Excesso de mortalidade por doenças crônicas não transmissíveis durante a pandemia de Covid-19 no Estado de São Paulo
Data
2023-08-01
Autores
Resende, Bruna de Souza 
Orientadores
Rezende, Leandro Fórnias Machado de
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Estimar o excesso de mortalidade por Doenças Crônicas Não Transmissíveis (DCNT) em residentes do Estado de São Paulo durante a pandemia de Covid-19. Métodos: Estudo epidemiológico, descritivo, ecológico com base em dados de rotina provenientes do Sistema de Informação sobre Mortalidade (SIM) do Estado de São Paulo. Foi realizada análise comparativa das mortes por DCNT no Estado de São Paulo antes (2017-2019) e durante (2020) a pandemia de Covid-19, considerando as seguintes causas básicas de óbito: Neoplasias; Diabetes Mellitus ; Doenças do Aparelho Circulatório e Doenças do Aparelho Respiratório. O excesso de óbitos foi estimado a partir dos coeficientes de mortalidade, sendo considerada a Razão de Mortalidade Padronizada -Standardized Mortality Ratio- (SMR) (2020 vs 2017-2019), segundo sexo, faixa etária, localização geográfica (estado, município de São Paulo e Departamentos Regionais de Saúde (DRS). As análises foram realizadas no Software Excel 2016 e Geográfico Qgis versão 3.28. Resultados: Entre janeiro e dezembro de 2020 ocorreram 341.704 óbitos no Estado de São Paulo, sendo 186.741 entre homens e 154.963 entre mulheres, o que representou um aumento na mortalidade geral de 19,4% para homens e 15,4 % para mulheres em comparação ao triênio que antecedeu a pandemia. Com relação a mortalidade por DCNT, observou- se redução do número de óbitos por câncer (-2,0%), doenças do aparelho circulatório (-4,8%) e respiratório (-11, 7%) e aumento do número de óbitos por Diabetes Mellitus (25,6%) durante o ano pandêmico. Todos os dezessete DRS apresentaram SMR superior a 1,00 para a mortalidade por Diabetes Mellitus, sendo o maior valor referente a Regional de Barretos (1,59), com excesso de 67 óbitos, e a menor na Regional de Taubaté (1,04), com excesso de 31 óbitos. Conclusão: Os achados do estudo corroboram com a necessidade de criação e o fortalecimento de políticas públicas orientadas para a prevenção e controle das DCNT e seus fatores de risco, bem como a criação de ações estratégicas capazes de mitigar os impactos danosos à saúde das pessoas que vivem com DCNT, de modo que futuras pandemias não venham a impactar no excesso de óbitos por DCNT, em especial das pessoas que vivem com Diabetes Mellitus.
Objective: To estimate the excess mortality due to Noncommunicable Diseases (NCD) in residents of the State of São Paulo during the Covid19 pandemic. Methods: Epidemiological, descriptive, ecological study based on secondary data from the Mortality Information System (SIM) of the State of São Paulo. A comparative analysis of deaths from NCD in the State of São Paulo before (20172019) and during (2020) the Covid19 pandemic was carried out, considering the following basic causes of death: Neoplasms; Diabetes Mellitus; Diseases of the Circulatory System and Diseases of the Respiratory System. Excess deaths were estimated from the mortality coefficients, considering the Standardized Mortality Ratio (SMR) (2020 x 20172019), according to sex, age group, geographic location (state, municipality of São Paulo and Regional Health department (DRS). Analyzes were performed using Excel 2016 and Geographic Qgis version 3.28 software. Results: Between January and December 2020, there were 341,704 deaths in the State of São Paulo, 186,741 among men and 154,963 among women, which represented an increase in general mortality of 19.4% for men and 15.4% for women compared to the threeyear period that preceded the pandemic. Regarding mortality from NCDs, there was a reduction in the number of deaths from cancer (2.0%), diseases of the circulatory (4.8%) and respiratory systems (11.7%) and an increase in the number of deaths from Diabetes Mellitus (25.6%) during the pandemic year. All seventeen DRS had an SMR greater than 1.00 for mortality from Diabetes Mellitus, with the highest value referring to the Barretos Region (1.59), with an excess of 67 deaths, and the lowest in the Taubaté Region (1.04), with an excess of 31 deaths. Conclusion: The study findings corroborate the need to create and strengthen public policies aimed at the prevention and control of NCDs and their risk factors, as well as the creation of strategic actions capable of mitigating the harmful impacts on the health of people who live with NCDs, so that future pandemics will not have an impact on excess deaths from NCDs, especially for people living with Diabetes Mellitus.
Objective: To estimate the excess mortality due to Noncommunicable Diseases (NCD) in residents of the State of São Paulo during the Covid19 pandemic. Methods: Epidemiological, descriptive, ecological study based on secondary data from the Mortality Information System (SIM) of the State of São Paulo. A comparative analysis of deaths from NCD in the State of São Paulo before (20172019) and during (2020) the Covid19 pandemic was carried out, considering the following basic causes of death: Neoplasms; Diabetes Mellitus; Diseases of the Circulatory System and Diseases of the Respiratory System. Excess deaths were estimated from the mortality coefficients, considering the Standardized Mortality Ratio (SMR) (2020 x 20172019), according to sex, age group, geographic location (state, municipality of São Paulo and Regional Health department (DRS). Analyzes were performed using Excel 2016 and Geographic Qgis version 3.28 software. Results: Between January and December 2020, there were 341,704 deaths in the State of São Paulo, 186,741 among men and 154,963 among women, which represented an increase in general mortality of 19.4% for men and 15.4% for women compared to the threeyear period that preceded the pandemic. Regarding mortality from NCDs, there was a reduction in the number of deaths from cancer (2.0%), diseases of the circulatory (4.8%) and respiratory systems (11.7%) and an increase in the number of deaths from Diabetes Mellitus (25.6%) during the pandemic year. All seventeen DRS had an SMR greater than 1.00 for mortality from Diabetes Mellitus, with the highest value referring to the Barretos Region (1.59), with an excess of 67 deaths, and the lowest in the Taubaté Region (1.04), with an excess of 31 deaths. Conclusion: The study findings corroborate the need to create and strengthen public policies aimed at the prevention and control of NCDs and their risk factors, as well as the creation of strategic actions capable of mitigating the harmful impacts on the health of people who live with NCDs, so that future pandemics will not have an impact on excess deaths from NCDs, especially for people living with Diabetes Mellitus.