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. 2023 Apr 21;120(4):e20211009.
doi: 10.36660/abc.20211009. eCollection 2023.

Association between Mortality from Chronic Noncommunicable Diseases and Human Development Index in Brazil between 1980 and 2019

[Article in English, Portuguese]
Sandra Chagas da Costa Feliciano  1 , Paolo Blanco Villela  1 , Gláucia Maria Moraes de Oliveira  1
Affiliations

Association between Mortality from Chronic Noncommunicable Diseases and Human Development Index in Brazil between 1980 and 2019

[Article in English, Portuguese]
Sandra Chagas da Costa Feliciano et al. Arq Bras Cardiol. .

Abstract
in English, Portuguese

Background: Chronic noncommunicable diseases (CNCDs) caused more than 734,000 deaths (55% of all deaths) in Brazil in 2019, with an important socioeconomic impact.

Objectives: To analyze the mortality rates from CNCDs in Brazil from 1980 to 2019 and their association with socioeconomic indicators.

Method: This was a descriptive, time-series study of deaths from CNCDs in Brazil from 1980 to 2019. Data on the annual frequencies of deaths and on population were obtained from the Department of Informatics of the Brazilian Unified Health System. Crude and standardized mortality rates per 100,000 inhabitants were estimated using the direct method (Brazilian population in 2000). The quartiles of each CNCD were calculated, where a quartile change, due to an increase in mortality rate, was represented by a chromatic gradient. The Municipal Human Development Index (MHDI) of each Brazilian federative unit was extracted from the Atlas Brasil website and correlated with the rates of CNCD mortality.

Results: There was a reduction in mortality rates due to diseases of the circulatory system during the period, except in the Northeast Region. There was also an increase in mortality from neoplasia and diabetes, while the rates of chronic respiratory diseases showed little variation. There was an inverse correlation between the federative units with greater reduction in CNCD mortality rates and the MHDI.

Conclusions: The observed decrease in mortality due to diseases of the circulatory system may reflect an improvement in socioeconomic indicators in Brazil during the period. The increase in mortality rates due to neoplasms is probably related to the aging of the population. The higher mortality rates of diabetes seem to be associated with an increase in the prevalence of obesity in Brazilian women.

Fundamento: No Brasil, em 2019, as doenças crônicas não transmissíveis (DCNT) acarretaram mais de 734 mil óbitos, 55% de todas as mortes, com importante impacto socioeconômico.

Objetivos: Analisar as taxas de mortalidade das DCNT, no Brasil, de 1980 a 2019, e sua associação com indicadores socioeconômicos.

Métodos: Trata-se de um estudo descritivo, de séries temporais dos óbitos por DCNT, no Brasil, de 1980 a 2019. Os dados relativos às frequências anuais de mortes e da população foram obtidos do DATASUS. Foram estimadas as taxas de mortalidade brutas e padronizadas por 100.000 habitantes, pelo método direto (população do Brasil de 2000). Foram calculados os quartis de cada DCNT, onde a mudança de quartil, por aumento das taxas de mortalidade, foi representada por gradiente cromático. O Índice de Desenvolvimento Humano Municipal (IDHM) de cada unidade da federação (UF) foi extraído do site Atlas Brasil e correlacionado com as taxas de mortalidade por DCNT.

Resultados: Ocorreu redução nas taxas de mortalidade por doenças do aparelho circulatório no período, exceto na região Nordeste. Houve também aumento da mortalidade por neoplasia e diabetes, enquanto as taxas das doenças respiratórias apresentaram poucas variações. Houve correlação inversa entre as UF com maior redução nas taxas de mortalidade por DCNT e o IDHM.

Conclusões: A redução observada na mortalidade por doenças do aparelho circulatório pode refletir melhoria dos indicadores socioeconômicos, no Brasil, nesse período. O aumento da taxa de mortalidade por neoplasias provavelmente se relaciona com o envelhecimento da população. As maiores taxas de mortalidade por diabetes parecem ser associadas com o aumento da prevalência da obesidade nas mulheres brasileiras.

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Conflict of interest statement

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Figures

Figura 1
Figura 1. – Taxas brutas (1A) e padronizadas (1B) de mortalidade por 100,000 habitantes das doenças crônicas não transmissíveis (DAC: doenças do aparelho circulatório; DRC: doenças respiratórias crônicas; DM: diabetes mellitus e NEO: neoplasias), em ambos os sexos, em todas as faixas etárias, no Brasil, no período de 1980 a 2019.
Figura Central
Figura Central. : Associação entre a Mortalidade por Doenças Crônicas Não Transmissíveis e o Índice de Desenvolvimento Humano no Brasil entre 1980 e 2019
Figura 2
Figura 2. – Gráfico de dispersão. Correlação entre a variação percentual do Índice de Desenvolvimento Humano Municipal (IDHM) 1991 e 2010 com a variação percentual da taxa de mortalidade das doenças crônicas não transmissíveis: doença do aparelho circulatório (DAC); doenças respiratórias crônicas (DRC); neoplasias (NEO); diabetes mellitus (DM), 1990 e 2019, no Brasil nas UF, em ambos os sexos.
Figura 3
Figura 3. – Gráfico de dispersão. Correlação entre Índice de Desenvolvimento Humano Municipal (IDHM) absoluto no ano de 2010 com a variação percentual da taxa de mortalidade das doenças crônicas não transmissíveis: doença do aparelho circulatório (DAC); doenças respiratórias crônicas (DRC); neoplasias (NEO); diabetes mellitus (DM), 1990 e 2019, no Brasil nas UF, em ambos os sexos.
Figure 1
Figure 1. – Crude (1A) and standardized (1B) mortality rates from chronic noncommunicable diseases (DCS: diseases of the circulatory system; CRD: chronic respiratory diseases; DM: diabetes mellitus and NEO: neoplasms) per 100,000 inhabitants, in both sexes and across all age groups from 1980 to 2019 in Brazil.
Central Illustration
Central Illustration. : Association between Mortality from Chronic Noncommunicable Diseases and Human Development Index in Brazil between 1980 and 2019
Definition of chronic noncommunicable diseases; mortality in Brazil with the percentage of deaths in 2019 and age-standardized mortality rates in 1980 and 2019; relationship between male and female sex regarding mortality rates; and possible association of mortality with the Human Development Index. CNCDs: chronic noncommunicable diseases.
Figure 2
Figure 2. – Scatter plot. Correlation between the percentage change in the 1991 and 2010 Municipal Human Development Index (MHDI) with the percentage change in mortality rate for chronic noncommunicable diseases: diseases of the circulatory system (DCS); chronic respiratory diseases (CRD); neoplasms; diabetes mellitus (DM), 1990 and 2019, in Brazil in the federative units, in both sexes.
Figure 3
Figure 3. – Scatter plot. Correlation between the absolute Municipal Human Development Index (MHDI) in the year 2010 with the percentage change in mortality rate for chronic noncommunicable diseases: diseases of the circulatory system (DCS); chronic respiratory diseases (CRD); neoplasms; diabetes mellitus (DM), 1990 and 2019, in Brazil in the federative units, in both sexes.
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