197148 Avoidable causes of death in a low-income area in Rio de Janeiro Sate, Brazil: A ten-year longitudinal record linkage study

Tuesday, November 10, 2009

Maria Teresa Cravo GuimarÃes Nimrichter DE Almeida, MD MSc , Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
Claudia Medina Coeli, MD PhD , Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Liz Maria de Almeida, MD PhD , Programa de Pós Graduação, Instituto Nacional do Cancer, Rio de Janeiro, Brazil
Kenneth Rochel de Camargo, MD PhD , Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
Background: Record linkage methodology represents a useful tool for monitoring health outcomes in small areas. Purpose: To evaluate the proportion of avoidable causes of death among total deaths identified trough a ten-year longitudinal record linkage study carried out in a low-income area where a major sanitation programme was partially implemented. Methods: A census of 29,807 households was conducted from June to December 1997 in Duque de Caxias County (Rio de Janeiro, Brazil). The census database (29,807 households members) was linked to the Rio de Janeiro State's mortality database (1997 to 2006; with 801,587 records), using an automatic probabilistic approach combined with an extensive clerical review. Avoidable causes of death were classified according to the list proposed by a Brazilian Ministry of Health work group. We restricted the analysis to the following age ranges: adolescents and young adults (10 to 24 years), adults (25 to 59 years), elderly (60 years or more) . Results: A total of 681 deaths were identified with 91 (13.4%) presenting an ill-defined cause. Avoidable causes accounted for 88.1% , 76.1% and 72.1% of deaths with a defined cause among adolescents and young adults, adults and the elderly, respectively. External causes were predominant in the younger age strata (70.2% homicides and 14.9% traffic accidents). The share of avoidable deaths due to non-transmissible causes rises with age, reaching 58.1% in the elderly group. Conclusion: The proportion of deaths due to avoidable causes in the area of the study is high, probably due to lacking health conditions and care.

Learning Objectives:
Demonstrate the application of probabilistic record linkage methods in the evaluation of health outcomes

Keywords: Developing Countries, Mortality

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am part of the research team that generated the work to be resented
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.