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. 2025 Jul 21:28:e250039.
doi: 10.1590/1980-549720250039. eCollection 2025.

The effect of premature mortality due to despair on life expectancy in Brazil

Raphael Mendonça Guimarães  1 , José Henrique Costa Monteiro-da-Silva  2
Affiliations

The effect of premature mortality due to despair on life expectancy in Brazil

Raphael Mendonça Guimarães et al. Rev Bras Epidemiol. .

Abstract
in English, Portuguese

Objective: The aim of this study was to estimate the impact of deaths of despair (DoD) on life expectancy at birth and by sex in Brazil in 2019, as well as the contribution of different age groups to this loss.

Methods: We used life tables from the Brazilian Institute of Geography and Statistics and cause-specific mortality data by age and sex from the Mortality Information System. A cause-deleted life table methodology was applied, assuming independence between DoD and other causes of death. The difference in life expectancy with and without DoD was decomposed by age using Arriaga's method. DoD included deaths from suicide, intentional or accidental poisoning, and mental and behavioral disorders due to substance use.

Results: In 2019, there were 23,391 DoD in Brazil (1.73% of all deaths), 89% of which were due to suicide. Removing these deaths would increase life expectancy by 0.43 years for men and 0.12 years for women, with men experiencing a 3.5 times greater impact. The 35-49 age group had the highest relative contribution, especially among men, where DoD accounted for up to 9.7% of the loss in life expectancy. The impact was more concentrated and earlier in men and more diffuse among women.

Conclusion: Although lower in absolute numbers, DoD have a measurable impact on life expectancy, especially among young men. These findings highlight the need for public policies focused on suicide prevention and addressing the social determinants that sustain despair.

Objetivo:: Estimar o impacto das mortes por desespero (DoD) na expectativa de vida ao nascer e por sexo no Brasil em 2019, bem como a contribuição das diferentes faixas etárias para essa perda.

Métodos:: Foram utilizados tábuas de vida do Instituto Brasileiro de Geografia e Estatística e dados de mortalidade por causa, idade e sexo do Sistema de Informação sobre Mortalidade. Aplicou-se a metodologia de tábuas de vida com causas deletadas (cause-deleted life table), assumindo-se independência entre DoD e outras causas. A diferença na expectativa de vida com e sem DoD foi decomposta por idade com base no método de Arriaga. Consideraram-se como DoD os óbitos por suicídio, intoxicações intencionais ou acidentais e transtornos mentais e comportamentais relacionados ao uso de substâncias.

Resultados:: Em 2019, ocorreram 23.391 mortes por desespero no Brasil (1,73% dos óbitos), sendo 57,8% por suicídio. A retirada dessas mortes das tábuas aumentaria a expectativa de vida em 0,43 anos para homens e 0,12 anos para mulheres — o impacto seria 3,5 vezes maior entre os homens. O grupo etário de 35-49 anos apresentou maior contribuição relativa, com destaque para homens, com essas mortes representando até 9,7% do impacto na expectativa de vida. O impacto é mais concentrado e precoce nos homens e mais difuso nas mulheres.

Conclusão:: As mortes por desespero, embora em menor número absoluto, têm efeito mensurável na expectativa de vida, sobretudo entre homens jovens. Esses resultados reforçam a importância de políticas públicas voltadas à prevenção de suicídio e ao enfrentamento dos determinantes sociais que sustentam o desespero.

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Conflict of interest statement

CONFLICT OF INTERESTS: nothing to declare

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