Bolsa Família program reduced mortality among patients with mental disorders

Does receiving Bolsa Família (income transfer program) reduce the risk of death? Yes, at least for specific causes. A study recently published in PLOS Medicine tested the association between access to the Bolsa Família Program (PBF) and mortality risk among patients hospitalized with any psychiatric disorder. The result? The program has not only reduced mortality rates among people hospitalized with mental disorders but could also prevent more deaths.

The research was conducted by the Center for Data and Knowledge Integration for Health (Cidacs/Fiocruz Bahia). To understand the impact of the benefit on the mortality of this specific audience, the research linked social and health data from the Cohort of 100 Million Brazilians* and followed up, from this large base, around 70,000 people who enrolled in the Program after a single hospitalization for a psychiatric disorder.

"We compared a group of people who received the benefit after hospitalization for a mental disorder with a group who did not. This comparison showed that Bolsa Família led to a 7% reduction in overall mortality and an 11% reduction in death by natural causes," explains Camila Bonfim, researcher at Cidacs/Fiocruz Bahia who led the investigation.

The reduction was greater for women and younger people

The people hospitalized with mental disorders included in the database were aged 10 to just over 100 and the data analyzed covers the period between 2008 and 2015. The figures indicate that, in the case of women, the Bolsa Família Program (PBF) had an impact of a 25% reduction in overall mortality and a 27% reduction in death by natural causes. The effect was also significant for people aged 10 to 24 years, with a 21% reduction in overall mortality and a 44% reduction in death by natural causes.

"These impacts on the reduction of death by natural causes such as cardiovascular diseases, cancers, respiratory diseases, among others, demonstrate how the Program has promoted better access to primary care services and routine exams, as one of the conditions for receiving the benefit is this follow-up", explains Camila.

In addition to reducing mortality, the program has also shown the potential to prevent deaths. By analyzing the database of people hospitalized for psychiatric disorders, the research found that if everyone had received the benefit, at least 4% of the deaths would have been prevented.

Poverty alleviation and preventive measures – According to Camila, although it was not designed to address the high mortality risk in this specific population, the figures highlight the importance of the benefit in this regard: "People hospitalized with psychiatric disorders have a lower life expectancy than the general population. We were able to see the potential of poverty reduction programs, such as Bolsa Família, in one of the highest-risk population groups in society", she states.

The study emphasizes the importance of practical measures for prevention: "There are many challenges in living with severe psychiatric disorders. The figures in this study not only help to increase knowledge about the effects of Bolsa Família in Brazil, but also highlight the urgency of considering intersectoral strategies to help prevent patient mortality following psychiatric hospitalization", she concludes.