RESUMO

The main aim of this study is to explore the relationship between the elderly population and economic growth in 25 North and South American countries use annual secondary data from 1961 to 2021. Instead of focusing on the conditional mean, this study tests for Granger causality in the entire conditional distribution of the elderly population and economic growth through wavelet coherence analysis. The study findings indicated a unidirectional Granger causality running from per capita gross domestic product (GDP) to the elderly population for Bolivia, Colombia, Guyana, Peru and Puerto Rico and also from elderly population to per capita GDP for Costa Rica, Ecuador and Honduras. However, there is no causal relationship between the elderly population and economic growth for the rest of the countries. Wavelet coherence analysis depicted that economic growth positively led the elderly population in North America during the early 21st century. Furthermore, economic growth had been negatively leading the elderly population in South America throughout the period under consideration. This empirical study shows that policymakers of these economies need to analyse the transformation in the elderly population-economic growth causality robustness throughout the year when devising policies.

RESUMO

Puerto Rico has endured multiple natural disasters in recent years, including Hurricanes Irma and Maria (2017), earthquakes (2019), and the COVID-19 pandemic (2020), which placed significant strain on its healthcare system. This study examined trends in health care utilization for injuries, infectious diseases, and mental health services across Puerto Rico's health regions from 2016 to 2022. Using private claims data from four major insurers, we analyzed trends in health care utilization rates per 1,000 beneficiaries across seven health regions. Infectious disease claims rose significantly following each disaster, with the sharpest increases observed post-2020, particularly in the Caguas region. Mental health and substance use claims exhibited a consistent upward trend across all health regions, with Caguas and Ponce reporting the largest increases. Injury claims declined in 2020 but rebounded in most regions by 2021, with Caguas consistently reporting the highest rates. These findings highlight the substantial and varied impacts of consecutive disasters on health care utilization in Puerto Rico, particularly for infectious diseases and mental health services. Notable regional disparities, such as higher utilization rates in Caguas, underscore the need for interventions to strengthen health system resilience and ensure equitable healthcare access in preparation for future disasters.

RESUMO

To describe the temporal evolution of the main causes of mortality in Minas Gerais (MG), Brazil, and to verify the association with socioeconomic indicators. This is a mixed ecological study in which age-standardized mortality rates were calculated per 100,000 inhabitants due to noncommunicable diseases (NCDs), communicable, neonatal and nutritional diseases (NNDs) and external causes (ECs) for 853 municipalities in MG, according to data from the Global Burden of Disease (GBD) study, in the three-year periods 2000 to 2002 (T1), 2009 to 2011 (T2) and 2016 to 2018 (T3). Between T1 and T3, mortality due to NCDs predominated; there was a 22.4% decrease in the rates for NCDs (553.6 to 429.9) and a 29% decrease in the rates for NCDs (83 to 58.9), and a 3.5% increase in EC (62.2 to 64.4). The correlation coefficients were positive (R > 0.70; p < 0.05) and higher mortality rates were found in areas with worse socioeconomic status.

Descrever a evolução temporal das principais causas de mortalidade em Minas Gerais (MG), Brasil, e verificar a associação com indicadores socioeconômicos. Estudo ecológico misto em que foram calculadas taxas de mortalidade padronizadas por idade, por 100 mil habitantes, por doenças crônicas não transmissíveis (DCNT), doenças transmissíveis, neonatais e nutricionais (TNN) e causas externas (CE), para 853 municípios de MG, segundo dados do estudo Carga Global de Doenças (GBD), nos triênios 2000 a 2002 (T1), 2009 a 2011 (T2) e 2016 a 2018 (T3). Entre T1 e T3 predominou a mortalidade por DCNT; houve decréscimo de 22,4% das taxas por DCNT (553,6 para 429,9) e de 29% da s taxas por TNN (83 para 58,9), e acréscimo de 3,5% por CE (62,2 para 64,4). Os coeficientes de correlação foram positivos (R > 0,70; p < 0,05) e foram encontrados taxas mais elevadas de mortalidade em áreas de pior status socioeconômico.

Describir la evolución temporal de las principales causas de mortalidad en Minas Gerais (MG), Brasil, y verificar la asociación con indicadores socioeconómicos. Estudio ecológico mixto en el que se calcularon las tasas de mortalidad estandarizadas por edad, por 100.000 habitantes, por enfermedades crónicas no transmisibles (ENT), enfermedades transmisibles, neonatales y nutricionales (ENN) y causas externas (CE), para 853 municipios de MG, según datos del estudio Carga Global de Enfermedad (GBD), en los trienios 2000 a 2002 (T1), 2009 a 2011 (T2) y 2016 a 2018 (T3). Entre T1 y T3 predominó la mortalidad por ENT; Se observó una disminución del 22,4% en las tasas de ENT (553,6 a 429,9) y una disminución del 29% en las tasas de TNC (83 a 58,9), y un aumento del 3,5% en las de EC (62,2 a 64,4). Los coeficientes de correlación fueron positivos (R > 0,70; p < 0,05) y se encontraron tasas de mortalidad más altas en zonas de peor nivel socioeconómico.

RESUMO

This article aims to analyze data on care in the field of public mental healthcare in Brazil from 2012 to 2022, corresponding to the years before and after the implementation of the New Mental Health Policy. For this purpose, quantitative methodology, of the longitudinal ecological study type, was used. Data was extracted for the period from 2012 to 2022. The sources used were Health Information Systems. The data was compiled into time series and analyzed using descriptive statistical techniques. The results pointed to the enhancement of outpatient services and a decrease in the expansion of Psychosocial Care Centers and Primary Care facilities after 2017, indicating compliance with the New Policy guidelines to deprioritize territorial and community-based services. The number of psychiatric hospitals showed little variation for the entire period, indicating not only alignment with the strengthening of hospital institutions indicated in the New Policy, but also weaknesses in the deinstitutionalization policy of the period prior to 2017. This study concludes that the effects of the changes in national policies on the organization, management and execution of the health system can be seen, but at the same time there is continuity in various aspects.

O artigo tem como objetivo analisar dados de assistência no campo da saúde mental coletiva no Brasil no período de 2012 a 2022, correspondente aos anos anteriores e posteriores à implementação da Nova Política de Saúde Mental. Foi empregada metodologia quantitativa, do tipo estudo ecológico longitudinal. Os dados foram extraídos para o período de 2012 a 2022. As fontes utilizadas foram os sistemas de informação em saúde. Os dados foram compilados em séries temporais e analisados por meio de técnicas de estatística descritiva. Os resultados apontaram fortalecimento dos serviços ambulatoriais e diminuição no crescimento de Centros de Atenção Psicossocial e equipamentos da atenção básica após 2017, indicando conformidade com as diretrizes da Nova Política de despriorizar os serviços de base territorial e comunitária. O quantitativo de hospitais psiquiátricos apresentou pouca variação para todo o período, indicando não apenas concordância com o fortalecimento das instituições hospitalares previsto na Nova Política, mas fragilidades na política de desinstitucionalização do período anterior a 2017. Percebem-se efeitos das mudanças nas políticas nacionais na organização, gestão e execução do sistema de saúde, e, ao mesmo tempo, continuidade em vários aspectos.

Este artículo tiene como objetivo analizar datos sobre la asistencia en el campo de la salud mental colectiva en Brasil de 2012 a 2022, correspondientes a los años anteriores y posteriores a la implementación de la Nueva Política de Salud Mental. Este estudio cuantitativo ecológico longitudinal extrajo los datos de 2012 a 2022 de los Sistemas de Información en Salud. Los datos fueron recopilados en series de tiempo y analizados mediante técnicas de estadística descriptiva. Los resultados mostraron un fortalecimiento de los servicios ambulatorios y una disminución en el crecimiento de los Centros de Atención Psicosocial y de equipamientos de Atención Primaria después de 2017, indicando el cumplimiento de los lineamientos de la Nueva Política de despriorizar los servicios territoriales y comunitarios. El número de hospitales psiquiátricos mostró poca variación para todo el período, lo que indica no solo acuerdo con el fortalecimiento de las instituciones hospitalarias previsto en la Nueva Política, sino también debilidades en la política de desinstitucionalización del período anterior a 2017. Se observaron efectos de los cambios en las políticas nacionales en organización, gestión y ejecución del sistema de salud y, al mismo tiempo, continuidad en varios aspectos.

RESUMO

BACKGROUND: Although movement behaviors are linked to mortality risk, few studies investigated the associations between daily steps and movement behaviors and all-cause mortality in low- and middle-income countries. OBJECTIVE: We investigated associations of step count, total activity volume, moderate-and-vigorous physical activity (MVPA), light-intensity physical activity (LPA), sedentary behavior, sleep duration, and various isotemporal substitutions with all-cause mortality in middle-aged and older Brazilian adults. METHODS: ELSA-Brasil cohort study 3rd wave (2017-2019) participants wore an ActiGraph wGT3X-BT on the waist for seven days and completed a sleep diary. We followed participants to January 1st, 2024. Using Cox regression models, we estimated adjusted hazard ratios (HR). Using compositional data analysis, we examined changes in mortality associated with isotemporal substitutions. RESULTS: Overall, 8832 participants (55.8 % female, age 59.2 ± 8.6) were followed for a median of 5.43 person-years (total 46,793.2), with 216 deaths. All behaviors except sleep showed curvilinear associations with mortality. Mortality declined with a plateauing effect at a daily total activity volume of 15.9 millii-g (HR 0.36, reference 7.83), 7300 steps (HR 0.48, reference 3881), 49.4 MVPA minutes (HR 0.28, reference 11.34), and 245.8 LPA minutes (HR 0.67, reference 135.6). Engaging in less than 842 sedentary behavior minutes/day was linked with an HR of 0.67. Reallocating 10 daily minutes from other behaviors to MVPA showed a consistent 10 % decrease in mortality. CONCLUSION: In Brazilian adults, step count, total activity volume, MVPA, LPA, and sedentary behavior were non-linearly associated with lower mortality. Reallocating any time from other behaviors to MVPA predicted lower mortality.

RESUMO

Objectives: To examine cancer mortality rates in Colombia by ethnic groups (Indigenous, Rom, Raizal, Afro-Colombian, and Mestizo) and assess trends from 2011 to 2022. Methods: National vital statistics from death certificates and the Colombian census data were used. Crude and direct age-standardized mortality rates were determined by ethnicity for the study period, by year, sex, and cancer type and Joinpoint analysis was conducted to examine trends. Results: Age-standardized cancer mortality of Mestizos (60.1 per 100,000 population) was lower than in Rom and Raizales (557.3 and 77.7 per 100,000), and higher than for Afro-Colombians and Indigenous (37.2 and 20.0 per 100,000). Indigenous people in Colombia had greater proportions of individuals under 45 dying of cancer than Mestizos (18.7% vs. 9.7%, p-value = <0.01). Compared to the Mestizo population, Raizales and Afro-Colombians experienced disproportionately higher age-standardized mortality rates due to prostate cancer (26.6/100,000 and 8.6/100,000 vs. 8.1/100,000), and for Raizales and Rom breast cancer (14.0/100,000 and 103.2/100,000 vs. 9.1/100,000). Conclusion: The disparities in cancer mortality in ethnic minorities in Colombia call for investigating cancer etiology and access to care among the Rom and the Raizal populations.

RESUMO

PURPOSE: To analyze the geographic and temporal patterns of biologic prescriptions for inflammatory bowel disease (IBD) in Brazil's public national unified health system (SUS). METHODS: This ecological study used data from patients with IBD in the SUS Outpatient Information System between 2008 and 2022. Prais-Winsten regression was used to estimate the trends in prescription rate of biologics. For geographic analysis, average prescription rate of biologics was calculated by state for three periods: 2008-2012, 2013-2017, and 2018-2022. Global Moran's index (GMI) and local indicators of spatial autocorrelation (LISA) were used to assess spatial autocorrelation and identify spatial clusters of biologic prescriptions, respectively. RESULTS: The prescription rate of biologics increased from 3.0% to 16.7%. Infliximab was the most prescribed drug from 2008 to 2012 (3.0%-4.2%), and adalimumab was the most widely prescribed drug from 2013 to 2022 (4.3%-9.1%). Higher prescription rates of biologics were observed in patients with Crohn's disease than in those with ulcerative colitis (40.5% vs. 3.2%). Biologics were primarily prescribed in the Southeast and South; however, the central-western and northern regions showed greater changes in prescription rates over time. There were increased clusters of high biologic prescriptions across the three evaluated periods. CONCLUSIONS: The increase in biologic prescriptions over time may be attributed to their enhanced efficacy in inducing and maintaining IBD remission. Biologic prescriptions in Brazil are experiencing temporal and geographical changes, indicating that disparities in drug prescriptions may decrease with universal, equitable healthcare access, despite administrative challenges in obtaining these medications through SUS.

RESUMO

BACKGROUND: As a female-specific health problem, pelvic organ prolapse (POP) causes serious damage to the physical and psychological health of numerous women, which poses a significant challenge to women's health care worldwide, especially in developing countries. We conducted an in-depth analysis of trends in the incidence of POP over the past 30 years globally and in Brazil, Russia, India, China, and South Africa (BRICS countries). MATERIALS AND METHODS: Data on the incidence of POP were obtained by location (5 countries), age (15-94 years old), year (1990-2019) from the Global Burden of Disease Study 2019. Age-period-cohort model was used to estimate the net drift, local drift, age effects, period and cohort effects between 1990 and 2019. RESULTS: The all-age incidence rate for POP in 2019 increased from 283.28/100,000 (95% UI: 229.97, 340.34) in China to 444.81/100,000 (369.92, 526.15) in Brazil, whereas the age-standardized incidence rate in 2019 was highest in India 400.06/100,000 (325.98, 476.91) and lowest in China 187.74/100,000 (154.21, 224.43). There was an emerging transition of incidences from the young population (15-39 years) to the middle and older population (≥ 40 years) in Brazil and India. The current findings reflect the different age, period, and cohort effects on POP incidence trends at global and BRICS levels. CONCLUSIONS: The BRICS countries have made different progress in reducing the prevalence of POP. We fully recognize the diversity of internal environments in the BRICS countries and suggest an incremental approach to advancing POP prevention matters based on possible policy-driven human and financial resources in a given setting.

RESUMO

Adequate fruit and vegetable consumption is recognized for its health benefits, including preventing noncommunicable diseases, therefore it should be monitored over the years. This study aimed to investigate the temporal trend of fruit and vegetable consumption among Brazilian adults (≥ 18 years) residing in 26 Brazilian capitals and the Federal District from 2008-2023. A time-series analysis of the Surveillance of Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel) was conducted. Regular (≥ 5 days/week) and recommended (≥ 5 servings/day on ≥ 5 days/week) fruit and vegetable consumption were analyzed for total population and sociodemographic groups. Prais-Winsten regression models were used to identify trends in the entire (2008-2023), initial (2008-2014) and most recent (2015-2023) periods. Regular and recommended consumption remained stable from 2008 to 2023. From 2008 to 2014, regular consumption increased in total population (0.71pp/year) and all sociodemographic groups, except for adults aged 25-34 years. From 2015 to 2023, regular consumption decreased in the total population (-0.56pp/year), mainly among men (-0.70pp/year), adults aged 25-34 years (-0.84pp/year), and with higher schooling (-0.96pp/year). The recommended consumption increased from 2008 to 2014 (0.81pp/year), mainly among women (0.90pp/year), adults aged 55-64 years (0.96pp/year), and those with higher schooling (0.77pp/year). The recommended consumption decreased from 2015 to 2023 in total population (-0.52pp/year) and all sociodemographic groups, except for men and adults aged ≥ 65 years. The Brazilian fruit and vegetable consumption increased from 2008 to 2014 but reduced recently (2015-2023).

RESUMO

OBJECTIVE: The goal of this study was to assess the Portuguese Intensive Care Referral Network, namely the mission and organization of the Portuguese National Health Service Intensive Care Medicine Services and patient flows between them. METHODS: The study was based on the responses to a semi-structured questionnaire by the directors of the forty-one Intensive Care Medicine Services, characterizing four domains: a) number, type, and management of beds; b) human resources and their consumption; c) outreach, including activities in the resuscitation room, intra-hospital emergency team and follow-up clinics; and d) referral network. RESULTS: The number of active Intensive Care Medicine Services beds in Portugal markedly increased in the last 12 years, but the beds/habitant ratio is still below the Organization for Economic Cooperation and Development average. The activation of all installed beds would likely allow for the reduction of the hospital care gap perceived by many of the Intensive Care Medicine Services directors. There is significant geographic heterogeneity in the beds/habitant ratio and in the performance of outreach activities. The number of intensivists is rapidly growing, but nursing staff should be augmented, especially rehabilitation nurses. The referral network is globally complied, but the secondary transport of critical patients needs improvement and an electronic information system, which can be constantly updated, is seen as a relevant decision aid. CONCLUSION: Although intensive care medicine has significantly strengthened in the last 12 years, both in number of beds and in role and mission, there is still relevant heterogeneity in the beds/habitant ratio and in the performance of outreach activities among different Intensive Care Medicine Services.

RESUMO

OBJECTIVE: to assess pain management in infants in a Neonatal Intensive Care Unit (NICU) and discuss its articulation with the Sustainable Development Goals, with a focus on promoting neonatal well-being. METHOD: a documentary study, retrospective in nature and quantitative approach, conducted in a NICU of a public hospital in Paraná, Brazil, between January and July 2022, with 386 medical records of infants, hospitalized for more than 24 hours, between 2019 and 2021. Data were subjected to descriptive and inferential analysis, considering p-value<0.05 as a statistical difference. National ethical guidelines were respected. RESULTS: all infants underwent at least one painful procedure, but only 13.7% had documented pain. Pharmacological interventions, such as fentanyl (25.9%), and non-pharmacological interventions, such as breastfeeding encouragement (86%) were used. Only 2.8% were reassessed. CONCLUSION: there was a devaluation of neonatal pain management that may perpetuate neonatal well-being and sustainable development.

RESUMO

OBJECTIVE: Describe the activities aimed at achieving the Sustainable Development Goals (SDGs), implemented by a polytechnic higher education institution, in the northern region of Portugal. METHODS: This is an experience report from a Higher Education Institution, which characterizes the contribution to the SDGs, within the scope of teaching, research, campus and leadership. RESULTS: In total, 1247 activities were mapped, with a preponderance in the "people" dimension (685 activities), with SDG 3 being the most prominent. Scientific articles contribute significantly to the SDGs, with a notable discrepancy between automatic (Scopus) and manual classifications, indicating a tendency to underestimate the impact of nursing studies. CONCLUSION: The results demonstrate the significant contribution of this institution to the SDGs, with a special focus on health and education. This contribution reflects the mission of the institution, which involves training competent and socially conscious health professionals, but simultaneously the need for greater awareness and training of the teaching staff.

RESUMO

OBJECTIVE: to comparatively analyze the health, education and social development systems of Brazil and Portugal, their relationship with the Sustainable Development Goals and the Organization for Economic Cooperation and Development averages. METHOD: exploratory and descriptive qualitative research, through documentary analysis. The indicators address health, education and social development, considering life expectancy, mortality, prevalence of chronic diseases, literacy, educational performance and poverty rates. RESULTS: indicate significant differences between countries. Portugal presents better indicators in life expectancy, educational quality and poverty rates, whereas Brazil faces greater challenges in chronic diseases and equity in access to healthcare services. FINAL CONSIDERATIONS: the importance of public policies adapted to local realities and the need for a strategic vision for healthcare systems aligned with the Sustainable Development Goals, in addition to the need for continuous investments and integration of digital health for efficient and equitable systems, stand out.

RESUMO

OBJECTIVE: To assess the morbidity profile and identify factors associated with frailty syndrome in post-COVID-19 elderly patients treated at the only Reference Center for Elderly Health Care in northern Minas Gerais. METHODS: This is a case series study, utilizing the Clinical-Functional Vulnerability Index-20 (CFVI-20) and Comprehensive Geriatric Assessment (CGA) to characterize and evaluate the health condition of the group. To define the variables associated with frailty, a multivariate analysis was conducted. RESULTS: The study included 204 elderly individuals, with a predominance of females (63.7%). The variables associated with frailty were cognitive impairment (OR: 2.95; 95% CI: 1.12-7.80; p=0.029), the presence of five or more comorbidities (OR: 11.55; 95% CI: 2.22-60.01; p=0.004), and impairment in instrumental activities of daily living (OR: 41.97; 95% CI: 5.47-321.93; p<0.001). CONCLUSIONS: The results of this study highlight the need for a well-established and prepared coordination of integrated care to meet the demands of the post-COVID-19 elderly population.

RESUMO

OBJECTIVE: to map the literature on quilombola children's health and its relationship with the Sustainable Development Goals. METHOD: a scoping review, which followed the JBI protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Searches were conducted in the LILACS, BDENF, Web of Science, Scopus, MEDLINE databases and Google Scholar platform. The research protocol was registered in the Open Science Framework. RESULTS: eighteen articles out of 2,055 studies were selected as relevant for this study. The articles were grouped into four axes: Access to healthcare services; Nutritional aspects of quilombola children; Health problems of quilombola children; and Care for quilombola children. The relationship between these articles and SDGs 1, 3, 4, 6 and 10 was observed. FINAL CONSIDERATIONS: the study provided an extremely important mapping of the theme of quilombola children's health and themes related to the Sustainable Development Goals.

RESUMO

OBJECTIVE: to analyze how motherhood is expressed in female prison units from the perspective of Bioethics of Protection. METHOD: qualitative research with an ethnographic approach, developed in two women's prison units. Participantes were: six mothers deprived of liberty, 15 health professionals, and nine prison officers. For data collection, semi-structured interviews and descriptive observation were used. Data analysis was based on the Content Analysis technique, thematic category. RESULTS: three categories emerged: women and children violated behind bars (inequities); mothers and children in prison exacerbating imbalances, tensions and conflicts; and limits and references for resocialization. FINAL CONSIDERATIONS: the Bioethics of Protection proposal appears as a valid tool for the analytical direction of the process of confronting issues in the scope of public health in prison units, considering vulnerable groups and aiming at equity and human dignity.

RESUMO

We carried out the health situation analysis in the Legal Amazon through morbidity and mortality indicators and the comparison between intra and inter-state federation of the region and Brazil. Analysis of the health situation, trends, and identification of clusters in the Brazilian Amazon, for the period from 2010 to 2021, using secondary data available in official health information systems. Circulatory diseases were the main cause of death, representing 23% of deaths. External causes and respiratory diseases contributed 16% and 9% of deaths, respectively; 52.6% of infant deaths occurred in the early neonatal period, and the infant mortality rate remained above the national average. The ratio of maternal mortality was also high and above the national average between 2010 and 2021. The dengue incidence rate remained below the national average with a drop trend of -59.50%. However, rates of Chagas disease, AIDS, Hansen's disease, American cutaneous leishmaniasis and tuberculosis remained above average rates in the country. It was concluded that the population of the Brazilian Amazon faces health challenges. The findings facilitate the identification of territorial priorities for the implementation of actions that impact morbidity and mortality reduction in the region.

RESUMO

The aim was to map evidence on the quality of records in the Mortality Information System (SIM) through a national scoping review of articles published up to April 2023 across five databases (PubMed, Embase, Scopus, LILACS, and SciELO). Studies focused on specific causes of death were excluded. Dimensions evaluated included accessibility, methodological clarity, coverage, completeness, reliability, consistency, non-duplication, timeliness, validity, and studies on ill-defined causes/garbage codes. Among the 33 included articles, a general improvement in SIM quality was observed, with a 68.5% reduction in garbage codes (2000-2015). However, regional inequalities in SIM persist, with coverage below 90% in Acre and Maranhão and poorer performance in the North and Northeast regions. A robust SIM is essential for public health strategies aimed at preventing avoidable deaths.

O objetivo foi mapear evidências sobre a qualidade dos registros do Sistema de Informação sobre Mortalidade (SIM) por meio de revisão de escopo nacional com artigos publicados até abril de 2023 em cinco bases (PubMed, Embase, scopus, LILACS e SciELO). Excluíram-se estudos focados em causas específicas de óbito. Foram avaliadas dimensões como acessibilidade, clareza metodologica, cobertura, completitude, confiabilidade, consistencia, nao-duplicidade, oportunidade, validade e estudos de causas mal definidas/garbage codes.. Dos 33 artigos incluídos, observou-se melhoria geral da qualidade do SIM, com redução de 68,5% nos garbage codes (2000-2015). Contudo, persistem desigualdades regionais no SIM, com cobertura abaixo de 90% no Acre e Maranhão e pior desempenho nas regiões Norte e Nordeste. Um SIM robusto é essencial para estratégias de saúde pública voltadas à prevenção de mortes evitáveis.

El objetivo fue mapear evidencias sobre la calidad de los registros del Sistema de Información sobre Mortalidad (SIM) a través de una revisión de alcance nacional con artículos publicados hasta abril de 2023 en cinco bases de datos (PubMed, Embase, Scopus, LILACS y SciELO). Se excluyeron estudios centrados en causas específicas de muerte. Se evaluaron dimensiones como accesibilidad, claridad metodológica, cobertura, completitud, fiabilidad, consistencia, no duplicación, oportunidad, validez y estudios sobre causas mal definidas/códigos basura. Entre los 33 artículos incluidos, se observó una mejora general en la calidad del SIM, con una reducción del 68,5% en los códigos basura (2000-2015). Sin embargo, persisten desigualdades regionales en el SIM, con una cobertura inferior al 90% en Acre y Maranhão y un peor desempeño en las regiones Norte y Nordeste. Un SIM robusto es esencial para estrategias de salud pública dirigidas a prevenir muertes evitables.

RESUMO

The aim is to identify the epidemiological profile of mortality among Brazilian indigenous children under five years of age, through an integrative review. Articles that evaluated the mortality of indigenous Brazilian children under one and/or five years of age, from 2000 to 2020, in Portuguese, English, and/or Spanish, in the LILACS, SciELO, and MEDLINE databases were included. Of the 3,229 publications found, 22 were included in the review. Infant mortality ranged from 15.2/1,000 live births (LB) (1995-1999) for the Kayabí ethnic group to 307.7/1,000 LB (2000) for the Hupdäh ethnic group. Among the studies that evaluated infant mortality by age components, the post-neonatal period stands out, with proportions that varied from 15.2% (1990-1994), for indigenous children from Paraná, to 83.3% (2007- 2008) for the Guarani ethnic group. The main cause of mortality was respiratory diseases, ranging from 17.1% (2010) to 75% (2007-2008) among the Guarani ethnic group. Brazilian indigenous children under one year of age experienced high mortality rates, when compared to non-indigenous children, for all ethnicities and regions of the country. Among the IMT components, a high number of deaths were observed in the post-neonatal period, with respiratory system diseases representing the main causes of death.

O objetivo é identificar, por meio de uma revisão integrativa, o perfil epidemiológico da mortalidade em crianças indígenas brasileiras menores de cinco anos. Foram incluídos artigos que avaliaram a mortalidade de crianças indígenas brasileiras menores de um e/ou cinco anos, entre 2000-2020, em português, inglês e/ou espanhol, nas bases LILACS, SciELO e MEDLINE. Das 3.229 publicações encontradas, 22 foram inseridas na revisão. A mortalidade infantil variou de 15,2/1.000 NV (1995-1999) para a etnia Kayabí a 307,7/1.000 NV (2000) para a etnia Hupdäh. Entre os estudos que avaliaram a mortalidade infantil pelos componentes etários, destaca-se o período pós-neonatal, com proporções que variaram de 15,2% (1990-1994), para crianças indígenas do Paraná, a 83,3% (2007-2008) para a etnia Guarani. A principal causa de mortalidade foram as doenças respiratórias, variando de 17,1% (2010) a 75% (2007-2008) entre a etnia Guarani. Crianças indígenas brasileiras menores de um ano apresentaram taxas de mortalidade elevadas, quando comparadas às crianças não-indígenas, para todas as etnias e regiões do país. Entre os componentes de TMI, observou-se elevado número de óbitos no período pós-neonatal, tendo como principal causas de óbito as doenças do aparelho respiratório.

El objetivo es identificar el perfil epidemiológico de la mortalidad en niños indígenas brasileños menores de cinco años, a través de una revisión integradora. Se incluyeron artículos que evaluaron la mortalidad de niños indígenas brasileños menores de uno o cinco años, entre 2000-2020, en portugués, inglés o español, en las bases de datos LILACS, SciELO y MEDLINE. Se incluyeron 22 de las 3.229 publicaciones encontradas en la revisión. La mortalidad infantil osciló entre 15,2/1.000 NV (1995-1999) para el grupo étnico Kayabí y 307,7/1.000 NV (2000) para el grupo étnico Hupdäh. Entre los estudios que evaluaron la mortalidad infantil por componentes de edad, se destaca el período posneonatal, con proporciones que variaron desde el 15,2% (1990-1994), para los niños indígenas de Paraná, hasta el 83,3% (2007-2008) para la etnia guaraní. La principal causa de mortalidad fueron las enfermedades respiratorias, oscilando entre el 17,1% (2010) y el 75% (2007-2008) entre la etnia guaraní. Los niños indígenas brasileños menores de un año experimentaron altas tasas de mortalidad en comparación con los niños no indígenas en todas las etnias y regiones del país. Entre los componentes del TMI, se observó un elevado número de muertes en el período posneonatal, siendo las enfermedades del sistema respiratorio las principales causas de muerte.

RESUMO

The scope of this article is to analyze the temporal trend and macro-regional distribution of the options on offer in terms of collective activities of bodily practices and physical activities (BPPA) and the number of participants in primary health care, developed by all health professionals and by Physical Education Professionals in Brazil. It involved an ecological time-series study, using data from the Health Information System for Primary Health Care (Sisab) between 2014 and 2022, which was assessed using regression analysis and Joinpoint software. At the national level, the results revealed an increase in the number of collective BPPA activities and participants in primary health care developed by all health professionals and by Physical Education Professionals between 2014 and 2019, followed by a reduction in both in 2020. The upward trend resumed in 2021 and 2022. The conclusion drawn is that, despite the exceptional scenario caused by the COVID-19 pandemic, upward trends have been identified in both the options on offer of collective BPPA activities and in the number of participants.

O objetivo é analisar a tendência temporal e a distribuição macrorregional da oferta de atividades coletivas de práticas corporais e atividades físicas (PCAF) e do número de participantes na atenção primária à saúde, desenvolvidas por todos os profissionais de saúde e por profissionais de educação física no Brasil. Estudo ecológico de série temporal, com dados do Sistema de Informação em Saúde para a Atenção Básica (Sisab) entre 2014 e 2022, por meio da análise de regressão no software Joinpoint. Na perspectiva nacional, identificou-se aumento do quantitativo de atividades coletivas de PCAF e de participantes na atenção primária desenvolvidas por todos os profissionais de saúde e por profissionais de educação física entre 2014 e 2019, seguido de uma redução de ambos em 2020. O aumento foi retomado em 2021 e 2022. Ainda que tenha ocorrido o cenário de excepcionalidade ocasionado pela pandemia de COVID-19, foram identificadas tendências de aumento tanto na oferta de atividades coletivas de PCAF quanto de participantes.

El objetivo es analizar la tendencia temporal y la distribución macrorregional de la oferta de actividades colectivas de prácticas corporales y actividades físicas (PCAF) y del número de participantes en la atención primaria de salud, desarrolladas por todos los profesionales de la salud y de la Educación Física en Brasil. Estudio de series de tiempo ecológicas, con datos del Sistema de Información en Salud para Atención Primaria (Sisab) brasileño entre 2014 y 2022, mediante análisis de regresión en el software Joinpoint. Desde una perspectiva nacional, se identificó un aumento en el número de actividades colectivas de PCAF y participantes en atención primaria desarrolladas por todos los profesionales de la salud y de Educación Física entre 2014 y 2019, seguido de una reducción de ambas en 2020. El aumento se reanudó en 2021 y 2022. Si bien ocurrió el escenario excepcional provocado por la pandemia de Covid-19, se identificaron tendencias crecientes tanto en la oferta de actividades colectivas del PCAF como en los participantes.