Epidemiology and Data Analysis Laboratory, Faculdade de Medicina do ABC, Santo André, São Paulo, Brazil.
Sci Rep. 2019 Mar 12;9(1):4173. doi: 10.1038/s41598-019-41012-8.
As well as breast cancer mortality, the income inequality in Brazil is different between Federative units, including between units of the same region. To assess the effects of the high-inequality of income on breast cancer mortality in Brazilian Federative Units, in the 2010 year. This is an ecologic study. Deaths from breast cancer in Brazilian women according to Federative units were obtained from the Department of Informatics of the Unified Health System. Mortality by breast cancer was estimated per 100,000 women and age-standardized by the direct method according to World Health Organization population. Income inequality was measured by the Gini index obtained from the United Nations Development Programme. The High-inequality of income was classified by the third tercile of the distribution from the Gini index of the Federative units. Univariate analysis was performed according to data normality. Linear regressions were performed by the stepwise backward method. The confidence level was 5%. Stata® (Stata Corp, LC) 11.0. was used. The High-inequality of income was associated with worse social and demographic indicators. The age-standardized breast cancer mortality was larger in the high-inequality of income Federative units. In the adjusted analysis, these Federative units presented a mean of 2 more deaths (ranging from the 0.4 to 3.7 deaths, r² = 0.79; p = 0.018) by breast cancer per 100,000 women when compared to the Federative units without high-inequality of income. In the Brazilian Federative units, the high-inequality of income was associated with age-standardized breast cancer mortality more.
除了乳腺癌死亡率之外,巴西各联邦单位之间的收入不平等也存在差异,包括同一地区的联邦单位之间。为了评估高收入不平等对巴西联邦单位乳腺癌死亡率的影响,我们在 2010 年进行了这项生态研究。从巴西妇女乳腺癌死亡率的角度来看,该研究是根据联邦单位来进行评估的,相关数据由统一卫生系统的信息部门提供。乳腺癌死亡率是根据每 10 万名妇女的死亡人数来估计的,并按照世界卫生组织的人口进行了直接法年龄标准化。收入不平等程度是通过联合国开发计划署获得的基尼指数来衡量的。高收入不平等是根据基尼指数的第三分位数对各联邦单位进行分类的。根据数据正态性进行了单变量分析。采用逐步后退法进行线性回归。置信水平为 5%。使用了 Stata®(StataCorp,LC)11.0 软件。高收入不平等与较差的社会和人口指标有关。高收入不平等的联邦单位的年龄标准化乳腺癌死亡率较高。在调整分析中,与没有高收入不平等的联邦单位相比,这些联邦单位的每 10 万名妇女乳腺癌死亡人数平均增加了 2 例(范围为 0.4 至 3.7 例,r²=0.79;p=0.018)。在巴西联邦单位中,高收入不平等与年龄标准化乳腺癌死亡率的相关性更强。