Epidemiology of Suicide Mortality in Paraguay from 2005 to 2019: A Descriptive Study.

Suicide is an important public health problem, fundamentally affecting the younger population and responding to multiple biological, psychological, and social causes. The objective of this study was to characterize changes in suicide mortality, suicide methods, and years of potential life lost from 2005 to 2019 in Paraguay. This observational, descriptive study used data from the Vital Statistics Information Subsystem of the Ministry of Public Health and Social Welfare. The average mortality rate from suicide was 4.9 per 100,000 inhabitants, with an increase from 4.2 between 2005 and 2009 to 5.8 from 2014 to 2019. Suicide was more common in men (75%) than in women. In men, the highest mortality rate was observed among those 20-24 years old, whereas in women, the ages most affected were the 15-19-year-old age group. The most-used method for suicide was hanging. The most frequent place of suicide occurrence was at home (73%). The seasonality of suicide occurrence showed a slight increase in the spring-summer months compared with autumn-winter (53% vs. 47%). The rate of potential years of life lost statistically significantly increased from 2005 to 2019. Public health measures need to be implemented to investigate the underlying reasons and implement interventions in the population to decrease suicide mortality in Paraguay.

Anos Potenciais de Vida Perdidos devido à COVID-19, segundo a raça/cor e gênero, no Brasil, entre 2020 e 2021 / Years of Potential Life Lost due to COVID-19 according to race/color and gender in Brazil between 2020 and 2021

Resumo A mortalidade provocada pela pandemia da COVID-19 tem produzido impactos aos indicadores de Anos Potenciais de Vida Perdidos (APVP) em nível mundial. Objetiva-se estimar os APVP devido à mortalidade por COVID-19, segundo sexo, faixa etária e raça/cor, no período de março de 2020 a dezembro de 2021, no Brasil. Foram caracterizadas as mortes por COVID-19, estimadas e comparadas as taxas e razão de taxas padronizadas de APVP, a média de anos potenciais de vida não vividos (APVNV) e a idade média do óbito (IMO). No geral, foram perdidos 13.776.969,50 anos potenciais de vida, o que determinou uma perda média de 22,5 anos potenciais não vividos. Houve maior perda de anos potenciais de vida nos homens (58,12%) e nas faixas etárias de 0 a 59 anos nas populações negra (58,92%) e indígena (63,35%), enquanto nas faixas etárias de 60 anos e mais foi observada maior perda de APVP nas populações branca (45,89%) e amarela (53,22%). As mulheres registraram as maiores IMO, com exceção das mulheres indígenas. Homens brancos (1,63), pardos (1,59) e pretos (1,61) tiveram as maiores taxas em comparação às mulheres brancas. Apesar da COVID-19 ter tido maior impacto em idosos, foram as populações negra e indígena na faixa de menos de 60 anos quem teve maior perda de anos potenciais de vida.

Abstract Mortality caused by the COVID-19 pandemic has impacted indicators of Years of Potential Life Lost (YPLL) worldwide. This study aimed to estimate the YPLL due to mortality caused by COVID-19, according to sex, age group, and race/color in Brazil, from March 2020 to December 2021. Deaths caused by COVID-19 were characterized, in which the rates and ratios of standardized YPLL rates, the average number of years of potential life lost (ANYPLL), and the average age at death (AAD) were estimated and compared. Overall, 13,776,969.50 potential years of life were lost, which resulted in an average loss of 22.5 potential years not lived. A greater loss of potential years of life was identified in men (58.12%) and in the age groups from 0 to 59 years in the black (58.92%) and indigenous (63.35%) populations, while in the age groups of 60 years and over, a greater loss of YPLL was observed in the white (45.89%) and yellow (53.22%) populations. Women recorded the highest ADD, with the exception of indigenous women. White men (1.63), brown men (1.59), and black men (1.61) had the highest rates when compared to white women. Although COVID-19 has a greater impact on the elderly, it was the black and indigenous populations under the age of 60 who had the greatest loss of potential years of life.

Años de vida perdidos y distribución espacial de la mortalidad por incidente vial en Medellín, 2010-2020

Objetivo: Estimar los años potenciales de vida perdidos y la distribución espacial de la mortalidad por incidente vial según modo de transporte en Medellín 2010-2020, como línea base para la implementación de la estrategia Visión Cero, de la Organización Mundial de la Salud, en la movilidad de la ciudad. Metodología: Estudio retrospectivo y descriptivo de corte transversal, con fuente secundaria. El cálculo de los años potenciales de vida perdidos se hizo tomando como edad límite la esperanza de vida al nacer de Colombia, según año y género. El análisis espacial se realizó a partir de la dirección del incidente; la representación de la densidad de Kernel fue por el método de clasificación estándar-cuantil, y las zonas de influencia se crearon por el método búfer de anillos múltiples, con distancias de 500 y 1000 metros. Resultados: Medellín, entre 2010 y 2020, registró 2988 muertes por incidente vial. Quienes más murieron fueron los peatones, con 1423 (47,6 %) muertes, seguidos por los motociclistas, con 1295 (43,3 %). Los años potenciales de vida perdidos fueron 98 787. Las comunas de mayor concentración en muerte de peatones fueron: Candelaria, Buenos Aires y Manrique; en motociclistas, la mayor concentración se evidenció en el sistema vial del río. Por zonas de influencia, los peatones fallecidos en un radio de 1000 metros del sistema vial del río fueron 688 (49,8 %), y los motociclistas, 636 (52,2 %). Conclusión: Los motociclistas fueron quienes murieron más jóvenes y más años dejaron de vivir. Politraumatismos son diagnósticos constantes de muerte, pero lesiones en cabeza, cráneo y tórax son más letales en peatones y motociclistas.

Objective: To estimate the potential years of life lost and the spatial distribution of mortality from road incidents by mode of transport in Medellín 2010-2020, as a baseline for the implementation of the Vision Zero strategy of the World Health Organization in the city's mobility. Methodology: This is a retrospective and descriptive cross-sectional study, with a secondary source. The calculation of the potential years of life lost was made using the life expectancy at birth in Colombia as the age limit, according to year and gender. The spatial analysis was carried out from the direction of the incident; Kernel density was represented by the standard-quantile classification method, and the zones of influence were created by the multiple ring buffer method, with distances of 500 and 1000 meters. Results: Between 2010 and 2020, Medellín registered 2,988 deaths due to road incidents. Those who died the most were pedestrians, with 1,423 (47.6%) deaths, followed by motorcyclists, with 1,295 (43.3%). Potential years of life lost were 98,787. The zones (comunas) with the highest concentration of pedestrian deaths were: Candelaria, Buenos Aires and Manrique; in motorcyclists, the highest concentration was evidenced in the river road system. By areas of influence, pedestrians killed within a radius of 1,000 meters from the river road system were 688 (49.8%), and motorcyclists, 636 (52.2%). Conclusion: Motorcyclists were the ones who died the youngest and the most years they stopped living. Polytrauma is a constant diagnosis of death, but injuries to the head, skull and thorax are more lethal in pedestrians and motorcyclists.

Objetivo: Estimar os anos potenciais de vida perdidos e a distribuição espacial da mortalidade por incidente de trânsito segundo o modo de transporte em Medellín 2010-2020, como linha base para a implementação da estratégia Visão Zero, da Organização Mundial da Saúde, na mobilidade da cidade. Metodologia: Estudo retrospectivo e descritivo de corte transversal, com fonte secundária. O cálculo dos anos potenciais de vida perdidos foi feito considerando como idade limite a esperança de vida ao nascer da Colômbia, segundo ano e gênero. A análise espacial realizou-se a partir do local do incidente; a representação da densidade de Kernel foi pelo método de classificação padrão-quantil, e as zonas de influência criaram-se pelo método buffer de anéis múltiplos, com distâncias de 500 e 1000 metros. Resultados: Medellín, entre 2010 e 2020, registrou 2988 mortes por incidente de trânsito. O maior número de mortes foi de pedestres, sendo 1423 (47,6%), seguido pelo de motoqueiros, sendo 1295 (43,3%). Os anos potenciais de vida perdidos foram 98.787. As localidades com maior concentração de mortes de pedestres foram: Candelaria, Buenos Aires e Manrique; no caso dos motoqueiros, a maior concentração evidenciou-se no sistema viário do rio. Por zonas de influência, os pedestres falecidos em um raio de 1000 metros do sistema viário do rio foram 688 (49,8%), e os motoqueiros 636 (52,2%). Conclusão: Os motoqueiros foram quem morreram mais novos e mais anos deixaram de viver. Politraumatismos são diagnósticos constantes de morte, mas lesões na cabeça, no crâneo e no tórax são mais letais em pedestres e motoqueiros.

Diferencias de sexo asociadas al suicidio y años potenciales de vida perdidos: un estudio retrospectivo

Objetivo: Identificar las diferencias de sexo asociadas a los años potenciales de vida perdidos por suicidio en el departamento de Nariño, periodo 2005-2019. Metodología: Estudio de tipo descriptivo observacional y retrospectivo, en el que se analizaron 1686 certificados de defunción por suicidio de hombres y mujeres en el departamento de Nariño, identificados en el Departamento Nacional Administrativo de Estadística. Resultados: En el periodo 2005-2019, se observaron 1212 suicidios en hombres y 474 en mujeres. Estas se suicidaron a edades más bajas que aquellos. El 50,5 % de los hombres habían cursado básica primaria, y el 46,0 % de las mujeres, básica secundaria. El mayor número de casos de suicidios en hombres y mujeres se presentaron en el área urbana (51,2 % y 45,1 % respectivamente). El envenenamiento fue el mecanismo de suicidio más utilizado por las mujeres (66,7 %), y para los hombres, el mayor porcentaje (41,7) correspondió al ahorcamiento. La tendencia anual de muertes por suicidio fue mayor en hombres que en mujeres. En aquellos, la tasa de suicidio se situó por encima de 4,5 suicidios por 100 000 habitantes, mientras que, en ellas, se mantuvo por debajo de 3,0. Conclusiones: Hubo un aumento en la tendencia de muertes en el periodo de tiempo analizado y el riesgo de morir por suicidio en el hombre fue 3,9 veces el riesgo de morir en una mujer. El estudio contempla importantes aspectos para ser abordados en la prevención del suicidio.

Objective: To identify the sex differences associated with the potential years of life lost due to suicide in the department of Nariño, from 2005 to 2019. Methodology: Descriptive, observational and retrospective study, in which 1686 death certificates by suicide of men and women in the department of Nariño, identified in the National Administrative Department of Statistics, were analyzed. Results: From 2005 to 2019, 1,212 suicide cases of men were observed and 474 of women. Women committed suicide at younger ages than men. 50.5% of the men had completed primary school, and 46.0% of the women, secondary school. The highest number of suicide cases of men and women occurred in the urban area (51.2% and 45.1% respectively). Poisoning was the suicide mechanism most used by women (66.7%), and for men, the highest percentage (41.7) corresponded to hanging. The annual trend of deaths by suicide was higher in men than in women. For men, the suicide rate was above 4.5 suicides per 100,000 inhabitants, while for women, it remained below 3.0. Conclusions: There was an increase in the trend of deaths in the period analyzed and the risk of dying by suicide in men was 3.9 times the risk of dying by suicide in women. The study contemplates important aspects to be addressed in suicide prevention.

Objetivo: Identificar as diferenças de sexo associadas aos anos potenciais de vida perdidos por suicídio no departamento de Nariño, no período 2005-2019. Metodologia: Estudo de tipo descritivo observacional e retrospectivo, em que foram analisados 1686 certificados de óbito por suicídio de homens e mulheres no departamento de Nariño, identificados no Departamento Nacional Administrativo de Estatística. Resultados: No período de 2005-2019, observaram-se 1212 suicídios em homens e 474 em mulheres. Elas suicidaram-se em idades menores do que eles. O 50,5% dos homens cursaram o ensino fundamental, e o 46% das mulheres o ensino médio. O maior número de casos de suicídios em homens e mulheres apresentou-se na área urbana (51,2% y 45,1%, respectivamente). O envenenamento foi o mecanismo de suicídio mais utilizado pelas mulheres (66,7%), e para os homens, a maior percentagem (41,7%) correspondeu ao enforcamento. A tendência anual de mortes por suicídio foi maior em homens do que em mulheres. Neles, a taxa de suicídio esteve por cima de 4,5 suicídios por 100.000 habitantes, enquanto nelas se manteve abaixo de 3,0. Conclusões: Houve um aumento na tendência de mortes no período de tempo analisado e o risco de morrer por suicídio no caso dos homens foi 3,9 vezes o risco de morrer de uma mulher. O estudo contempla aspectos importantes a serem abordados na prevenção do suicídio.

Caracterización de la mortalidad por accidentes en Cuba en el decenio 2010-2019

Fundamento: los accidentes constituyen cadenas de eventos y circunstancias que llevan a la ocurrencia de lesiones no intencionales. Son responsables de numerosas muertes cada año en el mundo. En el año 2019, los accidentes del tránsito y las caídas estuvieron entre las primeras 20 causas de muerte. En Cuba se erigieron como la quinta causa de mortalidad por todas las causas y edades en el decenio 2010-2019. Objetivo: caracterizar la mortalidad por accidentes en Cuba en el decenio 2010- 2019. Métodos: se realizó un estudio ecológico, longitudinal, descriptivo, de la mortalidad anual por accidentes en Cuba, a lo largo del decenio que comprende los años 2010 al 2019. Los anuarios estadísticos, publicados desde el año 2012 al 2022, por la Dirección de Registros Médicos y Estadísticas de Salud, del Ministerio de Salud Pública de Cuba, constituyeron la principal fuente de información. Para su procesamiento estadístico, los datos obtenidos fueron incluidos en una hoja de cálculo en Microsoft Excel y los resultados se expresaron en figuras y tablas. Resultados: las tasas brutas de mortalidad por accidentes en Cuba en el decenio 2010- 2019 se incrementaron de 43 a 49,9 por 100 000 habitantes, las más elevadas fueron por caídas: 23,7 en el año 2018 y 23,4 por 100 000 habitantes en el 2019. Los años de vida potencialmente perdidos por accidentes disminuyeron de 5,4 a 4,7 por 1 000 habitantes de 1 a 74 años. Conclusiones: en Cuba, en el decenio 2010- 2019, se observó un aumento en la mortalidad por accidentes a expensas de las caídas accidentales, estas con mayor frecuencia en el sexo femenino.

Background: accidents constitute chains of events and circumstances that lead to the occurrence of unintentional injuries. They are responsible for numerous deaths every year in the world. In 2019, traffic accidents and falls were among the top 20 causes of death. In Cuba, they stood as the fifth cause of mortality from all causes and ages in the decade 2010-2019. Objective: to characterize mortality from accidents in Cuba in the 2010-2019 decade. Methods: an ecological, longitudinal, descriptive study of annual mortality due to accidents in Cuba was carried out, throughout the decade from 2010 to 2019. The statistical yearbooks, published from 2012 to 2022, by the Directorate of Medical Records and Health Statistics, from the Ministry of Public Health of Cuba, constituted the main source of information. For its statistical processing, the data obtained were included in a spreadsheet in Microsoft Excel and the results were expressed in figures and tables. Results: the gross mortality rates due to accidents in Cuba in the 2010-2019 decade increased from 43 to 49.9 per 100,000 inhabitants, the highest being due to falls: 23.7 in 2018 and 23.4 per 100 000 inhabitants in 2019. The years of potential life lost due to accidents decreased from 5.4 to 4.7 per 1,000 inhabitants between 1 and 74 years of age. Conclusions: in Cuba, in the 2010-2019 decade, an increase in mortality from accidents was observed at the expense of accidental falls, these more frequently in the female sex.

Early physicians' mortality in Espírito Santo: a decade trend.

Introduction: Mortality data make it possible to develop indicators to guide the planning of health promotion and prevention actions in order to reduce mortality from preventable causes. However, there are no publications on physicians' mortality in the state of Espírito Santo, Brazil. Objectives: To describe mortality distribution and potential years of life lost from 2006 to 2015 among physicians who lived in Espírito Santo. Methods: This is a descriptive study of secondary data from the Mortality Information System of the Brazilian Ministry of Health. The distribution of socio-demographic variables and of basic cause of death was studied by absolute and relative frequencies. Potential years of life lost in each death were considered the years remaining from age at death up to the age limit of 70 years. Results: There were 20 deaths of female physicians (14.5%) and 118 (85.5%) of male physicians, with predominance of whites (87.9%) and married (56%) individuals. The main causes of death were neoplasms (39.1%), diseases of the circulatory system (19.6%), and external causes (19.6%). The majority of female and male deaths occurred from 60 to 69 years, but average death was significantly lower among women compared to men (respectively 58.3 and 67.0 years). Potential years of life lost totaled 1,226 years, with a mean of 14.6, which was greater in women (20.4) compared to men (13.4). Conclusions: Mortality trends observed in the general population were also present among physicians in Espírito Santo. However, contrary to the general population pattern, average death age was lower in women. Early mortality caused many lost years of life, especially among women.

Tuberculosis Mortality in Children under Fifteen Years of Age: Epidemiological Situation in Colombia, 2010-2018.

Pediatric tuberculosis is a serious infectious disease and a hidden global epidemic. The objective of this study was to describe the epidemiological situation of tuberculosis mortality in children under 15 years of age in Colombia in the period 2010-2018. A longitudinal descriptive study was conducted. The variables sex, age groups, and origin were studied. This study had 260 cases for analysis and was carried out in three phases. The first phase was the determination of the sociodemographic and clinical characteristics. The second phase was the construction of indicators by territorial entities. The third phase was stratification into four epidemiological situations according to the mortality rate and years of life lost. The median age was 7 years (range 0-14), 66.5% of cases were pulmonary tuberculosis (97.7% without bacteriological confirmation), 14.3781 years of life lost were recorded (95% CI: 142.811-168.333), and in children under 10-14 years, the loss was 110,057. Amazonas had the highest adjusted YLL rate (3979.7). In total, 36.4% of the territories had a high mortality, and 30.3% adjusted to the situation designated as 1. This is the first study that has used composite indicators to address the problem of premature mortality from childhood tuberculosis in Colombia. Our results allow us to specify that this disease remains a challenge for public health. It requires models of care and differential strategies by region. It also requires ensuring opportunities in diagnosis with sensitive methods, as well as intersectoral work for the optimal approach.

Situación del suicidio en Antioquia-Colombia durante los años 2016 y 2017: Resultados de los datos de vigilancia epidemiológica / The situation of suicide in Antioquia during 2016 and 2017: Results of epidemiological surveillance data

Introducción: la vigilancia epidemiológica del suicidio en una región permite identificar los patrones, la distribución y las características con que ocurre y sentar las bases de intervenciones para prevenirlo. Objetivo: describir la situación del suicidio en Antioquia para el periodo 2016-2017. Métodos: estudio descriptivo basado en datos del Sistema de Vigilancia Epidemiológica de Lesiones de Causa Externa del Instituto Nacional de Medicina Legal y Ciencias forenses. Se calcularon las tasas de suicidio y los años de vida potencialmente perdidos (AVPP) y se describieron las circunstancias del evento. Resultados: hubo 425 suicidios en 2016 y 419 en el 2017, con una tasa de suicidio de 6,50 y 6,34 por 100.000 habitantes/año respectivamente, y 16.446,8 AVPP para 2016 y 16.019,94 para 2017. La mayor parte de los suicidios se presentó en el sexo masculino, en los grupos de edad jóvenes, residentes en área urbana y estado civil soltero. Con respecto a las características del suicidio, el mecanismo más frecuentemente utilizado fue la asfixia mecánica seguido por el envenenamiento, en cerca del 40% de los casos se estableció un evento vital desencadenante como los conflictos de pareja, y se presentaron con mayor frecuencia los días domingo y lunes y en la noche y madrugada. Conclusión: las tasas de suicidio en Antioquia se han incrementado en 2016 y 2017 con respecto a años anteriores. Es más frecuente en hombres y en edades económicamente productivas, lo que explica los altos AVPP. La descripción de las características del suicidio podría facilitar la discusión de intervenciones preventivas.

Summary Background: Identifying the patterns, distribution, and characteristics of suicide in a region is possible with epidemiological surveillance which may lay the foundations for suicide prevention. Objective: To describe the situation of suicide in Antioquia during the period 2016-2017. Methods: Descriptive study based on data from the Epidemiological Surveillance System for External Cause Injuries of the National Institute of Legal Medicine and Forensic Sciences. Suicides rates and Years of Life Lost (YLL) were calculated and the circumstances of the event were described. Results: There were 425 suicides in 2016 and 419 in 2017, with a suicides rate of 6.50 and 6.34 per 100,000 inhabitants/year respectively, and 16,446.8 YLL for 2016 and 16,019.94 YLL for 2017. Most of the suicides occurred in males, in young age groups, urban residents and single marital status. Regarding the characteristics of suicide, the most frequently used mechanism was mechanical asphyxia followed by poisoning, in about 40% of cases a triggering life event was established, such as partner conflicts, and were more frequent on Sunday and Monday and at night and early morning. Conclusion: The incidence of suicide in Antioquia increased in 2016 and 2017 compared to previous years. It was more frequent in economically productive ages, which explains the high YLL. The description of the characteristics of suicide may facilitate the discussion of preventive interventions.

Premature mortality attributable to COVID-19: potential years of life lost in 17 countries around the world, January-August 2020.

BACKGROUND: Understanding the impact of the burden of COVID-19 is key to successfully navigating the COVID-19 pandemic. As part of a larger investigation on COVID-19 mortality impact, this study aims to estimate the Potential Years of Life Lost (PYLL) in 17 countries and territories across the world (Australia, Brazil, Cape Verde, Colombia, Cyprus, France, Georgia, Israel, Kazakhstan, Peru, Norway, England & Wales, Scotland, Slovenia, Sweden, Ukraine, and the United States [USA]). METHODS: Age- and sex-specific COVID-19 death numbers from primary national sources were collected by an international research consortium. The study period was established based on the availability of data from the inception of the pandemic to the end of August 2020. The PYLL for each country were computed using 80 years as the maximum life expectancy. RESULTS: As of August 2020, 442,677 (range: 18-185,083) deaths attributed to COVID-19 were recorded in 17 countries which translated to 4,210,654 (range: 112-1,554,225) PYLL. The average PYLL per death was 8.7 years, with substantial variation ranging from 2.7 years in Australia to 19.3 PYLL in Ukraine. North and South American countries as well as England & Wales, Scotland and Sweden experienced the highest PYLL per 100,000 population; whereas Australia, Slovenia and Georgia experienced the lowest. Overall, males experienced higher PYLL rate and higher PYLL per death than females. In most countries, most of the PYLL were observed for people aged over 60 or 65 years, irrespective of sex. Yet, Brazil, Cape Verde, Colombia, Israel, Peru, Scotland, Ukraine, and the USA concentrated most PYLL in younger age groups. CONCLUSIONS: Our results highlight the role of PYLL as a tool to understand the impact of COVID-19 on demographic groups within and across countries, guiding preventive measures to protect these groups under the ongoing pandemic. Continuous monitoring of PYLL is therefore needed to better understand the burden of COVID-19 in terms of premature mortality.

Exceso de mortalidad en población en edad de trabajar en nueve países de Latinoamérica, año 2020 / Excess mortality in 2020 in the working-age population of nine Latin American countries / Excesso de mortalidade na população em idade ativa em nove países da América Latina no ano de 2020

RESUMEN Objetivo. Estimar el impacto de la pandemia de la COVID-19 durante el año 2020, a través del exceso de mortalidad por todas las causas y los años potenciales de vida laboral perdidos en la población en edad de trabajar, de una selección de países latinoamericanos y el Caribe. Métodos. Estudio basado en datos de defunciones por todas las causas entre 15 y 69 años, procedentes principalmente de los Institutos Nacionales de Estadísticas. Se estimaron defunciones esperadas a partir de las registradas entre 2015 y 2019. El exceso de mortalidad fue estimado a través del indicador P, la razón de mortalidad estandarizada (RME) y los años potenciales de vida laboral perdidos (AVLP) hasta los 70 años. Resultados. El exceso de defunciones en Brasil, Bolivia, Chile, Colombia, Costa Rica, Cuba, México, Perú y República Dominicana sumó 426 978 (279 591 en hombres y 147 438 en mujeres), lo que representó una pérdida de 5 710 048 (3 738 775 en hombres y 1 971 273 en mujeres) de APVLP. La mortalidad observada fue significativamente superior a la esperada en todos los países, menos República Dominicana. Conclusiones. El impacto de la COVID-19 en la población en edad de trabajar tendrá un impacto profundo en la situación socioeconómica. El recuento oportuno del exceso de muertes resulta útil y puede ser usado como un sistema de alerta temprana para monitorizar la magnitud de los brotes de COVID-19. La monitorización del exceso de mortalidad en personas en edad de trabajar, realizada por el Observatorio Iberoamericano de Seguridad y Salud en el Trabajo permite evaluar con mayor exactitud la carga social y económica de la COVID-19.

ABSTRACT Objective. Estimate the impact of the COVID-19 pandemic in 2020, through excess all-cause mortality and potential years of productive life lost (YPLL) in the working-age population, in selected Latin American and Caribbean countries. Methods. Study based on data on deaths from all causes from age 15 to 69 years, mainly from national institutes of statistics. Estimates of expected deaths were based on reported deaths from 2015 to 2019. Excess mortality was estimated using the P indicator, standardized mortality ratio (SMR), and potential YPLL up to age 70 years. Results. Excess deaths in Brazil, Bolivia, Chile, Colombia, Costa Rica, Cuba, the Dominican Republic, Mexico, and Peru totaled 426 978 (279 591 men and 147 438 women), representing a potential loss of 5 710 048 (3 738 775 in men and 1 971 273 in women) years of productive life. Observed mortality was significantly higher than expected in all countries except the Dominican Republic. Conclusions. COVID-19 in the working-age population will have a profound impact on socio-economic conditions. Timely counting of excess deaths is useful and can be used as an early warning system to monitor the magnitude of COVID-19 outbreaks. Monitoring of excess mortality in working-age people by the Ibero-American Observatory on Safety and Health at Work enables more accurate assessment of the social and economic burden of COVID-19.

RESUMO Objetivo. Estimar o impacto da pandemia de COVID-19 durante o ano de 2020, por meio do excesso de mortalidade por todas as causas e dos anos produtivos de vida perdidos (APrVP) na população em idade ativa, em uma seleção de países da América Latina e do Caribe. Métodos. Estudo baseado em dados de óbitos por todas as causas entre 15 e 69 anos, principalmente dos Institutos Nacionais de Estatística. Os óbitos esperados foram estimados a partir daqueles registrados entre 2015 e 2019. O excesso de mortalidade foi estimado por meio do indicador P, da razão de mortalidade padronizada (RMP) e dos APrVP até os 70 anos. Resultados. O excesso de óbitos no Brasil, na Bolívia, no Chile, na Colômbia, na Costa Rica, em Cuba, no México, no Peru e na República Dominicana totalizou 426 978 (279 591 em homens e 147 438 em mulheres), o que representou uma perda de 5 710 048 (3 738 775 em homens e 1 971 273 em mulheres) APrVP. A mortalidade observada foi significativamente maior do que o esperado em todos os países, exceto na República Dominicana. Conclusões. O impacto da COVID-19 na população em idade ativa terá um impacto profundo na situação socioeconómica. O cálculo oportuno do excesso de mortes é útil e pode ser usado como um sistema de alerta precoce para monitorar a magnitude dos surtos de COVID-19. O monitoramento do excesso de mortalidade em pessoas em idade ativa, realizado pelo Observatório Ibero-Americano de Segurança e Saúde no Trabalho, permite avaliar com mais precisão a carga social e econômica da COVID-19.

Homicídios: mortalidade e anos potenciais de vida perdidos / Homicidios: mortalidad y años potenciales de vida perdidos / Homicide: mortality and years of potential life lost

Resumo Objetivo Investigar a tendência dos homicídios e estimar os anos potenciais de vida perdidos por essa causa na região sul do Brasil. Métodos Estudo de série temporal por homicídio construído a partir do Sistema de Informação sobre Mortalidade. Estimados os anos potenciais de vida perdidos segundo faixa etária, sexo e causa de óbito e calculadas as taxas de mortalidade. A análise de tendência foi verificada pela regressão de Prais-Winsten com cálculo da variação percentual anual. Resultados A região sul teve um incremento de 14,5% nas taxas de mortalidade por homicídio na série histórica com destaque para adultos jovens (20 a 29 anos) e população masculina como principais vítimas dos homicídios e com maiores anos potenciais de vida perdidos. As maiores taxas de homicídio foram registradas no Paraná, com tendência estacionária (APC= 0,10%; IC95%= -1,23; 1,65; p= 0,875). No Rio Grande do Sul houve tendência crescente com aumento de 25,0% (APC= 0,90% IC95%=0,49; 1,32; p<0,001); Santa Catarina com tendência crescente com aumento de 20,8% (APC= 0,70%; IC95%= 0,09; 1,32, p<0,001). Em relação ao sexo, houve maior prevalência do masculino no Rio Grande do Sul com 27,7% (APC= 0,90%; IC95%= 0,49; 1,32, p<0,001) e do feminino em Santa Catarina com 17,4% (APC= 0,70% IC95%= 0,50; 0,91, p<0,001). Conclusão A tendência foi de incremento dos homicídios nos estados da região sul com predominância de homicídio entre adultos jovens e a maior perda de anos de vida entre indivíduos do sexo masculino representa questões socioeconômicas importantes para uma causa prevenível.

Resumen Objetivo Investigar la tendencia de los homicidios y estimar los años potenciales de vida perdidos por esta causa en la región sur de Brasil. Métodos Estudio de serie temporal por homicidio construido a partir del Sistema de Información sobre Mortalidad. Se estimaron los años potenciales de vida perdidos según grupo de edad, sexo y causa de fallecimiento y se calcularon las tasas de mortalidad. El análisis de tendencia fue verificado por la regresión de Prais-Winsten con cálculo de la variación porcentual anual. Resultados La región sur tuvo un incremento del 14,5 % en las tasas de mortalidad por homicidio en la serie histórica con énfasis en adultos jóvenes (20 a 29 años) y población masculina como principales víctimas de los homicidios y con mayores años potenciales de vida perdidos. Las mayores tasas de homicidio fueron registradas en Paraná, con tendencia estacionaria (APC= 0,10 %; IC95 %= -1,23; 1,65; p= 0,875). En Rio Grande do Sul hubo tendencia creciente con aumento del 25,0 % (APC= 0,90 % IC95 %=0,49; 1,32; p<0,001); Santa Catarina con tendencia creciente con aumento del 20,8 % (APC= 0,70 %; IC95 %= 0,09; 1,32, p<0,001). Con relación al sexo, hubo mayor prevalencia del masculino en Rio Grande do Sul con el 27,7 % (APC= 0,90 %; IC95 %= 0,49; 1,32, p<0,001) y del femenino en Santa Catarina con el 17,4 % (APC= 0,70 % IC95 %= 0,50; 0,91, p<0,001). Conclusión La tendencia fue de incremento de los homicidios en los estados de la región sur con predominancia de homicidio entre adultos jóvenes, y la mayor pérdida de años de vida entre individuos de sexo masculino representa cuestiones socioeconómicas importantes para una causa prevenible.

Abstract Objective To investigate the trend of homicides and estimate the years of potential life lost due to this cause in southern Brazil. Methods This is a time series study for homicide constructed from the Mortality Information System. Years of potential life lost were estimated according to age group, sex and cause of death, and mortality rates were calculated. Trend analysis was verified by Prais-Winsten regression with calculation of annual percentage change. Results The South had a 14.5% increase in homicide mortality rates in the historical series, with emphasis on young adults (20 to 29 years) and the male population as the main victims of homicides and with greater years of potential life lost. The highest homicide rates were recorded in Paraná, with a stationary trend (APC= 0.10%; 95%CI= -1.23; 1.65; p= 0.875). In Rio Grande do Sul, there was a growing trend with an increase of 25.0% (APC=0.90%CI95%=0.49; 1.32; p<0.001). In Santa Catarina, there was a growing trend with an increase of 20.8% (APC= 0.70%; 95%CI= 0.09; 1.32, p<0.001). Regarding sex, there was a higher prevalence of males in Rio Grande do Sul with 27.7% (APC= 0.90%; 95%CI= 0.49; 1.32, p<0.001) and females in Santa Catarina with 17.4% (APC=0.70%; 95%CI=0.50; 0.91, p<0.001). Conclusion The trend was towards an increase in homicides in the southern states, with a predominance of homicides among young adults and the greater loss of years of life among males represents important socioeconomic issues for a preventable cause.

Potential years of life lost to cancer in Mato Grosso, stratified by sex: 2000 to 2019 / Anos potenciais de vida perdidos por câncer em Mato Grosso, estratificados por sexo: 2000 a 2019

ABSTRACT: Objective: To estimate the potential years of life lost (PYLL) to cancer in the State of Mato Grosso, from 2000 to 2019, stratified by sex, according to age groups and cancer types. Methods: It is a quantitative study with an ecological approach developed from secondary data, using the PYLL and its derivatives. Results: In the period analyzed, deaths from cancer in Mato Grosso resulted in 680,338 PYLL before the age of 80, with a variation of 82.5%. Of this total, 52.7% were assigned to males. The rate of the PYLL for cancer before the age of 60 was 70.9% in males, and 80.1% among women. The rates of PYLL increased in the period and showed slightly higher values in males. In the analysis according to age group, the rates of PYLL were also higher in males, except between the ages of 30 and 49. Lung cancers and lymphomas/leukemias resulted in greater losses of PYLL among men and female specific cancers (breast, cervical and uterine, and ovarian cancer) accounted for 36.26% of the PYLL among women, with variability per age groups. Conclusion: In Mato Grosso, the PYLL indicator for cancer presented unfavorable evolution between 2000 and 2019, with greater damage for males and for the younger population. Leukemias, lymphomas, and lung and breast cancers were the main causes for the PYLL.

RESUMO: Objetivo: Estimar os anos potenciais de vida perdidos por câncer no estado de Mato Grosso, no período de 2000 a 2019, estratificando os dados por sexo, segundo faixas etárias e tipos de câncer. Métodos: Trata-se de um estudo quantitativo, com abordagem ecológica a partir de dados secundários, utilizando-se o indicador anos potenciais de vida perdidos e seus derivados. Resultados: No período analisado, as mortes por câncer em Mato Grosso resultaram em 680.338 anos potenciais de vida perdidos antes dos 80 anos, com variação de 82,5%. Desse total, 52,7% foram atribuídos ao sexo masculino. O peso dos anos potenciais de vida perdidos por câncer antes dos 60 anos foi de 70,9% no sexo masculino e 80,1% entre as mulheres. As taxas de anos potenciais de vida perdidos aumentaram no período estudado e apresentaram valores ligeiramente mais elevados entre os homens. Na análise segundo faixas etárias, as taxas de anos potenciais de vida perdidos também foram maiores entre os homens, exceto entre 30 e 49 anos. Os cânceres de pulmão e linfomas/leucemias resultaram em maiores perdas de anos potenciais de vida entre os homens, e os cânceres de especificidade feminina (mama, colo e corpo do útero e ovário) responderam por 36,26% dos anos potenciais de vida perdidos entre as mulheres, com variabilidade por faixas etárias. Conclusão: Em Mato Grosso, o indicador anos potenciais de vida perdidos por câncer apresentou evolução desfavorável entre 2000 e 2019, com maior prejuízo para o sexo masculino e para a população mais jovem. As leucemias, linfomas e cânceres de pulmão e mama foram os principais responsáveis pelos anos potenciais de vida perdidos.

Mortality trend and analysis of potential years of life lost due to leukemia and lymphoma in Brazil and Mato Grosso / Tendência de mortalidade e análise de anos potenciais de vida perdidos por leucemias e linfomas no Brasil e em Mato Grosso

ABSTRACT: Objective: To estimate the mortality trend and to analyze the potential years of life lost (PYLL) due to leukemias and lymphomas in Brazil and Mato Grosso, from 2001 to 2019. Methods: Time-series study on deaths from leukemias and lymphomas with data obtained from the Mortality Information System. Trends were calculated by age group by the Joinpoint regression method, using calendar year as regressor variable, estimated annual percentage change (APC) and mean annual percentage change, considering 95% confidence intervals. PYLL rates were collected from the Cancer Mortality Atlas. Results: In Brazil, the mortality rate trend remained stable for both diseases in the period: leukemias (APC=0.2; 95%CI 0.0-0.3) and lymphomas (APC=0.2; 95%CI 0.4-0.1). In Mato Grosso state, the rate for leukemias was also stable (APC=0.3; 95%CI 1.0-1.6). For lymphomas, the trend was ascendant (APC=2.3; 95%CI 0.5-4.2), but descending among people younger than 59 years. For leukemias, PYLL rates were 64 and 65/100,000 in Brazil and Mato Grosso, respectively. For lymphomas, 27 and 22/100,000, respectively, with the highest rates found among males. Conclusion: The behavior of mortality rates from leukemia and lymphoma in Mato Grosso was different from that observed nationally, with an upward trend for lymphomas and no differences between age groups for both diseases. PYLL rates for leukemias were similar, while for lymphomas they were higher among men and lower in Mato Grosso when compared to Brazil.

RESUMO: Objetivos: Estimar a tendência de mortalidade e analisar os anos potenciais de vida perdidos (APVP) por leucemias e linfomas no Brasil e em Mato Grosso, entre os anos de 2001 e 2019. Métodos: Estudo de série temporal de óbitos por leucemias e linfomas obtidos do Sistema de Informação sobre Mortalidade. As tendências foram calculadas por faixa etária pelo método de regressão joinpoint, usando ano calendário como variável regressora, e estimaram-se a variação percentual anual (APC) e a variação percentual média anual, considerando intervalos de confiança de 95% (IC95%). As taxas de APVP foram coletadas do Atlas de Mortalidade por Câncer. Resultados: No Brasil, a tendência da taxa de mortalidade apresentou estabilidade para ambos os agravos, leucemias (APC=0,2; IC95% 0,0-0,3) e linfomas (APC=0,2; IC95% 0,4-0,1). No estado, a taxa por leucemias também apontou estabilidade (APC=0,3; IC95% 1,0-1,6). Para os linfomas, a tendência foi de aumento (APC=2,3; IC95% 0,5-4,2), contudo tendência decrescente foi observada entre aqueles com menos de 59 anos. Para leucemias, as taxas de APVP foram de 64 e 65/100 mil no Brasil e em Mato Grosso, respectivamente. Para linfomas, esses valores foram de 27 e 22/100 mil, respectivamente, sendo as maiores taxas encontradas no sexo masculino. Conclusão: As taxas de mortalidade por leucemias e linfomas em Mato Grosso apresentam comportamento diferente do observado nacionalmente, com tendência crescente para linfomas e sem diferenças entre as faixas etárias, para ambos os agravos. As taxas de APVP por leucemias foram semelhantes, no entanto para os linfomas foram maiores entre os homens e menores para o estado, quando comparadas com as do Brasil.

Tendência temporal dos anos potenciais de vida perdidos por acidentes de trabalho fatais segundo raça/cor da pele na Bahia, 2000-2019 / Time trend of potential years of life lost due to fatal occupational accidents according to race/skin color in Bahia, 2000-2019

Resumo Introdução: poucos estudos buscam evidenciar as diferenças raciais e o impacto social das mortes precoces decorrentes do trabalho, o que contribui para a inexistência de políticas públicas que objetivem superar essas desigualdades. Objetivo: analisar a tendência temporal das Taxas de Anos Potenciais de Vida Perdidos (TAPVP) decorrentes de acidentes de trabalho, segundo raça/cor da pele no estado da Bahia, de 2000 a 2019. Métodos: estudo de série temporal, com base em dados do Sistema de Informação sobre Mortalidade (SIM); consideraram-se os óbitos por acidentes de trabalho. Empregou-se o modelo de regressão linear pelo método Joinpoint para análise da série temporal e o cálculo da Variação Percentual Anual (VPA) das TAPVP. Resultados: foram notificados 2.137 óbitos por acidentes de trabalho no período estudado, correspondentes a 64.791,5 APVP, dos quais 74,2% envolveram trabalhadores da raça/cor da pele parda. Destaca-se que a VPA das TAPVP entre trabalhadores pardos e negros foi, respectivamente, 2,3 e 3,0 vezes a VPA dos trabalhadores brancos. Os trabalhadores pardos morreram mais precocemente e tiveram maior perda de anos potenciais de vida em quantidade e maior velocidade de crescimento da TAPVP, comparados com os trabalhadores brancos. Conclusão: a mortalidade precoce por acidentes de trabalho representa um relevante problema de saúde pública, destacando-se entre trabalhadores não-brancos.

Abstract Introduction: few studies seek to highlight racial differences and the social impact of early deaths resulting from work, which contributes to the lack of public policies that aim to overcome these inequalities. Objective: to analyze the time trend of Potential Years of Life Lost (PYLL) rates resulting from occupational accidents, according to race/skin color in Bahia, Brazil, from 2000 to 2019. Methods: a time series study was conducted using data collected from the Brazilian Mortality Information System (SIM). Only deaths from work-related accidents were included. Joinpoint linear regression was used to analyze the times series; the PYLL rates were estimated by annual percentage change. Results: the state of Bahia notified 2,137 deaths due to work-related accidents in the studied period, corresponding to a 64,791.5 PYLL, of which 74.2% involved black/brown skin workers. PYLL rates among brown and black workers was, respectively, 2.3 and 3.0 times that of white workers. Brown workers died earlier and had greater loss of PYLL, in quantity, and higher growth speed of the PYLL rates, when compared with white workers. Conclusion: early mortality due to occupational accidents constitute a relevant public health issue, especially among non-white workers.

Carga por mortalidad relacionada con el embarazo, parto y puerperio. Cuba 2005-2018 / Burden of mortality related to pregnancy, childbirth and the puerperium. Cuba 2005-2018

RESUMEN Fundamento la muerte materna representa uno de los acontecimientos más notables dentro de los conflictos de la salud sexual y reproductiva en el mundo. La elevada mortalidad por esta causa en el mundo es inadmisible. Sin embargo, las estimaciones para determinar la carga de morbilidad y mortalidad maternas aún son limitadas. Objetivo determinar la carga por mortalidad relacionada con el embarazo, parto y puerperio en Cuba entre los años 2005 y 2018. Métodos se realizó un estudio descriptivo, de datos transversales nacionales y periodicidad anual. El universo de estudio estuvo conformado por todas las muertes ocurridas durante el embarazo, parto y puerperio en el periodo 2005-2018, en Cuba (N=831). Se calcularon la razón de mortalidad, años de vida potencialmente perdidos por mortalidad, el porcentaje, el promedio y la tendencia. Resultados del total de fallecidas por muertes ocurridas durante el embarazo, parto y puerperio, 463 fueron por muerte directa; 247 por muerte indirecta; y 247, por otras muertes 121. La razón promedió 48,8 fallecidas por cada 100 000 nacidos vivos. Los años de vida potencialmente perdidos fueron 42582: 23433 por muertes directas, 12724 por indirectas, y 6425 por otras muertes. Conclusión las muertes obstétricas directas fueron las más frecuentes, y las de mayor impacto sobre la esperanza de vida; mientras que las obstétricas indirectas mostraron una tendencia a aumentar en el tiempo. Por otras muertes, las mujeres fallecieron en edades más tempranas.

ABSTRACT Background maternal death represents one of the most notable events in the conflicts of sexual and reproductive health in the world. The high mortality from this cause in the world is unacceptable. However, estimates for determining the burden of maternal morbidity and mortality health are still limited. Objective to determine the burden of mortality related to pregnancy, childbirth and the puerperium in Cuba between 2005 and 2018. Methods a descriptive study was carried out, with national cross-sectional data and annual periodicity. The universe of study was made up of all the deaths that occurred during pregnancy, childbirth and the puerperium in the period 2005-2018, in Cuba (N = 831). The mortality ratio, years of life potentially lost due to mortality, the percentage, the average and the trend were calculated. Results of the total number of deceased due to deaths that occurred during pregnancy, childbirth and the puerperium, 463 were due to direct death; 247 for indirect death; and 247, due to other deaths 121. The ratio averaged 48.8 deaths for every 100 000 live births. Years of life potentially lost were 42,582: 23,433 for direct deaths, 12,724 for indirect deaths, and 6,425 for other deaths. Conclusion direct obstetric deaths were the most frequent and those with the greatest impact on life expectancy; while indirect obstetrician women showed a tendency to increase over time. For other deaths, women died at an earlier age.

Estudio de la carga de mortalidad materna por causas directas. Cuba, 2005-2018 / Maternal mortality burden study from direct causes. Cuba, 2005-2018

RESUMEN Fundamento las complicaciones durante el embarazo, parto y puerperio constituyen las principales causas de muertes de mujeres en edad fértil. El estudio de la carga de mortalidad derivada de estas complicaciones es útil para cuantificar el impacto de muertes prematuras sobre la esperanza de vida de la población. Objetivo describir el comportamiento de la carga por muertes maternas debidas a causas directas en Cuba, entre el periodo 2005-2018. Métodos estudio descriptivo de series anuales, de corte transversal. El universo lo conformó el total de las muertes maternas directas (N=463). Se calcularon la razón de mortalidad, años de vida potencialmente perdidos por mortalidad, la tendencia, el porcentaje y el promedio. Resultados durante los años 2005-2018 fallecieron en Cuba 463 mujeres por causas obstétricas directas. Las muertes prematuras cuantificaron 22897 años de vida perdidos debido a esta causa, con una tendencia a decrecer en el tiempo y con un promedio anual de 1636 años de vida potencialmente perdidos; como promedio se dejaron de vivir por cada fallecida, 49 años. La causa directa que más años de vida perdidos generó fue el grupo de las complicaciones relacionadas con el puerperio (6 790). Conclusión las causas con mayor impacto sobre la esperanza de vida fueron las complicaciones relacionadas con el puerperio, otras hemorragias y embarazo ectópico; pero las mujeres que murieron en edades más jóvenes fueron a causa de aborto e infección puerperal. Las infecciones puerperales, trastornos placentarios y otras complicaciones mostraron tendencia a aumentar en el tiempo.

ABSTRACT Background complications during pregnancy, childbirth and the puerperium are the main causes of death in women of childbearing age. The study of the mortality burden derived from these complications is useful to quantify the impact of premature deaths on the population life expectancy. Objective to describe the behavior of the maternal deaths burden due to direct causes in Cuba, between 2005 and 2018. Methods descriptive study of annual series, cross-sectional. The universe was the total of direct maternal deaths (N = 463). The mortality ratio, years of life potentially lost due to mortality, the trend, the percentage and the average were calculated. Results during the years 2005-2018, 463 women died in Cuba from direct obstetric causes. Premature deaths quantified 22897 years of life lost due to this cause, with a tendency to decrease over time and with an annual average of 1636 years of life potentially lost; on average, they stopped living for each deceased, 49 years. The group of complications related to the puerperium (6790) was the direct cause that generated more years of life lost. Conclusion the causes with the greatest impact on life expectancy were complications related to the puerperium, other hemorrhages and ectopic pregnancy; but the women who died at younger ages were from abortion and puerperal infection. Puerperal infections, placental disorders, and other complications tended to increase over time.

Pérdidas laborales asociadas a la mortalidad por lesiones en accidentes de tránsito: estimaciones provinciales de ecuador / Labor productivity losses associated with road traffic injury fatalities: Provincial estimates of Ecuador

RESUMEN Objetivo Estimar los años potenciales de vida perdidos (APVP) y los años potenciales de vida laboral perdidos (APVLP) en la población en edad laboral asociados a los fallecimientos prematuros por lesiones en accidentes de tránsito para las 24 provincias de Ecuador. Métodos Se emplearon fuentes de información estadística (registro de defunciones CIE-10 V01 a V89 y censo poblacional) para estimar los APVP y APVLP en edades laborales (15 a 64 años de edad) por sexo y provincias. Además, se calcularon la tasa cruda y específica (edades laborales) y la edad media (IC95%). Resultados La mayoría de las muertes en edad laboral por lesiones en accidentes tránsito estuvo en hombres con edades jóvenes y en las provincias de las regiones amazónica (Orellana y Sucumbíos) y la costa del Pacífico del país (Los Ríos). El número de APVLP se estima en 69 314 años, mientras que los APVP asciende a 94 567 años, las provincias de Guayas y Pichincha acumulan la mayor cantidad de APVP y APVLP. Conclusiones Los años perdidos estimados por muertes prematuras por esta causa representan un problema de salud pública y un importante coste laboral para el desarrollo del país. Los resultados encontrados refuerzan la necesidad de intensificar la mejora de programas y actuaciones públicas en seguridad vial.

ABSTRACT Objetive To estimate the potential years of life lost (YPLL) and the potential years of wor-king life lost (YPPLL) in the working-age population associated with premature deaths from injuries in traffic accidents for the 24 provinces of Ecuador. Methods Statistical information sources (ICD-10 V01 to V89 death registry and population census) were used to estimate the YPLL and YPPLL for working ages (15 to 64 years of age) by sex and provinces. Additionally, the crude and specific rate (working ages) and the mean age (95% CI) were calculated. Results Most deaths of working age for injuries in traffic accidents was in men younger ages and in the provinces of the Amazon regions (Orellana and Sucumbíos) and the Pacific coast of the country (Los Ríos). The number of YPLL is estimated at 69,314 years, while the YPPLL amounts to 94,567 years, the provinces of Guayas and Pichincha accumulate the highest amount of YPLL and YPPLL. Conclusions Estimated lost years for this cause premature deaths represent a public health problem and a major labor cost for the development of the country. The results reinforce the need to strengthen public programs and improve road safety performances.

Evolución del nivel de mortalidad vial en Argentina en el periodo 1998-2017 / Evolution of the level of road mortality in Argentina in the period 1998-2017

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.

Life expectancy, death, and disability in Haiti, 1990-2017: a systematic analysis from the Global Burden of Disease Study 2017.

OBJECTIVE: To investigate the magnitude and distribution of the main causes of death, disability, and risk factors in Haiti. METHODS: We conducted an ecological analysis, using data estimated from the Global Burden of Disease Study 2017 for the period 1990-2017, to present life expectancy (LE), healthy life expectancy (HALE) at under 1-year-old, cause-specific deaths, years of life lost (YLLs), years lived with disability (YLDs), disability adjusted life-years (DALYs), and risk factors associated with DALYs. RESULTS: LE and HALE increased substantially in Haiti. People may hope to live longer in 2017, but in poor health. The Caribbean countries had significantly lower YLLs rates than Haiti for ischemic heart disease, stroke, lower respiratory infections, and diarrheal diseases. Road injuries were the leading cause of DALYs for people aged 5-14 years. Road injuries and HIV/AIDS were the leading causes of DALYs for men and women aged 15-49 years, respectively. Ischemic heart disease was the main cause of DALYs for people older than 50 years. Maternal and child malnutrition were the leading risk factors for DALYs in both sexes. CONCLUSION: Haiti faces a double burden of disease. Infectious diseases continue to be an issue, while non-communicable diseases have become a significant burden of disease. More attention must also be focused on the increase in worrying public health issues such as road injuries, exposure to forces of nature and HIV/AIDS in specific age groups. To address the burden of disease, sustained actions are needed to promote better health in Haiti and countries with similar challenges.

OBJETIVO: Investigar la magnitud y la distribución de las principales causas de muerte, discapacidad y factores de riesgo en Haití. MÉTODOS: Se llevó a cabo un análisis ecológico con datos estimados a partir del estudio Carga Global de Morbilidad 2017 para el período 1990-2017 para presentar la esperanza de vida (LE), la esperanza de vida saludable (HALE), la mortalidad por causas específicas, los años de vida perdidos (YLL), los años vividos con discapacidad (YLD), los años de vida ajustados por discapacidad (DALY), y los factores de riesgo asociados a los DALY. RESULTADOS: La LE y la HALE aumentaron sustancialmente en Haití. En 2017, la población puede esperar vivir más, pero con mala salud. Los países del Caribe tuvieron tasas de YLL significativamente más bajas que Haití en cuanto a cardiopatías isquémicas, accidentes cerebrovasculares, infecciones respiratorias bajas y enfermedades diarreicas. Las lesiones debidas a accidentes de tránsito fueron la principal causa de DALY para las personas de 5 a 14 años. Las lesiones debidas a accidentes de tránsito y el VIH/sida fueron las principales causas de DALY en hombres y mujeres de 15 a 49 años de edad, respectivamente. Las cardiopatías isquémicas fueron la principal causa de DALY para las personas mayores de 50 años. Las desnutriciones materna e infantil fueron los principales factores de riesgo de DALY en ambos sexos. CONCLUSIÓN: Haití se enfrenta a una doble carga de enfermedad. Las enfermedades infecciosas siguen siendo un problema, mientras que las enfermedades no transmisibles se han convertido en una carga significativa de enfermedad. También debe prestarse más atención al aumento de problemas de salud pública preocupantes, como las lesiones por accidentes de tránsito, la exposición a fenómenos naturales y el VIH/sida en grupos etarios específicos. Para hacer frente a la carga de morbilidad es necesario adoptar medidas sostenidas para promover una mejor salud en Haití y en los países con desafíos similares.

Assessment of premature mortality for noncommunicable diseases / Evaluación de la mortalidad prematura para la enfermedad crónica no transmisible / Avaliação da mortalidade prematura por doença crônica não transmissível

ABSTRACT Objectives: to analyze premature mortality and Potential Years of Life Lost by noncommunicable diseases in a city in the countryside of São Paulo from 2010 to 2014. Methods: ecological study of temporal tendency, using secondary source. For analysis, the premature mortality coefficient and the Potential Years of Life Lost indicator were used. Results: males had the highest premature mortality rate due to cardiovascular disease, with 213.04 deaths per 100 thousand inhabitants, followed by neoplasms, with 188.44. In women, there was an inversion with 134.22 deaths from cancer and 110.71 deaths from cardiovascular disease. Regarding Potential Years of Life Lost, males had an average of 12.19 years lost by death and females of 13.45 years lost. Conclusions: the results reinforce the need to increase public health prevention and promotion policies to reduce premature deaths, especially among men.

RESUMEN Objetivos: analizar la mortalidad prematura y los Años Potenciales de Vida Perdidos por enfermedades crónicas no transmisibles en una ciudad del interior de São Paulo, de 2010 a 2014. Métodos: Estudio ecológico de tendencia temporal, utilizando fuente secundaria. Para el análisis, se utilizaron el coeficiente de mortalidad prematura y el indicador de Años Potenciales de Vida Perdidos. Resultados: los hombres tuvieron la tasa de mortalidad prematura más alta debido a enfermedades cardiovasculares, con 213.04 muertes por cada 100 mil habitantes, seguidos de neoplasias, con 188.44. En las mujeres, hubo una inversión con 134.22 muertes por cáncer y 110.71 muertes por enfermedad cardiovascular. Con respecto a los posibles Años Potenciales de Vida Perdidos, los hombres tenían un promedio de 12,19 años perdidos por muerte y las mujeres de 13,45 años perdidos. Conclusiones: los resultados refuerzan la necesidad de aumentar la prevención pública y las políticas de promoción de la salud para reducir las muertes prematuras, especialmente entre los hombres.

RESUMO Objetivos: analisar a mortalidade prematura e os Anos Potenciais de Vida Perdidos por doenças crônicas não transmissíveis, em uma cidade do interior de São Paulo, no período de 2010 a 2014. Métodos: estudo ecológico, de tendência temporal, utilizando-se fonte secundária. Para análise, utilizou-se o coeficiente de mortalidade prematura e indicador de Anos Potenciais de Vida Perdidos. Resultados: o sexo masculino apresentou maior coeficiente de mortalidade prematura por doença cardiovascular, com 213,04 óbitos por 100 mil habitantes, seguido por neoplasias, com 188,44. Nas mulheres, houve uma inversão com 134,22 óbitos por neoplasias e 110,71 óbitos causados pelas doenças cardiovasculares. Em relação aos Anos Potenciais de Vida Perdidos, o sexo masculino apresentou média de 12,19 anos perdidos por óbito e o sexo feminino de 13,45 anos perdidos. Conclusões: os resultados reforçam a necessidade de incrementar políticas públicas de prevenção e promoção de saúde para redução de mortes prematuras, em especial dos homens.