Mortality of Bolivian immigrants in São Paulo, Brazil: analysis of avoidable causes

Silveira, Rubens Carvalho; Alencar, Gizelton Pereira; Silva, Zilda Pereira da

doi:10.1590/1413-81232023281.10082022EN

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ARTICLE • Ciênc. saúde coletiva 28 (01) • Jan 2023 • https://doi.org/10.1590/1413-81232023281.10082022EN copy

Mortality of Bolivian immigrants in São Paulo, Brazil: analysis of avoidable causes

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The objective was to analyze the mortality of Bolivian immigrants compared to the Brazilian population, living in the city of São Paulo, with an emphasis on the analysis of avoidable deaths. Descriptive study of deaths in the city of São Paulo, between 2007 and 2018, registered in the Mortality Information System. Deaths of people aged 5 to 74 years were analyzed, according to “Brazilian List of Causes of Preventable Deaths”, according to groups and sex; Pearson’s chi-square test was used to compare nationalities. The temporal trend of avoidable deaths was evaluated by Prais-Winsten regression. There were 1.123 Bolivians deaths and 883.116 among Brazilians, with a predominance of male deaths and the Bolivians died on average 13.6 years younger. The proportion of deaths from preventable causes was similar between Bolivians (71.0%) and Brazilians (72.8%) and the trend did not show significant proportional annual variation for both nationalities. There is a higher frequency, among Bolivians, of external causes (27.6%) and of causes reducible by actions to health promotion, prevention, control, and care for infectious diseases (20.8%) than to Brazilians. Conclusion: Bolivians died younger and showed no reduction in the proportion of potentially avoidable causes, which may indicate unequal access to health services.

Key words:
Immigrants; Cause of death; Mortality premature

Groups	Immigrants		Nonimmigrants*		p-value
Groups	Nº	Prop. (%) 95%CI	Nº	Prop. (%) 95%CI
1.0 - Avoidable causes 5-74 years	595	71.0[67.9;74.1]	377.391	72.8[72.7;72.9]	0.266
1.1 - Causes that could be avoided through immunoprevention actions	12	2.0[0.9;3.2]	519	0.1[0.1;0.2]	<0.001
1.2 - Causes that could be avoided through health promotion actions and adequate infectious disease prevention. control and care	124	20.8[17.6;24.1]	56.871	15.1[15.0;15.2]	<0.001
1.3 - Causes that could be avoided through adequate health promotion. prevention and control actions and non-communicable disease care	273	45.9[41.9;49.9]	255.443	67.7[67.5;67.8]	<0.001
1.4 - Causes that could be avoided through adequate prevention, control, and care of causes of maternal death	22	3.7[2.2;5.2]	1.189	0.3[0.0;0.3]	<0.001
1.5 - Causes that could be avoided through intersectoral, health promotion and prevention actions and adequate external cause care (accidents and violence)	164	27.6[24.0;31.2]	63.369	16.8[16.7;16.9]	<0.001
2.0 - Ill-defined causes of death	22	2.6[1.5;3.7]	7.369	1.4[1.4;1.5]	0.005
3.0 - Unavoidable causes of death	221	26.4[23.4;29.4]	133.809	25.8[25.7;25.9]	0.737
Total	838	100.00	518.569	100.00
Men
1.0 - Avoidable causes 5-74 years	364	72.1[68.2;76.0]	235.878	74.6[74.5;74.8]	0.210
1.1 - Causes that could be avoided through immunoprevention actions	6	1.6[0.3;3.0]	356	0.2[0.1;0.2]	<0.001
1.2 - Causes that could be avoided through health promotion actions and adequate infectious disease prevention, control and care	69	19.0[14.9;23.0]	35.249	14.9[14.8;15.1]	0.038
1.3 - Causes that could be avoided through adequate health promotion, prevention and control actions and non-communicable disease	163	44.8[39.7;49.9]	147.245	62.4[62.2;62.6]	<0.001
1.5 - Causes that could be avoided through intersectoral, health promotion and prevention actions and adequate external cause care (accidents and violence)	126	34.6[29.7;39.5]	53.028	22.5[22.3;22.6]	<0.001
2.0 - Ill-defined causes of death	18	3.7[1.9;5.2]	5.370	1.7[1.7;1.7]	0.002
3.0 - Unavoidable causes of death	123	24.4[20.6;28.1]	74.907	23.7[23.5;23.8]	0.766
Total	505	100.00	316.155	100.00
Women
1.0 - Avoidable causes 5-74 years	231	69.4[64.4;74.3]	141.506	69.9[69.7;70.1]	0.811
1.1 - Causes that could be avoided through immunoprevention actions	6	2.6[0.5;4.7]	163	0.1[0.1;0.1]	<0.001
1.2 - Causes that could be avoided through health promotion actions and adequate infectious disease prevention, control and care	55	23.8[18.3;29.3]	21.621	15.3[15.1;15.5]	<0.001
1.3 - Causes that could be avoided through adequate health promotion, prevention and control actions and non-communicable disease	110	47.6[41.2;54.1]	108.195	76.5[76.2;76.7]	<0.001
1.4 - Causes that could be avoided through adequate prevention, control, and care of causes of maternal death	22 38	9.5[5.7;13.3] 16.4[11.7;21.2]	1.187 10.340	0.8[0.8;0.9] 7.3[7.2;7.4]	<0.001 <0.001
2.0 - Ill-defined causes of death	4	1.2[0.0;2.4]	1.999	1.0[0.9;1.0]	0.907
3.0 - Unavoidable causes of death	98	29.4[24.5;34.3]	58.901	29.1[28.9;29.3]	0.952
Total	333	100.00	202.406	100.00

Groups	Immigrants		Nonimmigrants*		p - value
Groups	Nº	Prop. (%) 95%CI	Nº	Prop. (%) 95%CI
1.2 - Causes that could be avoided through health promotion actions and adequate infectious disease prevention, control and care	124	100.00	56.871	100.00	-
Tuberculosis	32	25.8[18.1;33.5]	3.081	5.4[5.2;5.6]	<0.001
Pneumonia	31	25.0[17.4;32.6]	23.503	41.3[40.9;41.7]	<0.001
Others	61	49.2[40.4;58.0]	30.287	53.3[52.8;53.7]	0.415
1.3 - Causes that could be avoided through adequate health promotion, prevention and control actions and non-communicable disease	273	100.00	255.443	100.00	-
Acute myocardial infarction	31	11.4[7.6;15.1]	42.819	16.8[16.6;16.9]	0.021
Ischaemic heart disease	4	1.5[0.02;2.9]	17.235	6.7[6.7;6.8]	<0.001
Others	238	87.2[83.2;91.1]	195.389	76.5[76.3;76.7]	<0.001
1.5 - Causes that could be avoided through intersectoral, health promotion and prevention actions and adequate external cause care (accidents and violence)	164	100.00	63.369	100.00	-
Transport accidents	43	26.2[19.5;33.0]	15.918	25.1[24.8;25.5]	0.815
Events of undetermined intent	15	9.1[4.7;13.6]	6.834	10.8[10.5;11.0]	0.583
Suicide	15	9.1[4.7;13.6]	6.140	9.7[9.5;9.9]	0.918
Falls	12	7.3[3.3;11.3]	6.667	10.5[14.9;15.5]	0.227
Homicide	7	4.3[1.2;7.4]	1.879	3.0[2.8;3.1]	0.452
Others	72	43.9[36.3;51.5]	25.931	40.9[40.5;41.3]	0.486

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[1] Chief editors:

Romeu Gomes, Antônio Augusto Moura da Silva