Uneven state distribution of homicides in Brazil and their effect on life expectancy, 2000–2015: a cross-sectional mortality study

Objective To determine cause-specific and age-specific contributions to life expectancy changes between 2000 2015, separately by state sex in Brazil, with a focus on homicides. Design Retrospective cross-sectional demographic analysis of mortality. Setting population Brazilian age, from 2015. Main outcome measure Using mortality data the Mortality Information System estimates National Statistics Office, we used death distribution methods linear integral decomposition model estimate levels expectancy. We also examine how multiple causes death, including those attributable homicides amenable/avoidable mortality, contributed these Results Between Brazil increased 71.5 75.1 years. Despite state-level variation gains, almost all states over this period. However across homicide contributed, varying degrees, either attenuated or decreased male gains. In Alagoas 2000–2007 Sergipe 2007–2015, reduction 1.5 years, offsetting gains achieved through improvements due medically amenable causes. period could have been improved more than half year 12 Brazil’s if had remained at 2007. Conclusions Homicide appears offset made recent medical services public health interventions, considerable subnational heterogeneity extent phenomenon. Efforts combating can increase beyond what has decades.