Differentials in deaths of despair in Brazilian subpopulations: a joinpoint regression analysis from 2000 to 2020

Abstract

Purpose: The death rate from despair is rising among middle-aged non-Hispanic whites with low education and income in the United States. It is unclear whether these trends are the same in different economic contexts. The study's objective is to analyze the temporal trend in the rates of deaths due to despair in Brazil from 2000 to 2020 according to race, sex, and age group. Methods: We used data stratified by sex, race, and age groups from the Brazilian Mortality Information System. We used joinpoint regression analysis to identify trends in death rates. Results: Between 2000 to 2020, deaths due to despair increased in all age groups, races, and genders. There was an overall increase of 86.9%. Regarding the speed of increase, we observed that gains are more accelerated in middle-aged groups (mainly between 50 and 59 years old), primarily among black men (AAPC 0.54%, CI 95% 0.41% – 0.68%). The risk persists in these categories during all the time series (Range for RR: man vs women = 5.6 – 6.2; 50-59 yrs vs. 20 – 29 yrs = 1.9 – 2.2; black x white people = 1.1 – 1.6) Conclusions: Trend analysis of subpopulations indicates that some groups, such as black and brown people, men, and middle-aged age groups, are more sensitive to adverse living conditions. The result, different from the pioneering study in the USA, suggests that the context is differential in explaining the volume and trend of deaths.