RESUMO
BACKGROUND: The percentage of the world's population with disabilities is estimated to be 16%, although its distribution and intensity varies within nations. We aim to disentangle the degree and types of disabilities, estimate the years spent with more severe disabilities, and analyze their distribution across states and between sexes in Mexico. METHODS: The Mexican Census of 2020 includes information on disabilities, which allows the study of its national distribution. We used life tables and the Sullivan method to calculate the number of years spent with disability (NYSD) and its percentage with respect to life expectancy for each state and each sex. RESULTS: In Mexico, the population with disabilities is estimated to be 16.5%. Of this total, 69% have milder disabilities, while the remaining 31% have more severe disabilities. At age eighteen, there is a higher NYSD from more severe disabilities for females with 5.67 years (95% CI 5.66 to 5.69) as opposed to males with 3.66 years (95% CI 3.65 to 3.67). Across states, a more homogeneous distribution with lower NYSD is observed for men (between 2.44 and 5.69 years) than for women (4.14 and 8.08 years). A north-south division can also be observed, with particularly notorious disadvantages among coastal states, which is more distinctive among women. CONCLUSIONS: This study shows that comparing the number of years spent with disability and the total life expectancy between subpopulations is essential for monitoring the well-being of aging populations, guiding policy decisions, and promoting a society that values and supports all individuals, regardless of their abilities.
Assuntos
Pessoas com Deficiência , Expectativa de Vida , Humanos , México , Masculino , Feminino , Pessoas com Deficiência/estatística & dados numéricos , Pessoa de Meia-Idade , Adulto , Idoso , Adolescente , Adulto Jovem , Pré-Escolar , Criança , Lactente , Idoso de 80 Anos ou mais , Recém-NascidoRESUMO
OBJECTIVE: To determine cause-specific and age-specific contributions to life expectancy changes between 2000 and 2015, separately by state and sex in Brazil, with a focus on homicides. DESIGN: Retrospective cross-sectional demographic analysis of mortality. SETTING AND POPULATION: Brazilian population by age, sex and state from 2000 to 2015. MAIN OUTCOME MEASURE: Using mortality data from the Brazilian Mortality Information System and population estimates from the National Statistics Office, we used death distribution methods and the linear integral decomposition model to estimate levels and changes in life expectancy. We also examine how multiple causes of death, including those attributable to homicides and amenable/avoidable mortality, contributed to these changes from 2000 to 2015. RESULTS: Between 2000 and 2015, life expectancy in Brazil increased from 71.5 to 75.1 years. Despite state-level variation in gains, life expectancy increased in almost all states over this period. However across Brazil, homicide mortality contributed, to varying degrees, to either attenuated or decreased male life expectancy gains. In Alagoas in 2000-2007 and Sergipe in 2007-2015, homicides contributed to a reduction in life expectancy of 1.5 years, offsetting gains achieved through improvements due to medically amenable causes. In the period 2007-2015, male life expectancy could have been improved by more than half a year in 12 of Brazil's states if homicide mortality had remained at the levels of 2007. CONCLUSIONS: Homicide mortality appears to offset life expectancy gains made through recent improvements to mortality amenable to medical services and public health interventions, with considerable subnational heterogeneity in the extent of this phenomenon. Efforts combating the causes of homicides can increase life expectancy beyond what has been achieved in recent decades.
Assuntos
Homicídio , Expectativa de Vida , Brasil/epidemiologia , Causas de Morte , Estudos Transversais , Humanos , Masculino , Mortalidade , Estudos RetrospectivosRESUMO
OBJECTIVE: To analyse average lifespan and quantify the effect of avoidable/amenable mortality on the difference between state-specific mortality and a low-mortality benchmark in Mexico during 1990-2015. DESIGN: Retrospective cross-sectional demographic analysis using aggregated data. SETTING: Vital statistics from the Mexican civil registration system. PARTICIPANTS: Aggregated national data (from 91.2 million people in 1995 to 119.9 in 2015) grouped in 64 populations (32 Mexican states (including Mexico City) by sex) with cause-of-death data. MAIN OUTCOME MEASURES: Cause-specific contributions to the gap in life expectancy with a low-mortality benchmark in three age groups (0-14, 15-49 and 50-84 years). RESULTS: Infants and children under the age of 15 years show improvements towards maximal survival in all states. However, adult males aged 15 to 49 years show deterioration after 2006 in almost every state due to increasing homicides, and a slow recovery thereafter. Out of 35 potential years, females and males live on average 34.57 (34.48 to 34.67) and 33.80 (33.34 to 34.27), respectively. Adults aged 50 to 84 years show an unexpected decrease in the low mortality benchmark, indicating nationwide deterioration among older adults. Females and males in this age group show an average survival of 28.59 (27.43 to 29.75) and 26.52 (25.33 to 27.73) out of 35 potential years, respectively. State gaps from the benchmark were mainly caused by ischaemic heart diseases, diabetes, cirrhosis and homicides. We find large health disparities between states, particularly for the adult population after 2005. CONCLUSIONS: Mexico has succeeded in reducing mortality and between-state inequalities in children. However, adults are becoming vulnerable as they have not been able to reduce the burden of violence and conditions amenable to health services and behaviours, such as diabetes, ischaemic heart diseases and cirrhosis. These trends have led to large health disparities between Mexican states in the last 25 years.
Assuntos
Expectativa de Vida , Mortalidade/tendências , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Criança , Pré-Escolar , Estudos Transversais , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/mortalidade , Feminino , Disparidades nos Níveis de Saúde , Homicídio/tendências , Humanos , Lactente , Recém-Nascido , Cirrose Hepática/epidemiologia , Cirrose Hepática/mortalidade , Longevidade , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Isquemia Miocárdica/epidemiologia , Isquemia Miocárdica/mortalidade , Estudos Retrospectivos , Fatores Sexuais , Adulto JovemRESUMO
OBJECTIVES: A disproportionate number of homicides have caused Mexican life expectancy to stagnate during the new millennium. No efforts currently exist to quantify the harm of violent acts on the lives of the general population. We quantified the impact of perceived vulnerability on life expectancy. METHODS: Three Mexican national surveys on perceptions of public safety, life tables, and crime and vital statistics (2000-2014) were used. Prevalence rates of vulnerability/safety by age and sex were obtained from surveys at 2 different levels: federal state and home. The Sullivan method was used to estimate life expectancy lived with and without vulnerability for Mexican women and men. RESULTS: Overall life expectancy at age 20 stagnated between 2005 and 2014 for females and males; yet, there was an increase of 40% and 70% in average number of years lived with vulnerability at the state and home levels, respectively. In 2014, female life expectancy at age 20 was 59.5â years (95% CI 59.0 to 60.1); 71% of these years (42.3â years, 41.6 to 43.0) were spent with perceived vulnerability of violence taking place in the state and 26% at the home (15.3â years, 15 to 15.8). For males, life expectancy at age 20 was 54.5â years (53.7 to 55.1); 64% of these years (34.6â years, 34.0 to 35.4) were lived with perceived vulnerability of violence at the state and 20% at the home (11.1â years, 10.8 to 11.5). CONCLUSIONS: The number of years lived with perceived vulnerability among Mexicans has increased by 30.5 million person-years over the last 10â years. If perceived vulnerability remains at its 2014 level, the average Mexican adults would be expected to live a large fraction of his/her life with perceived vulnerability of violence. Acts of violence continue to rise in the country and they should be addressed as a major public health issue before they become endemic.
Assuntos
Homicídio/estatística & dados numéricos , Longevidade , Violência/estatística & dados numéricos , Adulto , Idoso , Feminino , Humanos , Tábuas de Vida , Masculino , México/epidemiologia , Pessoa de Meia-Idade , PrevalênciaRESUMO
Life expectancy in Mexico increased for more than six decades but then stagnated in the period 2000-10. This decade was characterized by the enactment of a major health care reform-the implementation of the Seguro Popular de Salud (Popular Health Insurance), which was intended to provide coverage to the entire Mexican population-and by an unexpected increase in homicide mortality. We assessed the impact on life expectancy of conditions amenable to medical service-those sensitive to public health policies and changes in behaviors, homicide, and diabetes-by analyzing mortality trends at the state level. We found that life expectancy among males deteriorated from 2005 to 2010, compared to increases from 2000 to 2005. Females in most states experienced small gains in life expectancy between 2000 and 2010. The unprecedented rise in homicides after 2005 led to a reversal in life expectancy increases among males and a slowdown among females in most states in the first decade of the twenty-first century.
Assuntos
Causas de Morte , Diabetes Mellitus/mortalidade , Homicídio/estatística & dados numéricos , Expectativa de Vida/tendências , Adulto , Fatores Etários , Idoso , Bases de Dados Factuais , Países em Desenvolvimento , Diabetes Mellitus/fisiopatologia , Feminino , Homicídio/prevenção & controle , Humanos , Masculino , México , Pessoa de Meia-Idade , Saúde Pública , Estudos Retrospectivos , Medição de Risco , Fatores Sexuais , Adulto JovemRESUMO
OBJECTIVES: In the first decade of the 21st century, the Mexican life expectancy changed from a long trend of increase to stagnation. These changes concur with an increase in deaths by homicides that the country experienced in that decade, and an obesity epidemic that had developed over the last decades of the 20th century. We quantify the impact of causes of death on life expectancy from 2000 to 2010. METHODS: Two approaches to analyse causes of death are used: the number of life years lost due to each of the causes of death in a given year, and cause-decomposition techniques for comparisons of life expectancy from 2000 to 2010. RESULTS: The apparent stagnation in life expectancy is the result of an increase in deaths by homicides and diabetes mellitus on the one hand, and the positive improvements observed in other causes of death on the other. The negative impact of homicides is particularly observed for ages 15 and 50, and for that of diabetes mellitus at ages above 45â years. CONCLUSIONS: There is little basis for optimism regarding the future scenarios of the health of the Mexican population based on the first decade of the 21st century. Male life expectancy would have increased by 2â years if deaths by homicides and diabetes mellitus had been avoided.