TY - JOUR
T1 - Uneven state distribution of homicides in Brazil and their effect on life expectancy, 2000-2015
T2 - A cross-sectional mortality study
AU - Aburto, José Manuel
AU - Calazans, Julia
AU - Queiroz, Bernardo Lanza
AU - Luhar, Shammi
AU - Canudas-Romo, Vladimir
N1 - Publisher Copyright:
© Author(s) (or their employer(s)) 2021.
PY - 2021/2/15
Y1 - 2021/2/15
N2 - Objective To determine cause-specific and age-specific contributions to life expectancy changes between 2000 and 2015, separately by state and sex in Brazil, with a focus on homicides. Design Retrospective cross-sectional demographic analysis of mortality. Setting and population Brazilian population by age, sex and state from 2000 to 2015. Main outcome measure Using mortality data from the Brazilian Mortality Information System and population estimates from the National Statistics Office, we used death distribution methods and the linear integral decomposition model to estimate levels and changes in life expectancy. We also examine how multiple causes of death, including those attributable to homicides and amenable/avoidable mortality, contributed to these changes from 2000 to 2015. Results Between 2000 and 2015, life expectancy in Brazil increased from 71.5 to 75.1 years. Despite state-level variation in gains, life expectancy increased in almost all states over this period. However across Brazil, homicide mortality contributed, to varying degrees, to either attenuated or decreased male life expectancy gains. In Alagoas in 2000-2007 and Sergipe in 2007-2015, homicides contributed to a reduction in life expectancy of 1.5 years, offsetting gains achieved through improvements due to medically amenable causes. In the period 2007-2015, male life expectancy could have been improved by more than half a year in 12 of Brazil's states if homicide mortality had remained at the levels of 2007. Conclusions Homicide mortality appears to offset life expectancy gains made through recent improvements to mortality amenable to medical services and public health interventions, with considerable subnational heterogeneity in the extent of this phenomenon. Efforts combating the causes of homicides can increase life expectancy beyond what has been achieved in recent decades.
AB - Objective To determine cause-specific and age-specific contributions to life expectancy changes between 2000 and 2015, separately by state and sex in Brazil, with a focus on homicides. Design Retrospective cross-sectional demographic analysis of mortality. Setting and population Brazilian population by age, sex and state from 2000 to 2015. Main outcome measure Using mortality data from the Brazilian Mortality Information System and population estimates from the National Statistics Office, we used death distribution methods and the linear integral decomposition model to estimate levels and changes in life expectancy. We also examine how multiple causes of death, including those attributable to homicides and amenable/avoidable mortality, contributed to these changes from 2000 to 2015. Results Between 2000 and 2015, life expectancy in Brazil increased from 71.5 to 75.1 years. Despite state-level variation in gains, life expectancy increased in almost all states over this period. However across Brazil, homicide mortality contributed, to varying degrees, to either attenuated or decreased male life expectancy gains. In Alagoas in 2000-2007 and Sergipe in 2007-2015, homicides contributed to a reduction in life expectancy of 1.5 years, offsetting gains achieved through improvements due to medically amenable causes. In the period 2007-2015, male life expectancy could have been improved by more than half a year in 12 of Brazil's states if homicide mortality had remained at the levels of 2007. Conclusions Homicide mortality appears to offset life expectancy gains made through recent improvements to mortality amenable to medical services and public health interventions, with considerable subnational heterogeneity in the extent of this phenomenon. Efforts combating the causes of homicides can increase life expectancy beyond what has been achieved in recent decades.
KW - Demography
KW - Health policy
KW - Public health
UR - http://www.scopus.com/inward/record.url?scp=85101465213&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2020-044706
DO - 10.1136/bmjopen-2020-044706
M3 - Article
SN - 2044-6055
VL - 11
JO - BMJ Open
JF - BMJ Open
IS - 2
M1 - e044706
ER -