 258,338.97 in 1990 to 388,268.09 in 2017, the percentage has remained fairly stable, 28.89% and 28.78%, respectively (Global Burden of Disease Collaborative Network 2019). However, despite CVD being the main cause of mortality in Brazil (Lotufo 2019), CVD mortality rates are not uniformly distributed within the country (Borges 2017;Baptista, Queiroz, and Rigotti 2018;Baptista and Queiroz 2019). Brazil is marked by important regional disparities resulting from socioeconomic inequality and limited access to health services (Souza et al 2018).…”

Reduction of mortality and predictions for acute myocardial infarction, stroke, and heart failure in Brazil until 2030

“…Concerning geographic regions, varied patterns were verified among the diseases, with better perspectives of reduction for the regions with higher socioeconomic levels 31 , 35 , 38 . This could be related to factors such as social development, risk behavior, access and coverage of the health system in each region 35 , 39 , 40 , as Brazil has continental dimensions and evident regional inequalities 39 , 41 , 42 . Another important result was the higher mortality in men, which has also been reported by other studies 24 , 32 , 35 .…”

“…In this way, although decreasing rates were identified, this process implies in the necessity of a better structure of health systems to address the situation 34 , especially in more critical regions, with worse access to healthcare 34 . Therefore, population aging has generated several demands towards the health system, considering the necessities of reducing the burden of the disease and promoting healthy aging 32 , 33 , 36 , 39 , 43 .…”