Skip to main content
Erschienen in: International Journal of Public Health 5/2019

07.05.2019 | Original article

Reducing socioeconomic inequalities in life expectancy among municipalities: the Brazilian experience

verfasst von: Antonio Fernando Boing, S. V. Subramanian, Alexandra Crispim Boing

Erschienen in: International Journal of Public Health | Ausgabe 5/2019

Einloggen, um Zugang zu erhalten

Abstract

Objectives

This study analyzed the evolution of regional and socioeconomic inequality in life expectancy (LE) at birth and the probability of living up to 40 (LU40) and up to 60 years of age (LU60) in Brazilian municipalities between 1991 and 2010.

Methods

We analyzed data from the last three national census (1991, 2000 and 2010) computed for the 5565 Brazilian municipalities. They were divided into centiles according to the average per capita income. Poisson regression was performed to calculate the ratios between the poorest and the richest centiles.

Results

The average LE (+ 8.8 years), LU40 [6.7 percentage points (pp)] and LU60 increased (12.2 pp) between 1991 and 2010. The ratio of LE between the 1% of richest counties and the 1% of poorest counties decreased from 1.20 in 1991 to 1.09 in 2010. While in the poorest municipalities there was a gain of around 12 years of life, among the richest this increase was around 7 years.

Conclusions

There was a remarkable decrease in regional and socioeconomic inequality in LE, LU40 and LU60 in Brazil between 1991 and 2010.
Literatur
Zurück zum Zitat Barnish M, Tørnes M, Nelson-Horne B (2018) How much evidence is there that political factors are related to population health outcomes? An internationally comparative systematic review. BMJ Open. 8(10):e020886CrossRefPubMedPubMedCentral Barnish M, Tørnes M, Nelson-Horne B (2018) How much evidence is there that political factors are related to population health outcomes? An internationally comparative systematic review. BMJ Open. 8(10):e020886CrossRefPubMedPubMedCentral
Zurück zum Zitat Brasil (2010) Instituto Brasileiro de Geografia e Estatística. Síntese de Indicadores Sociais: uma análise das condições de vida da população brasileira 2010. IBGE, Rio de Janeiro Brasil (2010) Instituto Brasileiro de Geografia e Estatística. Síntese de Indicadores Sociais: uma análise das condições de vida da população brasileira 2010. IBGE, Rio de Janeiro
Zurück zum Zitat Brasil (2013) Instituto Brasileiro de Geografia e Estatística (IBGE). Tábuas abreviadas de mortalidade por sexo e faixa etária. IBGE, Brasília Brasil (2013) Instituto Brasileiro de Geografia e Estatística (IBGE). Tábuas abreviadas de mortalidade por sexo e faixa etária. IBGE, Brasília
Zurück zum Zitat Chetty R, Stepner M, Abraham S, Lin S, Scuderi B, Turner N, Bergeron A, Cutler D (2016) The association between income and life expectancy in the United States, 2001–2014. JAMA 315(16):1750–1766CrossRefPubMedPubMedCentral Chetty R, Stepner M, Abraham S, Lin S, Scuderi B, Turner N, Bergeron A, Cutler D (2016) The association between income and life expectancy in the United States, 2001–2014. JAMA 315(16):1750–1766CrossRefPubMedPubMedCentral
Zurück zum Zitat dos Reis AAC (2018) What will be of Brazil and SUS? Rev Eletron Comun Inf Inov Saúde 12(2):119–124CrossRef dos Reis AAC (2018) What will be of Brazil and SUS? Rev Eletron Comun Inf Inov Saúde 12(2):119–124CrossRef
Zurück zum Zitat Dwyer-Lindgren L, Bertozzi-Villa A, Stubbs RW, Morozoff C, Mackenbach JP, van Lenthe FJ, Mokdad AH, Murray CJL (2017) Inequalities in life expectancy among US counties, 1980 to 2014: temporal trends and keydrivers. JAMA Intern Med 177(7):1003–1011CrossRefPubMedPubMedCentral Dwyer-Lindgren L, Bertozzi-Villa A, Stubbs RW, Morozoff C, Mackenbach JP, van Lenthe FJ, Mokdad AH, Murray CJL (2017) Inequalities in life expectancy among US counties, 1980 to 2014: temporal trends and keydrivers. JAMA Intern Med 177(7):1003–1011CrossRefPubMedPubMedCentral
Zurück zum Zitat Fukuda Y, Nakao H, Yahata Y, Imai H (2007) Are health inequalities increasing in Japan? The trends of 1955 to 2000. Biosci Trends 1(1):38–42PubMed Fukuda Y, Nakao H, Yahata Y, Imai H (2007) Are health inequalities increasing in Japan? The trends of 1955 to 2000. Biosci Trends 1(1):38–42PubMed
Zurück zum Zitat Gómez-Dantés H, Fullman N, Lamadrid-Figueroa H et al (2016) Dissonant health transition in the states of Mexico, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 388(10058):2386–2402CrossRefPubMed Gómez-Dantés H, Fullman N, Lamadrid-Figueroa H et al (2016) Dissonant health transition in the states of Mexico, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 388(10058):2386–2402CrossRefPubMed
Zurück zum Zitat Guanais FC (2015) The combined effects of the expansion of primary health care and conditional cash transfers on infant mortality in Brazil, 1998–2010. Am J Public Health 105(Suppl 4):S593–S599CrossRefPubMedPubMedCentral Guanais FC (2015) The combined effects of the expansion of primary health care and conditional cash transfers on infant mortality in Brazil, 1998–2010. Am J Public Health 105(Suppl 4):S593–S599CrossRefPubMedPubMedCentral
Zurück zum Zitat Hone T, Rasella D, Barreto M, Atun R, Majeed A, Millett C (2017a) Large reductions in amenable mortality associated with Brazil’s primary care expansion and strong health governance. Health Aff (Millwood) 36(1):149–158CrossRef Hone T, Rasella D, Barreto M, Atun R, Majeed A, Millett C (2017a) Large reductions in amenable mortality associated with Brazil’s primary care expansion and strong health governance. Health Aff (Millwood) 36(1):149–158CrossRef
Zurück zum Zitat Hone T, Rasella D, Barreto ML, Majeed A, Millett C (2017b) Association between expansion of primary healthcare and racial inequalities in mortality amenable to primary care in Brazil: a national longitudinal analysis. PLoS Med 14(5):e1002306CrossRefPubMedPubMedCentral Hone T, Rasella D, Barreto ML, Majeed A, Millett C (2017b) Association between expansion of primary healthcare and racial inequalities in mortality amenable to primary care in Brazil: a national longitudinal analysis. PLoS Med 14(5):e1002306CrossRefPubMedPubMedCentral
Zurück zum Zitat Lustig N, Lopez-Calva LF, Ortiz-Juarez E (2012) Declining inequality in Latin America in the 2000s: the cases of Argentina, Brazil, and Mexico. World Bank, WashingtonCrossRef Lustig N, Lopez-Calva LF, Ortiz-Juarez E (2012) Declining inequality in Latin America in the 2000s: the cases of Argentina, Brazil, and Mexico. World Bank, WashingtonCrossRef
Zurück zum Zitat Macinko J, Dourado I, Aquino R, Bonolo PF, Lima-Costa MF, Medina MG, Mota E, de Oliveira VB, Turci MA (2010) Major expansion of primary care in Brazil linked to decline in unnecessary hospitalization. Health Aff (Millwood) 29(12):2149–2160CrossRef Macinko J, Dourado I, Aquino R, Bonolo PF, Lima-Costa MF, Medina MG, Mota E, de Oliveira VB, Turci MA (2010) Major expansion of primary care in Brazil linked to decline in unnecessary hospitalization. Health Aff (Millwood) 29(12):2149–2160CrossRef
Zurück zum Zitat MacIntyre S, MacIver S, Sooman A (1993) Area, class and health: should we be focusing on places or people? J Soc Psychol 22(2):213–234 MacIntyre S, MacIver S, Sooman A (1993) Area, class and health: should we be focusing on places or people? J Soc Psychol 22(2):213–234
Zurück zum Zitat Martins AP, Monteiro CA (2016) Impact of the Bolsa Família program on food availability of low-income Brazilian families: a quasi experimental study. BMC Public Health 16(1):827CrossRefPubMedPubMedCentral Martins AP, Monteiro CA (2016) Impact of the Bolsa Família program on food availability of low-income Brazilian families: a quasi experimental study. BMC Public Health 16(1):827CrossRefPubMedPubMedCentral
Zurück zum Zitat Massuda A, Hone T, Leles FAG, de Castro MC, Atun R (2018) The Brazilian health system at crossroads: progress, crisis and resilience. BMJ Glob Health 3(4):e000829CrossRefPubMedPubMedCentral Massuda A, Hone T, Leles FAG, de Castro MC, Atun R (2018) The Brazilian health system at crossroads: progress, crisis and resilience. BMJ Glob Health 3(4):e000829CrossRefPubMedPubMedCentral
Zurück zum Zitat Melo FLB, Figueiredo A, Mineiro AS, Mendonça SEA (2012) Rescuing the minimum wage as a tool for development in Brazil. Int J Labour Res 4(1):27–44 Melo FLB, Figueiredo A, Mineiro AS, Mendonça SEA (2012) Rescuing the minimum wage as a tool for development in Brazil. Int J Labour Res 4(1):27–44
Zurück zum Zitat Murphy M, Bobak M, Nicholson A, Rose R, Marmot M (2006) The widening gap in mortality by educational level in the Russian Federation, 1980–2001. Am J Public Health 96(7):1293–1299CrossRefPubMedPubMedCentral Murphy M, Bobak M, Nicholson A, Rose R, Marmot M (2006) The widening gap in mortality by educational level in the Russian Federation, 1980–2001. Am J Public Health 96(7):1293–1299CrossRefPubMedPubMedCentral
Zurück zum Zitat Neri MC (2007) Pobreza e políticas sociais na década da redução da desigualdade. Nueva Sociedade 3:53–73 Neri MC (2007) Pobreza e políticas sociais na década da redução da desigualdade. Nueva Sociedade 3:53–73
Zurück zum Zitat Nery JS, Pereira SM, Rasella D, Penna ML, Aquino R, Rodrigues LC, Barreto ML, Penna GO (2014) Effect of the Brazilian conditional cash transfer and primary health care programs on the new case detection rate of leprosy. PLoS Negl Trop Dis 8(11):e3357CrossRefPubMedPubMedCentral Nery JS, Pereira SM, Rasella D, Penna ML, Aquino R, Rodrigues LC, Barreto ML, Penna GO (2014) Effect of the Brazilian conditional cash transfer and primary health care programs on the new case detection rate of leprosy. PLoS Negl Trop Dis 8(11):e3357CrossRefPubMedPubMedCentral
Zurück zum Zitat Nery JS, Rodrigues LC, Rasella D, Aquino R, Barreira D, Torrens AW, Boccia D, Penna GO, Penna MLF, Barreto ML, Pereira SM (2017) Effect of Brazil’s conditional cash transfer programme on tuberculosis incidence. Int J Tuberc Lung Dis 21(7):790–796CrossRefPubMedPubMedCentral Nery JS, Rodrigues LC, Rasella D, Aquino R, Barreira D, Torrens AW, Boccia D, Penna GO, Penna MLF, Barreto ML, Pereira SM (2017) Effect of Brazil’s conditional cash transfer programme on tuberculosis incidence. Int J Tuberc Lung Dis 21(7):790–796CrossRefPubMedPubMedCentral
Zurück zum Zitat Östergren O, Martikainen P, Lundberg O (2018) The contribution of alcohol consumption and smoking to educational inequalities in life expectancy among Swedish men and women during 1991–2008. Int J Public Health 63(1):41–48CrossRefPubMed Östergren O, Martikainen P, Lundberg O (2018) The contribution of alcohol consumption and smoking to educational inequalities in life expectancy among Swedish men and women during 1991–2008. Int J Public Health 63(1):41–48CrossRefPubMed
Zurück zum Zitat Paim J, Travassos C, Almeida C, Bahia L, Macinko J (2011) The Brazilian health system: history, advances, and challenges. Lancet 377(9779):1778–1797CrossRefPubMed Paim J, Travassos C, Almeida C, Bahia L, Macinko J (2011) The Brazilian health system: history, advances, and challenges. Lancet 377(9779):1778–1797CrossRefPubMed
Zurück zum Zitat Pearce J, Dorling D (2006) Increasing geographical inequalities in health in New Zealand, 1980–2001. Int J Epidemiol 35(3):597–603CrossRefPubMed Pearce J, Dorling D (2006) Increasing geographical inequalities in health in New Zealand, 1980–2001. Int J Epidemiol 35(3):597–603CrossRefPubMed
Zurück zum Zitat Pochman M (2010) Social structure in Brazil: recent changes. Serv Soc Soc 104:637–649CrossRef Pochman M (2010) Social structure in Brazil: recent changes. Serv Soc Soc 104:637–649CrossRef
Zurück zum Zitat Programa das Nações Unidas para o Desenvolvimento (PNUD) (2013) Instituto de Pesquisa Econômica Aplicada (Ipea), Fundação João Pinheiro (FJP). Atlas de Desenvolvimento Humano Formosa, PNUD, Ipea, FJP Programa das Nações Unidas para o Desenvolvimento (PNUD) (2013) Instituto de Pesquisa Econômica Aplicada (Ipea), Fundação João Pinheiro (FJP). Atlas de Desenvolvimento Humano Formosa, PNUD, Ipea, FJP
Zurück zum Zitat Rasella D, Aquino R, Santos CA, Paes-Sousa R, Barreto ML (2013) Effect of a conditional cash transfer programme on childhood mortality: a nationwide analysis of Brazilian municipalities. Lancet 382(9886):57–64CrossRefPubMed Rasella D, Aquino R, Santos CA, Paes-Sousa R, Barreto ML (2013) Effect of a conditional cash transfer programme on childhood mortality: a nationwide analysis of Brazilian municipalities. Lancet 382(9886):57–64CrossRefPubMed
Zurück zum Zitat Rasella D, Basu S, Hone T, Paes-Sousa R, Ocké-Reis CO, Millett C (2018) Child morbidity and mortality associated with alternative policy responses to the economic crisis in Brazil: a nationwide microsimulation study. PLoS Med 15(5):e1002570CrossRefPubMedPubMedCentral Rasella D, Basu S, Hone T, Paes-Sousa R, Ocké-Reis CO, Millett C (2018) Child morbidity and mortality associated with alternative policy responses to the economic crisis in Brazil: a nationwide microsimulation study. PLoS Med 15(5):e1002570CrossRefPubMedPubMedCentral
Zurück zum Zitat Richardson EA, Pearce J, Mitchell R, Shortt NK, Tunstall H (2014) Have regional inequalities in life expectancy widened within the European Union between 1991 and 2008? Eur J Public Health 24(3):357–363CrossRefPubMed Richardson EA, Pearce J, Mitchell R, Shortt NK, Tunstall H (2014) Have regional inequalities in life expectancy widened within the European Union between 1991 and 2008? Eur J Public Health 24(3):357–363CrossRefPubMed
Zurück zum Zitat Riley JC (2005) Estimates of regional and global life expectancy, 1800–2001. Popul Dev Rev 31(3):537–543CrossRef Riley JC (2005) Estimates of regional and global life expectancy, 1800–2001. Popul Dev Rev 31(3):537–543CrossRef
Zurück zum Zitat Serrano F, Summa R (2012) Macroeconomic policy, growth and income distribution in the Brazilian economy in the 2000s. Investig Econ 71(282):55–92 Serrano F, Summa R (2012) Macroeconomic policy, growth and income distribution in the Brazilian economy in the 2000s. Investig Econ 71(282):55–92
Zurück zum Zitat Shei A, Costa F, Reis MG, Ko AI (2014) The impact of Brazil’s Bolsa Família conditional cash transfer program on children’s health care utilization and health outcomes. BMC Int Health Hum Rights 14:10CrossRefPubMedPubMedCentral Shei A, Costa F, Reis MG, Ko AI (2014) The impact of Brazil’s Bolsa Família conditional cash transfer program on children’s health care utilization and health outcomes. BMC Int Health Hum Rights 14:10CrossRefPubMedPubMedCentral
Zurück zum Zitat Son M, Cho Y, Oh J, Kawachi I, Yi J, Kwon S (2012) Social inequalities in life expectancy and mortality during the transition period of economic crisis (1993–2010) in Korea. Int J Equity Health 21(11):71CrossRef Son M, Cho Y, Oh J, Kawachi I, Yi J, Kwon S (2012) Social inequalities in life expectancy and mortality during the transition period of economic crisis (1993–2010) in Korea. Int J Equity Health 21(11):71CrossRef
Zurück zum Zitat Spiteri J, von Brockdorff P (2019) Economic development and health outcomes: evidence from cardiovascular disease mortality in Europe. Soc Sci Med 30(224):37–44CrossRef Spiteri J, von Brockdorff P (2019) Economic development and health outcomes: evidence from cardiovascular disease mortality in Europe. Soc Sci Med 30(224):37–44CrossRef
Zurück zum Zitat Vaitsman J, Paes-Sousa R (2007) Avaliação de Políticas e Programas do MDS: Resultados: Bolsa Família e Assistência Social. MDS, Brasília Vaitsman J, Paes-Sousa R (2007) Avaliação de Políticas e Programas do MDS: Resultados: Bolsa Família e Assistência Social. MDS, Brasília
Zurück zum Zitat Wiesebron M (2014) Social policies during the Lula administration: the conditional cash transfer program Bolsa Família. In: de Castro F, Koonings K, Wiesebron M (eds) Brazil under the workers’ party. Palgrave Macmillan, London Wiesebron M (2014) Social policies during the Lula administration: the conditional cash transfer program Bolsa Família. In: de Castro F, Koonings K, Wiesebron M (eds) Brazil under the workers’ party. Palgrave Macmillan, London
Zurück zum Zitat World Health Organization (WHO) (2016) World health statistics: monitoring health for the SDGs, sustainable development goals. WHO, Geneva, p 2016 World Health Organization (WHO) (2016) World health statistics: monitoring health for the SDGs, sustainable development goals. WHO, Geneva, p 2016
Zurück zum Zitat World Health Organization (WHO) (2017) World health statistics: monitoring health for the SDGs, sustainable development goals. World Health Organization, Geneva, p 2017 World Health Organization (WHO) (2017) World health statistics: monitoring health for the SDGs, sustainable development goals. World Health Organization, Geneva, p 2017
Metadaten
Titel
Reducing socioeconomic inequalities in life expectancy among municipalities: the Brazilian experience
verfasst von
Antonio Fernando Boing
S. V. Subramanian
Alexandra Crispim Boing
Publikationsdatum
07.05.2019
Verlag
Springer International Publishing
Erschienen in
International Journal of Public Health / Ausgabe 5/2019
Print ISSN: 1661-8556
Elektronische ISSN: 1661-8564
DOI
https://doi.org/10.1007/s00038-019-01244-x

Weitere Artikel der Ausgabe 5/2019

International Journal of Public Health 5/2019 Zur Ausgabe