Mortality in 5-19-year-olds due to external causes in Brazil (2014-2024): results from a nationwide spatiotemporal study

Abstract External causes are an important source of preventable mortality among children and adolescents in Brazil, with marked regional and age-specific differences. This study described spatial and temporal patterns of mortality from external causes among Brazilians aged 5–19 years from 2014 to 2024. We conducted an ecological study using data from the Brazilian Mortality Information System for 133 intermediate geographic regions. Mortality was analyzed by sex and age group (5–9, 10–14, and 15–19 years) using Bayesian spatiotemporal Poisson models estimated with the Integrated Nested Laplace Approximation (INLA). During the study period, 169,175 deaths from external causes were recorded among individuals aged 5–19 years, and 85.6% occurred in males. Mortality risk declined annually in both sexes and all age groups, stabilizing near the end of the period. Higher risks were concentrated in the North and in parts of the Northeast and Central-West, while lower risks predominated in the South and Southeast. Transport accidents were the leading external cause among children aged 5–9 years, whereas assaults predominated among adolescents aged 15–19 years. Self-inflicted injuries increased among females aged 10–14 and 15–19 years. Overall, mortality from external causes declined but remained spatially heterogeneous, with distinct patterns by age and sex. By integrating spatial and temporal dimensions, this study identifies vulnerable areas and population groups and provides evidence to support targeted prevention, territorial health planning, and policies to reduce avoidable mortality.