[Health surveillance after the Samarco dam disaster: evaluation of standards of care in chronic diseases and mental disorders (2008-2023)].

چکیده اصلی

This study compared the possible impacts caused by the Samarco dam collapse (Minas Gerais State, Brazil) and municipalities with a similar profile to analyze the morbidity and mortality patterns due to chronic noncommunicable diseases in the affected municipalities. This ecological study was based on publicly available secondary data (SIA/SUS, SIH/SUS, and SIM) from 2008 to 2023. The analyses were carried out by disease chapters and groups (circulatory, diabetes, respiratory, neoplasms, and mental disorders) and population strata. Rates per 100,000 inhabitants, percentage differences, and relative risk were calculated with 95% confidence intervals. The "post-collapse" period (2016-2019) was compared to the "before the collapse" (2008-2015) and "post-COVID-19" (2020-2023) ones. An increase in the rates of outpatient care occurred in the affected municipalities in relation to the comparison municipalities, especially regarding diabetes (strata 1, 2, 3, and 5), respiratory diseases (strata 1, 3, 4, and 5), mental disorders (strata 4 and 5), and neoplasms (strata 1, 2, 3, and 4). In hospitalizations, slight increases due to respiratory problems occurred in stratum 4 and due to neoplasms in strata 3, 4, and 5. Regarding mortality, this study found an increase in the rates of mental disorders in strata 2 and 4. These findings suggest changes in care patterns in the affected municipalities with possible post-disaster overload and reinforce the importance of surveillance and integration between health, environmental, and risk management policies.

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