Azevedo Nathalie Rodrigues Pontes, Souza-Santos Reinaldo, Domingues Rosa Maria Soares Madeira
Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2025 May 23;41(5):e00017524. doi: 10.1590/0102-311XPT017524. eCollection 2025.
This study aimed to analyze the temporal and spatial distribution of home mortality in the municipality of Rio de Janeiro, Brazil, before and during the first year of the COVID-19 pandemic. It is an ecological study of residents aged 15 or older, developed in two stages: (i) Time-series analysis on mortality rates according to place of occurrence; home mortality rates (HMR) according to underlying cause, age, and sex; and the proportion of home deaths by race/color and educational level from 2010 to 2020, and; (ii) Spatial analysis to observe the spatiotemporal variation of home deaths from 2010 to 2020 by Administrative Region (AR). Data from the Brazilian Mortality Information System, population estimates and the Social Progress Index (SPI) were used, all of which are publicly available and anonymized. Between 2019 and 2020, home deaths increased by 25.5%, mainly due to infectious and parasitic diseases, mental disorders, and ill-defined causes. HMR increased in all age groups except 15-19 years, with a higher proportion of home deaths among black individuals and in those with up to three years of education. Two clusters were detected: the primary (2016-2020) showed the highest HMR in ARs with high SPI, while the secondary (2020) had the highest HMR in ARs with lower SPI. Excess mortality was observed in the first year of the COVID-19 pandemic in municipality of Rio de Janeiro. Changes in the profile and causes of home deaths, along with the rise of HRM in AR with lower SPI, suggest an increase in home mortality among socially vulnerable populations during the pandemic.
本研究旨在分析巴西里约热内卢市在2019冠状病毒病大流行的第一年之前和期间家庭死亡的时空分布。这是一项针对15岁及以上居民的生态学研究,分两个阶段进行:(i)根据发生地点对死亡率进行时间序列分析;按潜在病因、年龄和性别划分的家庭死亡率(HMR);以及2010年至2020年按种族/肤色和教育程度划分的家庭死亡比例;(ii)空间分析,以观察2010年至2020年按行政区(AR)划分的家庭死亡的时空变化。使用了巴西死亡率信息系统的数据、人口估计数和社会进步指数(SPI),所有这些数据都是公开可用且经过匿名处理的。2019年至2020年期间,家庭死亡人数增加了25.5%,主要原因是传染病和寄生虫病、精神障碍以及病因不明。除15 - 19岁年龄组外,所有年龄组的HMR均有所上升,黑人个体以及受教育年限在三年及以下的人群中家庭死亡比例更高。检测到两个聚类:主要聚类(2016 - 2020年)在SPI较高的行政区显示出最高的HMR,而次要聚类(2020年)在SPI较低的行政区具有最高的HMR。在里约热内卢市2019冠状病毒病大流行的第一年观察到了超额死亡率。家庭死亡情况和原因的变化,以及SPI较低的行政区HRM的上升,表明在大流行期间社会弱势群体的家庭死亡率有所增加。