Villela Paolo Blanco, Klein Carlos Henrique, de Oliveira Gláucia Maria Moraes
Federal University of Rio de Janeiro, Edson Saad Heart Institute, Rio de Janeiro, Brazil.
Department of Epidemiology and Quantitative Methods in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
Rev Port Cardiol (Engl Ed). 2019 Mar;38(3):205-212. doi: 10.1016/j.repc.2018.07.007. Epub 2019 Apr 23.
Socioeconomic factors may affect mortality due to cerebrovascular diseases (CBVDs), hypertensive diseases (HYPDs), and circulatory system diseases (CSDs). This study aimed to assess the association between the Human Development Index (HDI) and the extent of supplementary health coverage and mortality due to these diseases in the Brazilian Federative Units (FUs) between 2004 and 2013.
The Municipal HDI (MHDI) scores of each FU for 2000 and 2010 were retrieved from the Atlas Brasil website, and supplementary health coverage data for the period 2004-2013 were obtained from the national regulatory agency for private health insurance. Population and mortality data were obtained from the website of the Department of Information Technology of the Unified Health System (DATASUS). Mortality rates were weighted by ill-defined causes of death and standardized by age.
The MHDI increased between 2000 and 2010 in all FUs, in half of which it was 0.7 or higher. Supplementary health coverage increased in the country during the study period and was inversely associated with mortality due to CSDs and CBVDs between 2004 and 2013. Mortality due to CBVDs and HYPD in 2013 showed an inverse linear association with the MHDI in 2000.
Mortality due to CSDs, CBVDs, and HYPDs was influenced by socioeconomic factors. There was a significant inverse association between socioeconomic factors and mortality due to CSDs, CBVDs, and HYPDs. Plans to reduce mortality due to these diseases should include measures to foster economic development and reduce inequality.
社会经济因素可能影响脑血管疾病（CBVD）、高血压疾病（HYPD）和循环系统疾病（CSD）导致的死亡率。本研究旨在评估2004年至2013年期间巴西联邦单位（FU）的人类发展指数（HDI）与补充健康保险覆盖范围以及这些疾病导致的死亡率之间的关联。
从巴西地图集网站检索各联邦单位2000年和2010年的城市人类发展指数（MHDI）得分，并从国家私人健康保险监管机构获取2004 - 2013年期间的补充健康保险覆盖数据。人口和死亡率数据来自统一卫生系统信息技术部网站（DATASUS）。死亡率按死因不明进行加权，并按年龄进行标准化。
2000年至2010年期间，所有联邦单位的MHDI均有所上升，其中一半单位的MHDI为0.7或更高。在研究期间，该国的补充健康保险覆盖范围有所增加，并且在2004年至2013年期间与CSD和CBVD导致的死亡率呈负相关。2013年CBVD和HYPD导致的死亡率与2000年的MHDI呈负线性相关。
CSD、CBVD和HYPD导致的死亡率受社会经济因素影响。社会经济因素与CSD、CBVD和HYPD导致的死亡率之间存在显著的负相关。降低这些疾病导致的死亡率的计划应包括促进经济发展和减少不平等的措施。
