Trends in premature mortality due to chronic non-communicable diseases in Brazilian federal units

Alves, Carla Guimarães; Morais Neto, Otaliba Libânio de

doi:10.1590/1413-81232015203.15342014

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Article • Ciênc. saúde coletiva 20 (3) • Mar 2015 • https://doi.org/10.1590/1413-81232015203.15342014 copy

Trends in premature mortality due to chronic non-communicable diseases in Brazilian federal units

Authorship SCIMAGO INSTITUTIONS RANKINGS

Chronic non-communicable diseases (NCDs) have a high mortality rate, mainly in lower and middle income countries. The major groups are cardiovascular disease (CVD), chronic respiratory disease (CRD), cancer and diabetes. The Action Plan to reduce NCDs in Brazil, 2011-2022 established a 2% yearly reduction in the NCD premature mortality rate as a goal. The aim of the study was to analyze trends in premature mortality rates and also show goal achievement scenarios for each Federal Unit (FU). A time series analysis of the standardized mortality rate between2000-2011 was performed using the linear regression model. The average annual rate of increase and the 95% confidence interval were estimated. Each FU was classified as being likely or unlikely to achieve the goal. The FUs likely to achieve the goal were: for CVD - Federal District, Santa Catarina, Mato Grosso, Rio Grande do Sul, Minas Gerais, Bahia, Espírito Santo and Paraná states; for CRD - Amazonas, Federal District and Paraná. For neoplasms and diabetes, none of the FUs are likely to achieve the goal. The articulation of the three levels of government will allow the strengthening of interventions to reduce the determinants of NCDs and to improve access and quality in health care.

Chronic disease; Epidemiology; Premature mortality

		Neoplasms					Diabetes

			95% CI					95% CI
FU	b^*	Rate (%)	LL	UL		b^*	Rate (%)	LL	UL
Rondônia	-0.0014^*	-0.33	-0.62	-0.03	0.0028		0.65	-2.62	4.02
Acre	-0.0003	-0.08	-0.50	0.35	0.0083		1.94	-0.03	3.95
Amazonas	-0.0065^*	-1.48	-1.72	-1.23	0.0070		1.63	-1.28	4.64
Roraima	0.0039	0.91	-1.45	3.31	-0.0149		-3.38	-8.26	1.76
Pará	-0.0050^*	-1.13	-1.58	-0.69	0.0093^*		2.16	0.10	4.27
Amapá	-0.0127^*	-2.88	-4.12	-1.62	0.0074		1.73	-1.53	5.09
Tocantins	0.0069^*	1.61	0.31	2.92	0.0095		2.22	-0.72	5.24
Maranhão	-0.0025	-0.57	-1.45	0.31	0.0078^*		1.82	1.23	2.41
Piauí	0.0062^*	1.44	1.24	1.64	0.0086^*		2.00	0.95	3.05
Ceará	-0.0044^*	-1.00	-1.67	-0.33	-0.0049		-1.13	-2.83	0.60
Rio Grande do Norte	0.0026^*	0.61	0.02	1.20	0.0005		0.12	-2.37	2.67
Paraíba	0.0087^*	2.02	1.39	2.66	0.0025		0.57	-1.92	3.14
Pernambuco	-0.0006	-0.15	-0.75	0.46	-0.0048^*		-1.10	-1.85	-0.34
Alagoas	0.0012	0.28	-0.80	1.36	0.0072^*		1.66	0.12	3.23
Sergipe	0.0059	1.37	-0.14	2.90	-0.0100^*		-2.27	-3.52	-1.00
Bahia	0.0030^*	0.70	0.42	0.97	-0.0026		-0.60	-1.40	0.20
Minas Gerais	0.0026^*	0.59	0.23	0.96	0.0005		0.11	-0.28	0.51
Espírito Santo	-0.0025	-0.58	-1.75	0.61	-0.0084		-1.91	-3.94	0.16
Rio de Janeiro	-0.0071^*	-1.63	-1.73	-1.52	-0.0023		-0.52	-1.11	0.07
São Paulo	-0.0039^*	-0.89	-1.10	-0.68	-0.0076^*		-1.73	-2.78	-0.68
Paraná	0.0001	0.03	-0.21	0.27	0.0037^*		0.86	0.08	1.64
Santa Catarina	-0.0040^*	-0.92	-1.11	-0.72	-0.0034		-0.77	-2.42	0.91
Rio Grande do Sul	-0.0024^*	-0.54	-0.69	-0.39	0.0012		0.28	-0.02	0.58
Mato Grosso do Sul	0.0003	0.06	-0.72	0.84	-0.0021		-0.48	-1.19	0.23
Mato Grosso	-0.0003	-0.06	-1.01	0.89	0.0014		0.33	-1.38	2.07
Goiás	0.0000	0.00	-0.35	0.36	0.0006		0.13	-1.77	2.07
Federal District	-0.0094^*	-2.14	-2.53	-1.75	-0.0133^*		-3.02	-4.34	-1.68
Brazil	-0.0021^*	-0.49	-0.59	-0.39	-0.0017		-0.40	-1.09	0.31
Rondônia	-0.0109^*	-2.49	-2.99	-1.99	-0.0081^*		-1.84	-2.72	-0.94
Acre	-0.0065	-1.49	-3.06	0.11	-0.0005		-0.12	-4.23	4.16
Amazonas	-0.0089^*	-2.02	-2.39	-1.64	-0.0202^*		-4.54	-6.86	-2.16
Roraima	-0.0114^*	-2.58	-3.25	-1.91	-0.0570^*		-12.29	-15.68	-8.78
Pará	-0.0089^*	-2.02	-2.74	-1.29	-0.0184^*		-4.15	-6.65	-1.58
Amapá	-0.0121^*	-2.76	-4.46	-1.03	-0.0258^*		-5.77	-10.12	-1.20
Tocantins	-0.0058^*	-1.32	-1.71	-0.92	-0.0022		-0.50	-5.94	5.27
Maranhão	-0.0093^*	-2.12	-2.45	-1.79	-0.0133^*		-3.03	-5.18	-0.82
Piauí	-0.0100^*	-2.28	-2.76	-1.80	-0.0114^*		-2.58	-3.55	-1.60
Ceará	-0.0074^*	-1.70	-2.28	-1.11	-0.0131^*		-2.97	-4.54	-1.37
Rio Grande do Norte	-0.0086^*	-1.97	-2.18	-1.76	-0.0017		-0.40	-2.89	2.15
Paraíba	-0.0033	-0.75	-1.50	0.00	-0.0093^*		-2.11	-2.58	-1.64
Pernambuco	-0.0086^*	-1.97	-2.04	-1.90	0.0088^*		2.05	0.78	3.34
Alagoas	-0.0063^*	-1.45	-1.87	-1.02	0.0006		0.13	-1.82	2.12
Sergipe	-0.0065^*	-1.48	-1.77	-1.18	-0.0082		-1.88	-3.84	0.12
Bahia	-0.0118^*	-2.68	-3.22	-2.15	-0.0065^*		-1.49	-1.97	-1.00
Minas Gerais	-0.0156^*	-3.54	-3.69	-3.39	-0.0169^*		-3.82	-4.80	-2.83
Espírito Santo	-0.0127^*	-2.87	-3.34	-2.41	-0.0122^*		-2.78	-4.12	-1.42
Rio de Janeiro	-0.0103^*	-2.35	-2.66	-2.05	-0.0172^*		-3.88	-4.31	-3.45
São Paulo	-0.0102^*	-2.31	-2.80	-1.82	-0.0143^*		-3.24	-4.22	-2.25
Paraná	-0.0128^*	-2.91	-3.03	-2.80	-0.0163^*		-3.69	-4.00	-3.37
Santa Catarina	-0.0122^*	-2.76	-3.00	-2.52	-0.0271^*		-6.06	-6.55	-5.56
Rio Grande do Sul	-0.0128^*	-2.91	-3.68	-2.14	-0.0236^*		-5.29	-6.42	-4.15
Mato Grosso do Sul	-0.0093^*	-2.11	-2.63	-1.59	-0.0075^*		-1.71	-3.03	-0.36
Mato Grosso	-0.0104^*	-2.37	-2.66	-2.07	0.0035		0.82	-1.90	3.61
Goiás	-0.0094^*	-2.15	-2.82	-1.48	-0.0092^*		-2.10	-3.62	-0.56
Federal District	-0.0161^*	-3.63	-4.80	-2.45	-0.0164^*		-3.70	-4.63	-2.75
Brazil	-0.0110^*	-2.49	-2.71	-2.27	-0.0159^*		-3.59	0.00	-2.97

		Neoplasms					Diabetes

			95% CI					95% CI
FU	b^*	Rate (%)	LL	UL		b^*	Rate (%)	LL	UL
Rondônia	-0.0048^*	-1.10	-1.55	-0.65	-0.0085		-1.95	-4.24	0.40
Acre	0.0017	0.38	-0.66	1.43	0.0006		0.13	-2.56	2.89
Amazonas	-0.0034	-0.78	-1.74	0.19	-0.0026		-0.59	-3.21	2.10
Roraima	0.0061^*	1.41	0.16	2.67	0.0151		3.53	-3.83	11.45
Pará	-0.0024	-0.55	-1.35	0.26	0.0017		0.39	-1.62	2.44
Amapá	-0.0086^*	-1.96	-3.85	-0.03	0.0097		2.25	-0.71	5.30
Tocantins	0.0037	0.85	-0.67	2.40	0.0038		0.88	-1.88	3.72
Maranhão	-0.0019^*	-0.45	-0.76	-0.13	0.0000		0.00	-1.13	1.13
Piauí	0.0023^*	0.53	0.03	1.02	0.0060^*		1.40	0.87	1.92
Ceará	-0.0041^*	-0.95	-1.84	-0.05	-0.0080		-1.83	-4.17	0.57
Rio Grande do Norte	-0.0037^*	-0.84	-1.17	-0.51	-0.0053		-1.21	-2.47	0.06
Paraíba	0.0061^*	1.42	0.76	2.08	-0.0048		-1.11	-2.59	0.39
Pernambuco	-0.0019^*	-0.45	-0.84	-0.05	-0.0074^*		-1.69	-2.63	-0.75
Alagoas	-0.0038	-0.87	-1.90	0.17	0.0037		0.87	-0.05	1.79
Sergipe	-0.0036	-0.82	-1.92	0.28	-0.0116^*		-2.63	-3.34	-1.92
Bahia	0.0016^*	0.38	0.21	0.54	-0.0084^*		-1.92	-2.34	-1.49
Minas Gerais	0.0005	0.11	-0.14	0.36	-0.0054^*		-1.23	-1.66	-0.79
Espírito Santo	-0.0044^*	-1.01	-1.94	-0.08	-0.0066^*		-1.51	-2.65	-0.36
Rio de Janeiro	-0.0031^*	-0.71	-1.14	-0.27	-0.0068^*		-1.55	-2.62	-0.46
São Paulo	-0.0016^*	-0.36	-0.54	-0.18	-0.0164^*		-3.70	-4.88	-2.50
Paraná	0.0003	0.07	-0.09	0.23	-0.0037		-0.84	-2.70	1.05
Santa Catarina	0.0006	0.13	-0.32	0.59	-0.0107^*		-2.44	-3.86	-1.00
Rio Grande do Sul	-0.0005	-0.12	-0.27	0.04	-0.0034		-0.78	-1.73	0.19
Mato Grosso do Sul	-0.0018^*	-0.41	-0.76	-0.05	-0.0107^*		-2.43	-3.09	-1.76
Mato Grosso	-0.0021	-0.47	-1.12	0.18	-0.0041		-0.94	-3.17	1.34
Goiás	0.0007	0.15	-0.06	0.36	-0.0022		-0.50	-1.99	1.01
Federal District	-0.0082^*	-1.87	-2.20	-1.54	-0.0160^*		-3.61	-4.78	-2.43
Brazil	-0.0013^*	-0.29	-0.33	-0.25	-0.0072^*		-1.64	-2.37	-0.90
Rondônia	-0.0135^*	-3.06	-3.38	-2.75	-0.0107^*		-2.43	-4.24	-0.58
Acre	-0.0007	-0.16	-2.70	2.45	-0.0045		-1.03	-7.60	6.01
Amazonas	-0.0121^*	-2.76	-3.12	-2.40	-0.0190^*		-4.28	-5.21	-3.35
Roraima	-0.0002	-0.05	-3.57	3.59	0.0000		0.00	-6.91	7.42
Pará	-0.0122^*	-2.78	-3.02	-2.54	-0.0138^*		-3.13	-4.67	-1.57
Amapá	-0.0176^*	-3.97	-6.04	-1.85	-0.0354^*		-7.82	-13.82	-1.40
Tocantins	-0.0128^*	-2.91	-4.25	-1.55	0.0026		0.59	-4.05	5.45
Maranhão	-0.0117^*	-2.65	-2.99	-2.31	-0.0031		-0.72	-2.14	0.72
Piauí	-0.0107^*	-2.43	-3.30	-1.54	-0.0108^*		-2.46	-3.16	-1.75
Ceará	-0.0104^*	-2.37	-3.25	-1.47	-0.0035		-0.81	-1.99	0.38
Rio Grande do Norte	-0.0146^*	-3.31	-4.02	-2.59	-0.0021		-0.49	-2.87	1.95
Paraíba	-0.0101^*	-2.31	-2.90	-1.71	-0.0078		-1.79	-3.88	0.35
Pernambuco	-0.0119^*	-2.71	-3.27	-2.14	-0.0027		-0.63	-1.37	0.11
Alagoas	-0.0093^*	-2.11	-2.69	-1.53	-0.0094^*		-2.15	-2.75	-1.54
Sergipe	-0.0127^*	-2.89	-3.41	-2.37	0.0216^*		5.10	2.19	8.08
Bahia	-0.0141^*	-3.20	-3.45	-2.94	-0.0045^*		-1.03	-1.79	-0.27
Minas Gerais	-0.0152^*	-3.45	-3.74	-3.16	-0.0136^*		-3.08	-3.45	-2.70
Espírito Santo	-0.0142^*	-3.22	-4.09	-2.34	-0.0067		-1.52	-3.63	0.64
Rio de Janeiro	-0.0102^*	-2.33	-2.81	-1.84	-0.0049^*		-1.11	-1.45	-0.77
São Paulo	-0.0117^*	-2.66	-3.16	-2.17	-0.0064^*		-1.46	-2.48	-0.42
Paraná	-0.0157^*	-3.55	-3.95	-3.15	-0.0144^*		-3.25	-3.63	-2.87
Santa Catarina	-0.0147^*	-3.32	-3.81	-2.83	-0.0120^*		-2.73	-3.99	-1.44
Rio Grande do Sul	-0.0131^*	-2.98	-3.73	-2.21	-0.0118^*		-2.68	-3.44	-1.91
Mato Grosso do Sul	-0.0109^*	-2.48	-3.29	-1.66	-0.0050		-1.15	-2.69	0.41
Mato Grosso	-0.0147^*	-3.32	-3.49	-3.16	-0.0007		-0.15	-1.58	1.30
Goiás	-0.0125^*	-2.83	-3.25	-2.41	-0.0086^*		-1.96	-2.75	-1.17
Federal District	-0.0185^*	-4.18	-4.91	-3.44	-0.0208^*		-4.67	-6.69	-2.61
Brazil	-0.0129^*	-2.93	-3.05	-2.82	-0.0097^*		-2.20	-2.82	-1.57

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[1] Collaborations CG Alves and OL Morais Neto participated in the conception, design, analysis, and interpretation of data, as well as in writing and revising the article.