Trend analysis in premature mortality due to non communicable diseases in the americas, 2000-2009/2010

To provide trends in premature mortality due to non communicable diseases (NCD) in the Americas is essential to monitor the global targets for the prevention and control of NCDs proposed by the World Health Organization (WHO) and the Pan American Health Organization (PAHO). We analyzed the trends in NCD premature mortality from 2000-2009/2010 in selected countries in the Americas. Methods: We extracted deaths due to the four major NCDs - cardiovascular (CVD), cancer, diabetes mellitus (DM) and chronic respiratory diseases, among people aged 30-69, from 40 countries, using the PAHO/Mortality Information System. Data was corrected for under-reporting and ill-defined deaths. To analyze trends we used the Joinpoint Regression Program. Findings: In 2009 in the Americas, the four NCDs caused about 1.3 million premature deaths (36% of all NCD deaths). CVDs were 43%, cancer 41%, DM 9%, and chronic respiratory diseases 7%. The age-adjusted rates/100,000 dropped 14%, from 378.5 in 2000 to 324.6 in 2009; the average annual percent change (AAPC) was -1.8% [-2.0;-1.5]. CVD showed the highest AAPC -2.8% [-3.1;-2.5]; DM mortality were stable overall but declined among females (AAPC -1.0% [-1.6;-0.4]). Highest rates/100,000: Guyana (613), Trinidad & Tobago (513) and Belize (429/100,000). Lowest rates/100,000: Canada (217), Costa Rica (233) and Chile (244). Men showed higher rates than women in most countries. Trends in NCD mortality declined significantly in the majority of countries but were stable in Dominica, Guatemala, Guyana, Mexico and Peru.Interpretation: Inequities remain in the current rates and trends among countries. More efforts should be taken to reach the 25% target reduction.