Relationship between social development indicators and mortality due to Diabetes Mellitus in Brazil: a space-time analysis.
Thiago Santos Garces, Lara Lídia Ventura Damasceno, George Jó Bezerra Sousa and 3 others
PMID 37586008WHAT IT FOUND
Brazil recorded 601,521 diabetes deaths from 2010 to 2020, with rising rates and high-risk clusters in the Northeast and South.
Deaths were linked to social vulnerability and primary care coverage.
Key findings
01Brazil recorded 601,521 deaths related to Diabetes Mellitus from 2010 to 2020, with a mean mortality rate of 29.8 per 100,000 inhabitants.
02Diabetes mortality rose overall, and high-rate municipalities tended to sit next to other high-rate municipalities, especially in the Northeast and in Rio de Janeiro, Paraná and Rio Grande do Sul.
03The chosen spatial model found the Gini index, social vulnerability index and Family Health Strategy coverage as the indicators that most influenced diabetes mortality.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study is ecological, so it compares municipality-level death rates with municipality-level social indicators. It cannot show that a social condition caused death in an individual patient. Death data were taken from existing records collected for clinical and administrative purposes, not for this study, and diabetes deaths may be underreported because they are recorded as sepsis, cardiovascular disease or vascular complications. Some social indicators came from the 2010 census, so they may not match the 2010 to 2020 mortality period exactly. Several relationships were weak or inconsistent across locations, and the authors caution that some indicators, including illiteracy and household density, had beta values close to zero. The chosen spatial model reported R² = 0.41, which means it accounted for part, not all, of the variation in mortality across municipalities.
The easy way to misread this
Do not conclude that improving income distribution, schooling, housing or Family Health Strategy coverage will reduce diabetes deaths in your patients. The study uses aggregate municipality data and cannot separate cause from other local conditions.