Mortalidade por doenças crônicas no Semiárido Brasileiro: hipertensão arterial e diabetes mellitus

Abstract

This study analyzed the patterns of proportional mortality and the crude and agestandardized mortality rates due to Diabetes Mellitus and Hypertension in the Brazilian Semi-arid region, for the years 2018 and 2021, with breakdowns by State and sex. The general objective was to analyze the behavior of mortality due to Hypertension and Diabetes Mellitus in the Brazilian semi-arid region in the years 2018 and 2021, considering regional and sex-related differences. The results revealed a mortality profile marked by a concentration of deaths in older age groups, typical of non-communicable chronic diseases, but with relevant nuances between States and between men and women. The proportional mortality curves showed that, despite the predominance of deaths from the age of 60 onward—especially in the 80+ age group—some States still reported significant proportions in intermediate age ranges, suggesting early and potentially avoidable deaths, particularly among men. The States of Espírito Santo and Sergipe presented atypical patterns, with abrupt fluctuations and irregular concentrations, indicating either inconsistencies in records or specific demographic realities. Meanwhile, the States of Piauí, Maranhão, and Minas Gerais showed persistently high standardized mortality rates, reflecting a more intense chronic disease burden possibly associated with structural inequalities in access to continuous care. The cluster analyses reinforced the heterogeneity among the States: while Ceará, Bahia, and Rio Grande do Norte formed a group with lower rates and temporal stability, others such as Piauí and Maranhão remained on the opposite end, with persistently high indicators for both men and women. The exclusion of Sergipe in some analyses was necessary to preserve the robustness of the clusters, due to its statistical outlier behavior in 2018. By integrating proportional and standardized mortality analyses, it was found that mortality from these diseases in the Brazilian Semi-arid region is not merely a result of population aging, but rather an outcome of the interplay between social, healthcare, and territorial factors. The findings highlighted the need for differentiated public policies that consider local specificities, prioritize prevention, and strengthen primary healthcare—especially in settings of higher epidemiological vulnerability.