National Policy of Comprehensive Women’s Health Care and Mortality in Menopause: Has Anything Changed?

Abstract Background: The National Policy of Comprehensive Women’s Health Care was implemented more than two decades ago, and the monitoring of potential benefits should be explored. Menopause is a period of life for which there are prevention and health promotion actions carried out by the government’s all-encompassing sole Unify Health System (UHS) and factored into Brazilian policies. It is thus our purpose to identify menopausal women’s main causes of death, as well as the mortality trend of such causes, especially after PNAISM implementation. Methods: This is an ecological study with secondary data analysis conducted by the Setor de Atenção Primária, Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia da Faculdade de Medicina da Universidade de São Paulo from 2018 to 2019. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the IT Department of SUS between 1996 and 2016, divided in two periods 1996 to 2004 and 2005 to 2006 according to implementation of the National Police. The data included the death records of Brazilian women aged 35 to 64 years who had a precise diagnosis (ICD-10). Trend and differences between periods were evaluated by linear regression. The significance level was set at 5%. Stata 11® (StataCorp, LCC) was used. Results: Menopausal women’s main causes of death were the circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine (29.39%), nutritional, and metabolic (6.81%, 170,881 deaths) diseases, and external causes of morbidity and mortality (5.49%, 137,674 deaths). Implementation of PNAISM led to increasing reduction in mortality from circulatory system diseases (β=-0.58; 95% CI, -0.68 to -0.48; r²=0.93; p<0.001), but not to any significant changes in neoplasm mortalities (β=0.07; 95% CI, -0.01 to 0.15; r²=0.22; p=0.070). Conclusions: The leading causes of death among menopausal women are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality. The trend of mortality rates among menopausal women, following PNAISM implementation, was a decline in circulatory system diseases and in nutritional, metabolic, and endocrine diseases, with no changes for neoplasms and respiratory system diseases.

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Brazilian National Policy of Comprehensive Women’s Health Care and Mortality in Menopause: Has Anything Changed?

10.21203/rs.3.rs-16831/v2 ◽

2020 ◽

Author(s):

Isabel Cristina Esposito Sorpreso ◽

Francisco Winter dos Santos Figueiredo ◽

José Lucas Souza Ramos ◽

Lea Tami SuzuKi Zuchelo ◽

Fernando Adami ◽

...

Keyword(s):

Health Care ◽

Health System ◽

Women’S Health ◽

Women's Health ◽

Respiratory System ◽

Causes Of Death ◽

National Policy ◽

Circulatory System ◽

Circulatory System Diseases ◽

External Causes

Abstract Background: The National Policy for Integral Attention to Women’s Health was implemented more than two decades ago, and the monitoring of potential benefits should be explored. One of the life cycles of women contemplated in this health policy is the importance of health care during the climacteric. In fact, prevention and health promotion actions carried out by the Brazil National Health System - Unified Health System (SUS) and enshrined in health Brazilian policies for women. Thus, our purpose is to identify menopausal women’s main causes of death, as well as the mortality trend of such causes, especially after PNAISM implementation.Methods: Ecological study conducted by Disciplina de Ginecologia da Faculdade de Medicina da Universidade de São Paulo from 2018 to 2019. Data were retrieved from Brazilian Health Department by accessing the mortality information system of National Health Information, divided in periods 1996-2004 and 2005-2006 according to implementation of the National Police. The death records of Brazilian women aged 35 to 64 years who had a diagnosis (ICD-10). Trend and differences between periods were evaluated by linear regression. The significance level was 5%. (Stata 11® -StataCorp, LCC). Results: Main causes of women’s death were the circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine (29.39%), nutritional, and metabolic (6.81%, 170,881 deaths) diseases, and external causes of morbidity and mortality (5.49%, 137,674 deaths). Implementation of PNAISM led to increasing reduction in mortality from circulatory system diseases (β=-0.58; 95% CI, -0.68 to -0.48; r²=0.93; p<0.001), and any significant changes in neoplasm mortalities (β=0.07; 95% CI, -0.01 to 0.15; r²=0.22; p=0.070). Conclusions: The leading causes of death during climacteric are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality, with no changes for neoplasms and respiratory system diseases. Thus, the analysis of women's health indicators, such as mortality rates, are fundamental in order to enable the monitoring of benefits and results related to PNAISM as well as directing the design and implementation of other new health policies to be developed for the women.

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Brazilian National Policy of Comprehensive Women’s Health Care and Mortality during Climacteric Period: Has Anything Changed?

10.21203/rs.3.rs-16831/v3 ◽

2020 ◽

Author(s):

Isabel Cristina Esposito Sorpreso ◽

Francisco Winter dos Santos Figueiredo ◽

José Lucas Souza Ramos ◽

Lea Tami SuzuKi Zuchelo ◽

Fernando Adami ◽

...

Keyword(s):

Health Care ◽

Health System ◽

Women’S Health ◽

Women's Health ◽

Respiratory System ◽

Causes Of Death ◽

National Policy ◽

Circulatory System ◽

Circulatory System Diseases ◽

External Causes

Abstract Background: The National Policy for Integral Attention to Women’s Health was implemented more than two decades ago, with the monitoring of potential benefits being explored. One of the life cycles of women contemplated in this health policy is the importance of health care during the climacteric. Prevention and health promotion actions carried out by the Brazil National Health System - Unified Health System and enshrined in health Brazilian policies for women. Thus, our purpose was to identify climacteric women’s main causes of death as well as the mortality trend of such causes, especially after PNAISM implementation. Methods: An ecological study was conducted by Disciplina de Ginecologia da Faculdade de Medicina da Universidade de São Paulo from 2018–2019. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the National Health Information, divided into periods 1996–2004 and 2005–2006 according to implementation of the National Police. The death records of Brazilian women aged 35 to 64 years who had a diagnosis were retrieved. Trends and differences between periods were evaluated using linear regression. The significance level was set at 5%. Results: The main causes of death in women were circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine , nutritional and metabolic diseases (6.81%, 170,881 deaths), and external causes of morbidity and mortality (5.49%, 137,674 deaths). Implementation of PNAISM led to a further reduction in mortality from circulatory system diseases (β=-0.58; 95% CI, -0.68 to -0.48; r²=0.93; p<0.001), and any significant changes in neoplasm mortality (β=0.07; 95% CI, -0.01. 0.15; r²=0.22; p=0.070). Conclusions: The leading causes of death during climacteric are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality, with no changes in neoplasms and respiratory system diseases. Thus, the analysis of women’s health indicators, such as mortality rates, is fundamental in order to enable the monitoring of benefits and results related to PNAISM as well as directing the design and implementation of other new health policies to be developed for women.

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Brazilian National Policy of Comprehensive Women’s Health Care and Mortality during Climacteric Period: Has Anything Changed?

10.21203/rs.3.rs-16831/v4 ◽

2020 ◽

Author(s):

Isabel Cristina Esposito Sorpreso ◽

Francisco Winter dos Santos Figueiredo ◽

José Lucas Souza Ramos ◽

Lea Tami SuzuKi Zuchelo ◽

Fernando Adami ◽

...

Keyword(s):

Health Care ◽

Health System ◽

Women’S Health ◽

Women's Health ◽

Respiratory System ◽

Causes Of Death ◽

National Policy ◽

Circulatory System ◽

Circulatory System Diseases ◽

External Causes

Abstract Background: The National Policy for Integral Attention to Women’s Health Care (PNAISM) was implemented more than two decades ago, with the monitoring of potential benefits being explored. One of the life cycles of women contemplated in this health policy was the importance of health care during the climacteric. Prevention and health promotion actions carried out by the Brazil National Health System - Unified Health System and enshrined in health Brazilian policies for women. Thus, our purpose was to identify climacteric women’s main causes of death as well as the mortality trends of such causes, especially after PNAISM implementation. Methods: An ecological study was conducted from 2018–2019. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the National Health Information, divided into periods 1996–2004 and 2005–2016 to correspond with the implementation of the National Policy. The death records of Brazilian women aged 35 to 64 years who had a diagnosis were retrieved. Trends and differences between periods were evaluated using linear regression. The significance level was set at 5%. Results: The main causes of death in women from 1996 to 2016 were circulatory system diseases (29.39%, 736,972 deaths), neoplasms (26.17%, 656,385 deaths), respiratory system diseases (7.29%, 182,812 deaths), endocrine , nutritional and metabolic diseases (6.81%, 170,881 deaths), and external causes of morbidity and mortality (5.49%, 137,674 deaths). Mortality from circulatory system diseases was reduced following implementation of the PNAISM (β=-0.58; 95% CI -0.68 to -0.48; r²=0.93; p<0.001), but no significant changes were observed in mortality from neoplasms (β=0.07; 95% CI -0.01 to 0.15; r²=0.22; p=0.070).Conclusions: The leading causes of death during climacteric are circulatory system diseases, neoplasms, respiratory system diseases, nutritional, metabolic, and endocrine diseases, and external causes of morbidity and mortality, with no changes in neoplasms and respiratory system diseases. Thus, the analysis of women’s health indicators, such as mortality rates, is fundamental in order to enable the monitoring of benefits and results related to PNAISM as well as directing the design and implementation of other new health policies to be developed for women.

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Brazilian National Policy of Comprehensive Women’s Health Care and mortality during climacteric period: has anything changed?

BMC Public Health ◽

10.1186/s12889-021-10556-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Isabel Cristina Esposito Sorpreso ◽

Francisco Winter dos Santos Figueiredo ◽

José Lucas Souza Ramos ◽

Lea Tami Suzuki Zuchelo ◽

Fernando Adami ◽

...

Keyword(s):

Health Care ◽

Women’S Health ◽

Women's Health ◽

National Health ◽

Respiratory System ◽

Causes Of Death ◽

National Policy ◽

Circulatory System ◽

Women's Health Care ◽

Circulatory System Diseases

Abstract Background The National Policy for Integral Attention to Women’s Health Care (PNAISM) was implemented in 2004, with monitoring of potential benefits. One of the life cycles of women contemplated in this health policy was the importance of health care during the climacteric. Prevention and health promotion are actions carried out by the Brazil National Health System and enshrined in health Brazilian policies for women. Thus, our purpose was to identify climacteric women’s main causes of death as well as the mortality trends of such causes, especially after implementation of PNAISM. Methods An ecological study was conducted from 2018 to 2020. Data were retrieved from the Brazilian Health Department by accessing the mortality information system of the National Health Information, divided into periods 1996–2004 and 2005–2016 the latter to correspond with the implementation of the National Policy. The death records of Brazilian women aged 40 to 64 years who had a designated cause of death were retrieved. Trends and differences between periods were evaluated using linear regression. The significance level was set at 5%. Results The main causes of death in women from 1996 to 2016 were circulatory system diseases (22.47%, 697,636 deaths), neoplasms (19.69%, 611,495 deaths), respiratory system diseases (5.5%, 170,716 deaths), endocrine, nutritional, and metabolic disorders (5.27%, 163,602 deaths), and digestive system diseases (3.74%, 116.280 deaths). Analyzing the changes in the major causes of death of climacteric women after implementation of the PNAISM we observed that mortality from circulatory system diseases and endocrine and nutritional diseases were significantly declined in post-PNAISM period: (β = − 3.63; 95% CI – 4.54 to − 2.73 r2 = 0.87; p < 0.001; β = − 0.51; 95% CI, − 0.71 to − 0.31; R2 = 0.73; p < 0.001, respectively). No changes were observed in mortality from neoplasms and respiratory system diseases in post-PNAISM period (p = 0,765; p = 0,233, respectively). Conclusions After implementation of the PNAISM, we observed a downward trend in rates of mortality from diseases of the circulatory and digestive systems and from endocrine, nutritional, and metabolic diseases but stability in the rates of death from neoplasm and respiratory system diseases.

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Characteristics of mortality in the Orenburg region population in 2011-2017

Science and Innovations in Medicine ◽

10.35693/2500-1388-2020-5-2-99-104 ◽

2020 ◽

Vol 5 (2) ◽

pp. 99-104

Author(s):

Evgenii L. Borschuk ◽

Dmitrii N. Begun ◽

Tatyana V. Begun

Keyword(s):

Mortality Rate ◽

Causes Of Death ◽

Age Groups ◽

Circulatory System ◽

Mortality Rates ◽

Female Population ◽

Orenburg Region ◽

The Third ◽

Circulatory System Diseases ◽

External Causes

Objectives - to study the mortality indicators, their dynamics and structure, in the population of the Orenburg region in the period of 2011-2017. Material and methods. The study was conducted using the data from the territorial authority of statistics in the Orenburg region in the period from 2011 to 2017. The analytical, demographic and statistical methods were implemented for the study of the demographic indicators. Results. Cities and municipal settlements of the Orenburg region with high mortality indicators were included in the second and fourth clusters during the cluster analysis. The first and third clusters included cities and municipal settlements with an average mortality. The most favorable position has the Orenburg area with the lowest mortality rate in the region in 2017 - 8.4%. The dynamics of mortality rates among the male and female population tends to decrease, more pronounced dynamics is in men. Though, the male population is characterized by higher mortality rates in all age groups. The leading position among the causes of death is taken by diseases of the circulatory system (46.3% of the total mortality). The second position is occupied by tumors (17.2%), the third - by external causes (8.4%). Mortality from circulatory system diseases and from external causes has reduced. The dynamics of mortality from tumors does not change significantly. The rank of leading causes of death is not identical in the clusters: in the third and fourth clusters, the other causes occupy the second place in the structure of mortality, while tumors occupy the third. Conclusion. In the Orenburg region, the mortality rate is higher than overage in the Russian Federation by 0.9 per 1000 people. The study revealed significant territorial differences in the mortality rates. In general, the mortality among men in all age groups is higher than the mortality of women. The mortality rate from diseases of the circulatory system plays the leading role in the structure of mortality, but has the tendency for decline. Until 2006, the mortality from external causes ranked the second place, now the second place is taken by death from tumors The mortality from external causes is decreasing; mortality from tumors does not change significantly. The obtained results could be used by local authorities in developing the program of public health protection and assessing its effectiveness.

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Krajské mestá Slovenska v kontexte príčin smrti

10.5817/cz.muni.p210-9896-2021-64 ◽

2021 ◽

Author(s):

Katarína Vilinová ◽

Jozef Kudlej

Keyword(s):

Causes Of Death ◽

Slovak Republic ◽

Circulatory System ◽

Economic Changes ◽

Mortality And Morbidity ◽

Circulatory System Diseases ◽

Common Causes ◽

Demographic Processes ◽

External Causes ◽

The Right

Interest in the health of the population is intensifying today. The main reasons include social, political and economic changes, but also the ongoing pandemic related to the spread of the COVID-19 virus. Due to many demographic changes in recent years, the study of the health status of the population emphasizes one of the demographic processes, which is mortality. The structure of the causes of death is very often monitored. After the stabilization of mortality and morbidity from infectious diseases in the eighties, civilization diseases such as circulatory system diseases and tumors came to the forefront of social interest in Slovakia. This indicator is also important in terms of the right direction in the field of regional development in relation to health care in individual regions. The aim of the paper is to characterize the structure of causes of death in regional cities of Slovakia. This paper will be based on data from the Statistical Office of the Slovak Republic for the period 1996-2017. The main methods used in the work will be methods of analysis, synthesis, as well as graphic and cartographic methods. In all regional cities of Slovakia, diseases of the circulatory system clearly dominated in men and women during the entire period under review. They were followed by cancer and external causes. The group of five most common causes was supplemented by diseases of the respiratory and digestive system.

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Avoidable mortality from circulatory system diseases in Moldova

Population and Economics ◽

10.3897/popecon.5.e65218 ◽

2021 ◽

Vol 5 (3) ◽

pp. 30-42

Author(s):

Vitalie V. Stirba

Keyword(s):

Life Expectancy ◽

Causes Of Death ◽

Heart Diseases ◽

Circulatory System ◽

Cerebrovascular Diseases ◽

Avoidable Mortality ◽

Circulatory System Diseases ◽

External Causes ◽

Policies And Programs ◽

Hypertensive Diseases

Mortality from avoidable circulatory system diseases causes one of the major losses in life expectancy, especially in males and population of working ages. The main contributors are the deaths caused by ischaemic heart diseases, cerebrovascular diseases, and hypertensive diseases. This article analyses the trends in avoidable mortality caused by diseases of the circulatory system and estimates the possible increases in life expectancy due to the elimination of these causes of death. In this regard, the author uses methods of standardization, mortality decomposition and cause-elimination model. The study shows a decline in avoidable mortality from circulatory system diseases during the analyzed period, especially for earlier ages. At the same time, there is a significant differentiation in mortality dynamics depending on sex. In 2016–2018, avoiding these deaths could assure an increase in life expectancy by 3.8 years in males and 2.8 years in females. This possible increase in life expectancy could be partially achieved by improving the quality of the health care system and introducing policies and programs aimed at improving the health of the population. Moreover, programs aimed at preventing diseases of the circulatory system might influence on mortality diminution from other non-communicable diseases and external causes of death.

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Mortality in Russia: the second epidemiological revolution that never was

Демографическое обозрение ◽

10.17323/demreview.v2i5.5581 ◽

2015 ◽

pp. 4-33 ◽

Cited By ~ 3

Author(s):

Anatoly Vishnevsky

Keyword(s):

Life Expectancy ◽

Causes Of Death ◽

Age Distribution ◽

Circulatory System ◽

Developed Countries ◽

Significant Rise ◽

Past Half Century ◽

External Causes Of Death ◽

External Causes ◽

Age Of Death

The article looks at different approaches to the conceptualization of the modern stage of mortality reduction (the "new stages” of the epidemiological transition, "the second epidemiological revolution”, the “health transition”). During this stage, which has lasted for at least half a century, revolutionary changes have taken place in most developed countries. These changes manifest themselves in the drastic expansion of the degree of control over non-infectious causes of death—particularly over diseases of the circulatory system, neoplasms, and other non-communicable diseases, as well as over external causes of death. As a consequence of these changes, there has been a rapid shift of deaths from the abovementioned causes to older ages, an increase in the mean age of death from these causes, and, ultimately, a significant rise in life expectancy. Russia, unfortunately, is watching this revolution from the outside, without taking any part in it. The age distribution of deaths from major classes of causes of death in Russia has not changed over the past half-century, life expectancy has stagnated, and Russia has increasingly lagged behind the majority of developed countries with respect to this indicator. Thus, the “second epidemiological revolution” has not yet to occur in Russia.

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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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Multimorbidity Analysis of 13 Systemic Diseases in Northeast China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17061817 ◽

2020 ◽

Vol 17 (6) ◽

pp. 1817

Author(s):

Jianxing Yu ◽

Fangying Song ◽

Yingying Li ◽

Zhou Zheng ◽

Huanhuan Jia ◽

...

Keyword(s):

Young People ◽

Respiratory System ◽

Metabolic Diseases ◽

Circulatory System ◽

Categorical Variables ◽

Systemic Diseases ◽

Middle Aged ◽

Old People ◽

Circulatory System Diseases ◽

Nutritional And Metabolic Diseases

Background: Multimorbidity not only affects the quality of patients’ lives, but can also bring a heavy economic burden to individuals, families and society. The purpose of this study was to reveal the connections between diseases, especially the important role each disease played in the entire multimorbidity network. Methods: A total of 1,155,734 inpatients were enrolled through multistage stratified random sampling in Jilin Province in 2017. Categorical variables were compared using the Rao–Scott-χ2 test. Weighted networks were adopted to present the complex relationships of multimorbidity. Results: The distributions of the number of diseases differed significantly by gender, age and health insurance scheme (P < 0.001). Diseases of the respiratory system had the highest weight in multimorbidity in young people. Endocrine, nutritional and metabolic diseases and circulatory system diseases were often associated with other systemic diseases in middle aged and old people. Conclusions: Multimorbidity with respiratory system diseases in young people should not be overlooked. Additionally, effective prevention efforts that target endocrine, nutritional and metabolic diseases and circulatory system diseases are needed in middle aged and old people.

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