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This diploma thesis analyzes mortality from external causes in the region of CZ between 2014 and 2018. The main focus is on external causes of death as a group, suicide rates, and mortality from traffic accidents. Another aim of this thesis is, besides the description of mortality from external causes, to identify regional correlation and differences in mortality from external causes and selected causes of death (suicides and traffic accidents). This study uses correlation, factor, and cluster analysis. Because of the low numbers of deaths in the case of women (in all dependent variables), the study analyzes mortality from both sexes together. Based on created factors clusters of regions are developed. Results show the difference between regions in CZ in mortality external causes. Regions also vary in suicide mortality rates and traffic accident mortality rates. Independent variables that correlate with mortality from external causes vary for external causes as a group, for suicides, and for mortality from traffic accidents. Keywords: external causes of death, suicides, traffic accidents, factor analysis, cluster analysis

International audience; The study aimed to explore the prospective associations between psychosocial factors at work from the job strain model and preventable mortality, including smoking- and alcohol-related mortality as well as external causes of death. The study was based on prospective data and relied on a sample of 1,511,456 individuals for which data on job history, mortality and causes of death were linked over the 1976–2002 period. Exposures were the factors from the job strain model imputed through a job-exposure matrix. Various time-varying measures of exposure were used including current exposure and two measures of cumulative exposure. Preventable mortality was defined using the OECD/Eurostat list of preventable causes of death. The associations between exposures and outcomes were studied using Cox proportional hazards models. Effect modification by gender was also assessed. Over the study period, 57,264 preventable deaths occurred before the age of 75 years. Low decision latitude, low social support, job strain, iso-strain, passive job, and high strain were associated with preventable mortality, and associations of stronger magnitude were found for job strain and isostrain among men. Stronger associations were observed for alcohol-related mortality than for smoking-related mortality and external causes of death. The fractions of preventable mortality attributable to current exposure to job strain and isostrain were significant among men only (5.1% and 3.3%). Psychosocial factors at work from the job strain model may play a role on preventable mortality. Intensifying research and prevention towards the psychosocial work environment may be helpful to reduce risky health-related behaviours and related mortality.

Mining is a recognized high-risk industry with a relatively high occurrence of occupational injuries and disease. In this study, we looked at the differences in mortality between male and female miners in South Africa. Data from Statistics South Africa regarding occupation and cause of death in the combined years 2013&ndash, 2015 were analyzed. Proportional mortality ratios (PMRs) were calculated to investigate excess mortality due to external causes of death by sex in miners and in manufacturing laborers. Results: Women miners died at a significantly younger age on average (44 years) than all women (60 years), women manufacturers (53 years), and male miners (55 yrs). There was a significantly increased proportion of deaths due to external causes in women miners (12.4%) compared to all women (4.8%) and women manufacturers (4.6%). Significantly increased PMRs were seen in car occupant accidents (467, 95% confidence interval (CI) 151&ndash, 1447), firearm discharge (464, 95% CI 220&ndash, 974), and contact with blunt objects (2220 95% CI 833&ndash, 5915). Conclusion: This descriptive study showed excess deaths in women miners due to external causes. Road accidents, firearm discharge, and contact with blunt objects PMRs were significantly increased. Further research is required to confirm the underlying reasons for external causes of death and to develop recommendations to protect women miners.

Objectives: To compare mortality by cancer sites and by other specific causes of death, and the prevalence of risk behaviors in farmers and non-farmers in Spain. Methods: Mortality by cause of death was calculated based on a longitudinal study with 10-years follow-up of 9.5 million men and 6 million women aged 20–64 years who were employed in 2001. The prevalence of risk behaviors was calculated from the 2001 National Health Survey in the 6464 employed men and 5573 employed women aged 20–64. The study subjects were grouped as farmers and non-farmers. For each cause of death, we estimated the ratio of age-standardized mortality rates, and for each risk behavior we estimated the age-standardized prevalence ratio in farmers versus non-farmers. Results: In men, the mortality rate for most cancer sites did not differ significantly between farmers and non-farmers, except for cancers of the lip, oral cavity, stomach, larynx and skin epidermoid carcinoma—which was higher in farmers—and cancers of the liver, pancreas and mesothelioma—which was lower in farmers. In contrast, farmers had a higher rate of mortality from most other diseases and from external causes of death. In women, farmers showed lower mortality from lung cancer, breast cancer and chronic lower respiratory disease, and higher mortality from external causes. The prevalence of smoking, excessive alcohol consumption, physical inactivity and obesity was higher in farmers than in non-farmers, except smoking and excessive alcohol consumption in women where prevalence was lower in farmers. Conclusions: Findings are different from those found in other studies. In men, greater exposure to the sun and the higher prevalence of risk behaviors in farmers could explain their excess mortality from some cancer sites and the other causes of death. However, other factors may be behind this excess risk of mortality from these causes, given that farmers did not show higher mortality from some cancers related to smoking. In women, no differences were observed in mortality rate for majority of causes of death between farmers and non-farmers.

Введение. Одной из стратегических задач, в том числе в Красноярском крае, является увеличение ожидаемой продолжительности жизни проживающего в регионе населения. Для разработки региональной стратегии повышения данного показателя на уровне региона необходим первичный анализ смертности населения. Целью исследования явился анализ динамики смертности населения Красноярского края за пятилетний период с 2012 по 2016 гг. Материал и методы. Изучение смертности населения Красноярского края основано на открыто опубликованных данных Управлением Федеральной службы государственной статистики по Красноярскому краю, Республике Хакасия и Республике Тыва, а также первичных баз смертности по городским округам и муниципальным районам Красноярского края за период с 2012 по 2016 гг. Для анализа смертности населения рассчитывался коэффициент смертности на 100 000 соответствующего населения и средний возраст умерших, а динамика изучаемых показателей оценивалась с использованием показателя темпа прироста. Результаты. За период с 2012 по 2016 годы общая смертность населения Красноярского края снизилась на 3,9%, а также снизилась смертность населения от психических расстройств и расстройств поведения, отдельных состояний, возникающих в перинатальном периоде, старости и неточно обозначенных и неизвестных причин смерти. За этот же период значительно выросла смертность населения Красноярского края от болезней крови, кроветворных органов и отдельных нарушений, вовлекающих иммунный механизм, болезней нервной системы и болезней кожи и подкожной клетчатки. Обсуждение. Показатель ожидаемой продолжительности жизни за анализируемый период в Красноярском крае увеличился на 2,3%. В работе представлены различия в динамике смертности населения от различных причин у мужчин и женщин, а также у сельского и городского населения. Помимо этого, проанализирован средний возраст умерших от различных причин среди различных категорий населения. Заключение. В структуре смертности у мужчин по сравнению с женщинами преобладает смертность от болезней органов дыхания и внешних причин, а у женщин – от болезней системы кровообращения, у городского населения – от злокачественных новообразований и болезней органов пищеварения, а у сельского населения – от внешних причин. Представленные в работе результаты могут быть использованы для сравнительного анализа смертности населения и среднего возраста умерших, а также при разработке мероприятий, направленных на повышение ожидаемой продолжительности жизни населения., Significance. One of the strategic objectives, including in the Krasnoyarsk region, is to increase the life expectancy of the population living in the region. To develop a regional strategy to increase this indicator at the regional level, a primary analysis of population mortality is necessary. The aim of the study was to analyze the dynamics of mortality in the Krasnoyarsk region for the period from 2012 to 2016. Methods. The study of population mortality in the Krasnoyarsk region is based on the data published by the Office of the Federal state statistics service for the Krasnoyarsk region, the Republic of Khakassia and the Republic of Tuva, as well as primary mortality databases for urban districts and municipal districts of the Krasnoyarsk region for the period from 2012 to 2016.to analyze the mortality rate of the population, the mortality rate per 100,000 of the population and the average age of the dead were calculated, and the dynamics of the studied indicators were estimated using the growth rate indicator. Results. During the period from 2012 to 2016, the total mortality of the population of the Krasnoyarsk territory decreased by 3.9%, as well as mortality from mental and behavioral disorders, certain conditions arising in the perinatal period, old age and inaccurately identified and unknown causes of death. During the same period significantly increased the mortality of the population of Krasnoyarsk region from diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism diseases of the nervous system and diseases of skin and subcutaneous tissue. Discussion. The indicator of life expectancy for the analyzed period in the Krasnoyarsk region by 2.3%. The paper presents differences in the dynamics of mortality from various causes in men and women, as well as in rural and urban population. In addition, the average age of deaths from various causes among different categories of the population is analyzed. Conclusions. In the structure of mortality in men, compared with women, mortality from respiratory diseases and external causes prevails, and in women – from diseases of the circulatory system, in the urban population – from malignant neoplasms and diseases of the digestive system, and in the rural population – from external causes. The results presented in the paper can be used for comparative analysis of mortality of the population and the average age of the deceased, as well as for the development of measures aimed at increasing life expectancy.

Objectives To examine the pattern and trend of deaths due to external causes among Polish children and adolescents in 1999–2012, and to compare trends in Poland’s neighboring countries. Methods Death records were obtained from the Central Statistical Office of Poland. External causes mortality rates (MR) with 95 % confidence interval were calculated. The annual percentage change of MR was examined using linear regression. To compare MR with Belarus, Ukraine, Czech Republic and Germany, data from the European Mortality Database were used. Results MR were the highest in the age 15–19 years (33.7/100,000) and among boys (22.7/100,000). Unintentional injuries including transport accidents, drowning, and suicides (especially in children over 10 years old), were the main cause of death in the analyzed groups. Between 1999 and 2012 annual MR for unintentional injuries declined substantially. MR due to injuries and poisoning in Poland were higher compared with Czech Republic and Germany and lower in comparison with Belarus and Ukraine. Conclusions Deaths due to unintentional injuries are still the leading cause of death among Polish children and adolescents. There are differences in death rates between Poland and neighboring countries.

Background: In low- and middle-income countries (LMICs), data on causes of death is often inaccurate or incomplete. In this paper, we test whether adding a few questions about injuries and accidents to mortality questionnaires used in representative household surveys would yield accurate estimates of the extent of mortality due to external causes (accidents, homicides, or suicides). Methods: We conduct a validation study in Niakhar (Senegal), during which we compare reported survey data to high-quality prospective records of deaths collected by a health and demographic surveillance system (HDSS). Results: Survey respondents more frequently list the deaths of their adult siblings who die of external causes than the deaths of those who die from other causes. The specificity of survey data is high, but sensitivity is low. Among reported deaths, less than 60Š of the deaths classified as due to external causes by the HDSS are also classified as such by survey respondents. Survey respondents better report deaths due to road-traffic accidents than deaths from suicides and homicides. Conclusions: Asking questions about deaths resulting from injuries and accidents during surveys might help measure mortality from external causes in LMICs, but the resulting data displays systematic bias in a rural population of Senegal. Future studies should 1) investigate whether similar biases also apply in other settings and 2) test new methods to further improve the accuracy of survey data on mortality from external causes. Contribution: This study helps strengthen the monitoring of sustainable development targets in LMICs by validating a simple approach for the measurement of mortality from external causes.

The article discusses long-term mortality trends (since 1956) from external causes of death in Russia. Russia has long lagged behind developed countries in this domain. The level of mortality from external causes of death remains high and its structure is still archaic with large contribution of homicides, alcohol poisoning and injuries of undetermined intent. Excess number of deaths from life tables of Russia and Western European countries is compared. It is shown that in Russia the greatest excess losses are associated with mortality from poisonings among both sexes, suicide among men and homicide among women. Mortality from external causes, along with mortality from diseases of the circulatory system, has had a significant impact on life expectancy. In general, over the period 1956-2012 the increase in mortality from external causes in the 15-64 age group reduced life expectancy by 2.6 years for males and 0.7 years for females. The decline, starting in 2003, of mortality from external causes of death has slightly reduced the gap between Russia and developed countries, bringing the current Russian level closer to those levels reached in Russia in the mid-1960s and 1980s. However, given the fluctuations of mortality from external causes, it is premature to say whether the current decline in mortality is robust.

The article assesses the risk of exposure to athmospheric pollution on the life expectancy at birth and mortality in the Republic of Karelia. Special focus is on the long-term(1996–2016) variation of pollutant emissions from fixed sources and the statistically related to it change in the rate of mortality from external causes. Thus, the number of suicidesand murders in the period studied decreased simultaneously with a decrease in the emissions of solid particles (r = 0.92 and 0.89, respectively), CO (0.92 and 0.88), SO2 (0.77 and 0.72), etc. Such dependencies are consistent with available publications on the effect of chemical pollution on suicidal and aggressive human behavior, as well as the general trend of the effect of emitted solids on the number of crimes associated with violent actions against victims in the Northwest Federal District. The health hazard of exposure to dust-like particles is shown. Their concentration in urban air increases after the snowcover had thawed, especially in the case of a deficit of spring precipitation. Dust particles have partially acute-angled shapes and an elevated content of heavy metals (W, Cu,V, Co, Zn, Ni, Mn, Sb, Sn, Cr, Mo) compared to urban soils. The data presented in this article and their analysis are important for the continuation of research aimed at assessing environmental risks and reducing the negative impact of chemical pollution on human health and behavior.

В Республике Саха (Якутия) уровень смертности от внешних причин остается достаточно высоким по сравнению с РФ в целом. Наиболее проблемными социально-демографическими группами выступают сельское население, мужчины трудоспособного возраста, население северных и арктических районов республики. The mortality rate from external causes In the Republic of Sakha (Yakutia) remains high in comparison with Russia. The rural population, men of working age, the population of Northern and Arctic regions of the Republic are the most problematic socio-demographic groups.

Информирование о технике безопасности наряду с созданием безопасных условий проживания и передвижения является важной задачей для сохранения независимости и самостоятельности пожилых. В статье рассмотрен опыт Великобритании в ограничении факторов риска, способных привести к различным травмам пожилых людей и даже их смерти. Успешность и эффективность мероприятий по обеспечению безопасного проживания пожилых людей могут быть оценены с помощью таких показателей, как стандартизованный коэффициент смертности от внешних причин, а также ожидаемая продолжительность жизни в возрасте 65 лет. Поскольку Россия по данным показателям значительно уступает Великобритании, а также учитывая мировую тенденцию старения населения, сделан вывод о необходимости использования британского опыта в нашей стране., Informing about safety along with the creation of safe living and movement conditions is an important task for preserving the independence of the elderly. The article describes the experience of the UK in limiting risk factors that can lead to various injuries of older people and even their death. The success and effectiveness of measures, which ensure safe living of the elderly, can be assessed through such indicators as age-standardized mortality rate from external causes and life expectancy at age 65. According to these indicators Russia is significantly behind the UK, and given the global trend of population ageing, we should use the experience of UK in our country.

O artigo compara dados de homicídios de residentes no município de São Paulo entre 1996 e 2000, divulgados pelo Pro-aim, Fundação Seade e Ministério da Saúde; e de homicídios por distrito de residência da vítima no município de São Paulo em 2000, divulgados pelo Pro-aim e pela Fundação Seade. Foram considerados homicídios os óbitos por agressão; intervenção legal e eventos de intenção não determinada causados por disparo de arma de fogo e por contato com objeto cortante/penetrante ou contundente. A diferença entre os números da Fundação Seade e do Ministério da Saúde é desprezível, mas a diferença entre os números do Pro-aim e da Fundação Seade para homicídios de residentes ocorridos na capital em 2000 é expressiva para muitos distritos do município de São Paulo. Além disso, o Pro-aim não registra óbitos de residentes na capital ocorridos em outro município. As análises da taxa de homicídio por distrito do município de São Paulo que utilizam dados do Pro-aim podem levar a resultados muito diferentes das que utilizam dados da Fundação Seade. The article compares city (Pro-aim), state (Fundação Seade) and federal (Ministério da Saúde) data for homicides of residents in Sao Paulo city between 1996 and 2000; and Pro-aim and Fundação Seade data for homicides per district in Sao Paulo municipality, in 2000. As homicides were considered deaths caused by assault, legal intervention and events of undetermined intent caused by firearm discharge and contact with sharp or blunt objects. The difference between Fundação Seade and Ministério da Saúde data is worthless. But the difference between Pro-aim and Fundação Seade numbers for homicides of residents in Sao Paulo city in 2000 has statistical significance for a large number of districts. Furthermore, Pro-aim does not record deaths of residents in Sao Paulo city occurred in other cities. Analysis of homicide rates per district in Sao Paulo city that uses Pro-aim data can lead to different results than analysis that uses Fundação Seade data.

Background We present a method for reclassifying external causes of death categorized as “event of undetermined intent” (EUIs) into non-transport accidents, suicides, or homicides. In nations like Russia and the UK the absolute number of EUIs is large, the EUI death rate is high, or EUIs comprise a non-trivial proportion of all deaths due to external causes. Overuse of this category may result in (1) substantially underestimating the mortality rate of deaths due to specific external causes and (2) threats to the validity of studies of the patterns and causes of external deaths and of evaluations of the impact of interventions meant to reduce them. Methods We employ available characteristics about the deceased and the event to estimate the most likely cause of death using multinomial logistic regression. We use the set of known non-transport accidents, suicides, and homicides to calculate an mlogit-based linear score and an estimated classification probability (ECP). This ECP is applied to EUIs, with varying levels of minimal classification probability. We also present an optional second step that employs a population-level adjustment to reclassify deaths that remain undetermined (the proportion of which varies based on the minimal classification probability). We illustrate our method by applying it to Russia. Between 2000 and 2011, 521,000 Russian deaths (15 % percent of all deaths from external causes) were categorized as EUIs. We used data from anonymized micro-data on the ~3 million deaths from external causes. Our reclassification model used 10 decedent and event characteristics from the computerized death records. Results Results show that during this period about 14 % of non-transport accidents, 13 % of suicides, and 33 % of homicides were officially categorized as EUIs. Our findings also suggest that 2011 levels of non-transport accidents and suicides would have been about 24 % higher and of homicide about 82 % higher than that reported by official vital statistics data. Conclusions Overuse of the external cause of death classification “event of undetermined intent” may indicate questionable quality of mortality data on external causes of death. This can have wide-ranging implications for families, medical professionals, the justice system, researchers, and policymakers. With our classification probability set as equal to or higher than 0.75, we were able to reclassify about two-thirds of EUI deaths in our sample. Our optional additional step allowed us to redistribute the remaining unclassified EUIs. Our method can be applied to data from any nation or sub-national population in which the EUI category is employed.

OBJETIVO: A taxa de mortalidade específica por acidentes de trânsito de veículos a motor é usualmente utilizada para efeito das políticas de saúde pública. Para mensurar o grau de violência no trânsito, foi realizado estudo com o objetivo de analisar o número de óbitos por acidentes de trânsito por veículo a motor. MÉTODOS: Com base nos dados sobre frota de veículos, população e óbitos por acidente de trânsito, publicados no Statiscal Yearbook (1999), Demografic Yearbook (1997), Denatran (1999), Ministério da Saúde (2000) e Fundação IBGE (2000), foram estudados 61 países e 51 localidades brasileiras.A taxa de mortalidade específica foi decomposta em número de veículos por habitante e número de óbitos por veículo. Numa primeira aproximação, cada uma das amostras (internacional e brasileira) foi subdividida em três grupos, de acordo com o número de veículos por habitante, para estudo da relação entre os três índices. Para testar a significância dessa relação, foi estimada uma função de regressão log-linear. RESULTADOS: Os resultados para as estimativas internacionais, assim como as do Brasil, demonstraram que, quanto maior o número de veículos por habitante, menor o número de óbitos por acidentes de trânsito por veículo, tendo-se elasticidade da ordem de -1,067, para as estimativas internacionais, e de -0,515, para as do Brasil. CONCLUSÕES: Para uma política de prevenção dos acidentes de trânsito, os resultados encontrados indicam a necessidade de estudar os fatores que possam explicar o maior número de óbitos por veículo nas regiões com menor número de veículos por habitante. OBJECTIVE: The mortality rate due to traffic accidents is an information often used while making public health policies. In order to measure traffic violence, a study was carried to analyze the number of death by traffic accidents per registered motor vehicle. METHODS: Based on the number of registered vehicles, population and traffic accident deaths, obtained from the Statistical Yearbook (1999), Demographic Yearbook (1997), Denatran (1999), Ministério da Saúde (2000) and Fundação IBGE (2000) 61 countries and 51 areas in Brazil were studied. Traffic accident mortality rate was broken down into registered motor vehicles per capita and the number of deaths per motor vehicle. To assess this relationship, the samples (international and Brazilian) were subdivided into three groups according to the number of vehicles per capita. To test the statistical significance of this relationship, log-linear regression was used. RESULTS: The number of deaths per motor vehicles is associated to the number of registered motor vehicles per capita. The statistical relationship is -1.067 for international data and -0.515 for the Brazilian data. CONCLUSIONS: To prevent traffic accidents, there is a need of further studies to explain the high numbers of deaths due to motor vehicles associated with the low rate of registered motor vehicles per capita.

The aim of my work is to describe and compare changes in mortality according to classes of causes of death in the Czech Republic and selected European countries between 1994 - 2009. The work includes mortality characteristics of the Czech Republic, Germany, Estonia, Austria and Finland. The work is divided into three main parts. The first part describes terms related to mortality. The second part deals with the coding of causes of death, its history and origin. The third part is devoted to comparing mortality by cause of death, where the emphasis is on diseases of the circulatory system, malignant neoplasms and external causes.

SUMMARY The aim of study was to determine the trends of mortality from external causes and suicides in Lithuania and other EU (European Union) countries in 1996-2006, using advanced trend analysis methods. Methods. Study design – descriptive epidemiology. Mortality from all external causes (by ICD-10 coding V01-Y98) and from suicides (by ICD-10 coding X60-X84) was analyzed in eighteen EU countries. It was used midyear of every countries population, numbers of deaths from external causes and from suicides based on five-year age groups, which totaled to 324 groups. Age-standardized (European standard population) mortality rates (per 100 000 persons) from causes mentioned above was calculated calculated using direct method. These standardized values were used to determine the trends, comparisons with other countries was made. MICROSOFT EXCEL 2003, WINPEPI module Describe (v. 1.78), JOINPOINT (v. 3.2.0), Harward Graphics 98 (v. 6.50), MAP WIEVER (v. 5.00) statistical packages and programmes were used for data processing and analysis. The following indices was calculated: standardized mortality rates, weighted standard error (SE), annual absolute change (AAC), annual percentage change (APC), 95% confidence intervals, data considered significant, when p

p. 1-204 Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-25T19:29:53Z No. of bitstreams: 1 3333333333.pdf: 1820220 bytes, checksum: 86a606b3784bfb57fb53abe9467d767e (MD5) Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-04T17:36:49Z (GMT) No. of bitstreams: 1 3333333333.pdf: 1820220 bytes, checksum: 86a606b3784bfb57fb53abe9467d767e (MD5) Made available in DSpace on 2013-05-04T17:36:49Z (GMT). No. of bitstreams: 1 3333333333.pdf: 1820220 bytes, checksum: 86a606b3784bfb57fb53abe9467d767e (MD5) Previous issue date: 2007 Introdução: Existe uma razoável produção acadêmica em algumas áreas do conhecimento que aponta piores condições de vida para a população brasileira afro descendente. Entretanto, são poucos os estudos na área de saúde que abordam a raça/cor da pele como importante determinante da falta de equidade entre grupos. Objetivos: analisar os diferenciais da mortalidade por causas externas, segundo a raça/cor em Salvador, Bahia, Brasil, no período 1998-2003. Material e Métodos: O primeiro dos três artigos que compõem o presente trabalho corresponde a uma revisão de literatura sobre desigualdades sociais em saúde no Brasil e nos Estados Unidos contemplando estudos que abordaram a raça/cor da pele, publicados em periódicos da área de Saúde Pública/ Epidemiologia no período de 1996 a 2005. O segundo é um estudo descritivo no qual se calculou o número de anos potenciais de vida perdidos (APVP) por causas externas por sexo, faixa etária e tipo de causa externa, segundo a raça/cor da pele. O terceiro artigo se constitui em um estudo ecológico espacial, que teve como unidade de análise as áreas de ponderação de Salvador. Mediante modelagem de Regressão Binomial Negativa foi testada a hipótese de que áreas com maior proporção de população masculina negra entre 15 e 49 anos apresentavam maior mortalidade por todas as causas externas em conjunto e por homicídio. Resultados: Dos 56 estudos norte-americanos e 7 brasileiros revistos, 68,7% foram publicados entre 2002 e 2005, 41 eram do tipo transversal (65,0%), 11 do tipo inquérito (17,5%), 6 eram de vigilância (9,5%), 3 ecológicos (4,8%) e 2 longitudinais (3,2%). Desses 60,3% se referiram à saúde da população e 39,7% a saúde de grupos populacionais específicos. A variável raça/cor da pele/etnia esteve associada ao efeito estudado em 84,4% dos estudos analíticos e as diferenças observadas se mostraram estatisticamente significantes em todos os estudos descritivos em que os autores utilizaram algum teste estatístico. Todavia, enquanto nos artigos dos Estados Unidos se observou uma tendência de superação das limitações observadas nesses tipos de estudos, no Brasil essa literatura está apenas começando a descrever a existência desse tipo de desigualdade. No segundo artigo verificou-se que os homens negros perderam 21,8 vezes mais anos potenciais de vida quando comparados aos homens brancos. As diferenças observadas no APVP/100.000hab. e nas razões de APVP/100.000 se mantiveram mesmo após a padronização por idade. No último estudo verificou-se que áreas com altas taxas de mortalidade por todas as causas externas e por homicídio tenderam a se aglomerar e tinham como características comuns uma maior proporção de população negra masculina com idade entre 15 e 49 anos. Áreas com maior proporção de população masculina negra entre 15 e 49 anos apresentavam maior mortalidade por causas externas (RR=1,18; p=0,03 para a associação entre proporção da população masculina negra com idade de 15 a 49 anos e taxa de mortalidade por todas as causas externas ajustada por proporção de chefes de família negros com renda de ≤2SM ). Conclusões: Foram produzidas evidências de que a população negra, especificamente a masculina negra com idade entre 15 e 49 anos, morre mais precocemente e apresenta maior risco de óbito por causas externas e, especialmente por homicídios. Entende-se que foram reveladas apenas uma das facetas de um problema bastante complexo, porém, espera-se que tais resultados estimulem e subsidiem a discussão sobre a falta de equidade em saúde segundo a raça/cor da pele e contribuam para a formulação de políticas públicas especificas. Salvador

p. 1-204 Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-25T19:29:53Z No. of bitstreams: 1 3333333333.pdf: 1820220 bytes, checksum: 86a606b3784bfb57fb53abe9467d767e (MD5) Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-04T17:36:49Z (GMT) No. of bitstreams: 1 3333333333.pdf: 1820220 bytes, checksum: 86a606b3784bfb57fb53abe9467d767e (MD5) Made available in DSpace on 2013-05-04T17:36:49Z (GMT). No. of bitstreams: 1 3333333333.pdf: 1820220 bytes, checksum: 86a606b3784bfb57fb53abe9467d767e (MD5) Previous issue date: 2007 Introdução: Existe uma razoável produção acadêmica em algumas áreas do conhecimento que aponta piores condições de vida para a população brasileira afro descendente. Entretanto, são poucos os estudos na área de saúde que abordam a raça/cor da pele como importante determinante da falta de equidade entre grupos. Objetivos: analisar os diferenciais da mortalidade por causas externas, segundo a raça/cor em Salvador, Bahia, Brasil, no período 1998-2003. Material e Métodos: O primeiro dos três artigos que compõem o presente trabalho corresponde a uma revisão de literatura sobre desigualdades sociais em saúde no Brasil e nos Estados Unidos contemplando estudos que abordaram a raça/cor da pele, publicados em periódicos da área de Saúde Pública/ Epidemiologia no período de 1996 a 2005. O segundo é um estudo descritivo no qual se calculou o número de anos potenciais de vida perdidos (APVP) por causas externas por sexo, faixa etária e tipo de causa externa, segundo a raça/cor da pele. O terceiro artigo se constitui em um estudo ecológico espacial, que teve como unidade de análise as áreas de ponderação de Salvador. Mediante modelagem de Regressão Binomial Negativa foi testada a hipótese de que áreas com maior proporção de população masculina negra entre 15 e 49 anos apresentavam maior mortalidade por todas as causas externas em conjunto e por homicídio. Resultados: Dos 56 estudos norte-americanos e 7 brasileiros revistos, 68,7% foram publicados entre 2002 e 2005, 41 eram do tipo transversal (65,0%), 11 do tipo inquérito (17,5%), 6 eram de vigilância (9,5%), 3 ecológicos (4,8%) e 2 longitudinais (3,2%). Desses 60,3% se referiram à saúde da população e 39,7% a saúde de grupos populacionais específicos. A variável raça/cor da pele/etnia esteve associada ao efeito estudado em 84,4% dos estudos analíticos e as diferenças observadas se mostraram estatisticamente significantes em todos os estudos descritivos em que os autores utilizaram algum teste estatístico. Todavia, enquanto nos artigos dos Estados Unidos se observou uma tendência de superação das limitações observadas nesses tipos de estudos, no Brasil essa literatura está apenas começando a descrever a existência desse tipo de desigualdade. No segundo artigo verificou-se que os homens negros perderam 21,8 vezes mais anos potenciais de vida quando comparados aos homens brancos. As diferenças observadas no APVP/100.000hab. e nas razões de APVP/100.000 se mantiveram mesmo após a padronização por idade. No último estudo verificou-se que áreas com altas taxas de mortalidade por todas as causas externas e por homicídio tenderam a se aglomerar e tinham como características comuns uma maior proporção de população negra masculina com idade entre 15 e 49 anos. Áreas com maior proporção de população masculina negra entre 15 e 49 anos apresentavam maior mortalidade por causas externas (RR=1,18; p=0,03 para a associação entre proporção da população masculina negra com idade de 15 a 49 anos e taxa de mortalidade por todas as causas externas ajustada por proporção de chefes de família negros com renda de ≤2SM ). Conclusões: Foram produzidas evidências de que a população negra, especificamente a masculina negra com idade entre 15 e 49 anos, morre mais precocemente e apresenta maior risco de óbito por causas externas e, especialmente por homicídios. Entende-se que foram reveladas apenas uma das facetas de um problema bastante complexo, porém, espera-se que tais resultados estimulem e subsidiem a discussão sobre a falta de equidade em saúde segundo a raça/cor da pele e contribuam para a formulação de políticas públicas especificas. Salvador

The article compares city (Pro-aim), state (Fundação Seade) and federal (Ministério da Saúde) data for homicides of residents in Sao Paulo city between 1996 and 2000; and Pro-aim and Fundação Seade data for homicides per district in Sao Paulo municipality, in 2000. As homicides were considered deaths caused by assault, legal intervention and events of undetermined intent caused by firearm discharge and contact with sharp or blunt objects. The difference between Fundação Seade and Ministério da Saúde data is worthless. But the difference between Pro-aim and Fundação Seade numbers for homicides of residents in Sao Paulo city in 2000 has statistical significance for a large number of districts. Furthermore, Pro-aim does not record deaths of residents in Sao Paulo city occurred in other cities. Analysis of homicide rates per district in Sao Paulo city that uses Pro-aim data can lead to different results than analysis that uses Fundação Seade data. O artigo compara dados de homicídios de residentes no município de São Paulo entre 1996 e 2000, divulgados pelo Pro-aim, Fundação Seade e Ministério da Saúde; e de homicídios por distrito de residência da vítima no município de São Paulo em 2000, divulgados pelo Pro-aim e pela Fundação Seade. Foram considerados homicídios os óbitos por agressão; intervenção legal e eventos de intenção não determinada causados por disparo de arma de fogo e por contato com objeto cortante/penetrante ou contundente. A diferença entre os números da Fundação Seade e do Ministério da Saúde é desprezível, mas a diferença entre os números do Pro-aim e da Fundação Seade para homicídios de residentes ocorridos na capital em 2000 é expressiva para muitos distritos do município de São Paulo. Além disso, o Pro-aim não registra óbitos de residentes na capital ocorridos em outro município. As análises da taxa de homicídio por distrito do município de São Paulo que utilizam dados do Pro-aim podem levar a resultados muito diferentes das que utilizam dados da Fundação Seade.

This study aimed to develop models based on Verbal Autopsy (VA) data and to estimate correct number of deaths from external causes in Thailand from 1996 to 2009. Logistic regression was used to create models of the three external causes of death classified by province, gender-age group and Vital registration (VR) cause-location group. Receiver operating characteristic (ROC) curves were used to validate the models by matching the number of reported deaths to the number of deaths predicted by the models. The models provided accurate prediction results, with false positive error rates 1.6%, 2.0% and 0.6% and sensitivities 73.8%, 46.3% and 62.0%, respectively. The results reveal that under-reporting of external causes of death increased over the 14-year period. Our statistical method confirms that the Thai 2005 VA data can be used to estimate external causes of death from VR report in Thailand to allow for the under-reporting rate.