Temporal trends in mortality with obesity recorded as the underlying cause in Espírito Santo, Brazil (2010–2023): an ecological time-series study
Introduction: Obesity is a multifactorial chronic disease associated with high morbidity and mortality and represents a major public health challenge in Brazil. Objective: To analyze temporal trends in deaths in which obesity was recorded as the underlying cause in Espírito Santo, Brazil, between 2010 and 2023. Methods: An ecological time-series study was conducted using data from the Mortality Information System (SIM). Deaths with obesity recorded as the underlying cause (ICD-10: E66) and its subcategories (E66.0 – E66.9) were included. Mortality rates per 100,000 inhabitants were calculated, and temporal trends were assessed using Prais-Winsten regression. Results: A total of 1,089 deaths were identified, with a mean age of 55.7 years, predominantly among women (62.9%). Unspecified obesity accounted for 76.9% of all records. A significant downward trend in mortality was observed, with an average annual reduction of 5.7 deaths (p < 0.001). Mortality rates decreased from 4.04 per 100,000 inhabitants in 2010 to 0.86 per 100,000 in 2023, corresponding to an average annual reduction of 7.2% (p = 0.009). Conclusion: There was a significant reduction in deaths in which obesity was recorded as the underlying cause in Espírito Santo between 2010 and 2023. However, these findings should be interpreted with caution, as obesity is frequently recorded as a contributing rather than an underlying cause of death. The findings highlight the importance of improving death certification practices to enhance the accuracy of mortality statistics related to obesity.