Probability of premature death due to chronic noncommunicable diseases: challenges to achieving the Sustainable Development Goals in Brazil ad its Federatives Units

Noncommunicable diseases (NCDs) are the leading causes of morbidity and mortality in Brazil. The aim of the present study was to determine whether the reduction in the occurrence of NCDs by 2030, which is one of the Sustainable Development Goals (SDGs), will be achieved through an analysis of trends in the unconditional probability of premature deaths between 1990 and 2021 in Brazil and its 27 states. A time-series study was conducted on the probability of premature death (30-69 years of age) due to NCDs (cardiovascular diseases, neoplasms, chronic respiratory diseases, and diabetes mellitus) based on data from the 2021 Global Burden of Disease Study. Joinpoint regression models were used to estimate trends and projections up to 2030 using Holt’s model. Regional inequalities were assessed based on quintiles of the sociodemographic index (SDI). The probability of premature death due to NCDs reduced from 0.233 (1990) to 0.152 (2021) (average annual percent change = -1.3; p < 0.001), with a decline in all SDI quintiles. Mortality was consistently higher among men. Projections indicate that the target of a one-third reduction by 2030 will likely not be achieved, especially in the lowest SDI quintiles, with variations according to sex. Despite the downward trend, regional and social inequalities persist. Improvements in access to health care and public policies contributed to the decline, but challenges remain, such as the weakening of risk factor control policies, the influence of commercial determinants of health, and the effects of the COVID-19 pandemic.

Keywords:
Noncommunicable Diseases; Premature Mortality; Sustainable Development; Time Series Studies