Guimarães Raphael Mendonça, Meira Karina Cardoso, da Silva Vicente Cristiane Teixeira, de Araújo Caribé Silvania Suely, da Silva Neves Luise Bernardes, Vardiero Nicole Almeida
Oswaldo Cruz Foundation, National School of Public Health, Graduate Program in Public Health, Rua Leopoldo Bulhões, 1480 - ENSP, Suite #916, Rio de Janeiro, RJ, 21041-210, Brazil.
School of Medicine, IDOMED - Estácio de Sá University, Rio de Janeiro, RJ, Brazil.
J Racial Ethn Health Disparities. 2024 Aug 19. doi: 10.1007/s40615-024-02134-6.
A new paradigm has been discussed regarding the impact of economic cycles on the mortality pattern from specific causes. These causes are called deaths of despair, and they selectively impact specific demographic groups. Also, low- and middle-income countries are most affected due to their economic and social instability. In this sense, the objective of study was to compare the magnitude of disparity in deaths from despair according to sex, age, and race in Brazil.
We performed Poisson regression modeling to estimate the magnitude of the association between sex, age group, race, and deaths from despair. Also, we estimated the relationship of time as a proxy of economic crisis phase and deaths of despair.
We found an association between mortality from despair and male sex (PR = 6.15, 95%CI 6.09-6.22); emphasis on the age groups from 40 to 49 years old (PR = 2.45, 95% CI 2.41-2.48) and 50 to 59 years old (PR = 2.39, 95% CI 2.36-2.43); and brown (PR = 1.21, 95% CI 1.20-1.22) and black race (PR = 1.36, 95% CI 1.34-1.37).
The present study preliminarily presents the effect of the economic crisis and mortality in the population, with demographic differences. Association with race was opposite to that verified in the original study in the USA, which suggests that this variable should be analyzed in the light of structural context.
关于经济周期对特定原因导致的死亡模式的影响，已经讨论了一种新的范式。这些原因被称为绝望死亡，它们有选择地影响特定的人口群体。此外，低收入和中等收入国家因其经济和社会不稳定而受影响最大。从这个意义上说，本研究的目的是比较巴西因绝望导致的死亡在性别、年龄和种族方面的差异程度。
我们进行了泊松回归建模，以估计性别、年龄组、种族与绝望死亡之间关联的程度。此外，我们估计了作为经济危机阶段代理变量的时间与绝望死亡之间的关系。
我们发现绝望死亡率与男性（PR = 6.15，95%CI 6.09 - 6.22）；40至49岁年龄组（PR = 2.45，95%CI 2.41 - 2.48）和50至59岁年龄组（PR = 2.39，95%CI 2.36 - 2.43）；以及棕色人种（PR = 1.21，95%CI 1.20 - 1.22）和黑人种族（PR = 1.36，95%CI 1.34 - 1.37）之间存在关联。
本研究初步呈现了经济危机对人口死亡率的影响以及人口统计学差异。与种族的关联与美国原研究中所证实的相反，这表明该变量应结合结构背景进行分析。
