562 Geographical Distribution of Deaths from Asthma in Salvador, Brazil (2000–2009)

BACKGROUND: Salvador is the 3rd largest city of Brazil with 3 million inhabitants, divided into neighborhoods with remarkable social inequalities, varied infrastructure and access to health services. OBJECTIVE: To evaluate the geographic distribution and identify areas of risk for asthma deaths in the city of Salvador, Bahia, Brazil (2000–2009). METHODS: Observational descriptive study of deaths from asthma according to ICD-10 in the period between 2000 and 2009, with information obtained from the National Database of Mortality of the Ministry of Health of Brazil. The distribution of deaths was mapped with points and public primary care facilities including emergency care units were located in the geographical grid of the City by the software Arcview. The risk areas were identified by the method of Kernel. Correlation between the number of deaths and number of health care units was assessed using the Spearman test. RESULTS: We geocoded the location of 395 of 409 deaths from asthma (96.58%) occurred during the study period. It was observed that 78% of deaths occurred in hospitals or health facilities. The highest density in areas of risk and the highest concentrations of death from asthma occurred in more populated and underprivileged areas. There was a direct correlation between the number of public primary health facilities and the number of deaths (rho = 0.667, P = 0.018). CONCLUSIONS: Asthma deaths in Salvador are concentrated in the poorest areas of the city where there are a great number of public primary health facilities. The geographic distribution of deaths indicates that current practices in primary care are insufficient to prevent deaths from asthma in Salvador, Brazil.