Cerebrovascular Disease Mortality Trend in Brazil (1996 To 2015) and Association with Human Development Index and Social Vulnerability

Souza, Carlos Dornels Freire de; Oliveira, Denilson José de; Silva, Leonardo Feitosa da; Santos, Camila Damasceno dos; Pereira, Monaliza Coelho; Paiva, João Paulo Silva de; Leal, Thiago Cavalcanti; Mariano, Renato de Souza; Araújo, Amanda Karine Barros Ferreira de; Baggio, Jussara Almeida de Oliveira

doi:10.36660/abc.20190532

Carlos Dornels Freire de Souza

Universidade Federal de Alagoas - Campus Arapiraca, Arapiraca, AL - Brazil

https://orcid.org/0000-0001-7995-1893

Denilson José de Oliveira

Faculdade São Francisco de Juazeiro, Juazeiro, BA - Brazil

Leonardo Feitosa da Silva

Universidade Federal de Alagoas - Campus Arapiraca, Arapiraca, AL - Brazil

Camila Damasceno dos Santos

Faculdade São Francisco de Juazeiro, Juazeiro, BA - Brazil

Monaliza Coelho Pereira

Faculdade São Francisco de Juazeiro, Juazeiro, BA - Brazil

João Paulo Silva de Paiva

Universidade Federal de Alagoas - Campus Arapiraca, Arapiraca, AL - Brazil

Thiago Cavalcanti Leal

Universidade Federal de Alagoas - Campus Arapiraca, Arapiraca, AL - Brazil

Renato de Souza Mariano

Instituto de Medicina Integral Professor Fernando Figueira – UPAE, Petrolina, RE - Brazil

Amanda Karine Barros Ferreira de Araújo

Universidade Federal de Alagoas - Campus Arapiraca, Arapiraca, AL - Brazil

Jussara Almeida de Oliveira Baggio

Universidade Federal de Alagoas - Campus Arapiraca, Arapiraca, AL - Brazil

Mailing Address: Carlos Dornels Freire de Souza • Universidade Federal de Alagoas - Campus Arapiraca – Medicina – Av. Manoel Severino Barbosa. Postal Code 57309-005, Arapiraca, AL – Brazil E-mail: carlos.freire@arapiraca.ufal.br

Author contributions

Conception and design of the research: Souza CDF, Santos CD, Pereira MC, Paiva JPS, Leal TC, Silva LF, Araújo AKBF; Acquisition of data: Souza CDF, Silva LF, Mariano RS, Paiva JPS; Analysis and interpretation of the data, Writing of the manuscript and Critical revision of the manuscript for intellectual content: Souza CDF, Santos CD, Pereira MC, Paiva JPS, Leal TC, Silva LF, Araújo AKBF, Baggio JAO, Oliveira DJ, Mariano RS; Statistical analysis: Souza CDF, Silva LF.

Potential Conflict of Interest

No potential conflict of interest relevant to this article was reported.

Variables	Male n= 938044 (50.68%)		Female n= 912202 (49.29%)		Unknown n= 565 (0.03%)		Total of Deaths n= 1850811 (100%)
Variables	n	%	n	%	n	%	n	%
Age range
0-4	1012	55.95	793	43.83	4	0.22	1809	1.00
5-9	565	53.25	496	46.75	0	0.00	1061	0.06
10-14	999	54.44	834	45.45	2	0.11	1835	0.10
15-19	1998	55.27	1616	44.70	1	0.03	3615	0.20
20-29	7158	52.66	6426	47.27	10	0.07	13594	0.73
30-39	21278	50.09	21186	49.87	17	0.04	42481	2.30
40-49	62652	50.98	60217	48.99	37	0.03	122906	6.64
50-59	124934	56.74	95185	43.23	65	0.03	220184	11.90
60-69	200551	57.92	145578	42.05	106	0.03	346235	18.71
70-79	268228	53.12	236627	46.85	135	0.03	504990	27.28
80 and over	246717	41.89	342104	58.09	124	0.02	588945	31.81
Unknown age	1952	61.85	1140	36.12	64	2.03	3156	0.17
Years of study
Illiterate	162163	42.91	215672	57.07	90	0.02	377925	20.42
1-3 years	192038	53.15	169257	46.84	13	0.01	361308	19.52
4-7 years	126285	53.86	108156	46.13	11	0.01	234452	12.67
8-11 years	54461	54.17	46075	45.83	6	0.01	100542	5.43
12 years and more	29083	57.64	21369	42.35	4	0.01	50456	2.73
1-8 years *	4868	53.92	4158	46.06	2	0.02	9028	0.49
9-11 years *	4551	54.08	3860	45.87	4	0.05	8415	0.45
Unknown	364595	51.45	343655	48.49	435	0.06	708685	38.29
Marital status
Single	163672	47.22	182828	52.75	87	0.03	346587	18.73
Married	499651	67.31	242565	32.67	143	0.02	742359	40.11
Widowed	152794	28.22	388484	71.76	124	0.02	541402	29.25
Divorced	40958	59.29	28116	40.70	6	0.01	69080	3.73
Other	12235	64.02	6875	35.97	1	0.01	19111	1.03
Unknown	68734	51.96	63334	47.88	204	0.16	132272	7.15

Spatial Unit	Both genders			Male			Female
	Rate¹		AAPC (CI 95%) p value	Rate¹		AAPC (CI 95%) p value	Rate¹		AAPC (CI 95%) p value
	1996	2015	AAPC (CI 95%) p value	1996	2015	AAPC (CI 95%) p value	1996	2015	AAPC (CI 95%) p value
North	50.5	58.6	0.4* (0.1 to 0.8); p<0.001	51.0	61.6	0.7* (0.3 to 1.1); p<0.001	52.6	58.6	0.1 (-0.3 to 0.5); p=0.6
RO	68.2	51.4	-1.8* (-2.2 to -1.8); p<0.001	65.9	53.3	1.6* (-2.3 to -1.0); p<0.001	74.2	51.5	-1.9*(-2.3 to -1.4); p<0.001
AC	57.4	63.1	-0.1 (-1.9 to 1.7); p=0.9	59.5	62.7	0.4 (-2.3 to 3.1); p=0.8	58.7	66.9	0.4 (-4.3 to 5.4); p=0.9
AM	49.7	56.1	0.6* (0.2 to 1.1); p<0.001	49.7	58.0	0.9* (0.2 to 1.5); p<0.001	52.7	57.3	0.4 (-0.1 to 1.0); p=0.1
RR	75.5	46.8	-2.2* (-3.0 to -1.3); p<0.001	92.0	50.7	-2.0* (-3.6 to -0.4); p<0.001	56.4	44.2	-2.3*(-3.3 to -1.3); p<0.001
PA	46.3	61.8	1.2 (-0.8 to 3.4); p=0.2	45.7	66.0	1.9 (-0.3 to 4.1); p=0.1	49.5	60.8	0.1 (-2.0 to 2.2); p=0.9
AP	79.5	49.2	-1.7 (-7.8 to 4.9); p=0.6	77.1	54.3	-0.8 (-4.8 to 3.5); p=0.7	86.2	46.6	-1.2 (-3.8 to 1.5); p=0.4
TO	43.4	59.3	1.9* (0.9 to 2.9); p<0.001	48.0	60.1	1.4 (-1.3 to 4.3); p=0.3	40.0	60.7	2.3* (0.7 to 3.9); p<0.001
Northeast	45.4	54.4	0.9 (-0.7 to 2.4); p=0.3	46.8	60.7	1.3 (-0.3 to 2.9); p=0.1	46.7	52.7	0.6 (-1.1 to 2.3); p=0.5
MA	29.0	68.2	4.6* (2.0 to 7.4); p<0.001	31.7	76.6	4.7* (2.5 to 7.0); p<0.001	27.2	64.8	4.3* (1.6 to 7.0); p<0.001
PI	33.3	76.9	3.9* (2.9 to 4.8); p<0.001	35.0	90.4	4.2* (2.9 to 5.5); p<0.001	33.0	70.3	4.0* (3.0 to 4.9); p<0.001
CE	42.0	55.1	1.3 (-0.2 to 2.8); p=0.1	43.5	62.6	1.7* (0.2 to 3.2); p<0.001	42.8	52.1	0.7 (-0.2 to 1.6); p=0.1
RN	33.0	38.0	0.9 (-0.1 to 1.8); p=0.1	34.4	43.7	1.3* (0.2 to 2.5); p<0.001	33.0	35.6	-0.4 (-0.8 to 1.5); p=0.5
PB	37.5	48.5	1.7* (0.4 to 3.0); p<0.001	39.0	52.2	1.9* (0.3 to 3.4); p<0.001	38.4	48.6	1.4 (-0.1 to 2.8); p=0.1
PE	64.8	58.0	-0.8 (-2.2 to 0.6); p=0.3	68.1	66.6	-0.4 (-1.0 to 0.2); p=0.2	65.9	55.2	-1.1 (-2.6 to 0.4); p=0.1
AL	55.5	69.3	0.8* (0.2 to 1.5); p<0.001	57.8	77.7	1.2* (0.6 to 1.8); p<0.001	57.1	66.9	0.5 (-0.5 to 1.5); p=0.3
SE	41.8	57.6	1.7* (1.0 to 2.3); p<0.001	45.7	64.7	1.9* (1.0 to 2.9); p<0.001	40.2	55.6	1.5* (0.5 to 2.5); p<0.001
BA	47.7	45.2	-0.0 (-0.6 to 0.5); p=0.9	47.4	47.5	0.2 (-0.3 to 0.8); p=0.4	51.0	46.2	-0.2 (-0.8 to 0.3); p=0.4
Midwest	69.5	46.3	-2.8* (-3.4 to -2.2); p<0.001	72.2	49.2	-2.7* (-3.3 to -2.2); p<0.001	69.1	46.2	-2.3 (-4.8 to 0.2); p=0.1
MS	76.9	52.9	-2.4* (-2.9 to -2.0); p<0.001	83.9	54.5	-2.4* (-3.0 to -1.8); p<0.001	73.1	54.5	-2.4* (-2.8 to 1.9); p<0.001
MT	65.7	44.2	-1.9* (-3.0 to -0.8); p<0.001	66.3	45.6	-2.1* (-3.5 to -0.6); p<0.001	67.6	44.8	-2.5*(-3.2 to -1.9); p<0.001
GO	64.2	46.2	-2.2* (-2.6 to -1.8); p<0.001	66.0	49.7	-1.6* (-2.7 to -0.4); p<0.001	65.1	45.6	-2.2 (-2.6 to -1.8); p<0.001
DF	81.3	41.6	-4.0* (-4.6 to -3.5); p<0.001	91.6	46.4	-4.0* (-4.6 to -3.4); p<0.001	77.2	40.5	-3.4 (-5.4 to -1.3); p<0.001
Southeast	86.1	41.4	-3.8* (-4.1 to -3.4); p<0.001	96.3	45.8	-3.8* (-4.2 to -3.5); p<0.001	82.3	40.2	-3.8*(-4.2 to -3.4); p<0.001
MG	74.1	39.3	-3.2* (-3.5 to -2.9); p<0.001	81.0	41.5	-3.3* (-3.7 to -3.0); p<0.001	71.5	39.5	-3.0*(-3.3 to -2.8); p<0.001
ES	98.4	46.7	-3.6* (-4.3 to -2.9); p<0.001	108.7	51.7	-3.5* (-4.0 to -3.1); p<0.001	94.2	45.1	-3.5*(-4.2 to -2.8); p<0.001
RJ	101.6	42.3	-4.5* (-5.3 to -3.7); p<0.001	113.8	47.9	-4.3* (-4.9 to -3.7); p<0.001	97.7	40.7	-4.5*(-5.8 to -3.2); p<0.001
SP	84.3	41.7	-3.8* (-4.2 to -3.4); p<0.001	95.8	46.7	-3.8* (-4.0 to -3.5); p<0.001	79.4	40.1	-3.8*(-4.0 to -3.5); p<0.001
South	91.0	45.9	-3.7* (-4.1 to -3.2); p<0.001	96.9	49.5	-3.7* (-4.1 to -3.2); p<0.001	91.3	45.6	-3.6*(-4.0 to -3.2); p<0.001
PR	98.9	49.9	-3.8* (-4.1 to -3.6); p<0.001	108.0	55.3	-3.8* (-4.1 to -3.5); p<0.001	95.5	48.0	-3.8*(-4.1 to -3.5); p<0.001
SC	89.1	37.7	-4.4* (-4.8 to -4.0); p<0.001	94.4	39.7	-3.9* (-5.9 to -2.0); p<0.001	89.5	38.2	-4.3*(-4.7 to -3.9); p<0.001
RS	86.1	46.5	-3.1* (-4.2 to -1.9); p<0.001	88.9	49.4	-3.0* (-3.6 to -2.3); p<0.001	89.3	47.0	-3.4*(-4.1 to -2.6); p<0.001

Spatial unit	Both genders		Male		Female
Spatial unit	Period	AAPC (95% CI) p value	Period	AAPC (CI 95%) p value	Period	AAPC (95% CI) p value
North	1996-2015	0.4* (0.0 to 0.8); p<0.001	1996-2015	0.7* (0.3 to 1.1); p<0.001	1996-2015	0.1 (-0.3 to 0.5); p=0.6
RO	1996-2015	-1.8*(-2.2 to -1.8) ; p<0.001	1996-2015	1.6* (-2.3 to -1.0); p<0.001	1996-2015	-1.9* (-2.3 to -1.4); p<0.001
AC	1996-1999	-16.2 (-30.7 to 1.4); p=0.1	1996-2002	-5.6 *(-9.4 to -1.7); p<0.001	1996-1999	-16.2 (-30.7 to 1.4); p=0.1
	1999-2006	9.9* (3.1 to 17.2); p<0.001	2002-2006	13.2* (0.5 to 27.5); p<0.001	1999-2006	9.9* (3.1 to 17.2); p<0.001
	2006-2011	-6.4 (-17 to 5.6); p=0.2	2006-2015	-0.8 (-2.9 to 1.4); p=0.4	2006-2011	-6.4 (-17.0 to 5.6); p=0.2
	2011-2015	7.1 (-5.0 to 20.8); p=0.2	2006-2015	-0.8 (-2.9 to 1.4); p=0.4	2011-2015	7.1 (-5.0 to 30.8); p=0.2
AM	1996-2015	0.6* (0.2 to 1.1); p<0.001	1996-2015	0.9* (0.2 to 1.5); p<0.001	1996-2015	0.4 (-0.1 to 1.0); p=0.1
RR	1996-2015	-2.2* (-3.0 to -1.3); p<0.001	1996-2015	-2.0* (-3.6 to -0.4); p<0.001	1996-2015	-2.3* (-3.3 to -1.3); p<0.001
PA	1996-2004	-0.8 (-2.9 to 1.2); p=0.9	1996-1998	11.6 (-1.1 to 25.9); p=0.1	1996-2004	-0.8 (-2.9 to 1.2); p=0.4
	2004-2008	6.3 (-3.3 to 16.8); p=1.4	1998-2001	-4.2 (-15.1 to 8.2); p=0.4	1996-2004	-0.8 (-2.9 to 1.2); p=0.4
	2008-2015	-2.3 (-4.7 to 0.2); p=-2.0	2001-2008	4.3* (2.2 to 6.4); p<0.001	2004-2008	6.3 (-3.3 to 16.8); p=0.2
	2008-2015	-2.3 (-4.7 to 0.2); p=-2.0	2008-2015	-0.5 (-2.1 to 1.2); p=0.5	2008-2015	-2.3 (-4.7 to 0.2); p=0.1
AP	1996-2007	-5.8* (-8.8 to -2.7); p=0.6	1996-2002	1.9 (-4.3 to 8.4); p=0.5	1996-2007	-5.8* (-8.8 to -2.7); p<0.001
	2007-2015	5.5* (0.1 to 11.3); p<0.001	2002-2006	-11.1 (-26.1 to 7.0); p=0.2	2007-2015	5.5* (0.1 to 11.3); p<0.001
	2007-2015	5.5* (0.1 to 11.3); p<0.001	2006-2015	2.4 (-1.0 to 5.9); p=0.2	2007-2015	5.5* (0.1 to 11.3); p<0.001
TO	1996-2003	11.6* (7.5 to 15.8); p<0.001	1996-2000	3.1 (-2.5 to 8.9); p=0.3	1996-2003	11.6* (7.5 to 15.8); p<0.001
	2003-2015	-2.8* (-4.4 to -1.1); p<0.001	2000-2003	15.3 (-3.1 to 37.3); p=0.1	2003-2015	-2.8* (-4.4 to -1.1); p<0.001
	2003-2015	-2.8* (-4.4 to -1.1); p<0.001	2003-2015	-2.3* (-3.3 to -1.3); p<0.001	2003-2015	-2.8* (-4.4 to -1.1); p<0.001
Northeast	1996-2003	1.7* (0.5 to 2.9); p=0.3	1996-2003	2.1* (-0.9 to 3.3); p=0.1	1996-2003	1.4* (0.1 to 2.7); p<0.001
	2003-2006	7.4 (-1.5 to 17.2); p=1.9	2003-2006	6.6 (-2.3 to 16.4); p=0.1	2003-2006	8.3 (-1.5 to 19.1); p=0.1
	2006-2010	-4.5* (-8.5 to -0.2); p=0.3	2006-2010	-3.7 (-7.8 to 0.6); p=0.1	2006-2010	-5.1* (-9.5 to -0.5); p<0.001
	2010-2015	0.3 (-1.7 to 2.2); p=0.3	2010-2015	1.1 (-0.9 to 3.1); p=0.2	2010-2015	-0.4 (-2.5 to 1.8); p=0.7
MA	1996-2006	4.5* (2.2 to 6.9); p<0.001	1996-2000	0.1 (-7.1 to 7.8); p=1.0	1996-2003	4.5* (2.2 to 6.9); p<0.001
	2003-2006	18.3 (-0.2 to 40.2); p=0.1	2000-2007	13.4* (8.9 to 18.0); p<0.001	2003-2006	18.3 (-0.2 to 40.2); p=0.1
	2006-2015	-0.2 (-1.7 to 1.4); p=0.8	2007-2015	-0.1 (-2.6 to 2.6); p=1.0	2006-2015	-0.2 (-1.7 to 1.4); p=0.8
PI	1996-2006	8.9* (7.6 to 10.3); p<0.001	1996-2007	8.4* (6.8 to 10.1); p<0.001	1996-2006	8.9* (7.6 to 10.3); p<0.001
PI	2006-2015	-1.3 (-2.7 to 0.2); p=0.1	2007-2015	-1.4 (-3.7 to 1.1); p=0.2	2006-2015	-1.3 (-2.7 to 0.2); p=0.1
CE	1996-2007	2.8* (1.7 to 3.9); p<0.001	1996-1998	11.5 (-2.2 to 27.0); p=0.1	1996-2007	2.8* (1.7 to 3.9); p<0.001
	2007-2015	-2.2* (-3.9 to -0.4); p<0.001	1998-2008	2.0* (0.8 to 3.2); p<0.001	2007-2015	-2.2* (-3.9 to -0.4); p<0.001
	2007-2015	-2.2* (-3.9 to -0.4); p<0.001	2008-2015	-1.2 (-2.9 to 0.5); p=0.1	2007-2015	-2.2* (-3.9 to -0.4); p<0.001
RN	1996-2009	2.4* (1.4 to 3.5); p<0.001	1996-2008	4.2* (2.9 to 5.4); p<0.001	1996-2009	2.4* (1.4 to 3.5); p<0.001
RN	2009-2015	-3.9* (-7.0 to -0.6); p<0.001	2008-2015	-3.3* (-5.9 to -0.6); p<0.001	2009-2015	-3.9* (-7.0 to -0.6); p<0.001
PB	1996-1998	-11.8*(-22.1 to 0.0); p<0.001	1996-1999	-5.5 (-12.3 to 2.3); p=0.1	1996-1998	-11.8* (-22.1 to 0.0); p<0.001
	1998-2007	8.9* (7.4 to 10.4); p<0.001	1999-2007	10.6* (8.3 to 13.0); p<0.001	1998-2007	8.9* (7.4 to 10.4); p<0.001
	2007-2015	-3.1* (-4.4 to -1.8); p<0.001	2007-2015	-3.5* (-5.1 to -1.8); p<0.001	2007-2015	-3.1* (-4.4 to -1.8); p<0.001
PE	1996-1998	5.1 (-2.8 to 13.7); p=0.2	1996-2006	1.1* (0.3 to 2.0); p<0.001	1996-1998	5.1 (-2.8 to 13.7); p=0.2
	1998-2001	-6.0 (-13.1 to 1.7); p=0.1	2006-2015	-2.0* (-3.0 to -1.1); p<0.001	1998-2001	-6.0 (-13.1 to 1.7); p=0.1
	2001-2005	4.9* (0.9 to 9.1); p<0.001			2001-2005	4.9* (0.9 to 9.1); p<0.001
	2005-2015	-3.2* (-3.8 to -2.6); p<0.001			2005-2015	-3.2* (-3.8 to -2.6); p<0.001
AL	1996-2007	2.4* (1.2 to 3.7); p<0.001	1996-2007	3.2* (2.4 to 4.0); p<0.001	1996-2007	2.4* (1.2 to 3.7); p<0.001
AL	2007-2015	-2.1 (-4.0 to -0.1); p<0.001	2007-2015	-1.5* (-2.7 to -0.3); p<0.001	2007-2015	-2.1* (-4.0 to -0.1); p<0.001
SE	1996-2005	5.7* (4.0 to 7.5); p<0.001	1996-2005	5.8* (4.1 to 7.4); p<0.001	1996-2005	5.7* (4.0 to 7.5); p<0.001
SE	2005-2015	-2.1* (-3.5 to -0.7); p<0.001	2005-2015	-1.4* (-2.7 to -0.1); p<0.001	2005-2015	-2.1* (-3.5 to -0.7); p<0.001
BA	1996-2015	-0.0 (-0.6 to 0.5); p=0.9	1996-2015	0.2 (-0.3 to 0.8); p=0.4	1996-2015	-0.2 (-0.8 to 0.3); p=0.4
Midwest	1996-2015	-2.8* (-3.4 to -2.2); p<0.001	1996-2015	-2.7* (-3.3 to -2.2); p<0.001	1996-2005	-0.5 (-2.0 to 1.0); p=0.5
					2005-2008	-0.9 (-23.1 to 7.7); p=0.2
					2008-2015	-1.6 (-3.8 to 0.6); p=0.1
MS	1996-2015	-2.4* (-2.9 to -2.0); p<0.001	1996-2015	-2.4* (-3.0 to -1.8); p<0.001	1996-2015	-2.4* (-2.8 to 1.9); p<0.001
MT	1996-2015	-1.9* (-3.0 to -0.8); p<0.001	1996-1998	9.7 (-3.5 to 24.6); p=0.1	1996-2015	-2.5* (-3.2 to -1.9); p<0.001
			1998-2010	-2.3* (-3.1 to -1.4); p<0.001
			2010-2015	-5.9* (-8.6 to -3.2); p<0.001
GO	1996-2015	-2.2* (-2.6 to -1.8); p<0.001	1996-1999	2.9 (-3.0 to 9.1); p<0.001	1996-2015	-2.2 (-2.6 to -1.8); p<0.001
			1999-2007	-3.8* (-5.3 to -2.3); p<0.001
			2007-2015	-0.9 (-2.1 to 0.4); p=0.2
DF	1996-1998	5.7 (-14.4 to 30.6); p=0.6	1996-2015	-4.0* (-4.6 to -3.4); p<0.001	1996-1998	5.7 (-14.4 to 30.6); p=0.6
DF	1998-2015	-4.4* (-5.1 to -3.7); p<0.001	1996-2015	-4.0* (-4.6 to -3.4); p<0.001	1998-2015	-4.4* (-5.1 to -3.7); p<0.001
Southeast	1996-2015	-3.8* (-4.1 to -3.4); p<0.001	1996-2015	-3.8* (-4.2 to -3.5); p<0.001	1996-2015	-3.8* (-4.2 to -3.4); p<0.001
MG	1996-2009	-2.6* (-3.2 to -1.9); p<0.001	1996-2015	-3.3* (-3.7 to -3.0); p<0.001	1996-2015	-3.0* (-3.3 to -2.8); p<0.001
MG	2009-2015	-5.5* (-7.4 to -3.5); p<0.001	1996-2015	-3.3* (-3.7 to -3.0); p<0.001	1996-2015	-3.0* (-3.3 to -2.8); p<0.001
ES	1996-2015	-3.6 (-4.3 to -2.9); p<0.001	1996-2015	-3.5* (-4.0 to -3.1); p<0.001	1996-2009	-2.6* (-3.2 to -1.6); p<0.001
ES	1996-2015	-3.6 (-4.3 to -2.9); p<0.001	1996-2015	-3.5* (-4.0 to -3.1); p<0.001	2009-2015	-5.5* (-7.4 to -3.5); p<0.001
RJ	1996-2005	-5.1* (-5.9 to -4.4); p<0.001	1996-2010	-3.9* (-4.4 to -3.5); p<0.001	1996-2005	-5.1* (-5.9 to -4.4); p<0.001
	2005-2008	-0.6 (-8.9 to 8.4); p=0.9	2010-2015	-5.4* (-7.4 to -3.3); p<0.001	2005-2008	-0.6* (-8.9 to 8.4); p<0.001
	2008-2015	-5.4* (-6.5 to -4.3); p<0.001	2010-2015	-5.4* (-7.4 to -3.3); p<0.001	2008-2015	-5.4* (-6.5 to -4.3); p<0.001
SP	1996-2015	-3.8* (-4.2 to -3.4); p<0.001	1996-2015	-3.8* (-4.0 to -3.5); p<0.001	1996-2015	-3.8* (-4.0 to -3.5); p<0.001
South	1996-2015	-3.7* (-4.1 to -3.2); p<0.001	1996-2015	-3.7* (-4.1 to -3.2); p<0.001	1996-2015	-3.6* (-4.0 to -3.2); p<0.001
PR	1996-2015	-3.8* (-4.1 to -3.6); p<0.001	1996-2015	-3.8* (-4.1 to -3.5); p<0.001	1996-2015	-3.8* (-4.1 to -3.5); p<0.001
SC	1996-2015	-4.4* (-4.8 to -4.0); p<0.001	1996-1998	5.2 (-9.2 to 21.9); p=0.5	1996-2015	-4.3* (-4.7 to -3.9); p<0.001
			1998-2002	-8.3*(-14.8 to -1.3); p<0.001
			2002-2015	-3.9* (-4.7 to -3.2); p<0.001
RS	1996-2012	-3.0* (-3.0 to -3.4); p<0.001	1996-1998	4.7 (-0.0 to 9.6); p<0.001	1996-2012	-3.0* (-3.4 to -2.6); p<0.001
	2012-2015	-5.4* (-10.0 to -0.6); p<0.001	1998-2006	-3.9* (-4.5 to -3.3); p<0.001	1996-2012	-3.0* (-3.4 to -2.6); p<0.001
			2006-2010	-1.6 (-3.8 to 0.7); p=0.1	2012-2015	-5.4* (-10.0 to -0.6); p<0.001
			2010-2015	-5.5* (-6.4 to -4.5); p<0.001	2012-2015	-5.4* (-10.0 to -0.6); p<0.001

Variable	Coefficient	t Statistics	p value
Municipal Human Development Index (MHDI)	61.588	2.091	0.046*
MHDI Longevity	90.265	1.866	0.073
MHDI Education	47.075	1.861	0.074
MHDI Income	56.476	2.301	0.029*
Social Vulnerability Index (SVI)	-40.802	-2.353	0.026*
SVI Urban infrastructure	-15.998	-1.110	0.277
SVI Human capital	-31.883	-2.092	0.046*
SVI Income and work	-35.322	-2.528	0.018*

[1] Mailing Address: Carlos Dornels Freire de Souza • Universidade Federal de Alagoas - Campus Arapiraca – Medicina – Av. Manoel Severino Barbosa. Postal Code 57309-005, Arapiraca, AL – Brazil E-mail: carlos.freire@arapiraca.ufal.br

Brasil

Brasil

Cerebrovascular Disease Mortality Trend in Brazil (1996 To 2015) and Association with Human Development Index and Social Vulnerability

Abstract

Background

Objective

Methods

Results

Conclusion