Work

Income Inequality and Mortality from Diabetes Mellitus and Hypertensive Diseases Among Adults Aged 30–69 Years in Brazilian Federative Units: A Longitudinal Analysis, 2012–2024

Year: 2026

Type: article

Abstract: Objective: To analyze the association between income inequality and age-standardized mortality from diabetes mellitus and hypertensive diseases among adults aged 30–69 across Brazilian Federative Units (2012–2024). Methods: Ecological longitudinal study using balanced panel data from the 27 Federative Units. Data were retrieved from the Mortality Information System and IBGE/IPEA databases. Mortality rates were standardized using the direct method (WHO population). Trends were evaluated via Joinpoint regression, and associations were analyzed using mixed linear models with random intercepts and first-order autoregressive covariance structure. Results: Inequality decreased in 25 Federative Units, accompanied by rising income and declining poverty, whereas national aggregated analysis showed a linear increase in inequality (APC = 0.514%; p < 0.001). Overall mortality trends were stationary for diabetes (AAPC = −1.507%; p = 0.102) and hypertension (AAPC = −0.881%; p = 0.524), despite significant declines from 2021 to 2024. In adjusted mixed models, higher per capita household income was independently associated with lower diabetes mortality (β = −0.012; p = 0.031), while hypertension displayed an upward adjusted linear trend (β = 0.289; p = 0.001). Neither the Gini Index nor poverty rates maintained significant independent associations with mortality. Conclusions: After structural adjustment, only absolute per capita household income maintained an independent protective association with diabetes mortality, highlighting the relevance of material living conditions beyond inequality measures alone.

Source: International Journal of Environmental Research and Public Health

DOI: 10.3390/ijerph23091164

Authors: Miguel Medeiros da Silva, Luiz Alves Morais Filho, Janmilli da Costa Dantas Santiago, Isaque Augusto Rosendo Costa, Richardson Augusto Rosendo da Silva, Cristiane da Silva Ramos Marinho

Institution: Universidade Federal do Rio Grande do Norte

Language: English

Topic: Health disparities and outcomes

Subfield: Health

Field: Social Sciences

Domain: Social Sciences

SDGs: Good health and well-being, Reduced inequalities

Open Access status: gold

Estimated APC paid: $3,016