Mortalidade por doenças cardiovasculares e níveis socioeconômicos na população de São José do Rio Preto, estado de São Paulo, Brasil

Estudo comparativo de mortalidade por doenças cardiovasculares em São Caetano do Sul (SP), Brasil, no período de 1980 a 2010

“…However, the results of this study in São Caetano do Sul seem not to follow this rule, as of the three units analyzed, it had the highest HDI and the lowest mortality due to CVD, even in age groups where death due to CVD is considered premature death. Ishitani et al 24 and Godoy et al 5 showed a negative association between CVD mortality in Brazil and the socioeconomic situation (income, years of schooling and housing), in particular schooling. On the other hand, Muller et al 6 found no relationship between unfavorable socioeconomic conditions and CVD mortality in the state of Paraná, possibly due to the heterogeneous socioeconomic profile of each macro-region.…”

“…Although some studies show a decrease in CVD deaths 1,[3][4][5][6][7][8]11,[19][20][21] , possibly due to accelerated economic development, bringing with it better living conditions and less exposure to infections during the perinatal period 4 , such deaths may present themselves in a non-homogeneous manner within the population groups of a given country, as mentioned by Frank et al 22 . Reinforcing these findings, Mansur et al 19 found an increase in the risk of death due to these diseases in the less developed states of the country, which agrees with the study by Farias et al 23 , which suggests that despite a decrease in recent years, these deaths may show different patterns in the different socioeconomic groups.…”

“…According to Kaplan and Keil 26 , higher income means easier access to better goods and services, including quality education and healthcare. Studies show that inequality in education is the more harmful as it has a direct effect on adopting healthy lifestyles, which minimize the effects of the risks for cardiovascular disease 5,[27][28][29] . Factors increasing the risk of CVD, such as high blood pressure, high cholesterol, tobacco use and a sedentary lifestyle are more frequent among those with less schooling 30,31 .…”

“…Public policies have expanded the traditional scope of medical care to include prevention, health promotion and inter-sectoral activities, among which we would mention the National Plan to Reorganize Attention to Hypertension and Diabetes Mellitus, the Stop Smoking Program, easier access to immediate care units (UPA), programs to distribute drugs for chronic diseases, such as Farmá-cia Popular, expanded support to Family Health Strategy teams by other healthcare professionals such as nutritionist, Physical Education teachers, psychologists and psychiatrists. Other possible causes that may have contributed to this outcome are the use of anti-hypertensive, hypolipidemic and hypoglycemic drugs, the increased use of polyunsaturated fats, less ingestion of cholesterol and a decline in smoking 5 . According to a study performed by Unal et al 36 , over half of the CVD deaths in the UK between 1981 and 2000 was due to a reduction in risk factors, especially smoking.…”

“…The nation has gone from high levels of infant mortality and a predominance of infectious and parasitic diseases, to higher mortality rates among those more advanced in age due to chronic, non-transmissible diseases and external causes 2 . In the last 60 years of the 20 th century, mortality due to all causes in Brazil dropped due to public health measures and preventive medicine techniques that, added to economic development, resulted in lower infant mortality and longer life-expectancy [3][4][5][6][7] .…”