Open AccessExcess deaths from all causes and by COVID-19 in Brazil in 2020
Author(s) -
Alcione Miranda dos Santos,
Bruno Feres de Souza,
Carolina Abreu de Carvalho,
Marcos Adriano Garcia Campos,
Bruno Luciano Carneiro Alves de Oliveira,
Eduardo Moraes Diniz,
Maria dos Remédios Freitas Carvalho Branco,
Rejane Christine de Sousa Queiroz,
Vitória Abreu de Carvalho,
Waleska Regina Machado Araújo,
Antônio Augusto Moura da Silva
Publication year - 2021
Publication title -
revista de saúde pública/revista de saúde pública
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.857
H-Index - 77
eISSN - 1518-8787
pISSN - 0034-8910
DOI - 10.11606/s1518-8787.2021055004137
Subject(s) - excess mortality , demography , medicine , covid-19 , mortality rate , epidemiology , cause of death , disease , surgery , sociology , infectious disease (medical specialty)
OBJECTIVE To estimate the 2020 all-cause and COVID-19 excess mortality according to sex, age, race/color, and state, and to compare mortality rates by selected causes with that of the five previous years in Brazil. METHODS Data from the Mortality Information System were used. Expected deaths for 2020 were estimated from 2015 to 2019 data using a negative binomial log-linear model. RESULTS Excess deaths in Brazil in 2020 amounted to 13.7%, and the ratio of excess deaths to COVID-19 deaths was 0.90. Reductions in deaths from cardiovascular diseases (CVD), respiratory diseases, and external causes, and an increase in ill-defined causes were all noted. Excess deaths were also found to be heterogeneous, being higher in the Northern, Center-Western, and Northeastern states. In some states, the number of COVID-19 deaths was lower than that of excess deaths, whereas the opposite occurred in others. Moreover, excess deaths were higher in men aged 20 to 59, and in black, yellow, or indigenous individuals. Meanwhile, excess mortality was lower in women, in individuals aged 80 years or older, and in whites. Additionally, deaths among those aged 0 to 19 were 7.2% lower than expected, with reduction in mortality from respiratory diseases and external causes. There was also a drop in mortality due to external causes in men and in those aged 20 to 39 years. Moreover, reductions in deaths from CVD and neoplasms were noted in some states and groups. CONCLUSION There is evidence of underreporting of COVID-19 deaths and of the possible impact of restrictive measures in the reduction of deaths from external causes and respiratory diseases. The impacts of COVID-19 on mortality were heterogeneous among the states and groups, revealing that regional, demographic, socioeconomic, and racial differences expose individuals in distinct ways to the risk of death from both COVID-19 and other causes.