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, Rio de Janeiro, RJ, Brazil.
IDOMED-Estácio de Sá University, School of Medicine, Rio de Janeiro, RJ, Brazil.
PLoS One. 2024 Dec 31;19(12):e0314294. doi: 10.1371/journal.pone.0314294. eCollection 2024.
Some recent analyses have described that, in the context of the instability of social protection institutions and economic crisis, there is an increase in mortality rates selectively from drug overdoses, suicides and alcohol-related liver diseases. This group of causes was named "Deaths of Despair. In the last decade, Brazil experienced economic stagnation and fiscal austerity, influencing the profile of illnesses and deaths. Therefore, our study aimed to evaluate the effect of the economic crisis and fiscal austerity measures on deaths of despair in Brazil and to describe the trend of deaths of despair in Brazil between 2003 and 2018, according to the phases of the economic cycle. We analyzed the time series of rates by covariates and fitted an interrupted time series model to assess the effect of the crisis on the trend through the Prais-Winsten method. The temporal analysis showed a significant difference in the mean values before and after economic stagnation (Mean 8.68 ± 0.71) and after (Mean 11.62 ± 0.62). We found a positive association between the economic crisis and deaths of despair, with a significant change in level (p-value = 0.003) and a non-significant trend effect (p-value = 0.300). There are differences in sex, age, and especially race: men, middle-aged and black/brown people are more at risk. The present study presents the effect of the economic crisis and mortality in the population, with demographic differences.
最近的一些分析表明，在社会保护制度不稳定和经济危机的背景下，因药物过量、自杀和酒精性肝病导致的死亡率有选择性地上升。这一组死因被称为“绝望死亡”。在过去十年中，巴西经历了经济停滞和财政紧缩，影响了疾病和死亡情况。因此，我们的研究旨在评估经济危机和财政紧缩措施对巴西绝望死亡的影响，并根据经济周期阶段描述2003年至2018年巴西绝望死亡的趋势。我们通过协变量分析了比率的时间序列，并采用普雷斯-温斯坦方法拟合了一个中断时间序列模型，以评估危机对趋势的影响。时间分析显示，经济停滞前后的平均值存在显著差异（经济停滞前平均值为8.68±0.71，经济停滞后平均值为11.62±0.62）。我们发现经济危机与绝望死亡之间存在正相关，水平有显著变化（p值=0.003），趋势效应不显著（p值=0.300）。在性别、年龄，尤其是种族方面存在差异：男性、中年人和黑人/棕色人种面临的风险更高。本研究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。
