Burden of disease in Brazil, 1990-2016: a systematic subnational analysis for the Global Burden of Disease Study 2016.
Burden of disease in Brazil, 1990-2016: a systematic subnational analysis for the Global Burden of Disease Study 2016.
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DOI：
10.1016/s0140-6736(18)31221-2
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发表时间：
2018-09-01
期刊：
影响因子：
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通讯作者：
GBD 2016 Brazil Collaborators
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文献类型：
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作者：
GBD 2016 Brazil Collaborators
巴西的政治、经济和流行病变化影响了健康和卫生系统。我们使用2016年全球疾病负担研究（GBD 2016）的结果来了解不断变化的健康模式，并为政策应对提供信息。我们分析了GBD 2016年对出生时预期寿命（LE），健康预期寿命（黑尔），全因和特定原因死亡率，寿命损失年（YLL），残疾生活年（YLD），残疾调整寿命年（DADs）的估计，以及巴西，其26个州和联邦区从1990年到2016年的风险因素，并将这些数据与十个比较国的国家估计数进行了比较。在全国范围内，LE从1990年的68.4年（95%不确定性区间[UI] 68.0 - 68.9）增加到2016年的75.2年（74.7 - 75.7），黑尔从59.8年（57.1 - 62.1）增加到65.5年（62.5 - 68.0）。全因年龄标准化死亡率下降了34.0%（33.4 - 34.5），而全因年龄标准化DALY率下降了30.2%（27.7 - 32.8）;下降的幅度因州而异。2016年，缺血性心脏病是年龄标准化YLL的主要原因，其次是人际暴力。下背部和颈部疼痛，感觉器官疾病和皮肤病是1990年和2016年YLD的主要原因。2016年导致糖尿病的主要风险因素是酒精和药物使用，高血压和高体重指数。从1990年到2016年，健康状况有所改善，但各州的改善和疾病负担各不相同。流行病向非传染性疾病和相关风险的转变在全国范围内发生，但后来在一些州发生，而人际暴力则成为一个健康问题。决策者可以利用这些结果来解决健康差距问题。比尔及梅林达·盖茨基金会和巴西卫生部。
Political, economic, and epidemiological changes in Brazil have affected health and the health system. We used the Global Burden of Disease Study 2016 (GBD 2016) results to understand changing health patterns and inform policy responses. We analysed GBD 2016 estimates for life expectancy at birth (LE), healthy life expectancy (HALE), all-cause and cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and risk factors for Brazil, its 26 states, and the Federal District from 1990 to 2016, and compared these with national estimates for ten comparator countries. Nationally, LE increased from 68·4 years (95% uncertainty interval [UI] 68·0–68·9) in 1990 to 75·2 years (74·7–75·7) in 2016, and HALE increased from 59·8 years (57·1–62·1) to 65·5 years (62·5–68·0). All-cause age-standardised mortality rates decreased by 34·0% (33·4–34·5), while all-cause age-standardised DALY rates decreased by 30·2% (27·7–32·8); the magnitude of declines varied among states. In 2016, ischaemic heart disease was the leading cause of age-standardised YLLs, followed by interpersonal violence. Low back and neck pain, sense organ diseases, and skin diseases were the main causes of YLDs in 1990 and 2016. Leading risk factors contributing to DALYs in 2016 were alcohol and drug use, high blood pressure, and high body-mass index. Health improved from 1990 to 2016, but improvements and disease burden varied between states. An epidemiological transition towards non-communicable diseases and related risks occurred nationally, but later in some states, while interpersonal violence grew as a health concern. Policy makers can use these results to address health disparities. Bill & Melinda Gates Foundation and the Brazilian Ministry of Health.