Mortality due to noncommunicable diseases in Brazil, 1990 to 2015, according to estimates from the Global Burden of Disease study :  Mortalidade por doenças não transmissíveis no Brasil, 1990 a 2015, segundo estimativas do estudo de Carga Global de Doenças

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

ABSTRACT

CONTEXT AND OBJECTIVE:

Noncommunicable diseases (NCDs) are the leading health problem globally and generate high numbers of premature deaths and loss of quality of life. The aim here was to describe the major groups of causes of death due to NCDs and the ranking of the leading causes of premature death between 1990 and 2015, according to the Global Burden of Disease (GBD) 2015 study estimates for Brazil.

DESIGN AND SETTING:

Cross-sectional study covering Brazil and its 27 federal states.

METHODS:

This was a descriptive study on rates of mortality due to NCDs, with corrections for garbage codes and underreporting of deaths.

RESULTS:

This study shows the epidemiological transition in Brazil between 1990 and 2015, with increasing proportional mortality due to NCDs, followed by violence, and decreasing mortality due to communicable, maternal and neonatal causes within the global burden of diseases. NCDs had the highest mortality rates over the whole period, but with reductions in cardiovascular diseases, chronic respiratory diseases and cancer. Diabetes increased over this period. NCDs were the leading causes of premature death (30 to 69 years): ischemic heart diseases and cerebrovascular diseases, followed by interpersonal violence, traffic injuries and HIV/AIDS.

CONCLUSION:

The decline in mortality due to NCDs confirms that improvements in disease control have been achieved in Brazil. Nonetheless, the high mortality due to violence is a warning sign. Through maintaining the current decline in NCDs, Brazil should meet the target of 25% reduction proposed by the World Health Organization by 2025.

RESUMO

CONTEXTO E OBJETIVO:

As doenças crônicas não transmissíveis (DCNT) são o principal problema de saúde global e geram um elevado número de mortes prematuras e perda de qualidade de vida. O objetivo foi descrever os principais grupos de causas de morte por DCNT e o ranking das causas de morte prematura entre 1990 a 2015, segundo estimativas do estudo Global Burden of Disease (GBD) 2015 para o Brasil.

TIPO DE ESTUDO E LOCAL:

Estudo transversal do Brasil e 27 Unidades Federadas.

MÉTODOS:

Estudo descritivo das taxas de mortalidade por DCNT, com correções para sub-registro e códigos garbage.

RESULTADOS:

O estudo aponta a transição epidemiológica no Brasil entre 1990 e 2015, com o crescimento da mortalidade proporcional por DCNT, seguida das violências, e com a redução das causas maternas, infecciosas e infantis na carga global de doenças. As DCNT cursaram com as taxas de mortalidade mais elevadas em todo o período, mas com declínio para as doenças cardiovasculares, respiratórias crônicas e câncer. O diabetes aumentou no período. As DCNT lideram entre as causas de morte prematura (30 a 69 anos): doenças isquêmicas do coração e doenças cerebrovasculares, seguidas de violência interpessoal, lesão no trânsito e HIV/aids.

CONCLUSÕES:

A queda da mortalidade por DCNT confirma melhora do controle de doenças no país. Entretanto, a alta mortalidade por violência é um sinal de alerta. Mantendo-se a queda atual das DCNT, o Brasil deverá atingir as metas de redução propostas pela Organização Mundial de Saúde de 25% até 2025.

Related collections

Most cited references 35

Record: found
Abstract: found
Article: found

Is Open Access

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

Haidong Wang, Mohsen Naghavi, Christine Allen … (2017)

Summary Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography–year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4–61·9) in 1980 to 71·8 years (71·5–72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7–17·4), to 62·6 years (56·5–70·2). Total deaths increased by 4·1% (2·6–5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8–18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6–16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9–14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1–44·6), malaria (43·1%, 34·7–51·8), neonatal preterm birth complications (29·8%, 24·8–34·9), and maternal disorders (29·1%, 19·3–37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000–183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000–532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Funding Bill & Melinda Gates Foundation.

0 comments Cited 1296 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Mohammad Forouzanfar, Ashkan Afshin, Lily T Alexander … (2017)

Summary Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation.

0 comments Cited 997 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

GBD 2010: design, definitions, and metrics.

Christopher Murray, Majid Ezzati, Abraham Flaxman … (2012)

0 comments Cited 442 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Journal ID (nlm-ta): Sao Paulo Med J

Journal ID (iso-abbrev): Sao Paulo Med J

Journal ID (publisher-id): Sao Paulo Med J

Title: São Paulo Medical Journal

Publisher: Associação Paulista de Medicina - APM

ISSN (Print): 1516-3180

ISSN (Electronic): 1806-9460

Publication date (Electronic): 03 April 2017

Publication date Collection: 2017

Volume: 135

Issue: 3

Pages: 213-221

Affiliations

[I ] originalMD, PhD. Professor and Researcher, Department of Mother and Child and Public Health, Nursing School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.

[II ] originalMD, PhD. Associate Professor, Department of Preventive and Social Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.

[III ] originalPhD. Researcher, Nucleus of Education in Collective Health, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.

[IV ] originalMSc. Nurse, Municipal Health Department, Belo Horizonte, and Researcher, School of Medical Sciences, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.

[V ] originalBA. Researcher and Strategic Planning Manager, Hospital Israelita Albert Einstein (HIAE), São Paulo (SP), Brazil.

[VI ] originalStatistician, Postgraduate Program on Epidemiology, Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte (MG), Brazil.

[VII ] originalMD, PhD. Professor, Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte (MG), Brazil.

[VIII ] originalMD, PhD. Director, Ministry of Health, Brasília (DF), Brazil.

[IX ] originalPhD. Senior Engagement Manager in the Global Engagement Team, Institute for Health Metrics and Evaluation (IHME), Washington DC, United States.

[X ] originalMD, MPH, PhD. Professor of Global Health, Institute for Health Metrics and Evaluation (IHME), Washington DC, United States.

Author notes

Address for correspondence: Deborah Carvalho Malta. Departamento de Enfermagem Materno-Infantil e Saúde Pública, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena 190 - Santa Efigênia, Belo Horizonte (MG) - Brasil. CEP 30130-100. Tel. (+55 31) 3409-9862. E-mail: dcmalta@ 123456uol.com.br

Conflict of interest: None

Article

DOI: 10.1590/1516-3180.2016.0330050117

PMC ID: 10019842

PubMed ID: 28746656

SO-VID: a3f59486-2dae-4fa1-a116-dbd53b63d62b

License:

This is an open access article distributed under the terms of the Creative Commons license.

History

Date received : 31 December 2016

Date accepted : 05 January 2017

Page count

Figures: 4, Tables: 0, Equations: 0, References: 34, Pages: 09

Comments

Comment on this article

scite_

Cited by 44

See all cited by

Most referenced authors 3,965

See all reference authors

- Version 1

Mortality due to noncommunicable diseases in Brazil, 1990 to 2015, according to estimates from the Global Burden of Disease study : Mortalidade por doenças não transmissíveis no Brasil, 1990 a 2015, segundo estimativas do estudo de Carga Global de Doenças

Read this article at

ABSTRACT

CONTEXT AND OBJECTIVE:

DESIGN AND SETTING:

METHODS:

RESULTS:

CONCLUSION:

RESUMO

Related collections

Annual Reviews HIV/AIDS: Public Health and Society

Most cited references 35

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

GBD 2010: design, definitions, and metrics.

Author and article information

Journal

Affiliations

Author notes

Article

History

Page count

Categories

Comments

Comment on this article

Similar content 114

Cited by 44

Most referenced authors 3,965