Revista de saude publica最新文献

{"title":"HPV immunization in Brazil and proposals to increase adherence to vaccination campaigns.","authors":"Wagner Mesojedovas Santos, Debora Mesojedovas Santos, Márcia Santana Fernandes","doi":"10.11606/s1518-8787.2023057005410","DOIUrl":"10.11606/s1518-8787.2023057005410","url":null,"abstract":"<p><strong>Objectives: </strong>To identify the possible causes of low adherence to vaccination campaigns in Brazil, find and analyze campaigns regarding human papillomavirus (HPV) in Brazil and abroad, and apply quality tools to prepare proposals to increase vaccination coverage (VC) and prevent HPV in the country.</p><p><strong>Method: </strong>This is a qualitative and deductive-hypothetical research. A narrative review of the literature (especially on the narratives and formats applied in vaccination campaigns in Brazil) was the technique used to develop our method.</p><p><strong>Results: </strong>Brazil had a 49.6% VC in 2019, unlike countries such as Australia (80.2% in 2017), Mexico (97.5% in 2019), and Peru (91% in 2019). This study found evidence of the use of social marketing strategies to engage communities as good practices in the vaccination campaigns of these countries.</p><p><strong>Conclusion: </strong>With the retrieved information, three quality tools (Ishikawa diagram, Pareto graph, and 5W2H) classified and quantified the causes of low VC in Brazil and enabled proposals that can direct its Ministry of Health to take more effective strategies to achieve the HPV VC goal recommended by the WHO.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"79"},"PeriodicalIF":2.8,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10609638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71485537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of household availability of regional foods in Amazonas.","authors":"Rita de Cássia de Assunção Monteiro, Eliseu Verly Júnior","doi":"10.11606/s1518-8787.2023057004804","DOIUrl":"10.11606/s1518-8787.2023057004804","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the evolution of household availability of regional foods in the state of Amazonas, their distribution according to sociodemographic characteristics, and potential differences when compared to the remaining areas of Brazil.</p><p><strong>Methods: </strong>Data on food acquisition for home consumption from the 2002-2003, 2008-2009, and 2017-2018 Pesquisa de Orçamentos Familiares (POFs - Consumer Expenditure Surveys) were analyzed, covering, respectively, 48,470, 55,970, and 57,920 households in Brazil, of which 1,075, 1,344, and 1,833 are in Amazonas. Foods were categorized into three groups: cassava and its derivatives, freshwater fish, and regional fruits. The study analyzed the amount of regional food purchased, expressed in relative household caloric share, for the entire area of Amazonas. Additionally, the data was stratified and analyzed according to sociodemographic variables, with differences assessed through the overlapping of 95% confidence intervals.</p><p><strong>Findings: </strong>The household caloric share of the total regional foods in Amazonas was 22.54% in 2002-2003, 18.18% in 2008-2009, and 6.49% in 2017-2018. Across Brazil, those percentages were much lower in the same period: 3.67%, 3.34%, and 1.82%, respectively. Changes in Amazonas were primarily attributed to the steep drop in the cassava and derivatives group, which decreased from 14.30% in 2002-2003 to 12.74% in 2008-2009 and further declined to 3.09% in 2017-2018. Additionally, there was a gradual decline in household availability of freshwater fish, decreasing from 7.30% in 2002-2003 to 4.85% in 2008-2009 and reaching 2.90% in 2017-2018. Households in rural areas and with lower per capita income presented a higher proportion of calories from total regional foods; this particular stratum also experienced the most significant reductions in their consumption.</p><p><strong>Conclusion: </strong>During the study period, there was a significant decrease in the consumption of regional foods in Amazonas, particularly in lower income households in rural areas. Among them, the family reference person was typically a younger male with a lower educational background.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"69"},"PeriodicalIF":2.1,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50162731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iron salt supplementation during gestation and gestational diabetes mellitus.","authors":"Vanessa Iribarrem Avena Miranda, Tatiane da Silva Dal Pizzol, Marysabel Pinto Telis Silveira, Sotero Serrate Mengue, Mariângela Freitas da Silveira, Bárbara Heather Lutz, Andréa Dâmaso Bertoldi","doi":"10.11606/s1518-8787.2023057004871","DOIUrl":"10.11606/s1518-8787.2023057004871","url":null,"abstract":"","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"71"},"PeriodicalIF":2.8,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10547396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50162736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proadi-SUS: analysis of financial resources in the three-year periods 2009-2011, 2012-2014 and 2015-2017.","authors":"Julia Amorim Santos,&nbsp;Luciana Palhares,&nbsp;Aquilas Mendes","doi":"10.11606/s1518-8787.2023057004385","DOIUrl":"10.11606/s1518-8787.2023057004385","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the tax exemption resources used in the Support Program for Institutional Development of the Unified Health System (Proadi-SUS) in the 3-year periods 2009-2011, 2012-2014, 2015-2017, considering the total volume of resources linked to the debate on tax expenditures on health and the constitution of a \"new form of philanthropy\" in the sector.</p><p><strong>Methods: </strong>To understand the philanthropic sector, tax expenditures between 2001 and 2017 were analyzed. To evaluate the resources used in the program, the values of projects and areas of activity were examined.</p><p><strong>Results: </strong>A real increase in the values of general tax expenses and tax expenses referring to the philanthropic sector was found. There was also a real increase in the program's resources. A total of 407 projects were carried out, amounting to R$ 3.4 billion for the period. An analysis of the average value of the projects shows an increase in values for all hospitals included in the program, with the exception of one of the institutions. In the 2009-2011 and 2012-2014 periods, the area with the highest number of projects and the most resources was \"Management techniques and operation in health services\". In the 3-year period 2015-2017, however, the sector that received the most investments and the largest number of projects developed was \"Human Resources Training\".</p><p><strong>Conclusion: </strong>The program characterizes a different expression of the public-private partnership in the health sector linked to the principles of the new public management. As a development for future investigations, a qualitative characterization of the projects developed and the actions' impact on the public sector demands is necessary.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"61"},"PeriodicalIF":2.8,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10519681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50162740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adequacy of prenatal care and associated factors in the State of Rio Grande do Sul, Brazil.","authors":"Aline De Gregori Adami,&nbsp;Leonardo Rapone da Motta,&nbsp;Rosa Dea Sperhacke,&nbsp;Sérgio Kakuta Kato,&nbsp;Gerson Fernando Mendes Pereira,&nbsp;Rosa Maria Rahmi","doi":"10.11606/s1518-8787.2023057005146","DOIUrl":"10.11606/s1518-8787.2023057005146","url":null,"abstract":"ABSTRACT OBJECTIVE This study aims to assess the degree of adequacy of prenatal care (PNC) in the state of Rio Grande do Sul (RS) and in its 7 macro-regions considering the time of PNC initiation and the number of appointments attended. It also aims to verify the mode of delivery prevalence and the factors associated with PNC adequacy by mode of delivery. METHODS Sub analysis from a cross-sectional study conducted among 13,432 childbearing women aged 15–49 years assisted in 66 maternity hospitals of the Unified Health System (SUS) and private associated facilities from September 2017 to October 2019. A standardized form was used to collect sociodemographic data, and information about PNC and delivery from the childbearing women’s prenatal cards, hospital records, and medical reports. RESULTS The PNC coverage was (98.4%), but only 57.5% of the participants had an adequate PNC defined as the one initiated until the 12th gestational week, with attendance of at least 6 appointments. The cesarean rate was 57.2%. Among women who performed vaginal delivery, multivariate analysis showed that for each 1-year increase in the age of the parturient, the chance of having an adequate PNC increased by 5%. White parturients with higher education and fewer deliveries residing in the macro-region of Valleys were more likely to have an adequate PNC when compared with non-white parturients, who were illiterate and/or had incomplete elementary school, with 3 or more deliveries and who resided in other macro-regions. During pregnancy, 96.0% of the women performed at least one anti-HIV test, 55.8% a rapid test for syphilis, and 75.0% a Venereal Disease Research Laboratory test (VDRL). CONCLUSIONS Despite the almost universal PNC coverage in RS, the PNC offered by the SUS was adequate for just half of the population, therefore public health policies targeted at women receiving care in this setting shall be revisited.","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"68"},"PeriodicalIF":2.8,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10519679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50162707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case-Finding tool for COPD in LMIC (COLA) - translation and cross-cultural adaptation into Brazilian Portuguese language.","authors":"Erika Zavaglia Kabbach,&nbsp;Naiara Tais Leonardi,&nbsp;Trishul Siddharthan,&nbsp;Audrey Borghi-Silva,&nbsp;Jaber Saud Alqahtani,&nbsp;John R Hurst,&nbsp;Renata Gonçalves Mendes","doi":"10.11606/s1518-8787.2023057004904","DOIUrl":"10.11606/s1518-8787.2023057004904","url":null,"abstract":"<p><strong>Objective: </strong>To translate and cross-culturally adapt the COPD in Low- and middle-income countries (LMICs) Assessment (COLA) questionnaire into Brazilian Portuguese, a case-finding instrument for chronic obstructive pulmonary disease (COPD).</p><p><strong>Methods: </strong>Translation and cross-cultural adaptation were completed in six steps: the original version was translated into Brazilian Portuguese by two native speakers of the target language; the translated versions were synthesized; back-translation was performed by two native speakers of the original language; the back-translation and the Brazilian Portuguese version of the COLA were reviewed and harmonized by an expert committee of specialists; and, then, the pre-final version was tested by 30 health professionals who were asked if the items were clear to understand. The acceptability, clarity, and understandability of the translated version were evaluated. A final review of the questionnaire was produced by the authors and approved by the author of the original questionnaire.</p><p><strong>Results: </strong>Some idiomatic, semantic, and experiential inconsistencies were identified and properly adjusted. Item 3 was considered the most unclear item (23,3%). Items 7, 8, and 9 presented clarity above 80% (93%, 90%, and 90%, respectively). Suggestions were discussed and incorporated into the tool and COLA was found to be clear and easy to understand.</p><p><strong>Conclusions: </strong>The Brazilian version of the COLA was easily understood by healthcare professionals and adapted to Brazilian culture. Translation and cultural adaptation of the COLA instrument into Brazilian Portuguese can be an important case-finding instrument for chronic obstructive pulmonary disease in Brazil.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"63"},"PeriodicalIF":2.8,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10519672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50162708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital mortality from covid-19 in children and adolescents in Brazil in 2020-2021.","authors":"Amanda Cilene Cruz Aguiar Castilho da Silva,&nbsp;Ronir Raggio Luiz,&nbsp;José Rodrigo de Moraes,&nbsp;Pedro Henrique Vieira Rocha,&nbsp;Regina Célia Gollner Zeitoune,&nbsp;Arnaldo Prata Barbosa,&nbsp;Jessica Pronestino de Lima Moreira","doi":"10.11606/s1518-8787.2023057005172","DOIUrl":"10.11606/s1518-8787.2023057005172","url":null,"abstract":"ABSTRACT OBJECTIVE To describe cases, deaths, and hospital mortality from covid-19 in children and adolescents in Brazil, according to age group, during the evolving phases of the pandemic in 2020 and 2021. METHODS Census of patients aged up to 19 committed with severe acute respiratory syndrome, due to covid-19 or unspecified, notified to the Brazilian Influenza Epidemiological Surveillance Information System, from January 1, 2020, to December 31, 2021. The two years were divided into six phases, covering the spread of the disease—first, second and third wave—as well as the impact of vaccination. The pediatric population was categorized into infants, preschoolers, schoolchildren, and adolescents. Hospital mortality was assessed by pandemic phase and age group. RESULTS A total of 144,041 patients were recorded in the two years, 18.2% of whom had confirmed cases of covid-19. Children under 5 years old (infants and preschoolers) accounted for 62.8% of those hospitalized. A total of 4,471 patients died, representing about 6.1 deaths per day. Infants were the ones who most progressed to the intensive care unit (24.7%) and had the highest gross number of deaths (n = 2,012), but mortality was higher among adolescents (5.7%), reaching 9.8% in phase 1. The first peak of deaths occurred in phase 1 (May/2020), and two other peaks occurred in phase 4 (March/2021 and May/2021). There was an increase in cases and deaths for younger ages since phase 4. Hospital mortality in the pediatric population was higher in phases 1, 4, and 6, following the phenomena of dissemination/interiorization of the virus in the country, beginning of the second wave and beginning of the third wave, respectively. CONCLUSION The absolute number of cases of covid-19 in children and adolescents is significant. Although complete vaccination in descending order of age provided a natural deviation in age range, there was a greater gap between the curve of new hospitalized cases and the curve of deaths, indicating the positive impact of immunization.","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"56"},"PeriodicalIF":2.8,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10519682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50162733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Entomological Reference Collection: 85 years of contributions to public health.","authors":"Mariana de Carvalho Dolci,&nbsp;Fabrício Auad Spina,&nbsp;Maria Anice Mureb Sallum","doi":"10.11606/s1518-8787.2023057004963","DOIUrl":"10.11606/s1518-8787.2023057004963","url":null,"abstract":"<p><p>The Department of Hygiene of the Faculty of Medicine of São Paulo (FMUSP), organized with the support of the Rockefeller Foundation, became the Institute of Hygiene, with the inaugural class taught by Samuel Darling in 1918. The history of Public Health Entomology is mixed with that of the Institute itself, which became the Faculty of Hygiene and Public Health in 1945. Still in the 1930s, Paulo César de Azevedo Antunes and John Lane organized Public Health Entomology within the Medical Parasitology area of the then Institute of Hygiene. During this period, the entomology laboratory came to be recognized for its research in the systematics of hematophagous insects, as well as in the ecology, biology and behavior of vectors. The Entomological Reference Collection (CER) originated naturally from the research of Paulo César Antunes and John Lane and is a national and international heritage covering primary and secondary types of insect species that are of interest to public health. Over the years, it has been consolidated with the efforts of Augusto Ayroza Galvão, Renato Corrêa, José Coutinho, Nelson Cerqueira, Ernesto Rabello, Oswaldo Forattini and others. In its over eighty years of activities, CER has enabled the training of several scientists able to act in programs of surveillance and control of endemic diseases associated with insect vectors throughout Latin America, in addition to training taxonomists focused on insects of interest in Public Health. Researchers from other Brazilian institutes and abroad joined the entomology laboratory because of its importance and the research developed in it. The growing scientific production made it possible for entomological studies developed at the Faculty of Public Health (FSP) to gain international visibility, contributing to the development of disease prevention and epidemic control actions in the country.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"57"},"PeriodicalIF":2.8,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10519704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50162730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early motor development: risk factors for delay in a population study in Southern Brazil.","authors":"Ana Carolina Zago,&nbsp;Jéssica Puchalski Trettim,&nbsp;Bárbara Borges Rubin,&nbsp;Carolina Coelho Scholl,&nbsp;Fernanda Teixeira Coelho,&nbsp;Fernanda Ulguim,&nbsp;Luísa Mendonça de Souza Pinheiro,&nbsp;Mariana Bonati de Matos,&nbsp;Ricardo Tavares Pinheiro,&nbsp;Luciana de Avila Quevedo","doi":"10.11606/s1518-8787.2023057004991","DOIUrl":"10.11606/s1518-8787.2023057004991","url":null,"abstract":"<p><strong>Objective: </strong>To assess risk factors associated with motor development delay at three months of age.</p><p><strong>Methods: </strong>Cross-sectional study with mothers and their three-month-old babies in Southern Brazil. The Bayley-III Scale of Infant and Toddler Development (BSID-III) and the Alberta Infant Motor Scale (AIMS) were used to assess motor development.</p><p><strong>Results: </strong>We evaluated 756 mothers and their three-month-old babies. The overall mean motor development assessed by the BSID-III and the AIMS was 104.7 (SD 13.5) and 55.4 (SD 25.4), respectively. When assessed by the BSID-III, the lowest motor development scores were among babies born by cesarean delivery (p = 0.002), prematurely (p < 0.001), and with low birth weight (p < 0.001). When assessed by the AIMS, babies born prematurely (p = 0.002) and with low birth weight (p=0.004) had the lowest motor development means. After a cluster analysis, we found that babies born by cesarean delivery, with low birth weight, and prematurely had more impaired motor development compared with children born without any risk factors.</p><p><strong>Conclusion: </strong>Identifying risk factors allows the implementation of early interventions to prevent motor development delay and, therefore, reduce the probability of other future problems.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"59"},"PeriodicalIF":2.8,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10519674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50162712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebrovascular mortality: trend and seasonality in Brazilian capitals, 2000-2019.","authors":"Luis Sauchay Romero, Ludmilla da Silva Viana Jacobson, Sandra de Souza Hacon","doi":"10.11606/s1518-8787.2023057004813","DOIUrl":"10.11606/s1518-8787.2023057004813","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the trend and seasonality of cerebrovascular mortality rates in the adult population of Brazilian capitals from 2000 to 2019.</p><p><strong>Methods: </strong>This is an ecological and descriptive study of a time series of mortality due to cerebrovascular causes in adults (≥ 18 years) living in Brazilian capitals from 2000 to 2019, based on the Brazilian Mortality Information System. Descriptive statistical techniques were applied in the exploratory analysis of data and in the summary of specific, standardized rates and ratios by sociodemographic characteristics. The jointpoint regression model was used to estimate the trend of cerebrovascular mortality rates by gender, age groups, and geographic regions. The seasonal variability of rates by geographic regions was estimated using the generalized additive model by smoothing cubic splines.</p><p><strong>Results: </strong>People aged over 60 years comprised 77% of all cerebrovascular deaths. Women (52%), white individuals (47%), single people (59%), and those with low schooling (57%, elementary school) predominated in our sample. Recife (20/1,000 inhab.) and Vitória (16/1,000 inhab.) showed the highest crude mortality rates. Recife (49/10,000 inhab.) and Palmas (47/10,000 inhab.) prevailed after we applied standardized rates. Cerebrovascular mortality rates in Brazil show a favorable declining trend for adults of all genders. Seasonality influenced rate increase from July to August in almost all region capitals, except in the North, which rose in March, April, and May.</p><p><strong>Conclusions: </strong>Deaths due to cerebrovascular causes prevailed in older single adults with low schooling. The trend showed a tendency to decline and winter, the greatest risk. Regional differences can support decision-makers in implementing public policies to reduce cerebrovascular mortality.</p>","PeriodicalId":21230,"journal":{"name":"Revista de saude publica","volume":"57 ","pages":"53"},"PeriodicalIF":2.8,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10519683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50162709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}