Laura Rodríguez Wong

O rápido processo de envelhecimento populacional do Brasil: sérios desafios para as políticas públicas

The positive effects of the recent age structure transition (AST) in Brazil can be seen in children’s health services, education and other areas. The higher growth rate estimated for the economically active population in coming decades constitutes a new area of opportunities. The combination of the older segment of the labor force (ages 25 to 64), which is showing high growth, with the junior segment (ages 15 to 24), which is showing very low or even negative growth rates, indicates a trend toward reducing the demographic pressure for new jobs. The training of the future labor force has become an indispensable component for a more just intergenerational, social and economic balance. Due to the age structure transition, new challenges are emerging related to the expansion of the older population. If the present per capita transfer of funds from the government is maintained constant, the difference between revenue and expenses will increase, causing an unsustainable fiscal deficit. The expected crisis brought about by the aging of the population and the current irrational social security system must be urgently discussed in Brazilian society. The best must be made of the opportunities generated by age structure transition in order to prepare to face the new resulting challenges.

Estimating pregnancy-related mortality from census data: experience in Latin America

OBJECTIVE To assess the feasibility of measuring maternal mortality in countries lacking accurate birth and death registration through national population censuses by a detailed evaluation of such data for three Latin American countries. METHODS We used established demographic techniques, including the general growth balance method, to evaluate the completeness and coverage of the household death data obtained through population censuses. We also compared parity to cumulative fertility data to evaluate the coverage of recent household births. After evaluating the data and adjusting it as necessary, we calculated pregnancy-related mortality ratios (PRMRs) per 100 000 live births and used them to estimate maternal mortality. FINDINGS The PRMRs for Honduras (2001), Nicaragua (2005) and Paraguay (2002) were 168, 95 and 178 per 100 000 live births, respectively. Surprisingly, evaluation of the data for Nicaragua and Paraguay showed overreporting of adult deaths, so a downward adjustment of 20% to 30% was required. In Honduras, the number of adult female deaths required substantial upward adjustment. The number of live births needed minimal adjustment. The adjusted PRMR estimates are broadly consistent with existing estimates of maternal mortality from various data sources, though the comparison varies by source. CONCLUSION Census data can be used to measure pregnancy-related mortality as a proxy for maternal mortality in countries with poor death registration. However, because our data were obtained from countries with reasonably good statistical systems and literate populations, we cannot be certain the methods employed in the study will be equally useful in more challenging environments. Our data evaluation and adjustment methods worked, but with considerable uncertainty. Ways of quantifying this uncertainty are needed.