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Free Content Household income, sex and respiratory mortality in São Paulo, Brazil, 1996–2010

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Abstract:

SETTING: Respiratory mortality rates are declining in several countries, including Brazil; however, the effect of socio-economic indicators and sex is unclear.

OBJECTIVE: To identify differences in mortality trends according to income and sex in the city of São Paulo, Brazil.

DESIGN: We performed a time-trend analysis of all respiratory diseases, including chronic obstructive pulmonary disease (COPD), lung cancer and tuberculosis, using Joinpoint regression comparing high, middle and low household income levels from 1996 to 2010.

RESULTS: The annual per cent change (APC) and 95% confidence intervals (95%CIs) for death rates from all respiratory disease in men in high-income areas was −1.1 (95%CI −2.7 to 0.5) in 1996–2002 and −4.3 (95%CI −5.9 to −2.8) in 2003–2009. In middle- and low-income areas, the decline was respectively −1.5 (95%CI −2.2 to −0.7) and −1.4 (95%CI −1.9 to −0.8). For women, the APC declined in high-income (−1.0, 95%CI −1.9 to −0.2) and low-income areas (0.8, 95%CI −1.3 to −0.2), but not in middle-income areas (−0.5, 95%CI −1.4 to 0.3) from 1996 to 2010.

CONCLUSION: Death rates due to COPD and all respiratory disease declined more consistently in men from high-income areas. Mortality due to lung cancer decreased in men, but increased in women in middle- and low-income areas.

Keywords: COPD; TB; lung cancer; smoking; social inequality

Document Type: Research Article

DOI: http://dx.doi.org/10.5588/ijtld.12.0121

Affiliations: 1: School of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil 2: Hospital Universitário, University of São Paulo, São Paulo, São Paulo, Brazil

Publication date: December 1, 2012

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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