Morbimortality transition in Brazil: a challenge to 30 years of SUS

Abstract

In 2020, we celebrated 30 years since the publication of the Organic Laws of the Unified Health System. Since then, the change in the profile of morbidity and mortality has challenged management. The health service can meet the significant heterogeneity of almost 6000 municipalities. For this, it is necessary to monitor the leading indicators of the country. The present study aimed to present an overview of trends in mortality and morbidity in Brazil between 1990 and 2019. We used data from the Global Burden of Disease Study to describe morbidity and mortality by large groups (infectious diseases, chronic diseases, and external causes), according to sex and age groups. There is a reduction in morbidity and mortality in the period, regardless of the cause or age group. Also, there is a varying difference between sex according to the cause group. The contribution of chronic diseases is increasing with age, with a substantial difference according to sex. The mortality and years lost curves due to disability curves have a typical pattern. We emphasize the different patterns for male curves due to external causes, with marked over-mortality at young ages. The trend confirms the decline of indicators in a linear manner in the period. The peculiarities of the health transition and the mortality transition in Brazil need to be seen in the light of the different socio-spatial patterns and demographic profiles.