Income Inequality, Economic Growth and Stroke Mortality in Brazil: Longitudinal and Regional Analysis 2002-2009.
OBJECTIVE
Stroke accounts for more than 10% of all deaths globally and most of it occurs in low- and middle-income countries (LMIC). Income inequality and gross domestic product (GDP) per capita has been associated to stroke mortality in developed countries. In LMIC, GDP per capita is considered to be a more relevant health determinant than income inequality. This study aims to investigate if income inequality is associated to stroke mortality in Brazil at large, but also on regional and state levels, and whether GDP per capita modulates the impact of this association.


METHODS
Stroke mortality rates, Gini index and GDP per capita data were pooled for the 2002 to 2009 period from public available databases. Random effects models were fitted, controlling for GDP per capita and other covariates.


RESULTS
Income inequality was independently associated to stroke mortality rates, even after controlling for GDP per capita and other covariates. GDP per capita reduced only partially the impact of income inequality on stroke mortality. A decrease in 10 points in the Gini index was associated with 18% decrease in the stroke mortality rate in Brazil.


CONCLUSIONS
Income inequality was independently associated to stroke mortality in Brazil.
Social Medicine and Global Health, Department of Clinical Sciences Malmö, Lund University-Malmö, Malmö, Sweden; CAPES Foundation, Ministry of Education of Brazil, Brasilia-DF, Brazil.
Natalia
N
Vincens
Social Medicine and Global Health, Department of Clinical Sciences Malmö, Lund University-Malmö, Malmö, Sweden.
Martin
M
Stafström
D001938:Brazil / Q000453:epidemiology; D003906:Developing Countries / Q000191:economics; D057217:Economic Development / Q000706:statistics & numerical data*; D059066:Gross Domestic Product / Q000706:statistics & numerical data; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D018803:Models, Economic; D012044:Regression Analysis; D012959:Socioeconomic Factors; D020521:Stroke / Q000191:economics / Q000401:mortality*