Eugênia Maria S. Rodrigues, MD, MPH, DrPH

Vilma Pinheiro Gawryszewski, MD, MPD, PhD

Brazil Ministry of Health

Data source:

Mortality: Information Mortality System.

Morbidity: Hospitalization Information System from Public Health System (SIH/SUS).

Ministry of Health Brazil, 2003

• Strengths – Coverage (MIS)– Cause of injury or death (by intent, and

nature of injury)– Demographic data (sex, age, residence)

• Weaknesses – Coverage (HIS)– Cause of injury or death (undetermined

cause of death, unknown intent of injury)– Demographic data (race, education,

occupation)– Data on costs

Sources

Brazil resident population, 2003

FEMALE 89.807.838

51%

MALE 87.068.413

49%

1970 2000

Men Women

Brazil, Population distribution

Source: UN World Population Prospects, 2000 REV

0

1.000.000

2.000.000

3.000.000

4.000.000

5.000.000

6.000.000

7.000.000

8.000.000

9.000.000

10.000.000

< 1

Ye

ar

1-4

Ye

ar

5-9

Ye

ar

10

-14

Ye

ar

15

-19

Ye

ar

20

-24

Ye

ar

25

-29

Ye

ar

30

-34

Ye

ar

35

-39

Ye

ar

40

-44

Ye

ar

45

-49

Ye

ar

50

-54

Ye

ar

55

-59

Ye

ar

60

-64

Ye

ar

65

-69

Ye

ar

70

-74

Ye

ar

75

-79

Ye

ar

80

or

mo

re

Population

Male Female

Population, 2003, Brazil

0

150

300

< 1ano

1 a 4 5 a 9 10 a14

15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75 E+

Male Female

por 100 mil hab.

I Injury mortality rate per gender and age group , Brazil, 2003

Source: Mortality Information System-

Source: Mortality Information System-

583.059

58,2%

Male

1.002.638

418.755

41,8%

Female

All Deaths

126. 749

12,6%

Injury deaths

33.182

26,2%

106.901

84,3%

Male 19.783

15,7%

Female

The burden of injuries in the Brazilian mortality, 2003

MV Injuries

Injury deaths per 100,000 population (Crude rate), 2003, BRAZIL

122,6

22

0

20

40

60

80

100

120

140

MALE FEMALE

per

100

mil

hab.

Source: Information Mortality System/Ministry of Health

Injury morbidity per 100,000 population (Crude rate), 2003, BRAZIL

601,2

249,8

0

100

200

300

400

500

600

700

MALE FEMALE

per

100

mil

hab.

Source: Hospitalization Information System/Ministry of Health

Source: Hospitalization Information System-

4.772.558

40,1%

Male

11.891.497 i

7.118.920

59,9%

Female

All hospitalizations

726.283 7,8%

Injuries

309.460

42,6%

Falls

512.155

70,5%

Male214.128

29,5%

Female

The burden of injuries in the Brazilian morbidity, 2003

Injury deaths and morbidity per 100,000 population (Crude rate), 2003, BRAZIL

0

5

10

15

20

25

30

35

Unintentional Suicides Homicides Undetermined intent

de

ath

s p

er

10

0 m

il h

ab

0

50

100

150

200

250

300

350

400

mo

rbid

ity

pe

r 1

00

mil

ha

b

deaths morbidity

Source: Information Mortality System/Ministry of Health Hospitalization Information System/Ministry of Health

0

10

20

30

40

50

60

70

80

de

ath

s p

er

10

0 m

il h

ab

0

50

100

150

200

250

300

350

400

450

mo

rbid

ity

pe

r 1

00

mil

ha

b

Morbidity death

Injury deaths and morbidity per 100,000 population (Crude rate), 2003, BRAZIL

Source: Information Mortality System/Ministry of Health Hospitalization Information System/Ministry of Health

0

2

4

6

8

10

12

14

de

ath

s p

er

10

0 m

il h

ab

0

50

100

150

200

250

300

350

mo

rbid

ity

pe

r 1

00

mil

ha

b

Morbidity death

Injury deaths and morbidity per 100,000 population 1-14 years, 2003, Brazil (pop=49,056,442)

Source: Information Mortality System/Ministry of Health Hospitalization Information System/Ministry of Health

0

10

20

30

40

50

60

70

80

90

100

de

ath

s p

er

10

0 m

il h

ab

0

50

100

150

200

250

300

350

400

450

mo

rbid

ity

pe

r 1

00

mil

ha

b

Morbidity death

Injury deaths and morbidity per 100,000 population 15-24 years, 2003 Brrazil (pop=

35,531,287)

Source: Information Mortality System/Ministry of Health Hospitalization Information System/Ministry of Health

0

10

20

30

40

50

60

70

80

90

de

ath

s p

er

10

0 m

il h

ab

0

50

100

150

200

250

300

350

400

450

mo

rbid

ity

pe

r 1

00

mil

ha

b

Morbidity death

Injury deaths and morbidity per 100,000 population 35-54 years, 2003 Brazil (pop=

40,184,605)

Source: Information Mortality System/Ministry of Health Hospitalization Information System/Ministry of Health

0

20

40

60

80

100

120

140

de

ath

s p

er

10

0 m

il h

ab

0

100

200

300

400

500

600

700

800

mo

rbid

ity

pe

r 1

00

mil

ha

b

Morbidity death

Injury deaths and morbidity per 100,000 population 65 years and older, 2003 Brazil (pop=10,281,137)

Source: Information Mortality System/Ministry of Health Hospitalization Information System/Ministry of Health

• Management of database at local level (city health department)

• Health Analysis

• Information system to determine the costs

• Use of information for action

Challenges

Challenges

Research priorities - drug and alcohol consumption among injury victims

Population-based surveillance for Emergency Departments is also needed for monitoring injuries and for using in prevention program planning

Challenges

•The findings that types injuries differs on mortality data to morbidity data suggest that prevention efforts should focus not only on fatal injuries, as usual, but also on those nonfatal injuries that can have impact on health sector, especially those that determines hospitalization or high economic and social costs.

• Decreasing the burden of injuries is a big challenge for public health in Brazil and to improve the understanding of the magnitude and characteristics of the problem is a better way to the development of injury prevention programs.

Challenges