Burden of disease in Brazil, 1990–2016: a systematic subnational analysis for the Global Burden of Disease Study 2016
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Data
2018
Tipo de documento
Artigo de Periodico
Título da Revista
ISSN da Revista
Título de Volume
Área do conhecimento
Ciências da Saúde
Modalidade de acesso
Acesso aberto
Editora
Autores
GBD 2016 Brazil Collaborators
Traebert, Jefferson
Orientador
Coorientador
Resumo
Background: 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.
Methods: 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.
Findings: 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 agestandardised
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.
Interpretation 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.
Palavras-chave
Burden of Disease