Ischemic heart disease: mortality in natives and migrants, Sao Paulo, Brazil, 1979-1998

Objective The State of Sao Paulo has been a major center of attraction for foreign and Brazilian migrants since the 19th century. The pattern of mortality due to ischemic heart disease according to place of birth is, however, unknown. Thus, the objective of the study was to identify differences in mortality due to ischemic heart disease among residents of the State of Sao Paulo according to their place of birth. Methods Analytical time series study based on secondary data. Rates were not calculated due to lack of denominators. Instead, non-census indicators (proportional mortality and standardized mortality ratio weighted for years of potential life lost before the age of 100 years) and medians were utilized. Temporal trends were analyzed by means of simple linear regression. Results In the State of Sao Paulo, about 40% of deaths due to ischemic heart disease occurred among migrants. The trend was negative for foreigners and positive for Brazilian migrants. Those born in northeastern Brazil, who presented the highest percentage of deaths in hospitals, had the worst performance: their proportional mortality due to ischemic heart disease remained unchanged throughout the study period (while this clearly declined for all other groups) and they died at younger ages. Conclusions Migrants' share of total deaths due to ischemic heart disease in the State of Sao Paulo is very high. While there is a declining trend for foreigners, it is growing among Brazilian migrants. Among the compared groups, mortality due to ischemic heart disease in the State of Sao Paulo is most prominent for those born in northeastern Brazil.