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9999-12-31
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NONCOMMUNICABLE DISEASE BURDEN IN BRAZIL AND ITS STATES FROM 1990 TO 2021, WITH PROJECTIONS FOR 2030
Author
Malta, Deborah Carvalho
Gomes, Crizian Saar
Veloso, Guilherme Augusto
Teixeira, Renato Azeredo
Mendes, Mariana Santos Felisbino
Brant, Luisa Campos Caldeira
Prates, Elton Junio Sady
Silva, Alanna Gomes
Souza, Juliana Bottoni de
Duncan, Bruce Bartholow
Schmidt, Maria Inês
Souza, Maria de Fátima Marinho de
Vasconcelos, Ana Maria Nogales
Szwarcwald, Célia Landmann
Velásquez Meléndez, Jorge Gustavo
Machado, Ísis Eloah
Naghavi, Mohsen
Ribeiro, Antônio Luiz Pinho
Gomes, Crizian Saar
Veloso, Guilherme Augusto
Teixeira, Renato Azeredo
Mendes, Mariana Santos Felisbino
Brant, Luisa Campos Caldeira
Prates, Elton Junio Sady
Silva, Alanna Gomes
Souza, Juliana Bottoni de
Duncan, Bruce Bartholow
Schmidt, Maria Inês
Souza, Maria de Fátima Marinho de
Vasconcelos, Ana Maria Nogales
Szwarcwald, Célia Landmann
Velásquez Meléndez, Jorge Gustavo
Machado, Ísis Eloah
Naghavi, Mohsen
Ribeiro, Antônio Luiz Pinho
Affilliation
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brasil.
Universidade Federal Fluminense. Departamento de Estatística. Niterói, RJ, Brasil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brasil.
Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Porto Alegre, RS, Brasil.
Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Porto Alegre, RS, Brasil.
Vital Strategies. São Paulo, SP, Brasil.
Universidade de Brasília. Departamento de Estatística. Brasília, DF, Brasil.
Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brasil.
Universidade Federal de Ouro Preto. Departamento de Medicina de Família, Saúde Mental e Coletiva. Ouro Preto, MG, Brasil.
University of Washington. Institute for Health Metrics and Evaluation. Seattle, WA, USA.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brasil.
Universidade Federal Fluminense. Departamento de Estatística. Niterói, RJ, Brasil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brasil.
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brasil.
Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Porto Alegre, RS, Brasil.
Universidade Federal do Rio Grande do Sul. Faculdade de Medicina. Porto Alegre, RS, Brasil.
Vital Strategies. São Paulo, SP, Brasil.
Universidade de Brasília. Departamento de Estatística. Brasília, DF, Brasil.
Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.
Universidade Federal de Minas Gerais. Escola de Enfermagem. Belo Horizonte, MG, Brasil.
Universidade Federal de Ouro Preto. Departamento de Medicina de Família, Saúde Mental e Coletiva. Ouro Preto, MG, Brasil.
University of Washington. Institute for Health Metrics and Evaluation. Seattle, WA, USA.
Universidade Federal de Minas Gerais. Faculdade de Medicina. Belo Horizonte, MG, Brasil.
Abstract
Objectives: The aim of this study was to analyse the burden of disease due to noncommunicable diseases (NCDs) between 1990 and 2021 in Brazil. In addition, this study compared mortality from NCDs with mortality from all causes and COVID-19, analysed NCD mortality trends and projections for 2030, and analysed NCD mortality rates and risk factors attributed to these deaths among the 27 states of Brazil. Study design: Ecological studies. Methods: This study used the Global Burden of Disease study (GBD) database from 1990 to 2021. Premature deaths from four NCDs (neoplasms, cardiovascular disease, chronic respiratory diseases and diabetes mellitus) were analysed. The following metrics were used to analyse the burden of NCDs in Brazil: absolute number of deaths, proportional mortality, mortality rate, years of life lost due to premature death (YLL), years lived with disabilities (YLD) and disability-adjusted years of life lost due to premature death (DALY). For comparison between the years studied and states, age-standardised rates were used. Results: Finding from this study showed that there was increase in the proportion of premature deaths due to NCDs between 1990 and 2019 (29.4 % in 1990, 30.8 % in 2019), and a reduction in 2021 (24.7 %). The mortality rates, DALY and YLL from NCDs declined between 1990 and 2019 (− 37.7 %, − 34.5 % and − 38.3 %, respectively); however, a stability in mortality rates, DALY, YLD, YLL was observed between 2019 and 2021 (− 0.1 %, 0.7 %, − 0.1 % and 0.8 %, respectively). Between 1990 and 2021, there was a decline in mortality rates, DALY and YLL for most states and an increase in YLD rates. However, results suggest that the Sustainable Development Goal (SDG) for the reduction in mortality from NCDs by one-third by 2030 will not be achieved. The main risk factors associated with premature death from NCDs in 2021 were high blood pressure, tobacco use, dietary risks, high body mass index (BMI) and high blood glucose levels. The correlation between sociodemographic index and percentage change in mortality rates was significant for the following total NCDs, cardiovascular disease, chronic respiratory disease, diabetes and neoplasms. Conclusions: The current study highlights the importance of deaths from NCDs in Brazil and the worsening of mortality rates since 2016, as a result of austerity measures and the COVID-19 pandemic, which compromises the achievement of the SDG reduced mortality targets for NCDs. There was a reduction in risk factors for NCDs, mainly behavioural, although metabolic risk factors are of great concern and require new strategies to promote health, prevention and comprehensive care.
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