title: Chronic non-communicable diseases in Brazil: burden and current challenges.
abstract: Non-communicable diseases (NCDs) have become a major health priority in Brazil--72% of all deaths were attributable to NCDs in 2007. They are also the main source of disease burden, with neuropsychiatric disorders being the single largest contributor. Morbidity and mortality due to NCDs are greatest in the poor population. Although the crude NCD mortality increased 5% between 1996 and 2007, age-standardised mortality declined by 20%. Declines were primarily for cardiovascular and chronic respiratory diseases, in association with the successful implementation of health policies that lead to decreases in smoking and the expansion of access to primary health care. Of note, however, the prevalence of diabetes and hypertension is rising in parallel with that of excess weight; these increases are associated with unfavourable changes of diet and physical activity. Brazil has implemented major policies for the prevention of NCDs, and its age-adjusted NCD mortality is falling by 1·8% per year. However, the unfavourable trends for most major risk factors pose an enormous challenge and call for additional and timely action and policies, especially those of a legislative and regulatory nature and those providing cost-effective chronic care for individuals affected by NCDs.
authors.affiliation: Faculty of Medicine, Federal University of Rio Grande do Sul, Brazil. maria.schmidt@ufrgs.br
authors.forename: Maria Inês
authors.initials: MI
authors.lastname: Schmidt
authors.forename: Bruce Bartholow
authors.initials: BB
authors.lastname: Duncan
authors.forename: Gulnar
authors.initials: G
authors.lastname: Azevedo e Silva
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Menezes
authors.forename: Carlos Augusto
authors.initials: CA
authors.lastname: Monteiro
authors.forename: Sandhi Maria
authors.initials: SM
authors.lastname: Barreto
authors.forename: Dora
authors.initials: D
authors.lastname: Chor
authors.forename: Paulo Rossi
authors.initials: PR
authors.lastname: Menezes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001247:Asthenia / Q000453:epidemiology; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology* / Q000401:mortality; D017281:Cost of Illness; D019049:Developed Countries; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult