Temporal trends in mortality and regional inequalities of socially determined diseases in brazil, 2014–2023
1
Maternal-Infant and Public Health Nursing Department, University of São Paulo College of Nursing at Ribeirão Preto, Ribeirão Preto, Brazil
2
Department of Preventive Medicine and Public Health, University of Seville, Seville, Spain
Popul. Med. 2026;8(Supplement Supplement 1):A1317
ABSTRACT
INTRODUCTION:
Socially determined diseases (SDDs) contribute substantially to mortality among socially vulnerable populations, reflecting structural inequalities. This study analyzed mortality trends from SDDs and differences across brazilian macroregions.
METHODS:
An ecological study was conducted using Brazilian macroregions as the unit of analysis from 2014 to 2023. Secondary data on deaths due to tuberculosis, leprosy, viral hepatitis, schistosomiasis, Chagas disease, and malaria were obtained from the Mortality Information System (SIM). Annual mortality rates per 100000 inhabitants were calculated based on population estimates from the Brazilian Institute of Geography and Statistics (IBGE). Temporal trends were assessed using Prais-Winsten regression, estimating the Annual Percent Change (APC) and 95% confidence intervals (95%CI), using R (version 4.5.1).
RESULTS:
Between 2014 and 2023, 120423 deaths from SDDs were recorded. Tuberculosis accounted for the highest number of deaths (n=48796; 40.5%), followed by Chagas disease (n=42719; 35.5%) and viral hepatitis (n=22319; 18.5%), together representing 94.5% of all deaths. Mortality was higher among men (n=77090; 64%) and individuals of mixed race (“pardo”) (n=54787; 45.5%). The Central-West region showed the highest mean mortality rate (8.82 per 100000 inhabitants), whereas the South had the lowest (4.07 per 100000). Over the study period, mortality rates decreased in the South (APC -2.25%; 95%CI -2.97 to -1.53), Central-West (APC -2.01%; 95%CI -3.08 to -0.93), and Southeast (APC -1.66%; 95%CI -2.54 to -0.77). In contrast, rates remained stationary in the Northeast (APC -0.36%; 95%CI -1.41 to 0.69) and North (APC +1.02%; 95%CI -0.13 to 2.17).
CONCLUSIONS:
Mortality from SDDs declined in most Brazilian macroregions, remained stable in the Northeast and North, and exhibited marked territorial heterogeneity, with a higher burden in the Central-West. These findings highlight the need for integrated interventions to reduce inequalities and strengthen health actions in the most vulnerable territories.
Socially determined diseases (SDDs) contribute substantially to mortality among socially vulnerable populations, reflecting structural inequalities. This study analyzed mortality trends from SDDs and differences across brazilian macroregions.
METHODS:
An ecological study was conducted using Brazilian macroregions as the unit of analysis from 2014 to 2023. Secondary data on deaths due to tuberculosis, leprosy, viral hepatitis, schistosomiasis, Chagas disease, and malaria were obtained from the Mortality Information System (SIM). Annual mortality rates per 100000 inhabitants were calculated based on population estimates from the Brazilian Institute of Geography and Statistics (IBGE). Temporal trends were assessed using Prais-Winsten regression, estimating the Annual Percent Change (APC) and 95% confidence intervals (95%CI), using R (version 4.5.1).
RESULTS:
Between 2014 and 2023, 120423 deaths from SDDs were recorded. Tuberculosis accounted for the highest number of deaths (n=48796; 40.5%), followed by Chagas disease (n=42719; 35.5%) and viral hepatitis (n=22319; 18.5%), together representing 94.5% of all deaths. Mortality was higher among men (n=77090; 64%) and individuals of mixed race (“pardo”) (n=54787; 45.5%). The Central-West region showed the highest mean mortality rate (8.82 per 100000 inhabitants), whereas the South had the lowest (4.07 per 100000). Over the study period, mortality rates decreased in the South (APC -2.25%; 95%CI -2.97 to -1.53), Central-West (APC -2.01%; 95%CI -3.08 to -0.93), and Southeast (APC -1.66%; 95%CI -2.54 to -0.77). In contrast, rates remained stationary in the Northeast (APC -0.36%; 95%CI -1.41 to 0.69) and North (APC +1.02%; 95%CI -0.13 to 2.17).
CONCLUSIONS:
Mortality from SDDs declined in most Brazilian macroregions, remained stable in the Northeast and North, and exhibited marked territorial heterogeneity, with a higher burden in the Central-West. These findings highlight the need for integrated interventions to reduce inequalities and strengthen health actions in the most vulnerable territories.
| eISSN: | 2654-1459 |
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