Health transition in Brazil: regional variations and divergence/convergence in mortality.

This study analyzes the main characteristics of the health transition in Brazil and its five major regions, using a framework that accounts for regional inequalities in mortality trends. The regional mortality divergence/convergence process is described and discussed by considering the specific contributions of age groups and causes of death in life expectancy variations. Results show that mortality change in Brazil has follow the epidemiologic transition theory to some extent during the period under analysis - for instance, the sharp decline in infant mortality in all regions (first from infectious and parasitic diseases and then from causes associated with the perinatal period) and the increase in the participation of chronic and degenerative diseases as the main cause of death. However, some features of Brazilian transition have not followed the linear and unidirectional pattern proposed by the epidemiologic transition theory, which helps to understand the periods of regional divergence in life expectancy, despite the long-term trends showing reducing regional inequalities. The emergence of HIV/AIDS, the persistence of relatively high levels of other infections and parasitic diseases, the regional differences in the unexpected mortality improvements from cardiovascular diseases, and the rapid and strong variations in mortality from external causes are some of the examples.