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Mortalidade segundo sua causa de morte e seus determinantes: uma an?lise para as capitais brasileiras e munic?pios do nordeste do Brasil, 2000 e 2010Dantas, Thiago de Medeiros 31 July 2014 (has links)
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Previous issue date: 2014-07-31 / Esta disserta??o foi desenvolvida considerando a elabora??o de dois artigos cient?ficos, ambos
relacionados ? mortalidade no Brasil. No primeiro artigo, objetivou-se analisar a mortalidade
segundo os tr?s grandes grupos de causa de morte nas capitais brasileiras. No segundo artigo,
construiu-se uma tipologia para os munic?pios nordestinos levando em conta informa??es
sobre mortalidade por causas externas e um conjunto de indicadores relacionados aos aspectos
socioecon?micos, demogr?ficos e de infraestrutura de tais munic?pios, ambos artigos para os
anos de 2000 e 2010. Desta forma, utilizaram-se os dados do Sistema de Informa??es sobre
Mortalidade do Minist?rio da Sa?de. Ademais, fez-se uso das informa??es dos Censos
Demogr?ficos para aqueles anos. As vari?veis referentes ?s condi??es socioecon?micas e
demogr?ficas usadas neste trabalho foram aquelas dispon?veis na home-page do Programa das
Na??es Unidas para o Desenvolvimento. Utilizou-se no Artigo 1 o m?todo de distribui??o
pro-rata para realizar a redistribui??o dos ?bitos por causas mal definidas. Ademais, fez-se
uso da t?cnica de analise de cluster com o objetivo de agrupar as capitais que apresentavam
propor??es de ?bitos por causas mal definidas similares entre si.. J? no Artigo 2, utilizaram-se
a t?cnica de estima??o Bayesiana Emp?rica; as t?cnicas de estat?stica espacial e; por fim, o
m?todo Grade of Membership para encontrar tipologias dos munic?pios a partir de
informa??es sobre mortalidade por causas externas associadas ?s vari?veis socioecon?micas,
demogr?ficas e de infraestrutura. Quanto aos principais resultados, destaca-se no Artigo 1
que, em rela??o a qualidade dos dados, observou-se a forma??o de quatro grupos de capitais
similares entre si, quanto a propor??o de causas mal definidas. Com rela??o ao
comportamento da mortalidade, segundo os tr?s grandes grupos de causa de morte, notou-se
tanto para o ano de 2000 como para 2010 a preval?ncia dos ?bitos por doen?as n?o
transmiss?veis para ambos os sexos, apesar de ter sido identificado a redu??o das taxas em
algumas das capitais. As doen?as transmiss?veis se destacaram como a segunda causa de
morte entre as mulheres. Tamb?m, foi poss?vel verificar que os ?bitos por causas externas s?o
respons?veis pela segunda causa de morte entre os homens, al?m de apresentar um aumento
entre as mulheres. J? quanto ao Artigo 2, destaca-se, em linhas gerais, n?o s? uma amplia??o
das taxas de mortalidade por causas externas nos munic?pios, como tamb?m, uma amplia??o
da mancha configuradora de exist?ncia de mortes por causas externas para toda a ?rea da
regi?o Nordeste. Em rela??o ? tipologia dos munic?pios, constru?ram-se tr?s perfis extremos:
o Perfil 1, que congrega munic?pios com altas taxas de mortalidade por causas externas e os
melhores indicadores sociais; o Perfil 2, composto por munic?pios que se caracterizam por
iv
apresentar reduzidas taxas de mortalidade por causas externas e os mais baixos indicadores
sociais; e o Perfil 3, que agrupa munic?pios com intermedi?rias taxas de mortalidade e valores
considerados medianos em rela??o aos indicadores sociais. Embora n?o se tenha verificado
mudan?as nas caracter?sticas dos perfis, observou-se o aumento da propor??o dos munic?pios
que pertencem ao Perfil extremo 3, levando em considera??o os perfis mistos. / This dissertation considered the development of two papers, both related to mortality in
Brazil. In the first article, "The context of mortality according to the three broad groups of
causes of death in Brazilian capitals, 2000 and 2010", the objective was to analyze the
mortality rate according to the three major groups of causes of death in Brazilian capitals. In
the second article, "Typology and characteristics of mortality from external causes in the
municipalities in the Northeast of Brazil, 2000 and 2010", it was built up a typology for the
Northeastern municipalities taking into account information on mortality from external causes
and a set of indicators related to socioeconomic, demographic, and infrastructure aspects of
such municipalities, both articles for the years 2000 and 2010. Thus, we used data from the
Mortality Information System of the Ministry of Health. Furthermore, it was used information
from the Demographic Census for those years. The variables relating to socioeconomic and
demographic conditions used in this study were those available on the home page of the
United Nations Program for Development. The variables relating to socioeconomic and
demographic conditions used in this study were those available on the home page of the
United Nations Program for Development. Was used in Article 1 the pro-rata distribution
method to accomplish the redistribution of ill-defined causes. Moreover, made use of the
technique of cluster analysis with the aim of grouping the capital that had proportions of
deaths from ill-defined causes similar to each other. Already in Section 2, we used the
technique of Empirical Bayesian estimation; spatial statistics technique; and finally, the Grade
of Membership method to find types of municipalities from information on mortality from
external causes associated with socioeconomic, demographic and infrastructure variables. As
the main results, it stands out in Article 1, in relation to data quality, we observed the
formation of four groups of similar capital between themselves, as the proportion of illdefined
causes. Regarding the behavior of mortality, according to the three major groups of
causes of death, it was noted both for 2000 and for 2010 the prevalence of deaths from noncommunicable
diseases for both sexes, although the reduction was identified rates in some of
the capitals. Communicable diseases stood out as the second cause of death among women.
Also, we found that deaths due to external causes are responsible for the second cause of
death among men, as well as presenting an increase among women. As for the Article 2,
stands out, in general, not just an extension of mortality from external causes in the
municipalities, as well as an enlargement of the configurator stain existence of external cause
deaths for the whole area of Northeast. Regarding the typology of municipalities, three
vi
extreme profiles were buit: the profile 1, which comprises municipalities with high rates of
mortality from external causes and the best social indicators; the profile 2, that was composed
of municipalities that are characterized by having low mortality rates from external causes and
the lowest social indicators; and the profile 3, that brings together municipalities with
intermediate mortality rates and median values considered in relation to social indicators.
Although we have not seen changes in the characteristics of the profiles, we observed an
increase in the proportion of municipalities that belong to the extreme profile 3, taking into
account the mixed profiles.
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