Mortality according to gender identity and sexual orientation: Data relationship strategies for Rio de Janeiro, Brazil

Abstract

Objective: To evaluate the accuracy, potential, and limits of probabilistic data relationships to yield information on deaths according to sex identity and sexual orientation in the state of Rio de Janeiro. Methods: This study evaluated the accuracy of the probabilistic relationship of data to obtain information on deaths according to gender and sexual orientation. Data from two information systems were used from June 15, 2015 to December 31, 2020. We constructed nine probabilistic data relationship strategies and identified the performance and cutoff points of the best strategy. Results: The best data blocking strategy was established through logical blocks with the first and last names, birthdate, and mother's name in the pairing strategy. With a population base of 80,178 records, 1556 deaths were retrieved. With an area under the curve of 0.979, this strategy presented 93.26% accuracy, 98.46% sensitivity, and 90.04% specificity for the cutoff point ≥ 17.9 of the data relationship score. The adoption of the cutoff point optimized the manual review phase, identifying 2259 (90.04%) of the 2509 false pairs and identifying 1532 (98.46%) of the 1556 true pairs. A crude mortality rate of 19.11 deaths per 1,000 people was observed, where women who had sex with women, transvestites, and transgender women had higher mortality rates than heterosexual cisgender women. Neither men nor men with gender markers had higher mortality rates than heterosexual cisgender women. Conclusion: With the identification of possible strategies for determining probabilistic data relationships, the retrieval of information on mortality according to sexual and sex markers has become feasible. Based on information from the daily routine of health services, the formulation of public policies that consider the LGBT+ population more closely reflects the reality experienced by these population groups.