Health transition in Brazil: regional variations and divergence/convergence in mortality

Abstract: This study analyzes the main characteristics of the health transition in Brazil and its five major regions, using a framework that accounts for regional inequalities in mortality trends. The regional mortality divergence/convergence process is described and discussed by considering the specific contributions of age groups and causes of death in life expectancy variations. Results show that mortality change in Brazil has follow the epidemiologic transition theory to some extent during the period under analysis - for instance, the sharp decline in infant mortality in all regions (first from infectious and parasitic diseases and then from causes associated with the perinatal period) and the increase in the participation of chronic and degenerative diseases as the main cause of death. However, some features of Brazilian transition have not followed the linear and unidirectional pattern proposed by the epidemiologic transition theory, which helps to understand the periods of regional divergence in life expectancy, despite the long-term trends showing reducing regional inequalities. The emergence of HIV/AIDS, the persistence of relatively high levels of other infections and parasitic diseases, the regional differences in the unexpected mortality improvements from cardiovascular diseases, and the rapid and strong variations in mortality from external causes are some of the examples.

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Mortality from external causes in Russia over half a century

Демографическое обозрение ◽

10.17323/demreview.v1i5.3174 ◽

2015 ◽

pp. 85-108

Author(s):

Ekaterina Kvasha ◽

Tatiana Kharkova ◽

Valeriy Yumaguzin

Keyword(s):

Life Expectancy ◽

Causes Of Death ◽

Circulatory System ◽

Developed Countries ◽

Large Contribution ◽

Mortality Trends ◽

Undetermined Intent ◽

External Causes Of Death ◽

Excess Number ◽

External Causes

The article discusses long-term mortality trends (since 1956) from external causes of death in Russia. Russia has long lagged behind developed countries in this domain. The level of mortality from external causes of death remains high and its structure is still archaic with large contribution of homicides, alcohol poisoning and injuries of undetermined intent. Excess number of deaths from life tables of Russia and Western European countries is compared. It is shown that in Russia the greatest excess losses are associated with mortality from poisonings among both sexes, suicide among men and homicide among women. Mortality from external causes, along with mortality from diseases of the circulatory system, has had a significant impact on life expectancy. In general, over the period 1956-2012 the increase in mortality from external causes in the 15-64 age group reduced life expectancy by 2.6 years for males and 0.7 years for females. The decline, starting in 2003, of mortality from external causes of death has slightly reduced the gap between Russia and developed countries, bringing the current Russian level closer to those levels reached in Russia in the mid-1960s and 1980s. However, given the fluctuations of mortality from external causes, it is premature to say whether the current decline in mortality is robust.

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FACTORS THAT DETERMINE THE OUTCOME OF PREGNANCY AND HEALTH OF CHILDREN BORN TO WOMEN WITH GENITOURINARY SYSTEM DISEASES USING ASSISTED REPRODUCTIVE TECHNOLOGIES

PEDIATRIA Journal named after G N SPERANSKY ◽

10.24110/0031-403x-2021-100-1-52-59 ◽

2021 ◽

Vol 100 (1) ◽

pp. 52-59

Author(s):

A.N. Plaksina ◽

◽

O.P. Kovtun ◽

S.L. Sinotova ◽

O.V. Limanovskaya ◽

...

Keyword(s):

Assisted Reproductive Technologies ◽

Risk Group ◽

Perinatal Period ◽

Reproductive Technologies ◽

Parasitic Diseases ◽

Genitourinary System ◽

System P ◽

History Of ◽

External Causes ◽

Mental And Behavioral Disorders

Objective of the research: identification of risk factors that potentially affect the outcomes of pregnancies achieved by assisted reproductive technologies (ART), with an assessment of the health status of children born to women with genitourinary system (GUS) diseases. Materials and methods: a retrospective uncontrolled non-randomized multicenter study of 821 women and 836 children under the age of 3 years. Results: gynecological history of women has little effect on pregnancy outcomes achieved by ART (Matthews coefficient <0,2). Children born to mothers with GUS diseases are statistically significantly more likely to have some infectious and parasitic diseases (p=0,0002), mental and behavioral disorders (p=0,009), diseases of the nervous system (p=0,031), respiratory system (p=0,009), oral cavity, salivary glands and digestion (p=0,002), musculoskeletal system and connective tissue (p=0,001), genitourinary system (p=0,009), certain conditions arising in the perinatal period (p=0,009), as well as trauma, poisoning, and some other consequences of external causes (p=0,009) than children from mothers without GUS diseases. Conclusion: children born by ART from women with GUS pathology are a risk group for the development of diseases in early age.

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Nosological and Age and Gender Profile of the Vologda Oblast Population Mortality and the Associated Demographic Losses

Statistics and Economics ◽

10.21686/2500-3925-2021-3-27-45 ◽

2021 ◽

Vol 18 (3) ◽

pp. 27-45

Author(s):

A. V. Korolenko

Keyword(s):

Causes Of Death ◽

Age Groups ◽

Premature Mortality ◽

Parasitic Diseases ◽

Age And Gender ◽

Vologda Oblast ◽

High Contribution ◽

Gender Profile ◽

External Causes ◽

And Gender

The continuation and deepening of regional studies of the nosological and age and gender structure of mortality and its temporal dynamics is due both to the need for scientific monitoring of the implementation of regional programs and projects of the Vologda Oblast dedicated to the protection and promotion of public health, and the need to update the trends in mortality of the region residents in the context of modern socio-demographic challenges (population aging, depopulation, a complex epidemiological situation against the background of the spread of coronavirus infection).The purpose of the study was the analysis of the nosological and age and gender profile of mortality in the Vologda Oblast and the resulting demographic losses, including their transformation over the period from 2015 to 2019. The choice of the analyzed period is not accidental: if in 2015 the region was characterized by the most positive indicators of natural population movement (the total coefficient of natural loss since the beginning of the 2000s reached a minimum of -1.1 per mille), then by 2019 the situation changed dramatically — the indicator of natural loss increased and amounted to - 4.5 per mille.Materials and methods. The study was based on both general scientific and special statistical and demographic methods of research — structural and dynamic analysis of mortality indicators of the Vologda oblast population; assessment of demographic losses due to premature mortality by calculating lost years of potential life; calculation of mortality rates. The information base was the data of the territorial body of the Federal state statistics service for the Vologda Oblast, in particular, the annual data on the distribution of the deceased by sex, age groups and causes of death for 2015-2019.Results. The conducted study allowed us to establish that, in general, the structure of mortality in the region shows signs of its gradual modernization: the level of mortality from diseases of the circulatory system, external causes of death and their share in the total number of deaths are reduced, while increasing the proportion of neoplasms, symptoms, signs, deviations from the norm detected in clinical and laboratory tests, which is quite natural due to the shift in mortality to older age groups. At the same time, its features “slow down” the evolution of the mortality structure, such as a high proportion of young age groups (under 45 years old), especially categories 30-44 years old, in mortality from external causes, infectious and parasitic diseases, endocrine diseases, nutritional disorders, metabolic disorders and, as a result, the large scale of premature mortality of the region's population; male premature super-mortality, as well as the high contribution of the child population (0-14 years old) to premature mortality from diseases of the nervous system and sensory organs.Conclusion. Against the background of the coronavirus pandemic, the fact of a high contribution of young age groups (up to 45 years) to mortality from infectious and parasitic diseases is of great concern due to the likelihood of a sharp increase in the scale of human losses as a result of the layering of new premature deaths due to the consequences of COVID-19. It is considered necessary to include additional indicators of mortality reflecting its gender, age and nosological profile in the regional comprehensive program “Public health — in the center of attention”.

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Hospitalization of children under five years of age due to avoidable causes

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692012000100018 ◽

2012 ◽

Vol 20 (1) ◽

pp. 135-142 ◽

Cited By ~ 7

Author(s):

Rosana Rosseto de Oliveira ◽

Josane Rosenilda da Costa ◽

Thais Aidar de Freitas Mathias

Keyword(s):

Health Care ◽

Primary Health Care ◽

Child Health ◽

Hospital Admissions ◽

Age Groups ◽

Perinatal Period ◽

Parasitic Diseases ◽

Main Diagnosis ◽

Primary Health ◽

Hospital Morbidity

This study characterizes the profile of hospital morbidity according to the main diagnosis upon admission, in individuals younger than five years old, residents of three cities (Maringá, Sarandi and Paiçandu) in the Paraná state, Brazil. Information contained in hospital admission forms from 1998 to 2009 was used. The hospitalizations of 41,220 individuals younger than five years old were analyzed. The results indicate a decline of 16.1% in hospital admissions of patients younger than five years old in relation to the total number of admissions in all age groups. As for the main diagnoses, there were diseases of the respiratory system (55.6%), infectious and parasitic diseases (14.8%) and diseases originating in the perinatal period (12.9%). Such conditions can be avoided by implementing primary health care measures, which shows the need to intensify the actions recommended by the programs directed to child health.

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Mortality trends in a new South Africa: Hard to make a fresh start1

Scandinavian Journal of Public Health ◽

10.1080/14034950701355668 ◽

2007 ◽

Vol 35 (69_suppl) ◽

pp. 26-34 ◽

Cited By ~ 56

Author(s):

Kathleen Kahn ◽

Michel L. Garenne ◽

Mark A. Collinson ◽

Stephen M. Tollman

Keyword(s):

South Africa ◽

Size Structure ◽

Communicable Disease ◽

Age Groups ◽

Early Period ◽

Rapid Decline ◽

Health Transition ◽

Mortality Trends ◽

Rural South ◽

Hiv Aids

Aims: This paper examines trends in age-specific mortality in a rural South African population from 1992 to 2003, a decade spanning major sociopolitical change and emergence of the HIV/AIDS pandemic. Changing mortality patterns are discussed within a health-transition framework. Methods: Data on population size, structure, and deaths, obtained from the Agincourt health and demographic surveillance system, were used to calculate person-years at risk and death rates. Life tables were computed by age, sex and calendar year. Mortality rates for the early period 1992—93 and a decade later, 2002— 03, were compared. Results: Findings demonstrate significant increases in mortality for both sexes since the mid-1990s, with a rapid decline in life expectancy of 12 years in females and 14 years in males. The increases are most prominent in children (0—4) and young adult (20—49) age groups, in which increases of two- and fivefold respectively have been observed in the past decade. Sex differences in mortality patterns are evident with increases more marked in females in most adult age groups. Conclusions: Empirical data demonstrate a marked ``counter transition'' with mortality increasing in children and young adults, ``epidemiologic polarization'' with vulnerable subgroups experiencing a higher mortality burden, and a ``protracted transition'' with simultaneous emergence of HIV/AIDS together with increasing non-communicable disease in older adults. The health transition in rural South Africa is unlikely to predict patterns elsewhere; hence the need to examine trends in as many contexts as have the data to support such analyses.

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Longevity in Slovenia: Past and potential gains in life expectancy by age and causes of death

Slovenian Journal of Public Health ◽

10.1515/sjph-2017-0016 ◽

2017 ◽

Vol 56 (2) ◽

pp. 124-130 ◽

Cited By ~ 1

Author(s):

Aleša Lotrič Dolinar ◽

Petra Došenović Bonča ◽

Jože Sambt

Keyword(s):

Life Expectancy ◽

Causes Of Death ◽

Age Groups ◽

Lower Mortality ◽

Life Expectancy At Birth ◽

Prevention Programmes ◽

External Causes ◽

Evidence Based Decision Making ◽

Total Elimination ◽

Circulatory Diseases

AbstractIntroductionIn Slovenia, longevity is increasing rapidly. From 1997 to 2014, life expectancy at birth increased by 7 and 5 years for men and women, respectively. This paper explores how this gain in life expectancy at birth can be attributed to reduced mortality from five major groups of causes of death by 5-year age groups. It also estimates potential future gains in life expectancy at birth.MethodsThe importance of the five major causes of death was analysed by cause-elimination life tables. The total elimination of individual causes of death and a partial hypothetical adjustment of mortality to Spanish levels were analysed, along with age and cause decomposition (Pollard).ResultsDuring the 1997–2014 period, the increase in life expectancy at birth was due to lower mortality from circulatory diseases (ages above 60, both genders), as well as from lower mortality from neoplasms (ages above 50 years) and external causes (between 20 and 50 years) for men. However, considering the potential future gains in life expectancy at birth, by far the strongest effect can be attributed to lower mortality due to circulatory diseases for both genders. If Spanish mortality rates were reached, life expectancy at birth would increase by more than 2 years, again mainly because of lower mortality from circulatory diseases in very old ages.Discussion and conclusionsLife expectancy analyses can improve evidence-based decision-making and allocation of resources among different prevention programmes and measures for more effective disease management that can also reduce the economic burden of chronic diseases.

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Epidemiologic Transition in Australia – the last hundred years

Canadian Studies in Population ◽

10.25336/p6vp5j ◽

2016 ◽

Vol 43 (1-2) ◽

pp. 23 ◽

Cited By ~ 2

Author(s):

Heather Booth

Keyword(s):

Life Expectancy ◽

Cause Of Death ◽

Transition Theory ◽

Economic Factors ◽

Degenerative Diseases ◽

Epidemiologic Transition ◽

Mortality Change ◽

Age Patterns ◽

Three Stages ◽

Socio Economic Factors

Mortality change in Australia since 1907 is analysed in the light of Epidemiologic Transition theory. Trends in life expectancy by sex and the sex difference, are examined at ages 0, 50, 65 and 85 years. Trends in mortality by major cause of death are broadly related to the stages of the Epidemiologic Transition, and a decomposition of changes in life expectancy by age and cause of death is used to further elaborate on the progression through three stages, the Age of Receding Pandemics, the Age of Degenerative and Man-Made Diseases and the Age of Delayed Degenerative Diseases. A consideration of temporal changes in age patterns of mortality decline includes a focus on infant mortality, the accident hump and mortality at older ages. In the early decades of the twentieth century, Australia was a leader in the Epidemiologic Transition, but had lost this advantage by 1950. Differentials by state/territory, indigeneity and socio-economic factors identify the leaders and laggards in the transition.

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How have changes in death by cause and age group contributed to the recent stalling of life expectancy gains in Scotland? Comparative decomposition analysis of mortality data, 2000–2002 to 2015–2017

BMJ Open ◽

10.1136/bmjopen-2019-036529 ◽

2020 ◽

Vol 10 (10) ◽

pp. e036529

Author(s):

Julie Ramsay ◽

Jon Minton ◽

Colin Fischbacher ◽

Lynda Fenton ◽

Maria Kaye-Bardgett ◽

...

Keyword(s):

Life Expectancy ◽

Cause Of Death ◽

Age Groups ◽

Decomposition Analysis ◽

Future Research ◽

Mortality Data ◽

Age Group ◽

Mortality Trends ◽

Life Expectancy At Birth ◽

The Impact

ObjectiveAnnual gains in life expectancy in Scotland were slower in recent years than in the previous two decades. This analysis investigates how deaths in different age groups and from different causes have contributed to annual average change in life expectancy across two time periods: 2000–2002 to 2012–2014 and 2012–2014 to 2015–2017.SettingScotland.MethodsLife expectancy at birth was calculated from death and population counts, disaggregated by 5 year age group and by underlying cause of death. Arriaga’s method of life expectancy decomposition was applied to produce estimates of the contribution of different age groups and underlying causes to changes in life expectancy at birth for the two periods.ResultsAnnualised gains in life expectancy between 2012–2014 and 2015–2017 were markedly smaller than in the earlier period. Almost all age groups saw worsening mortality trends, which deteriorated for most cause of death groups between 2012–2014 and 2015–2017. In particular, the previously observed substantial life expectancy gains due to reductions in mortality from circulatory causes, which most benefited those aged 55–84 years, more than halved. Mortality rates for those aged 30–54 years and 90+ years worsened, due in large part to increases in drug-related deaths, and dementia and Alzheimer’s disease, respectively.ConclusionFuture research should seek to explain the changes in mortality trends for all age groups and causes. More investigation is required to establish to what extent shortcomings in the social security system and public services may be contributing to the adverse trends and preventing mitigation of the impact of other contributing factors, such as influenza outbreaks.

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Trends in mortality and life expectancy in Fiji over 20 years

BMC Public Health ◽

10.1186/s12889-021-11186-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Catherine Dearie ◽

Christine Linhart ◽

Eric Rafai ◽

Devina Nand ◽

Stephen Morrell ◽

...

Keyword(s):

Life Expectancy ◽

Statistical Significance ◽

Age Groups ◽

Adult Mortality ◽

International Agency ◽

Mortality Trends ◽

Indian Women ◽

International Agencies ◽

Mortality Probability ◽

Inform Resource Allocation

Abstract Background Fiji, a Pacific Island nation of 884,887 (2017 census), has experienced a prolonged epidemiological transition. This study examines trends in mortality and life expectancy (LE) in Fiji by sex and ethnicity over 1996–2017, with comparisons to published estimates. Methods Trends in infant mortality rates (IMR), under-5 mortality (U5M), adult mortality (probability of dying), LE (at birth) and directly age-standardised death rates (DASRs) by sex and ethnicity, are calculated (with 95% confidence limits) using unit death records from the Fiji Ministry of Health and Medical Services. The LE gap between populations, or within populations over time, is examined using decomposition by age. Period trends are assessed for statistical significance using linear regression. Results Over 1996–98 to 2014–17: IMR and U5M for i-Taukei and Fijians of Indian descent declined; U5M decline for i-Taukei (24.6 to 20.1/1000 live births) was significant (p = 0.016). Mortality (15–59 years) for i-Taukei males was unchanged at 27% but declined for Indians 33 to 30% (p = 0.101). Mortality for i-Taukei females increased 22 to 24% (p = 0.011) but declined for Indians 20 to 18% (p = 0.240). DASRs 1996–2017 were lower for i-Taukei (9.3 to 8.2/1000 population) than Indian males (10.6 to 9.8/1000). DASRs declined for i-Taukei (both sexes, p < 0.05), and for Indians (both sexes, p > 0.05). Over 22 years, LE at birth increased by 1 year or less (p = 0.030 in male i-Taukei). In 2014–17, LE (years) for males was: i-Taukei 64.9, Indians 63.5; and females: i-Taukei 67.0 and Indians 68.2. Mortality changes in most 5-year age groups increased or decreased the LE gap less than 10 weeks over 22 years. Compared to international agency reports, 2014–17 empirical LE estimates (males 64.7, females 67.8) were lower, as was IMR. Conclusions Based on empirical data, LE in Fiji has minimally improved over 1996–2017, and is lower than some international agencies report. Adult mortality was higher in Indian than i-Taukei men, and higher in i-Taukei than Indian women. Exclusion of stillbirths resulted in IMRs lower than previously reported. Differing mortality trends in subgroups highlight the need to collect census and health data by ethnicity and sex, to monitor health outcomes and inform resource allocation.

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Understanding epidemiological transition in urban population of Maharashtra

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20151254 ◽

2015 ◽

Vol 1 (7) ◽

pp. 275

Author(s):

Bal Kishan Gulati ◽

Arvind Pandey

Keyword(s):

Cause Of Death ◽

Causes Of Death ◽

Circulatory System ◽

Perinatal Period ◽

National Average ◽

Epidemiological Transition ◽

Parasitic Diseases ◽

Mortality Trends ◽

Future Health ◽

Double Burden

Background: Change in causes of death pattern is a reflection of epidemiological transition in which infectious and parasitic diseases shift to chronic and degenerative diseases of adulthood. Cause of death trend and pattern is important for future health policy planning.Methods: This study attempts to measure mortality trends by different causes of death for urban Maharashtra by using MCCD data for 1990-2010 by calculating proportion of major cause of death to total deaths by age and sex for all these years.Results: Results reveal that there has been shift in the structure of mortality by cause. Diseases of circulatory system were the leading causes of death accounting for about 31% share of all medically certified deaths which is well above the national average of about 30%. Similarly, the proportion of deaths due to certain conditions originating in the perinatal period appears to be low in the state (3.9%) compared to national average (7%). The proportions of deaths due to certain infectious and parasitic diseases and disease of the respiratory system appear to be very high (15.7% and 12.1% respectively) compared to national average (13.1% and 9.5% respectively). Conclusions: It was found that socio-economically developed and demographically advanced urban Maharashtra bears the double burden of disease specific mortality.

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