© 1995 Oxford University Press
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Social Inequality in Mortality in São Paulo State, Brazil
* Social Medicine Department, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul Porto Alegre, RS Brazil.
** Epidemiology Department, Faculdade de Saúde Pública, University de Sao Paulo, SP Brazil. Current address: Department of Community Health Sciences, Faculty of Medicine, University of Calgary Calgary, Alberta, Canada
Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS Brazil. Current address: Resident, Oncology, Hospital Santa Rita, Irmandade Santa Casa de Misericórdia Porto Alegre, RS, Brazil.
Faculdade de Medicina, Universidade Federal do Rio Grande do Sul Porto Alegre, RS Brazil.
Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS Brazil. Current address: Municipal Health Department Porto Alegre, RS Brazil.
Reprint requests to: Dr Bruce B Duncan, Assessoria Científica, Faculdade de Medicine, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcellos 2600/414, Porto Alegre, RS 90035–003, Brazil.
Background. Epldemiological studies have consistently demonstrated social inequality to be an Important factor in the distribution of illness and death in society. However, little work has been published on social differentials inmortality in the world's developing countries, where socioeconomic contrasts are often considerably greater.
Methods. In order to evaluate the extent of social differentials in mortality in a setting of major social inequality—theState of S
o Paulo, Brazil, deaths in men aged 15–64 years residing in S{macron}o Paulo from 1980 to 1982 were linked inbroad, occupationally-determined categories to estimates of population size based on the 1980 Brazilian national census. The occupational categorizations utilized a Brazilian classification scheme and additionally that of the British Registrar General.
Results. Mortality was 3.8 and 2.9 times greater comparing least to most socially favoured occupational category on each of the two classification systems, respectively. Independent of system, mortality decreased approximately 1.1% for each 1% increase along the occupationally-defined social gradient. This decrease was 48% greater than the equivalent calculated decrease for men of England and Wales.
Conclusions. These data support the contention that mortality for Brazllian adults, even more so than for adults, even more so than for adults of the world's more economically developed nations, is inextricably bound to the issue of social equity.
Received 1 October 1994
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