Ganhos em expectativa de vida ao nascer no Brasil nos anos 2000: impacto das variações da mortalidade por idade e causas de morte / Gains in life expectancy at birth in Brazil after the year 2000: the impact of mortality variations by age and cause of death

Resumo A expectativa de vida ao nascer é um indicador sintético de mortalidade que reflete as condições gerais de vida de uma população. A variação da mortalidade por idade e causas gera mudanças não explícitas na análise simples do indicador. A aplicação de um método que decomponha a variação da expectativa de vida pode ajudar a melhor entender o fenômeno. O objetivo deste estudo foi mensurar a contribuição dos grupos etários e causas de morte na variação da expectativa de vida ao nascer de homens e mulheres, a partir da aplicação do método de decomposição de Pollard aos dados brasileiros de 2000 e 2010. Foram utilizadas as tábuas de mortalidade disponibilizadas pelo Instituto Brasileiro de Geografia e Estatística e os dados de óbitos do Sistema de Informações sobre Mortalidade. Os resultados mostram que o grupo etário que mais contribuiu para o aumento da expectativa de vida foi o dos menores de 1 ano de idade. Dentre as causas definidas, as doenças cardiovasculares foram as responsáveis pelo maior acréscimo à média de anos de vida dos brasileiros.

Abstract Life expectancy at birth is a synthetic mortality indicator that reflects the general living conditions of the population. Changes in mortality by age and causes of death generate no explicit changes in the indicator. The application of a decomposition method can bring light to the analysis of the phenomenon. The aim of this study was to estimate the contribution of age groups and causes of death in the variation in life expectancy at birth, for men and women, from 2000 to 2010, by applying Pollard's decomposition method. Brazilian life tables were obtained from IBGE and death data from SIM. The results indicate that the age group that most contributed to the increase in life expectancy was of less than 1 year old. Among the defined causes, cardiovascular diseases were responsible for the largest increase in life expectancy.

Cambio en la esperanza de vida según tres grandes grupos de causas de muerte en Medellín, Colombia, de 1989-1991 a 1994-1996 / Change in life expectancy in connection with three large groups of causes of death in Medellín, Colombia, between 1989 -1991 and 1994-1996

Objetivos. Examinar los cambios en la esperanza de vida en Medellín, Colombia, entre los trienios de 1989-1991 y 1994-1996, en relación con los cuatro grupos de causas de muerte utilizados convencionalmente en los estudios sobre la carga de morbilidad: grupo 1, enfermedades transmisibles, perinatales, maternas y nutricionales; grupo 2, enfermedades no transmisibles; grupo 3, traumatismos; grupo 4, causas mal definidas. Estas últimas se excluyeron del análisis debido a su ambigüedad. Métodos. Para hacer los cálculos se utilizó el método descrito por J. H. Pollard en 1986, con ayuda del programa Microsoft Excel, usando las fórmulas requeridas para su aplicación. Las operaciones fueron verificadas con el programa EPIDAT (versión 3.0 no oficial). Resultados. Entre el primer y segundo trienio (1994-1996 y 1989-1991, respectivamente) se observó una ganancia total de 1,93 años en la esperanza de vida al nacer, la cual subió de 62,13 a 64,06 años. Esta ganancia fue mayor en los hombres que en las mujeres (2,42 y 1,09 años, respectivamente). Al aplicar el método de Pollard, se advirtió una ganancia en la esperanza de vida general de 2,03 años para el total de la población. La ganancia en el sexo femenino se concentró en las edades extremas (niñas de 1 a 4 años y mujeres mayores de 54), y en los hombres en las edades intermedias (entre los 25 y 44 años). Se destaca, además, que en ambos sexos la mayor pérdida porcentual en la esperanza de vida se presentó en el grupo de 15 a 19 años (23 por ciento en los hombres y 4 por ciento en las mujeres, aproximadamente). El grupo 1 de causas de defunción se asoció con una pérdida de la esperanza de vida en los hombres (0,04 años), mientras que en el grupo 2 se observó en ambos sexos un aumento de dicha esperanza (0,60 años para los hombres y 0,55 años para las mujeres). Se destaca que la mayor ganancia masculina en la esperanza de vida se relacionó con una reducción de la mortalidad por traumatismos (1,98 años). Conclusiones. Si la esperanza de vida al nacer observada en Medellín al final del período de estudio se compara con la esperanza de vida en toda Colombia en 1995, que era de 70 años, se advierte que la cifra en Medellín sigue siendo inferior a la de todo el país, pese a que ha aumentado paulatinamente en el transcurso de los años. Este fenómeno refleja la transición epidemiológica observada en la ciudad,...

Objectives. To examine changes in life expectancy in Medellin, Colombia, between 1989­1991 y 1994­1996, in connection with four large groups of causes of death commonly employed in studies on the burden of disease: group 1, communicable diseases, perinatal and maternal health problems, and nutritional deficits; group 2, noncommunicable diseases; group 3, wounds; group 4, ill-defined causes. The latter were excluded from the analysis because of their ambiguity. Methods. The calculations were made according to the method described by J. H. Pollard in 1986, with the aid of Microsoft Excel, by using the recommended formulas.The computations were double checked with EPIDAT (version 3.0, unofficial). Results. Between 1989­1991 y 1994­1996, a total gain of 1,93 years in life expectancy was seen in Medellin, with a rise from 62,13 to 64,06 years. The gain was greater in men than in women (2,42 vs. 1,09 years, respectively). The increase noted among females was greatest in the extreme age groups (girls 1 to 4 and women over 54 years of age); in men, it was highest in the middle years (between the ages of 25 and 44). In both sexes, the greatest percentage loss in life expectancy was seen in persons 15 to 19 years of age (23% in men and 4% in women, roughly). In the group comprising communicable diseases, perinatal and maternal health problems, and nutritional deficits, a loss in life expectancy was seen in men (0,04 years), whereas in the group of non-communicable diseases there was a gain in life men and 0,55 years among women). The greater gain in life expectancy among men was linked to a reduction in mortality from wounds (1,98 years). Conclusions. If one compares the results obtained in Medellin at the end of the study period with life expectancy at birth in Colombia in 1995, which was 70 years, it is obvious that life expectancy in Medellin is still lagging behind, even though it has risen progressively over the years. This is in keeping with the epidemiological transition the city has experienced, which has been linked with a rise in mortality from degenerative and cardiovascular diseases, chronic respiratory ailments, and diabetes, as well as from diseases resulting from human activity. Nevertheless, this epidemiological transition has been slow in Medellin when compared to Colombia as a whole due to high rates of death from infectious and parasitic diseases, which are more characteristic of the transition in its earlier stages. Despite the fact that mortality from wounds has decreased in Medellin, particularly among young males, it may be worthwhile to reassess the effectiveness of interventions undertaken in recent years to promote peaceful coexistence and tolerance in the community