Socioeconomic Factors and the Elderly Mortality Profile in a Poor Brazilian State: An Ecological Study Comparing Two Distinct Age Groups

The rate of the aging process of the Brazilian population and the accentuated social inequality and fragile institutions determine differentials in the mortality of the population, with many challenges for the health system. The aim of the present study was to analyze the mortality profile of individuals aged 60 to 69 years (young-old) and those aged 80 years or more (oldest-old) in a poor Brazilian state, as well as to investigate the associated socioeconomic factors. The Specific Mortality Rate by Age was calculated using aggregated data from the Mortality Information System (SIM) and the Brazilian Institute of Geography and Statistics (IGBE). In order to identify the mortality profiles of the municipalities, non-hierarchical clustering (K-means) was applied and Principal Components Analysis was used to reduce the socioeconomic variables. In the young-old age group, the misinformation profile, the development profile and the development paradox were more affected by education and poverty. In addition to the misinformation profile, the oldest-old group exhibited the epidemiological transition profile and the epidemiological paradox profile, associated with municipal development. The results for the oldest-old age group confirmed less of an influence at a contextual level. The mortality profiles and associated socioeconomic aspects differed according to age. Health inequalities among elderly individuals could be reduced by considering the different demands, improving the levels of education and poverty, and optimizing the use of health services.