RESUMO
OBJECTIVE: To analyze the spatiotemporal distribution of the burden of occupational cancer in Brazil and federative units between 1990 and 2019. METHODS: Data were extracted from the Global Burden of Disease (GBD) study. Deaths from cancer whose attributable risk factor was occupational carcinogens were considered. Spatial analysis was performed with the first and last years of the series (1990 and 2019). Age-adjusted mortality rates were used to estimate the global Moran's Index (Moran's I), and the local indicator of spatial association (LISA) to identify clusters in the country with the respective statistical significance. The occupational cancer mortality rate, adjusted for age, was analyzed based on its trend for Brazil and federative units, in the period between 1990 and 2019. RESULTS: Between 1990 and 2019, occupational cancer mortality rate showed a decreasing trend (R2=0.62; p<0.001) as well as the burden of disease indicator - DALY (R2=0.84; p<0.001). However, mortality is increasing in most states, suggesting that a minority of federative units induce the country's global trend. There is also the development of a spatial pattern of autocorrelation, indicating clusters of states with low mortality and DALY rates in the Northeast and high values in the South of the country. CONCLUSION: The overall decreasing trend in the trend of occupational cancer masks the heterogeneity across states. This scenario may be associated with the diversity of economic activities, and suggests a decentralized and equitable plan for occupational cancer surveillance.
Assuntos
Carga Global da Doença , Neoplasias , Humanos , Brasil/epidemiologia , Fatores de Risco , Neoplasias/epidemiologiaRESUMO
Abstract Objectives: to analyze the fertility pattern in Brazil and its relationship with human development in the Brazilian federation units in 2000 and 2010. Methods: this is an ecological study whose unit of analysis was the Brazilian Federative Units in the period of 2000 and 2010. The fertility was assessed considering the social (HDI), inequality, (Gini, Theil and Income Ratio) and fertility indicators (fertility rate and mean age of fertility). Results: Brazil has been experiencing a rapid fertility transition. The pattern of fertility curves changed in all Federative Units between 2000 and 2010, with a reduction in cusp size and postponement of fecundity. This change was more evident among the Federative Units with better development and lower inequality. The correlation between social and fertility indicators lost strength in the period, corroborating the transition hypothesis. Conclusions: there is a direct relation between the fecundity and inequality indicators, and inversing human development. Changes should be taken in consideration in the age structure of the population, as well as inequality indicators, for better planning in public policies for public health.
Resumo Objetivos: analisar o padrão de fecundidade no Brasil e sua relação com o desenvolvimento humano nas unidades de federação no Brasil em 2000 e 2010. Métodos: trata-se de estudo ecológico cuja unidade de análise foram as Unidades Federativas brasileiras no período de 2000 e 2010. A fecundidade foi avaliada considerando os indicadores sociais (IDH), indicadores de desigualdade (Gini, Theil e Razão de Renda) e os indicadores de fecundidade (taxa de fecundidade e idade média de fecundidade). Resultados: o Brasil vem experimentando rápida transição da fecundidade. O padrão das curvas de fecundidade modificou em todas as UF entre 2000 e 2010, com redução do tamanho da cúspide e postergação da fecundidade. Esta mudança foi mais evidente entre as UF com melhor desenvolvimento e menor desigualdade. A correlação entre indicadores sociais e de fecundidade perdeu força no período, corroborando a hipótese de transição. Conclusões: existe relação direta entre os indicadores de fecundidade e desigualdade, e inversa com desenvolvimento humano. Deve-se considerar as modificações na estrutura etária da população, bem como nos indicadores de desigualdade, para melhor planejamento de políticas públicas na saúde pública.
