Abstract

SILVA, Ligia Maria Vieira da et al. Reducible gaps in mortality in State Capitals, Brazil (1980 - 1998). Epidemiol. Serv. Saúde [online]. 2005, vol.14, n.4, pp.203-222. ISSN 1679-4974.  http://dx.doi.org/10.5123/S1679-49742005000400002.

A descriptive ecological study was carried out on avoidable deaths in Brazilian urban settings from 1980 to 1998. The Mortality Information System (SIM), the Brazilian Institute of Geography and Statistics Foundation (IBGE) and the United Nations Development Programme (UNDP) were utilized as data sources. Standardized mortality rates were estimated for tuberculosis and cerebrovascular disease. Infant mortality rates for diarrhea and acute respiratory infection were also calculated. Stratification by city was done through principal component analysis. For each capital, the following were calculated: reducible mortality gaps (BRM), in relation to stratum (BRE), annual rate of reduction, and ratio of inequality between capitals. Decreases in infant mortality rates for diarrhea (between -77.4% and -5.3%) and acute respiratory infection (between -69.9% and -7.1%) were observed in most of the cities studied. There were also decreases in the attributable risk (BRE) related to both diseases during the study period. Those trends are compatible with the success of the programs directed to control both health problems. With respect to tuberculosis and cerebrovascular mortality, despite a decline in the majority of the cities studied, there was an upward trend in several cities for at least one disease, indicating problems with control measures. The elevated relative risks (BRP) found and the inequality ratios, which varied from 0.4 to 11.0, refiect the persistence of social health inequalities in Brazil.

Keywords : inequality; avoidable deaths; evaluation; gaps.

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