Temporal and spatial estimates of adult mortality for small areas in Brazil, 1980-2010

BACKGROUND The study of mortality level and trends in developing countries is limited by the quality of vital registration system and population data, especially for small areas. However, understanding regional differences in data quality and mortality is crucial for public health planning. OBJECTIVE The paper aims to estimate adult mortality levels for small-areas in Brazil and to examine variations and spatial patterns of adult mortality across regions, overtime and by sex in the country METHODS We combine a three-method strategy. We apply a standardization technique to smooth rates in small areas. We then obtained measures of completeness of death counts coverage using Death Distribution Methods. And spatial analysis to investigate variations and patterns of adult mortality in small areas of the country. RESULTS We find that completeness of death counts coverage improved overtime across the country. We observed that regions in the south and southeast have complete death registration systems and areas in the less developed regions are improving. We observe a large and constant differential in adult mortality by sex and regions. CONCLUSIONS We find that the quality of mortality data in Brazil and regions is improving over time. The improvement is mostly explain by public investments in collection health data. Gender differences remained high over the period of analysis due to the increase in external causes of deaths for males. This increase also explains the concentration of high mortality levels for males in some areas of the country. CONTRIBUTION A new methodological procedure on estimating and analyzing the evolutions on adult mortality pattern over time and across smaller areas on the presence of defective data, on both vital statistics and population data.