1990 年至 2021 年巴西及其各州的非传染性疾病负担，以及对 2030 年的预测

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Pub Date : 2024-09-20 DOI:10.1016/j.puhe.2024.09.006

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引用次数: 0

摘要

本研究旨在分析 1990 年至 2021 年期间巴西非传染性疾病 (NCD) 所造成的疾病负担。此外，本研究还将非传染性疾病导致的死亡率与所有原因导致的死亡率和 COVID-19 进行了比较，分析了非传染性疾病死亡率趋势和 2030 年的预测，并分析了巴西 27 个州的非传染性疾病死亡率和导致这些死亡的风险因素。分析了四种非传染性疾病（肿瘤、心血管疾病、慢性呼吸系统疾病和糖尿病）导致的过早死亡。分析巴西的非传染性疾病负担时使用了以下指标：死亡绝对数、死亡率比例、死亡率、因过早死亡而损失的寿命年数（YLL）、残疾寿命年数（YLD）和因过早死亡而损失的残疾调整寿命年数（DALY）。研究结果表明，1990 年至 2019 年间，非传染性疾病导致的过早死亡比例有所上升（1990 年为 29.4%，2019 年为 30.8%），2021 年有所下降（24.7%）。1990 年至 2019 年间，非传染性疾病导致的死亡率、残疾调整寿命年数（DALY）和过早死亡年数（YLL）有所下降（分别为-37.7%、-34.5%和-38.3%）；然而，2019 年至 2021 年间，死亡率、残疾调整寿命年数（DALY）、过早死亡年数（YLD）和过早死亡年数（YLL）保持稳定（分别为-0.1%、0.7%、-0.1%和 0.8%）。1990 至 2021 年间，大多数州的死亡率、残疾调整寿命年数和年均生命损失率都有所下降，而年均生命损失率则有所上升。然而，结果表明，到 2030 年将非传染性疾病死亡率降低三分之一的可持续发展目标（SDG）将无法实现。2021 年与非传染性疾病导致过早死亡相关的主要风险因素是高血压、吸烟、饮食风险、高体重指数（BMI）和高血糖水平。社会人口指数与死亡率百分比变化之间的相关性在以下所有非传染性疾病、心血管疾病、慢性呼吸系统疾病、糖尿病和肿瘤中都很显著。结论当前的研究强调了巴西非传染性疾病死亡的重要性，以及自 2016 年以来由于紧缩措施和 COVID-19 大流行而导致的死亡率恶化，这影响了可持续发展目标中降低非传染性疾病死亡率目标的实现。非传染性疾病的风险因素有所减少，主要是行为因素，尽管代谢风险因素令人极为关切，需要采取新的战略来促进健康、预防和全面护理。

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Noncommunicable disease burden in Brazil and its states from 1990 to 2021, with projections for 2030

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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来源期刊

Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

0.00%

发文量

280

审稿时长

37 days

期刊介绍： Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.