Journal Article

Burden of disease in Brazil, 1990–2016: a systematic subnational analysis for the Global Burden of Disease Study 2016

Guimaraes, Mark D C, Palone, Marcos Roberto Tovani, Brant, Luisa C C, Curado, Maria Paula, Goulart, Alessandra Carvalho, Naghavi, Mohsen, Faro, André, Lozano, Rafael, Santos Silva, Diego Augusto, Bustamante-Teixeira, Maria Teresa, Gall, Julia, Santos, Itamar S, de Azeredo Passos, Valéria Maria, Felisbino-Mendes, Mariana Santos, Traebert, Jefferson, Murray, Christopher J L, Ferri, Cleusa P, Abreu, Daisy M X, Camargos, Paulo A M, Schneider, Ione J C, Szwarcwald, Celia L, Ribeiro, Antonio L, Costa Pereira, Alexandre, Bensenor, Isabela M, Lotufo, Paulo A, Barreto, Mauricio L, Claro, Rafael M, Marinho, Fatima, Miller-Petrie, Molly K, Pereira, Claudia C, Kieling, Christian, Silveira, Dayane Gabriele Alves, Ishitani, Lenice Harumi, Marcenes, Wagner, Roever, Leonardo, Ladeira, Roberto Marini, Wang, Yuan-Pang, Machado, Isis Eloah, Oliveira, Patricia Pereira Vasconcelos, Velasquez-Melendez, Gustavo, Vasconcelos, Ana Maria Nogales, Rasella, Davide, Martins, Sheila Cristina Ouriques, Ray, Sarah E, Barboza França, Elizabeth, Mooney, Meghan D, Melo, Ana Paula Souto, de Moares Pedroso, Marcel

2018

Overview

Political, economic, and epidemiological changes in Brazil have affected health and the health system. We used the Global Burden of Disease Study 2016 (GBD 2016) results to understand changing health patterns and inform policy responses. We analysed GBD 2016 estimates for life expectancy at birth (LE), healthy life expectancy (HALE), all-cause and cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and risk factors for Brazil, its 26 states, and the Federal District from 1990 to 2016, and compared these with national estimates for ten comparator countries. Nationally, LE increased from 68·4 years (95% uncertainty interval [UI] 68·0–68·9) in 1990 to 75·2 years (74·7–75·7) in 2016, and HALE increased from 59·8 years (57·1–62·1) to 65·5 years (62·5–68·0). All-cause age-standardised mortality rates decreased by 34·0% (33·4–34·5), while all-cause age-standardised DALY rates decreased by 30·2% (27·7–32·8); the magnitude of declines varied among states. In 2016, ischaemic heart disease was the leading cause of age-standardised YLLs, followed by interpersonal violence. Low back and neck pain, sense organ diseases, and skin diseases were the main causes of YLDs in 1990 and 2016. Leading risk factors contributing to DALYs in 2016 were alcohol and drug use, high blood pressure, and high body-mass index. Health improved from 1990 to 2016, but improvements and disease burden varied between states. An epidemiological transition towards non-communicable diseases and related risks occurred nationally, but later in some states, while interpersonal violence grew as a health concern. Policy makers can use these results to address health disparities. Bill & Melinda Gates Foundation and the Brazilian Ministry of Health.

• Publisher: Elsevier Ltd,Elsevier Limited,Elsevier
• Subject: Age / Age Distribution / Aggression / Alcoholic beverages / Blood pressure / Brazil - epidemiology / Cardiovascular diseases / Cause of Death / Charities / Coronary artery disease / Disabled Persons - statistics & numerical data / Disease / Epidemiology / Female / Global Burden of Disease - statistics & numerical data / Heart / Heart diseases / Humans / Hypertension / Injuries / Life Expectancy / Life span / Male / Mortality / Neck / Pain / Population / Population Surveillance / Quality-Adjusted Life Years / Risk analysis / Risk Factors / Skin diseases / Sociodemographics / Violence