ABSTRACT
ABSTRACT: Objective: To assess the impact of the COVID-19 pandemic on mortality in Argentina, considering temporal trends in life expectancy at birth and premature mortality rate during 2010-2020. Methods: Based on demographic projections, this ecological time-series study compares a "normal" versus a "COVID-19" mortality scenario for 2020 over a set of 11 Argentine provinces. Annual life expectancy at birth and age-standardized rates of premature mortality were estimated from 2010 to 2020. Joinpoint regression and multilevel models were used. Results: A potential reduction in life expectancy at birth (a gap between scenarios >1 year) was observed. A significant (negative) point of inflection in temporal trends was identified for the country and most of the provinces, under the COVID-19 mortality scenario. However, our findings reveal disparities between provinces in the estimated life expectancy reduction toward 2020 (values range from -0.63 to -1.85 year in females and up to -2.55 years in males). While men showed more accentuated declines in life expectancy at birth in 2020 (a national gap between scenarios of -1.47 year in men vs. -1.35 year in women), women experienced more unfavorable temporal trends of premature mortality. In the absence of COVID-19, an improvement in both indicators was estimated toward 2020 in both sexes, while a return to levels reported in the past was observed under the COVID-19 scenario. Conclusion: The COVID-19 pandemic might seriously affect the trends of mortality and exacerbate health disadvantages in Argentina. A temporal and contextual perspective of health inequities merits special attention in the COVID-19 research.
RESUMO: Objetivo: Avaliar o impacto da pandemia de COVID-19 sobre a mortalidade na Argentina, considerando as tendências temporais da expectativa de vida ao nascer e a taxa de mortalidade prematura 2010-2020. Métodos: Com base em projeções demográficas, este estudo ecológico de séries temporais compara um cenário de mortalidade "normal" versus "COVID-19" para 2020 em 11 províncias argentinas. Foram calculadas a expectativa de vida ao nascer anual e taxas de mortalidade prematura padronizadas por idade (2010-2020). Utilizaram-se modelos de regressão joinpoint e multiníveis. Resultados: Observou-se redução da expectativa de vida ao nascer (lacuna entre cenários >1 ano). Foi identificado um ponto de inflexão significativo (negativo) nas tendências temporais para o país e a maioria das províncias no cenário COVID-19. Nossos resultados revelam disparidades entre as províncias na redução da expectativa de vida 2020 (valores de -0,63 a -1,85 ano nas mulheres e até -2,55 nos homens). Enquanto os homens mostraram declínios mais acentuados na expectativa de vida ao nascer em 2020 (lacuna nacional entre os cenários de -1,47 vs. -1,35 ano nas mulheres), as mulheres experimentaram tendências temporais mais desfavoráveis de mortalidade prematura. Na ausência do COVID-19, estimou-se melhoria de ambos os indicadores até 2020 em ambos os sexos, enquanto se observou retorno aos níveis reportados no passado no cenário COVID-19. Conclusão: A pandemia de COVID-19 pode afetar seriamente as tendências de mortalidade e agravar as desvantagens para a saúde na Argentina. Uma perspectiva temporal e contextual das iniquidades em saúde merece atenção especial na pesquisa em COVID-19.
ABSTRACT
Resumen Objetivo: Determinar el impacto que tuvieron las muertes por atropellos de peatones y colisiones entre vehículos sobre la esperanza de vida en Argentina durante el periodo 1998-2017. Material y métodos: Se obtuvieron las bases de datos sobre las causas de muerte, sexo, edad y jurisdicción de residencia de los fallecidos de la Dirección de Estadísticas e Investigación en Salud de Argentina. Se calcularon las tasas de mortalidad y el indicador de los años de esperanza de vida perdidos (AEVP) para determinar el impacto de la mortalidad vial. Resultados: Argentina redujo en un 13 % los fallecimientos por atropellos de peatones y choques entre vehículos durante los últimos 20 años. La tasa de mortalidad vial pasó de 12.0 a 10.6 defunciones cada 100 000 habitantes entre los trienios 1998-2000 y 2015-2017 respectivamente. Los decesos en el tránsito tuvieron mayor impacto entre los hombres de edades de 15 a 49 años. Al mismo tiempo, hubo un fuerte contraste del nivel de mortalidad vial registrado en cada una de las jurisdicciones del interior del país, donde las tasas de mortalidad oscilaron entre 1.2 y 24.1 decesos cada 100 000 habitantes. Conclusiones: Si bien hubo una disminución del nivel de mortalidad vial, las políticas públicas implementadas en Argentina no han logrado el objetivo de reducir a la mitad la cantidad de defunciones. Este flagelo sigue generando la destrucción y desarticulación de las familias del país. Es necesario la implementación de nuevos programas que apunten a reducir las conductas violatorias de las normas de tránsito.
Abstract Objective: To determine the impact that the deaths caused by pedestrian abuses and vehicle collisions had on life expectancy in Argentina during the period 1998-2017. Material and methods: The databases on the causes of death, sex, age and jurisdiction of residence of the deceased of the Directorate of Health Statistics and Research of Argentina were obtained. Mortality rates and the indicator of years of life expectancy lost (YLEL) were calculated to determine the impact of road mortality. Results: Argentina reduced by 13% the number of deaths due to pedestrian accidents and collisions between vehicles during the last 20 years. The road mortality rate went from 12.0 to 10.6 deaths per 100.000 inhabitants between the triennia 1998-2000 and 2015-2017, respectively. Deaths in transit had a greater impact among men aged 15 to 49 years. At the same time, there was a strong contrast in the level of road mortality recorded in each of the jurisdictions in the interior of the country, where mortality rates ranged from 1.2 to 24.1 deaths per 100,000 inhabitants. Conclusions: Although there was a decrease in the level of road mortality, public policies implemented in Argentina have not achieved the objective of halving the number of deaths. This scourge continues to cause destruction and disarticulation of families residing in the country. It is necessary to implement new programs that aim to reduce the behaviors that violate traffic regulations.