Gender inequalities in non communicable disease mortality in Brazil.

The relative burden due to non communicable diseases (NCD) is increasing worldwide and has been shown to be generally greater for men than women. The objective of this paper is to describe gender differences in NCD mortality rates and trends in Brazil. Standardized mortality rates for the years 1991-2010 were corrected for sub notification and ill defined causes of death and calculated using sex specific five year age grades. Trends in standardized mortality were studied using joinpoint regression models. In 2010, rates for NCDs (men: 479/100000; women: 333/100000) and for most major NCD categories (cardiovascular diseases, cancer, chronic respiratory diseases and other chronic diseases) were higher for men than women. Age standardized mortality rates declined for both sexes over the period, beginning in 1993 and attenuating in more recent years. From its peak in 1993 to 2010, the unconditional probability of dying between the ages of 30 and 70 due to one of the four principal NCD groupings decreased for men from 32.3% to 22.8%; for women, from 23.5% to 15.4%. In conclusion, age standardized NCD mortality, though decreasing dramatically over the past two decades in Brazil, remains notably greater in men than in women and, this difference, in relative terms, will increase if these trends continue.