Socioeconomic Factors and the Elderly Mortality Profile in a Poor Brazilian State: An Ecological Study Comparing Two Distinct Age Groups

Tamires Carneiro de Oliveira^1*, Wilton Rodrigues Medeiros², Yan Nogueira Leite de Freitas¹, Kenio Costa de Lima¹

¹Postgraduate Public Health Program (PPGSCol-UFRN), Department of Dentistry, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil.
²Ana Bezerra University Hospital, Empresa Brasileira de Serviços Hospitalares (EBSERH), Praça Tequinha Farias, Santa Cruz, Brazil.

DOI: 10.4236/oalib.1101271                

Abstract

The rate of the aging process of the Brazilian population and the accentuated social inequality and fragile institutions determine differentials in the mortality of the population, with many challenges for the health system. The aim of the present study was to analyze the mortality profile of individuals aged 60 to 69 years (young-old) and those aged 80 years or more (oldest-old) in a poor Brazilian state, as well as to investigate the associated socioeconomic factors. The Specific Mortality Rate by Age was calculated using aggregated data from the Mortality Information System (SIM) and the Brazilian Institute of Geography and Statistics (IGBE). In order to identify the mortality profiles of the municipalities, non-hierarchical clustering (K-means) was applied and Principal Components Analysis was used to reduce the socioeconomic variables. In the young-old age group, the misinformation profile, the development profile and the development paradox were more affected by education and poverty. In addition to the misinformation profile, the oldest-old group exhibited the epidemiological transition profile and the epidemiological paradox profile, associated with municipal development. The results for the oldest-old age group confirmed less of an influence at a contextual level. The mortality profiles and associated socioeconomic aspects differed according to age. Health inequalities among elderly individuals could be reduced by considering the different demands, improving the levels of education and poverty, and optimizing the use of health services.

Keywords

Aged, Mortality, Cause of Death, Socioeconomic Factors, Brazil

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	World Health Organization (2008) The Global Burden of Disease: 2004 Update. Geneva, 1-160.
[2]	Lima-Costa, M.F., Peixoto, S.V., Matos, D.L., et al. (2011) Predictors of 10-Year Mortality in a Population of Community-Dwelling Brazilian Elderly: The Bambuí Cohort Study of Aging. Caderno de Saúde Pública, 27, S360-S369. http://dx.doi.org/10.1590/S0102-311X2011001500006
[3]	National System for Health Information (2013) http://www.datasus.gov.br
[4]	Closs, V.E. and Schwanke, C.H.A. (2012) Aging Index Development in Brazil, Regions, and Federative Units from 1970 to 2010. Revista Brasileira de Geriatria e Gerontologia, 15, 443-458. http://dx.doi.org/10.1590/S1809-98232012000300006
[5]	Brazilian Institute for Geography and Statistics (2013) Síntese de indicadores sociais: Uma análise das condiççes de vida da população brasileira. IBGE, Rio de Janeiro.
[6]	Veras, R.P. (2009) Population Aging Today: Demands, Challenges and Innovations. Revista de Saúde Pública, 43, 548-554. http://dx.doi.org/10.1590/S0034-89102009000300020
[7]	Wong, L.L.R. and Carvalho, J.A. (2006) The Rapid Process of Aging in Brazil: Serious Challenges for Public Policies. Revista Brasileira de Estudos Populacionais, 23, 5-26. http://dx.doi.org/10.1590/S0102-30982006000100002
[8]	Menezes, T.M.O. and Lopes, R.L.M. (2012) The Meaning of Care for Elderly Individuals Aged 80 Years or Older. Revista Eletrônica de Enfermagem, 14, 240-247.
[9]	Davies, K., Collerton, J.C., Jagger, C., et al. (2010) Engaging the Oldest Old in Research: Lessons from the Newcastle 85+ Study. BioMed Central Geriatrics, 10, 1-9.
[10]	Panagiotakos, D.B., Chrysohoou, C., Siasos, G., et al. (2011) Sociodemographic and Lifestyle Statistics of Oldest Old People (>80 Years) Living in Ikaria Island: The Ikaria Study. Cardiology Research and Practice, 2011, Article ID: 679187. http://dx.doi.org/10.4061/2011/679187
[11]	Ailshire, J.A. and Crimmins, E.M. (2011) Psychosocial Factors Associated with Longevity in the United States: Age Differences between the Old and Oldest-Old in the Health and Retirement Study. Journal of Aging Research, 2011, Article ID: 530534. http://dx.doi.org/10.4061/2011/530534
[12]	Nóbrega, O.T., Faleiros, V.P. and Telles, J.E. (2009) Gerontology in the Developing Brazil: Achievements and Challenges in Public Policies. Geriatrics and Gerontology International, 9, 135-139. http://dx.doi.org/10.1111/j.1447-0594.2008.00499.x
[13]	Araújo, J.D. (2012) Epidemiological Polarization in Brazil. Epidemiologia e Serviços de Saúde, 21, 533-538. http://dx.doi.org/10.5123/S1679-49742012000400002
[14]	Geib, L.T.C. (2012) Social Determinants of Health in the Elderly. Ciência & Saúde Coletiva, 17, 123-133. http://dx.doi.org/10.1590/S1413-81232012000100015
[15]	Instituto Brasileiro de Geografia e Estatística, IBGE (2010) Produto interno bruto dos municípios 2010. Contas nacionais. Diretório de Pesquisas. Coordenaç ão de Contas Nacionais. Contas Nacionais, 39, 1-105.
[16]	Sivieiro, P.C.L. (2009) Níveis e padrões do diferencial de mortalidade por sexo no município de São Paulo, 1920-2005. Master Dissertation, Faculdade de Ciências Econômicas da Universidade Federal de Minas Gerais, Belo Horizonte.
[17]	Goldman, N., Turra, C.M., Rosero-Bixby, L., Weir, D. and Crimmins, E. (2011) Do Biological Measures Mediate the Relationship between Education and Health: A Comparative Study. Social Science & Medicine, 72, 307-315. http://dx.doi.org/10.1016/j.socscimed.2010.11.004
[18]	Simsek, H., Doganay, S., Budak, R. and Ucku, R. (2014) Relationship of Socioeconomic Status with Health Behaviors and Self-Perceived Health in the Elderly: A Community-Based Study, Turkey. Geriatrics and Gerontology International, 14, 960-968. http://dx.doi.org/10.1111/ggi.12166
[19]	Jerliu, N., Toçi, E., Burazeri, G., Ramadani, N. and Brand, H. (2013) Prevalence and Socioeconomic Correlates of Chronic Morbidity among Elderly People in Kosovo: A Population-Based Survey. BMC Geriatrics, 13, 1-9. http://dx.doi.org/10.1186/1471-2318-13-22
[20]	Benzeval, M., Taylor, J. and Judge, K. (2000) Evidence on the Relationship between Low Income and Poor Health: Is the Government Doing Enough? Fiscal Studies, 21, 375-399. http://dx.doi.org/10.1111/j.1475-5890.2000.tb00029.x
[21]	Ribeiro, A.G., Cotta, R.M.M. and Ribeiro, S.M.R. (2012) The Promotion of Health and Integrated Prevention of Risk Factors for Cardiovascular Diseases. Ciência e Saúde Coletiva, 17, 7-17. http://dx.doi.org/10.1590/S1413-81232012000100002
[22]	Justino, J.R. (2010) Estimaç ão de sub-registros de óbitos em pequenas áreas com estimador bayesiano empírico e agoritmo EM. Master Dissertation, Universidade Federal do Rio Grande do Norte, Natal.
[23]	Oliveira, A.C. and Bettcher, L. (2010) Epidemiological Aspects of the Occurrence of Vancomycin-Resistant Enterococci. Revista da Escola de Enfermagem da USP, 44, 725-731. http://dx.doi.org/10.1590/S0080-62342010000300025
[24]	Teixeira, R.S. (2007) Reflexões sobre a origem e a evoluç ão das doenças infecciosas e parasitárias no estado da Bahia. Gazeta Médica da Bahia, 77, 158-181.