Banca de DEFESA: DANILO ERIVELTON MEDEIROS DIAS

MORTALITY FROM EXTERNAL CAUSES IN THE ELDERLY IN BRAZIL

Time Series Studies. Aging. Primary Health Care. Senescence. Senility.

Human aging can be understood as a common, dynamic, and progressive artifice where several physiological, morphological, physical, biochemical, and psychological changes occur continuously over time. However, in this process, two phases deserve to be understood: senescence and senility.  The first one concerns the aging process, where a series of natural physiological transformations occurs; it is linked to age and does not represent a disease. On the other hand, the second one is associated with pathological events, which are responsible for gradually causing a decline in the functioning of the body systems. The epidemiological transition led to changes in the main causes of morbidity and mortality among the elderly, reducing the number of deaths from infectious and parasitic diseases, and increasing mortality from violent events, that is, external causes. These can be understood as phenomena of the external environment, which through an effect, whether a force gradient, chemical, or radioactive, are capable of causing damage to the human organism with several undesirable effects, such as physical and neurological disabilities, or even the death of the individual. Nowadays, external causes are a relevant public health problem, as they impact the quality of life of individuals and cause hospitalization and/or rehabilitation, disability, or death. However, these are preventable events, that is, they can be avoided if the Primary Health Care network plays a fundamental, efficient, and effective role in acting on the main causes and health problems, as in the case of external causes. This requires qualified assistance from Primary Health Care, which needs to receive investments for training professionals so as to make them able to recognize vulnerable groups, such as the elderly. Thus, this thesis aims to investigate mortality from external causes among the elderly in Brazil. Two studies were carried out: the first one was an ecological study using secondary data, which aimed to analyze the mortality rate from external causes among the elderly in Brazil, between 2019 and 2021; the second one is a scope review protocol, whose objective is to map and describe the scientific evidence on the role of Primary Health Care in the face of mortality from external causes among the elderly, based on the Joanna Briggs Institute Review Manual, 2015. The first study showed an upward trend in mortality rates from external causes among the elderly in Brazil during the study period. The interval between 2000 and 2014 was the period in which the coefficient of mortality from external causes among the elderly increased the most, with an average Annual Percentage Change (APC) of 1.83% (95%CI: 1.6; 2.0). The second study aims to present the main evidence of research on the subject, allowing the identification of gaps in the literature so as to guide actions for coping with external causes among the elderly through Primary Health Care.