eugênia maria s. rodrigues, md, mph, drph vilma pinheiro gawryszewski, md, mpd, phd brazil ministry...
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Eugênia Maria S. Rodrigues, MD, MPH, DrPH
Vilma Pinheiro Gawryszewski, MD, MPD, PhD
Brazil Ministry of Health
Data source:
Mortality: Information Mortality System.
Morbidity: Hospitalization Information System from Public Health System (SIH/SUS).
Ministry of Health Brazil, 2003
• Strengths – Coverage (MIS)– Cause of injury or death (by intent, and
nature of injury)– Demographic data (sex, age, residence)
• Weaknesses – Coverage (HIS)– Cause of injury or death (undetermined
cause of death, unknown intent of injury)– Demographic data (race, education,
occupation)– Data on costs
Sources
Brazil resident population, 2003
FEMALE 89.807.838
51%
MALE 87.068.413
49%
1970 2000
Men Women
Brazil, Population distribution
Source: UN World Population Prospects, 2000 REV
0
1.000.000
2.000.000
3.000.000
4.000.000
5.000.000
6.000.000
7.000.000
8.000.000
9.000.000
10.000.000
< 1
Ye
ar
1-4
Ye
ar
5-9
Ye
ar
10
-14
Ye
ar
15
-19
Ye
ar
20
-24
Ye
ar
25
-29
Ye
ar
30
-34
Ye
ar
35
-39
Ye
ar
40
-44
Ye
ar
45
-49
Ye
ar
50
-54
Ye
ar
55
-59
Ye
ar
60
-64
Ye
ar
65
-69
Ye
ar
70
-74
Ye
ar
75
-79
Ye
ar
80
or
mo
re
Population
Male Female
Population, 2003, Brazil
0
150
300
< 1ano
1 a 4 5 a 9 10 a14
15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75 E+
Male Female
por 100 mil hab.
I Injury mortality rate per gender and age group , Brazil, 2003
Source: Mortality Information System-
Source: Mortality Information System-
583.059
58,2%
Male
1.002.638
418.755
41,8%
Female
All Deaths
126. 749
12,6%
Injury deaths
33.182
26,2%
106.901
84,3%
Male 19.783
15,7%
Female
The burden of injuries in the Brazilian mortality, 2003
MV Injuries
Injury deaths per 100,000 population (Crude rate), 2003, BRAZIL
122,6
22
0
20
40
60
80
100
120
140
MALE FEMALE
per
100
mil
hab.
Source: Information Mortality System/Ministry of Health
Injury morbidity per 100,000 population (Crude rate), 2003, BRAZIL
601,2
249,8
0
100
200
300
400
500
600
700
MALE FEMALE
per
100
mil
hab.
Source: Hospitalization Information System/Ministry of Health
Source: Hospitalization Information System-
4.772.558
40,1%
Male
11.891.497 i
7.118.920
59,9%
Female
All hospitalizations
726.283 7,8%
Injuries
309.460
42,6%
Falls
512.155
70,5%
Male214.128
29,5%
Female
The burden of injuries in the Brazilian morbidity, 2003
Injury deaths and morbidity per 100,000 population (Crude rate), 2003, BRAZIL
0
5
10
15
20
25
30
35
Unintentional Suicides Homicides Undetermined intent
de
ath
s p
er
10
0 m
il h
ab
0
50
100
150
200
250
300
350
400
mo
rbid
ity
pe
r 1
00
mil
ha
b
deaths morbidity
Source: Information Mortality System/Ministry of Health Hospitalization Information System/Ministry of Health
0
10
20
30
40
50
60
70
80
de
ath
s p
er
10
0 m
il h
ab
0
50
100
150
200
250
300
350
400
450
mo
rbid
ity
pe
r 1
00
mil
ha
b
Morbidity death
Injury deaths and morbidity per 100,000 population (Crude rate), 2003, BRAZIL
Source: Information Mortality System/Ministry of Health Hospitalization Information System/Ministry of Health
0
2
4
6
8
10
12
14
de
ath
s p
er
10
0 m
il h
ab
0
50
100
150
200
250
300
350
mo
rbid
ity
pe
r 1
00
mil
ha
b
Morbidity death
Injury deaths and morbidity per 100,000 population 1-14 years, 2003, Brazil (pop=49,056,442)
Source: Information Mortality System/Ministry of Health Hospitalization Information System/Ministry of Health
0
10
20
30
40
50
60
70
80
90
100
de
ath
s p
er
10
0 m
il h
ab
0
50
100
150
200
250
300
350
400
450
mo
rbid
ity
pe
r 1
00
mil
ha
b
Morbidity death
Injury deaths and morbidity per 100,000 population 15-24 years, 2003 Brrazil (pop=
35,531,287)
Source: Information Mortality System/Ministry of Health Hospitalization Information System/Ministry of Health
0
10
20
30
40
50
60
70
80
90
de
ath
s p
er
10
0 m
il h
ab
0
50
100
150
200
250
300
350
400
450
mo
rbid
ity
pe
r 1
00
mil
ha
b
Morbidity death
Injury deaths and morbidity per 100,000 population 35-54 years, 2003 Brazil (pop=
40,184,605)
Source: Information Mortality System/Ministry of Health Hospitalization Information System/Ministry of Health
0
20
40
60
80
100
120
140
de
ath
s p
er
10
0 m
il h
ab
0
100
200
300
400
500
600
700
800
mo
rbid
ity
pe
r 1
00
mil
ha
b
Morbidity death
Injury deaths and morbidity per 100,000 population 65 years and older, 2003 Brazil (pop=10,281,137)
Source: Information Mortality System/Ministry of Health Hospitalization Information System/Ministry of Health
• Management of database at local level (city health department)
• Health Analysis
• Information system to determine the costs
• Use of information for action
Challenges
Challenges
Research priorities - drug and alcohol consumption among injury victims
Population-based surveillance for Emergency Departments is also needed for monitoring injuries and for using in prevention program planning
Challenges
•The findings that types injuries differs on mortality data to morbidity data suggest that prevention efforts should focus not only on fatal injuries, as usual, but also on those nonfatal injuries that can have impact on health sector, especially those that determines hospitalization or high economic and social costs.
• Decreasing the burden of injuries is a big challenge for public health in Brazil and to improve the understanding of the magnitude and characteristics of the problem is a better way to the development of injury prevention programs.
Challenges