Spatiotemporal Trends in Deaths From External Causes in Brazil: 23-Year Ecological and Population-Based Study

巴西外部原因死亡的时空趋势:一项为期23年的生态学和人口学研究

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Abstract

BACKGROUND: Mortality from external causes is a major public health issue globally, with significant impacts on both lives and economies. In Brazil, external cause mortality has shown spatiotemporal variations across regions, influenced by social, economic, and demographic factors. OBJECTIVE: This study aimed to examine the spatiotemporal dynamics of mortality from external causes in Brazil for 23 years (2000-2022), identifying patterns across regions and demographic groups and assessing the major contributing causes of death. METHODS: This ecological study used data from the Brazilian Mortality Information System (SIM) and used joinpoint regression to analyze temporal trends, Moran I for spatial analysis, and Poisson scanning statistics for spatiotemporal patterns. A total of 3,240,023 deaths were analyzed, with specific attention given to regional and demographic disparities. RESULTS: The study found that mortality from external causes remained significant, with men and young adults (20-39 years) having the highest rates of death. The main causes of death were assaults (36.61%), transport accidents (26.55%), falls (7.83%), and self-harm (7.43%). Despite an overall decrease in mortality, increases were observed in the North and Northeast regions and among the older adults. High-risk areas were predominantly located in the North, Northeast, and Central-West regions. The mortality trends varied by region, with significant differences in risk across the country. CONCLUSIONS: Although there was a general reduction in mortality from external causes in Brazil, this trend was not uniform across all regions. The North, Northeast, and Central-West regions showed the highest mortality risks, with men and young adults being the most affected demographic groups. These findings emphasize the need for targeted public health interventions that address the regional and demographic disparities in mortality from external causes.

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