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Global Health Economics and
Sustainability
Hospitalizations due to obesity and deaths from diabetes

non-communicable chronic diseases (NCDs) due to their Health and accessible through the SUS Department of
multifactorial origins and long latency periods. They are Informatics (DATASUS). Data were extracted for cases
often interrelated and share common risk factors, such reported between 2000 and 2021 for T2DM and from 2013
as physical inactivity, poor diets, and unhealthy lifestyles to 2021 for obesity, capturing 100% of the official database
(Hu, 2011). Ng et al. (2013) highlight that the global rise for individuals aged 18 and over. The variables analyzed
in obesity, driven by a combination of economic, social, include age, sex, and race/skin color (Court of Justice of
and cultural factors has contributed to the increasing the Federal District and Territories, 2023). These data
prevalence of T2DM across all age groups. The close were linked to deaths, hospitalizations, hospital costs, and
relationship between these two conditions creates a dual municipal-level information in the state of Acre, Brazil.
burden for healthcare systems, particularly in developing
countries, where effective prevention and treatment 2.2. Data analysis
remain limited (Malik et al., 2013). Data were analyzed using the Statistical Package for Social
The need to understand the trends in mortality and Sciences (SPSS) version 20.0. Descriptive statistics were
hospitalization rates related to T2DM and obesity is performed for all variables. Results are presented as mean
pressing, as these conditions are known to lead to a range ± standard deviation or median (interquartile range), along
of health complications, including cardiovascular, renal, with minimum and maximum values where appropriate.
and neurological diseases (Grant et al., 2012). In Brazil, Spearman and non-parametric Pearson correlations were
the economic burden of these comorbidities has become used to compare initial and final values within each group.
a critical concern. According to data from the Unified Statistical significance was set at p ≤ 0.05 and p ≤ 0.01 for
Health System (SUS), the rising number of hospitalizations both analyses.
due to complications due to T2DM and obesity-related For this study, which focuses on NCDs, T2DM and
complications results in escalating hospital costs, straining obesity were the main variables of interest. The analysis of
public health resources that are already facing budgetary obesity-related hospitalizations was limited to the period
and structural challenges (Ministry of Health, 2020). from 2013 to 2021 due to the availability of data from
Therefore, examining trends in mortality, hospitalizations, DATASUS starting in 2013. Thus, when correlating both
and associated costs can provide valuable insights for the variables, the same time period (2013 – 2021) was used.
development of more effective public health policies.
The decision to focus on Brazil is further supported 2.3. Ethical aspects
by the increasing prevalence of obesity and T2DM in the This study did not require submission to an institutional
country, which currently affects more than 25% of the adult Research Ethics Committee, as it utilized secondary data
population (IBGE, 2022). These statistics reflect significant from publicly available databases, specifically the SIM and
lifestyle changes among the Brazilian population over recent the SIH/SUS of the DATASUS.
decades, driven by rapid urbanization and the increased
consumption of ultra-processed foods (Monteiro et al., 3. Results
2004). Given the complexity and socioeconomic impacts Table 1 presents the highest hospitalization costs due
of these conditions, understanding the growth patterns of to T2DM in the municipalities of Rio Branco, followed
these diseases and the factors influencing the sustainability by Cruzeiro do Sul and Sena Madureira, which had the
of the healthcare system, particularly in preventive and highest expenditures on hospitalizations from 2000 to
primary care settings, is crucial (Conde et al., 2022).
2021. Regarding age groups, the 60 – 69 age group had
Based on these considerations, the primary objective of the highest number of hospitalizations and, consequently,
this study is to assess the trends in deaths, hospitalizations, the highest costs, followed by the 50 – 59 age group. The
and hospital costs associated with T2DM and obesity in 70 – 79 age group also showed significant hospitalization
Acre, Brazil, from 2000 to 2021. costs related to T2DM, though slightly lower than those of
the 50 – 59 age group.
2. Method
Table 2 shows the deaths from T2DM recorded between
2.1. Study design 2000 and 2021, categorized by age group, race/skin color,
This study is classified as an ecological, retrospective time- and sex. The highest number of deaths was observed in the
series analysis using official microdata from the Mortality 70 – 79 age group, followed by those aged 80 and above.
Information System (SIM), the Hospital Information System In terms of race/skin color, a higher percentage of deaths
(SIH/SUS), and the Notifiable Diseases Information System were recorded for individuals with missing race/skin color
(SINAN), all of which are registered with the Ministry of information, followed by those identified as mixed race,

Volume 3 Issue 2 (2025) 105 https://doi.org/10.36922/ghes.3027