SOCIAL-INEQUALITY IN MORTALITY IN SAO-PAULO STATE, BRAZIL

Background. Epidemiological studies have consistently demonstrated soc ial inequality to be an important factor in the distribution of illnes s and death in society. However, little work has been published on soc ial differentials in mortality in the world's developing countries, wh ere socioeconomic contrasts are often considerably greater. Methods. I n order to evaluate the extent of social differentials in mortality in a setting of major social inequality - the State of Sao Paulo, Brazil , deaths in men aged 15-64 years residing in Sao Paulo from 1980 to 19 82 were linked in broad, occupationally-determined categories to estim ates of population size based on the 1980 Brazilian national census. T he occupational categorizations utilized a Brazilian classification sc heme and additionally that of the British Registrar General. Results. Mortality was 3.8 and 2.9 times greater comparing least to most social ly favoured occupational category in each of the two classification sy stems, respectively. Independent of system, mortality decreased approx imately 1.1% for each 1% increase along the occupationally-defined soc ial gradient. This decrease was 48% greater than the equivalent calcul ated decrease for men of England and Wales. Conclusions. These data su pport the contention that mortality for Brazilian adults, even more so than for adults of the world's more economically developed nations, i s inextricably bound to the issue of social equity.