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Spatial inequalities of premature mortality for chronic non-transmissible diseases in the municipality of São Paulo, Brazil, 2006 to 2019

Abstract

Background

This study uses mortality data to monitor social inequalities in health.

Objective

To analyze the trend in premature mortality rates (30 to 69 years) by selected groups of NCDs in areas of social inclusion and exclusion in the city of São Paulo, between 2006 and 2019, and to assess the magnitude of inequalities in the years 2006-2008 and 2017-2019.

Method

The Exclusion/Inclusion Index was used to delimit areas, Prais-Winsten regression to analyze trends, and rate ratio (RT) to measure inequalities.

Results

The trends showed declines, with greater social inclusion in males for ischemic heart diseases (IHD), chronic diseases of the lower respiratory tract (DLRT) and diabetes mellitus (DM). There were significant increases in RT in males for IHD (1.62 and 2.17), DCR (1.60 and 3.00) and DM (1.81 and 2.26), while in females there was no increase.

Conclusion

The decline in rates in areas of social exclusion, the non-expansion of inequality in women and, due to cerebrovascular and hypertensive diseases in men, is probably due to the existence of a universal health system. The expansion of inequality between men requires adequate health services to ensure the integrality of this group.

Keywords:
social inequity; premature mortality; chronic disease

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E-mail: cadernos@iesc.ufrj.br