不断升级的健康危机:剖析巴西东北部土著居民的死亡原因和趋势。

IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Disaster Medicine and Public Health Preparedness Pub Date : 2024-10-28 DOI:10.1017/dmp.2024.155
Paulo Ricardo Martins-Filho, Taise Ferreira Cavalcante, Shirley Verônica Melo Almeida Lima, Bianca Marques Santiago, Carlos Eduardo Palhares Machado, Eugénia Cunha
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引用次数: 0

摘要

目标:在巴西最贫穷的东北部地区,土著社区面临着严峻的医疗挑战。尽管在法律上有权使用统一医疗系统(SUS),但系统性障碍依然存在,加剧了健康差异和死亡率。这项生态研究分析了阿拉戈斯-塞尔希培土著特别卫生区(DSEI)十年来的死亡率趋势和死亡原因:方法:从土著卫生秘书处获得了 2012 年至 2022 年的死亡数据。死亡原因分为 13 类。研究计算了每千名原住居民的死亡率,并使用 Mann-Kendall 检验分析了趋势。研究还比较了各年龄组的死亡原因:死亡率从千分之 3.3 到千分之 5.2 不等,随着时间的推移呈中度上升趋势(τ = 0.5,p = 0.042)。主要原因包括心脏和血管疾病(24.3%)、外部原因(12.4%)、呼吸系统问题(11.1%)和感染(10.9%)。约三分之一的儿科死亡病例与一般新生儿并发症有关:这项研究表明,巴西东北部原住民社区的死亡率在不断上升。主要死因反映了更广泛的公共卫生问题。这些趋势凸显了制定更有效、文化敏感性更强的公共卫生政策和改善医疗服务的紧迫性。
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Escalating Health Crisis: Dissecting Mortality Causes and Trends Among Indigenous Populations in Northeast Brazil.

Objectives: In Northeast Brazil, the poorest region of the country, indigenous communities face critical health care challenges. Despite legal entitlements to the Unified Health System (SUS), systemic barriers persist, exacerbating health disparities and mortality. This ecological study analyzed mortality trends and causes of death within the Special Indigenous Sanitary District (DSEI) Alagoas-Sergipe over a decade.

Methods: Data on deaths from 2012 to 2022 were obtained from the Indigenous Health Secretariat. Causes of death were classified into 13 categories. Mortality rates per 1,000 indigenous inhabitants were calculated, and trends were analyzed using the Mann-Kendall test. The study also compared causes of death by age group.

Results: Mortality rates ranged from 3.3 to 5.2 per 1,000, showing a moderate upward trend over time (τ = 0.5, p = 0.042). Predominant causes included heart and vascular disorders (24.3%), external causes (12.4%), respiratory issues (11.1%), and infections (10.9%). About one-third of pediatric deaths were associated with general neonatal complications.

Conclusions: This study highlights increasing mortality in indigenous communities in Northeast Brazil. The predominant causes of death reflect broader public health concerns. These trends emphasize the urgency for more effective, culturally sensitive public health policies and improved health care access.

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来源期刊
Disaster Medicine and Public Health Preparedness
Disaster Medicine and Public Health Preparedness PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
4.40
自引率
7.40%
发文量
258
审稿时长
6-12 weeks
期刊介绍: Disaster Medicine and Public Health Preparedness is the first comprehensive and authoritative journal emphasizing public health preparedness and disaster response for all health care and public health professionals globally. The journal seeks to translate science into practice and integrate medical and public health perspectives. With the events of September 11, the subsequent anthrax attacks, the tsunami in Indonesia, hurricane Katrina, SARS and the H1N1 Influenza Pandemic, all health care and public health professionals must be prepared to respond to emergency situations. In support of these pressing public health needs, Disaster Medicine and Public Health Preparedness is committed to the medical and public health communities who are the stewards of the health and security of citizens worldwide.
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