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Magalhães AS, Andrade ACDS, Moreira BDS, Lopes AADS, Caiaffa WT. Physical and social neighborhood disorder in Latin American cities: a scoping review. CAD SAUDE PUBLICA 2023; 39:e00038423. [PMID: 37729304 PMCID: PMC10513154 DOI: 10.1590/0102-311xpt038423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 09/22/2023] Open
Abstract
Neighborhood disorder is an important aspect that may influence the health of residents in urban areas. The aims of this study were to map and systematize methods for measuring physical and social neighborhood disorder in studies conducted in Latin American cities. By means of a scoping review, articles published from 2000 in English, Spanish, and Portuguese with the following descriptors were mapped: neighborhood, physical disorder, and social disorder. Searches were conducted in MEDLINE (PubMed), LILACS (Virtual Health Library), Scopus, Web of Science, and Cochrane Library. Information on authorship, year, study type, locality, data source, target population, outcome, dominion, indicator, method, geographic unit, and unit of analysis was extracted. Variables from the disorder-related studies were extracted and grouped by similarity of content and themes. A total of 22 articles were identified, all published between 2012 and 2022, the majority in Brazil (n = 16). The perception of the individual was the most used method. The most frequent theme addressed in the physical disorder dominion was public streets (n = 20) and security (n = 15), in the social disorder dominion. A lack of consensus in the literature regarding variables used to measure physical and social neighborhood disorder in Latin American cities was detected. In addition to the need for standardization of the theme, studies to verify the sustainability of proposed measurement methods relevant to dynamically classify and compare urban neighborhoods and health impacts based on levels of exposure to physical and social disorder, are recommended.
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Affiliation(s)
- Amanda Silva Magalhães
- Observatório de Saúde Urbana de Belo Horizonte, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Amanda Cristina de Souza Andrade
- Observatório de Saúde Urbana de Belo Horizonte, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Instituto de Saúde Coletiva, Universidade Federal de Mato Grosso, Cuiabá, Brasil
| | - Bruno de Souza Moreira
- Observatório de Saúde Urbana de Belo Horizonte, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Núcleo de Estudos em Saúde Pública e Envelhecimento, Universidade Federal de Minas Gerais/Fundação Oswaldo Cruz, Belo Horizonte, Brasil
| | - Adalberto Aparecido Dos Santos Lopes
- Observatório de Saúde Urbana de Belo Horizonte, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
- Grupo de Estudos e Pesquisa em Ambiente Urbano & Saúde, Universidade Federal de Santa Catarina, Florianópolis, Brasil
| | - Waleska Teixeira Caiaffa
- Observatório de Saúde Urbana de Belo Horizonte, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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Mokhele T, Mutyambizi C, Manyaapelo T, Ngobeni A, Ndinda C, Hongoro C. Determinants of Deteriorated Self-Perceived Health Status among Informal Settlement Dwellers in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4174. [PMID: 36901185 PMCID: PMC10001468 DOI: 10.3390/ijerph20054174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/24/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
Self-perceived health (SPH) is a widely used measure of health amongst individuals that indicates an individual's overall subjective perception of their physical or mental health status. As rural to urban migration increases, the health of individuals within informal settlements becomes an increasing concern as these people are at high health and safety risk due to poor housing structures, overcrowding, poor sanitation and lack of services. This paper aimed to explore factors related to deteriorated SPH status among informal settlement dwellers in South Africa. This study used data from the first national representative Informal Settlements Survey in South Africa conducted by the Human Sciences Research Council (HSRC) in 2015. Stratified random sampling was applied to select informal settlements and households to participate in the study. Multivariate logistic regression and multinomial logistic regression analyses were performed to assess factors affecting deteriorated SPH among the informal settlement dwellers in South Africa. Informal settlement dwellers aged 30 to 39 years old (OR = 0.332 95%CI [0.131-0.840], p < 0.05), those with ZAR 5501 and more household income per month (OR = 0.365 95%CI [0.144-0.922], p < 0.05) and those who reported using drugs (OR = 0.069 95%CI [0.020-0.240], p < 0.001) were significantly less likely to believe that their SPH status had deteriorated compared to the year preceding the survey than their counterparts. Those who reported always running out of food (OR = 3.120 95%CI [1.258-7.737], p < 0.05) and those who reported having suffered from illness or injury in the past month preceding the survey (OR = 3.645 95%CI [2.147-6.186], p < 0.001) were significantly more likely to believe that their SPH status had deteriorated compared to the year preceding the survey than their counterparts. In addition, those who were employed were significantly (OR = 1.830 95%CI [1.001-3.347], p = 0.05) more likely to believe that their SPH status had deteriorated compared to the year preceding the survey than those who were unemployed with neutral SPH as a base category. Overall, the results from this study point to the importance of age, employment, income, lack of food, drug use and injury or illness as key determinants of SPH amongst informal settlement dwellers in South Africa. Given the rapid increasing number of informal settlements in the country, our findings do have implications for better understanding the drivers of deteriorating health in informal settlements. It is therefore recommended that these key factors be incorporated into future planning and policy development aimed at improving the standard of living and health of these vulnerable residents.
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Affiliation(s)
- Tholang Mokhele
- Geospatial Analytics, eResearch Knowledge Centre, Human Sciences Research Council, Pretoria 0001, South Africa
| | | | - Thabang Manyaapelo
- Africa Health Research Institute, KwaZulu-Natal, Somkhele 3935, South Africa
| | | | - Catherine Ndinda
- Human and Social Capabilities Division, Human Sciences Research Council, Cape Town 8000, South Africa
| | - Charles Hongoro
- Developmental, Capable and Ethical State Division, Human Sciences Research Council, Pretoria 0001, South Africa
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Morais ÉAHD, Abreu MNS, Assunção AÁ. [Self-rated health and factors related to the work of basic education's teachers in Brazil]. CIENCIA & SAUDE COLETIVA 2023; 28:209-222. [PMID: 36629565 DOI: 10.1590/1413-81232023281.07022022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 07/08/2022] [Indexed: 01/11/2023] Open
Abstract
The scope of this article is to analyze the association between teachers' self-rated health and the conditions in which they work in Basic Education schools in Brazil. It involved a cross-sectional study, carried out between 2015 and 2016, representative of Basic Education teachers in the country, the outcome variable of which was self-rated health (SRH). The explanatory variables were the work-related characteristics. To assess the factors associated with SRH, the Proportional Odds Logistic Regression Model was used. The prevalence of poor SRH was 27%. The probability of poor SRH was significantly higher for the group that reported episodes of verbal violence (OR=1.26; 95%CI 1.09-1.44), work pressure (OR=1.18; 95%CI 1, 04-1.33), and a commute to school of more than 50 minutes (OR=1.19; 95%CI 1.03-1.38). The probability of poor SRH was significantly better for those who reported having enough time to complete their tasks (OR=0.77; 95%CI 0.64-0.92), social support (OR=0.79; 95%CI 0.69-0.89) and satisfaction with their workload (OR=0.79; 95%CI 0.69-0.91). Actions on the school environment and organization and improvements in the transport of teachers to work are desirable.
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Affiliation(s)
- Évelin Angélica Herculano de Morais
- Departamento de Enfermagem Aplicada, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG). R. Alfredo Balena 190, sala 510, Bairro Santa Efigênia. 30150-331 Belo Horizonte MG Brasil.
| | | | - Ada Ávila Assunção
- Departamento de Medicina Preventiva e Social, Faculdade de Medicina, UFMG. Belo Horizonte MG Brasil
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Teixeira da Silva AC, Chagas Gerônimo de Lima CC, de Oliveira Prado Sousa B, Dos Santos MA, Pillon SC, Souza ALTD. Tobacco and alcohol consumption and health behaviors among nursing students. AVANCES EN ENFERMERÍA 2022. [DOI: 10.15446/av.enferm.v40n2.92408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023] Open
Abstract
Objetive: To evaluate the association between attitudes, health behaviors, and the use of tobacco and alcohol among nursing students.
Materials and method: Exploratory, descriptive and cross-sectional study conducted with 182 undergraduate nursing students in the countryside of São Paulo, Brazil. Sociodemographic Information Form, Alcohol Use Disorders Identification Test – C(AUDIT-C), Fagerström Test for Nicotine Dependence (FTND), Attitudes and Health Behaviors Questionnaire (AHBQ), and Patient Health Questionnaire – 2 (PHQ-2) were applied.
Results: More than half of the students showed appropriate health behaviors and positive attitudes. Approximately 50% of the participants had consumed alcoholic beverages in the last month. Experimental use of illicit drugs and smoking were also observed. In addition, students who reported excessive alcohol use presented a deficit in self-care.
Conclusion: The precariousness in health attitudes and behaviors identified in this study was associated with various patterns of psychoactive substance use. Thus, the results indicate the need for interventions aimed at promoting well-being and a healthy lifestyle in the university environment.
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Tadiri CP, Gisinger T, Kautzky-Willer A, Kublickiene K, Herrero MT, Norris CM, Raparelli V, Pilote L. Determinants of perceived health and unmet healthcare needs in universal healthcare systems with high gender equality. BMC Public Health 2021; 21:1488. [PMID: 34332567 PMCID: PMC8325202 DOI: 10.1186/s12889-021-11531-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 07/21/2021] [Indexed: 11/22/2022] Open
Abstract
Background Patient attitudes about health and healthcare have emerged as important outcomes to assess in clinical studies. Gender is increasingly recognized as an intersectional social construct that may influence health. Our objective was to determine potential sex differences in self-reported overall health and access to healthcare and whether those differences are influenced by individual social factors in two relatively similar countries. Methods Two public health surveys from countries with high gender equality (measured by UN GII) and universal healthcare systems, Canada (CCHS2014, n = 57,041) and Austria (AT-HIS2014, n = 15,212), were analysed. Perceived health was assessed on a scale of 1 (very bad) to 4 (very good) and perceived unmet healthcare needs was reported as a dichotomous variable (yes/no). Interactions between sex and social determinants (i.e. employment, education level, immigration and marital status) on outcomes were analysed. Results Individuals in both countries reported high perceived health (Scoring > 2, 85.0% in Canada, 79.9% in Austria) and a low percentage reported unmet healthcare needs (4.6% in Canada, 10.7% in Austria). In both countries, sex and several social factors were associated with high perceived health, and a sex-by-marital status interaction was observed, with a greater negative impact of divorce for men. Female sex was positively associated with unmet care needs in both countries, and sex-by-social factors interactions were only detected in Canada. Conclusions The intersection of sex and social factors in influencing patient-relevant outcomes varies even among countries with similar healthcare and high gender equality. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11531-z.
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Affiliation(s)
- Christina P Tadiri
- Research Institute of McGill University Health Centre, Division of Clinical Epidemiology McGill University, Montreal, Canada.
| | - Teresa Gisinger
- Department of Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Department of Medicine III, Division of Endocrinology and Metabolism, Medical University of Vienna, Vienna, Austria
| | - Karolina Kublickiene
- Department of Renal Medicine, Institution for Clinical Science, Intervention & Technology, Karolinska Institute, Stockholm, Sweden
| | - Maria Trinidad Herrero
- Clinical and Experimental Neuroscience (NiCE), Institute for Aging Research, Institute for Bio-Health Research of Murcia (IMIB), School of Medicine, University of Murcia, Murcia, Spain
| | - Colleen M Norris
- Faculty of Nursing, University of Alberta, Edmonton, Canada.,Heart Health & Stroke, Strategic Clinical Network-Alberta Health Services, Edmonton, Alberta, Canada
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy.,University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Louise Pilote
- Research Institute of McGill University Health Centre, Division of Clinical Epidemiology McGill University, Montreal, Canada
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Sousa APDM, Pereira IC, Araujo LDL, Rocha MRD, Bandeira HMM, Lima LHDO. Prevalence and factors associated with overweight in adults in Brazilian capitals and the Federal District, 2019. ACTA ACUST UNITED AC 2021; 30:e2020838. [PMID: 34287557 DOI: 10.1590/s1679-49742021000300014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 03/02/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Se To analyze the prevalence and factors associated with overweight in Brazilian capitals and the Federal District, Brazil, 2019. METHODS Se Cross-sectional study, with data from the Surveillance of risk and protective factors for chronic diseases by telephone survey, 2019. Prevalence was calculated overweight and association with sociodemographic and behavioral characteristics and health status, stratified according to sex. RESULTS Se The prevalence of overweight was 55.9% (95%CI 54.9;56.9), associated in men with age of 35-44 years (PR=1.87 - 95%CI 1.65;2.12), alcohol consumption (PR=1.09 - 95%CI 1.03;1.15), and hypertension (PR=1.24 - 95%CI 1.17;1.31); and in women, associated to age 45-54 years (PR=2.03 - 95%CI 1.77;2.32), habit of watching television for 3h/day (PR=1.09 - 95%CI 1.04;1.15), and poor/very poor health status (PR=1.31 - 95%CI 1.20;1.43). CONCLUSION Se Overweight was observed in more than half of the sample, associated with hypertension, diabetes mellitus and alcohol consumption, in both sexes.
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Affiliation(s)
| | - Izabela Cristina Pereira
- Universidade Federal do Piauí, Programa de Pós-Graduação em Saúde e Comunidade, Teresina, PI, Brasil
| | - Laécio de Lima Araujo
- Universidade Federal do Piauí, Programa de Pós-Graduação em Saúde e Comunidade, Teresina, PI, Brasil
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Szwarcwald CL, Damacena GN, Barros MBDA, Malta DC, Souza Júnior PRBD, Azevedo LO, Machado ÍE, Lima MG, Romero D, Gomes CS, Werneck AO, Silva DRPD, Gracie R, Pina MDFD. Factors affecting Brazilians' self-rated health during the COVID-19 pandemic. CAD SAUDE PUBLICA 2021; 37:e00182720. [PMID: 33950075 DOI: 10.1590/0102-311x00182720] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 07/28/2020] [Indexed: 01/02/2023] Open
Abstract
This is a cross-sectional study investigating the factors affecting brazilians' self-rated health during the COVID-19 pandemic, based on data from the web-based behavior survey. Carried out from April 24 to May 24, 2020, the survey recruited participants by a chain sampling procedure. Its outcome was the worsening of self-rated health during the pandemic. Statistical analysis was based on a hierarchical model of determination. Logistic regression models were used to test the associations between sociodemographic characteristics, pre-existing health conditions, lifestyle indicators and intensity of social restraint measures, and biological and psychological issues during the pandemic. From the total sample of 45,161 participants, 29.4% reported worsening of health state during this period. After adjusting for hierarchical distal factors, the health problems mostly associated with worsening health state were: bad self-rated health (adjusted OR = 4.35, p < 0.001), health care seeking for mental health problem (adjusted OR = 3.95, p < 0.001), and for COVID-19 (adjusted OR = 3.60, p < 0.001). People who experienced sleep problems, worsening of back pain, depression and at least one flu symptom during the pandemic were twice as likely to report worsening of health status. Sedentary and eating behaviors and adherence to social distancing measures showed significant correlation with the outcome. There exists a relation between social, biological, and psychological factors, mediated by lifestyles and variables pertaining to confinement. Altogether, these factors have negatively affected self-rated health during the COVID-19 pandemic in Brazil.
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Affiliation(s)
- Celia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Giseli Nogueira Damacena
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | | | | | - Luiz Otávio Azevedo
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Ísis Eloah Machado
- Escola de Medicina, Universidade Federal de Ouro Preto, Ouro Preto, Brasil
| | | | - Dália Romero
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Crizian Saar Gomes
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | | | | | - Renata Gracie
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Maria de Fátima de Pina
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Vaz C, Andrade AC, Silva U, Rodríguez D, Wang X, Moore K, Friche AA, Diez-Roux AV, Caiaffa WT. Physical Disorders and Poor Self-Rated Health in Adults Living in Four Latin American Cities: A Multilevel Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238956. [PMID: 33276424 PMCID: PMC7730272 DOI: 10.3390/ijerph17238956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/23/2020] [Accepted: 11/26/2020] [Indexed: 11/16/2022]
Abstract
Considering that urban environments may affect self-rated health through behavioral and psychosocial mechanisms, the aim of this study was to investigate the association between self-rated health and perceived urban environment characteristics among adults living in four Latin American cities. Data is from a population-based survey by Development Bank of Latin America, encompassing adults between 20 and 60 years old in Buenos Aires, Lima, Mexico City, and Panama City. Self-rated health was measured using a single question and the response options were categorized as poor and good. The explanatory variables were empirical Bayes estimates of self-reported area physical disorder, social disorder, access to services, and access to leisure spaces derived from the survey. The covariates were: individual age, sex, education, wealth index, and length of residency in the neighborhood; and an area social environment index. Multilevel logistic regressions with two levels (individual and sub-city areas) were fitted. Poor self-rated health was reported by 34.73% (95% CI: 33.17 to 36.29) of the participants and was associated with physical disorder (OR = 1.16 per SD; 95% CI: 1.02 to 1.32). Our findings suggest that public policies to promote population health should consider area urban environment factors, especially those associated with disorder.
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Affiliation(s)
- Camila Vaz
- Department of Physical Therapy, Federal University of Juiz de Fora, Rua São Paulo 745, Governador Valadares 35010-180, Brazil
- Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte 30130-100, Brazil; (A.C.A.); (U.S.); (A.A.F.); (W.T.C.)
- Correspondence: ; Tel.: +55-(31)99701-5146
| | - Amanda Cristina Andrade
- Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte 30130-100, Brazil; (A.C.A.); (U.S.); (A.A.F.); (W.T.C.)
- Institute of Public Health, Federal University of Mato Grosso, Avenida Fernando Corrêa 2367, Cuiabá 78060-900, Brazil
| | - Uriel Silva
- Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte 30130-100, Brazil; (A.C.A.); (U.S.); (A.A.F.); (W.T.C.)
| | - Daniel Rodríguez
- Department of City and Regional Planning and Institute for Transportation Studies, University of California, 228 Wurster Hall, Berkeley, CA 94720, USA;
| | - Xize Wang
- Department of Real State, National University of Singapore, 4 Architecture Drive, Singapore 117566, Singapore;
| | - Kari Moore
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, PA 19104, USA; (K.M.); (A.V.D.-R.)
| | - Amélia Augusta Friche
- Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte 30130-100, Brazil; (A.C.A.); (U.S.); (A.A.F.); (W.T.C.)
- Faculty of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena 190, Belo Horizonte 30130-100, Brazil
| | - Ana Victoria Diez-Roux
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, 3215 Market Street, Philadelphia, PA 19104, USA; (K.M.); (A.V.D.-R.)
| | - Waleska Teixeira Caiaffa
- Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte 30130-100, Brazil; (A.C.A.); (U.S.); (A.A.F.); (W.T.C.)
- Faculty of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena 190, Belo Horizonte 30130-100, Brazil
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Life Satisfaction and Self-rated Health in Adolescents: The Relationships between them and the Role of Gender and Age. SPANISH JOURNAL OF PSYCHOLOGY 2020; 23:e4. [PMID: 32436483 DOI: 10.1017/sjp.2020.10] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The purpose of this study was to analyze the relationships between self-reported life satisfaction, self-rated health, gender, and age in adolescents. 1,141 secondary school students aged between 12 and 17 participated in our study. The data were analyzed using bivariate and nonlinear canonical correlation analyses. The results of the bivariate correlation analysis support the results of previous studies. Life satisfaction was positively correlated with same-day perceived health (r = .37; p < .01) and negatively correlated with anxiety/depression (r = -.37; p < .01). Same-day perceived health was positively correlated with health in the past 12 months (r = .38; p < .01) and negatively correlated with pain/discomfort (r = -.32; p < .01) and with anxiety/depression (r = -.32; p < .01). The nonlinear canonical correlation analysis provided further evidence of the relationship between the variables, suggesting the complementarity of the indicators of self-rated health analyzed. Multiple fit values showed that demographic variables age (.61) and gender (.56) were the variables with the best discriminatory power. Graphically, two groups of related variables were displayed. A non-linear analysis better explains the relationships between the variables analyzed, showing that age and gender have a high level of discriminatory power for life satisfaction and self-rated health, suggesting a role as a moderator in the relationship between health and well-being variables.
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Pinilla-Roncancio M, González-Uribe C, Lucumí DI. Do the determinants of self-rated health vary among older people with disability, chronic diseases or both conditions in urban Colombia? CAD SAUDE PUBLICA 2020; 36:e00041719. [PMID: 32402010 DOI: 10.1590/0102-311x00041719] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 10/08/2019] [Indexed: 11/21/2022] Open
Abstract
Our study aimed to identify the main determinants of self-rated health for individuals aged 60 years or older in Bogotá, Colombia, and if those determinants vary between groups. Data was obtained from the Demographic Health Survey 2011 for Bogotá. Logistic regression models were estimated to identify the determinants of excellent/good self-rated health among people aged 60 years or older living in Bogotá. Moreover, a subgroup analysis was conducted seeking to identify if the determinants changed between groups (men, women, persons with disability, with chronic disease(s), and persons with both disability and chronic disease(s)). The likelihood of reporting an excellent/good self-rated health health decreases when the individual has a disability, a chronic disease or reports that their household income is not enough to cover the basic needs. On the other hand, the odds of reporting excellent/good self-rated health increase when the individual is more educated and reports to receive family support. The subgroup analysis showed that although some determinants are only associated with one group (age with chronic diseases), in general, three main determinants stood out: years of education, socioeconomic status variables and receiving family support. The determinants of self-rated health for older adults in Bogotá differ according to the disability and the chronic disease status. Thus, public policies aiming to improve the levels of health and quality must consider the impacts of those characteristics on individuals' perceptions of their own health.
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Fernandes SGG, Pirkle CM, Sentell T, Costa JV, Maciel ACC, da Câmara SMA. Association between self-rated health and physical performance in middle-aged and older women from Northeast Brazil. PeerJ 2020; 8:e8876. [PMID: 32309044 PMCID: PMC7153554 DOI: 10.7717/peerj.8876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 03/09/2020] [Indexed: 11/20/2022] Open
Abstract
Background Self-rated Health (SRH) is regarded as a simple and valid measure of a person’s health status, given its association to adverse health outcomes, including low physical performance in older populations. However, studies investigating these associations in low- and middle-income settings are scarce, especially for middle-aged populations. Understanding the validity of SRH in relation to objective health measures in low-income populations could assist in decision making about health policy and strategies, especially in under-resourced settings. Objective Assess the relationship between SRH and physical performance measures in middle-aged and older women in a low-income setting of Brazil. Methods This is a cross-sectional study of 571 middle-aged (40–59 years old) and older (60–80 years old) women living in Parnamirim and Santa Cruz in the Northeast region of Brazil. Participants reported their health status and were allocated to the “SRH good” or “SRH poor” groups. The physical performance evaluation included: handgrip strength, one-legged balance with eyes open and closed and chair stand test. The relationship between SRH and physical performance for middle-aged and older women was assessed by quantile regression (modeling medians) adjusted for potential confounders (age, socioeconomic variables, body mass index, menopause status, age at first birth, parity, chronic conditions and physical activity). Results Middle-aged women from the “SRH good” group presented better physical performance with 1.75 kgf stronger handgrip strength (95% CI [0.47–3.02]; p = 0.004), 1.31 s longer balance with eyes closed ([0.00–2.61]; p = 0.030), and they were 0.56 s faster in the chair stand test ([0.18–0.94]; p = 0.009) than those who reported “SRH poor”. No association was found for balance with eyes open. For older women, there was no evidence of associations between physical performance and SRH. Conclusion This study showed that SRH is significantly associated with objective measures of physical performance in a sample of low-income middle-aged women. SRH can be an important tool to indicate the need for further evaluation of physical performance among middle-aged women and can be particularly useful for low-income communities.
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Affiliation(s)
- Sabrina Gabrielle Gomes Fernandes
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
| | - Catherine M Pirkle
- Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Tetine Sentell
- Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI, USA
| | - José Vilton Costa
- Department of Demography and Actuarial Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | - Saionara Maria Aires da Câmara
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Rio Grande do Norte, Brazil
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Andrade GFD, Loch MR, Silva AMR. [Changes in health-related behaviors as predictors of changes in health self-perception: longitudinal study (2011-2015)]. CAD SAUDE PUBLICA 2020; 35:e00151418. [PMID: 31066778 DOI: 10.1590/0102-311x00151418] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 12/27/2018] [Indexed: 11/22/2022] Open
Abstract
Health self-perception is recognized as an interesting health indicator, due to its capacity to predict morbimortality, among others. Studies that investigate its association with health-related behaviors are more recent and, for the most part, cross-sectional, which indicates that this relationship may be better understood in longitudinal studies. This article sought to verify the relationship between changes in health-related behaviors and the incidence of positive and negative health self-perception. We carried out a prospective, population-based cohort study with 883 individuals aged 40 years or more interviewed in 2011 and 2015. We verified the incidence of negative and positive health self-perception according to changes in four health-related behaviors: leisure-time physical activity, fruit and vegetable consumption, abusive alcohol consumption and smoking - using crude and adjusted Poisson regression. The incidence of negative health self-perception was of 27.2%, and was higher, after adjusting for demographic, health, and other behavioral variables, among individuals with negative changes in leisure-time physical activity (RR = 1.88; 95%CI: 1.17-3.05) and in fruit and vegetable consumption (RR = 1.95; 95%CI: 1.15-3.28). The incidence of positive health self-perception was 33.2% and was higher among those who had a positive change in smoking (RR = 8.37; 95%CI: 2.79-25.09) and lower among those who had a negative change in fruit and vegetable consumption (RR = 0.51; 95%CI: 0.29-0.90). We conclude that some changes in health-related behaviors have a possible impact on health self-perception, which reinforces the importance of policies related to health-related behaviors, going beyond their relationship with morbimortality.
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Carvalho BGCD, Andrade ACDS, Andrade RGD, Mendes LL, Velasquez-Melendez G, Xavier CC, Proietti FA, Caiaffa WT. Densidade de estabelecimentos que comercializam bebidas alcoólicas na área residencial está associada ao consumo de álcool em adolescentes? REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200089. [DOI: 10.1590/1980-549720200089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 01/30/2020] [Indexed: 11/22/2022] Open
Abstract
RESUMO: Objetivos: Investigar a associação entre a densidade de estabelecimentos de venda de bebidas alcoólicas no entorno da residência dos adolescentes e a prevalência de consumo de álcool na vida e atual, ajustado por fatores individuais e familiares. Métodos: As informações provêm da pesquisa domiciliar por amostragem probabilística estratificada e por conglomerados em três estágios (setor censitário, domicílio, adulto e adolescente), realizada em Belo Horizonte, Brasil (Saúde em Beagá, 2008-9) e de fontes oficiais de estabelecimentos que comercializam bebidas alcoólicas, devidamente georreferenciados. O desfecho foi o autorrelato de consumo de álcool na vida e atual pelos adolescentes. A variável de exposição foi a densidade de estabelecimentos definida como número de locais de venda de bebida dentro do buffer de 200 metros da residência dos adolescentes. A associação foi estimada pela regressão de Poisson ajustada por fatores individuais e familiares. Resultados: Participaram 601 adolescentes de 14-17 anos; 53,3% eram homens e 71% tinham renda familiar até cinco salários mínimos. A prevalência de consumo de álcool na vida foi de 57,0% (intervalo de confiança de 95% - IC95% 51,5 - 62,6) e o atual de 11,9% (IC95% 8,7 - 15,0). Na análise multivariada, verificou-se associação significativa entre o consumo atual de bebidas alcoólicas e a densidade de lanchonetes (razão de prevalência - RP = 1,13; IC95% 1,03 - 1,24), bares (RP = 1,21; IC95% 1,05 - 1,38) e restaurantes (RP = 1,11; IC95% 1,02 - 1,21). Interações significativas entre densidade de estabelecimentos com sexo e idade foram encontradas. Conclusão: O consumo atual de álcool pode ser potencializado pela presença de alguns tipos de estabelecimentos localizados no buffer de 200 metros da residência dos adolescentes.
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Teixeira Vaz C, de Souza Andrade AC, Proietti FA, Coelho Xavier C, de Lima Friche AA, Teixeira Caiaffa W. A multilevel model of life satisfaction among old people: individual characteristics and neighborhood physical disorder. BMC Public Health 2019; 19:861. [PMID: 31269940 PMCID: PMC6607521 DOI: 10.1186/s12889-019-7228-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 06/24/2019] [Indexed: 11/17/2022] Open
Abstract
Background Considering the lack of studies that examine built environmental factors associated with life satisfaction among old people in developing countries, particularly those focused on Brazil, the aim of this study was to estimate the prevalence of life satisfaction among old adults residents in a Brazilian urban center and to investigate its association with individual characteristics and objective measures of the built environment. Methods A household survey (N = 832) in Belo Horizonte, Minas Gerais, Brazil (2008–2009) and a Systematic Social Observation (SSO) was used in this study. Life satisfaction was assessed through Self-Anchoring Ladder Scale, developed by Cantril, in 1965. Participants’ answers were categorized as satisfied (rungs 6–10) and dissatisfied (rungs 0–5). A Multilevel Poisson regression analysis with robust variance was performed. Results The prevalence of satisfaction with life was approximately 82%. Higher prevalence of life satisfaction was significantly associated with old people who reported higher incomes, higher religious participation, who practice physical activity and who perceive their health as good and very good. In contextual level, results showed that when the contextual features were adjusted separately by the individual characteristics they were no longer significant. The results also showed a lower prevalence of life satisfaction among those living in neighborhoods with higher physical disorder, even after adjusting for individual and other contextual characteristics. Conclusions The present findings suggest that life satisfaction should be assessed whenever evaluating urban redevelopment programs designed to improve neighborhood characteristics, reducing physical disorder, especially among old adults.
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Affiliation(s)
- Camila Teixeira Vaz
- Department of Physical Therapy, Federal University of Juiz de Fora - Campus Governador Valadares, Rua São Paulo 745, Governador Valadares, 35010-180, Brazil. .,Faculty of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil. .,Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil.
| | - Amanda Cristina de Souza Andrade
- Faculty of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil.,Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil.,Institute of Public Health, Federal University of Mato Grosso, Avenida Fernando Corrêa 2367, Cuiabá, 78060-900, Brazil
| | - Fernando Augusto Proietti
- Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil.,Faculty of Health and Human Ecology, Rua São Paulo 958, Vespasiano, 33200-000, Brazil
| | - César Coelho Xavier
- Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil.,Faculty of Health and Human Ecology, Rua São Paulo 958, Vespasiano, 33200-000, Brazil
| | - Amélia Augusta de Lima Friche
- Faculty of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil.,Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil
| | - Waleska Teixeira Caiaffa
- Faculty of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil.,Belo Horizonte Observatory for Urban Health, Avenida Alfredo Balena 190, Belo Horizonte, 30130-100, Brazil
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Felicíssimo MF, Friche AADL, Xavier CC, Proietti FA, Neves JAB, Caiaffa WT. Socioeconomic position and disability: "The Belo Horizonte, Brazil Health Study". CIENCIA & SAUDE COLETIVA 2018; 22:3547-3556. [PMID: 29211160 DOI: 10.1590/1413-812320172211.22432017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 09/04/2017] [Indexed: 11/21/2022] Open
Abstract
This study aims to investigate the association of socioeconomic status and comorbidities of self-reported disability. Data were obtained from a population survey in Belo Horizonte from 2008 to 2009. The sample was probabilistic and stratified by conglomerates in three stages: census tracts, households and individuals. The outcome variable was disability, defined by the self-reported problems in bodily functions or structures. The explanatory variables were gender, age, self-reported morbidity and socioeconomic status index that included variables mother and respondent schooling and household income. The factorial analysis was used to evaluate the socioeconomic status index and logistic regression. The prevalence of disability was 10.43% (95% CI: 9.1-11.7%). Self-reported disability was associated with age (OR = 1.02; 95% CI: 1.01-1.03) and reporting of two or more diseases (OR = 3.24; CI 95%; 2.16-4.86) and socioeconomic status index (OR = 0.96; 95% CI: 0.95-0.97). The worse socioeconomic status and occurrence of diseases appear to contribute to the occurrence of disability. These results show health inequities among people with disabilities, and BPC relevance supporting vulnerable populations.
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Affiliation(s)
- Mônica Faria Felicíssimo
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena 190, Funcionários. 30130-100 Belo Horizonte MG Brasil.
| | - Amélia Augusta de Lima Friche
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena 190, Funcionários. 30130-100 Belo Horizonte MG Brasil.
| | | | | | | | - Waleska Teixeira Caiaffa
- Faculdade de Medicina, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena 190, Funcionários. 30130-100 Belo Horizonte MG Brasil.
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Santos SM, Werneck GL, Faerstein E, Lopes CS, Chor D. Focusing neighborhood context and self-rated health in the Pró-Saúde Study. CAD SAUDE PUBLICA 2018; 34:e00029517. [DOI: 10.1590/0102-311x00029517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 10/31/2017] [Indexed: 11/22/2022] Open
Abstract
The influence of neighborhood characteristics on self-rated health has been little studied. A multilevel approach using hierarchical models was applied to analyze the relationship between the socioeconomic characteristics in 621 neighborhoods (level 2) in the city of Rio de Janeiro, Brazil, and the self-rated health of 3,054 university employees (level 1) from the baseline of the Pró-Saúde Study. Neighborhoods were created using the SKATER algorithm (Spatial ‘K’luster Analysis by Tree Edge Removal) to cluster census tracts according to four indicators and a minimum population of 5,000 people. After adjustment for individual factors (per capita income, schooling, age, sex, ethnicity, health-related behavior and chronic diseases), low level of neighborhood income and higher numbers of members per household were significantly associated with poor self-rated health. Participants living in medium income-level neighborhoods were 34% more likely to self-rate their health as being poor. Those living in areas with a higher density of members per household were 50% more likely to present poor self-rated health. Neighborhood context influences self-rated health, beyond the effect of individual factors. Worsening neighborhood socioeconomic conditions affect health adversely, which in turn increasing the chance of poor self-rated health.
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De Oliveira da Silva P, Miguez Nery Guimarães J, Härter Griep R, Caetano Prates Melo E, Maria Alvim Matos S, Del Carmem Molina M, Maria Barreto S, De Jesus Mendes da Fonseca M. Association between Body Image Dissatisfaction and Self-Rated Health, as Mediated by Physical Activity and Eating Habits: Structural Equation Modelling in ELSA-Brasil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040790. [PMID: 29670031 PMCID: PMC5923832 DOI: 10.3390/ijerph15040790] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/10/2018] [Accepted: 04/10/2018] [Indexed: 11/16/2022]
Abstract
This study investigated whether the association between body image dissatisfaction and poor self-rated health is mediated by insufficient physical activity and unhealthy eating habits. The participants were 6727 men and 8037 women from the baseline (2008–2010) of the Longitudinal Study of Adult Health (Estudo Longitudinal de Saúde do Adulto, ELSA-Brasil). Structural equation modelling was used. Associations were found between body image dissatisfaction and poor self-rated health in both sexes. Insufficient physical activity was a mediator. However, unhealthy eating habits were found to exert a mediator effect only via insufficient physical activity. Body image dissatisfaction was found to associate, both directly and possibly indirectly, with poor self-rated health, mediated by insufficient physical activity and unhealthy eating habits. Accordingly, encouraging physical activity and healthy eating can contribute to reducing body image dissatisfaction and favour better self-rated health.
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Affiliation(s)
- Patricia De Oliveira da Silva
- National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480, Manguinhos, 21041-210 Rio de Janeiro, RJ, Brazil.
| | - Joanna Miguez Nery Guimarães
- National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480, Manguinhos, 21041-210 Rio de Janeiro, RJ, Brazil.
| | - Rosane Härter Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Avenida Brasil, 4365, Manguinhos, 21040-360 Rio de Janeiro, RJ, Brazil.
| | - Enirtes Caetano Prates Melo
- National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480, Manguinhos, 21041-210 Rio de Janeiro, RJ, Brazil.
| | | | - Maria Del Carmem Molina
- Health Sciences Centre, Universidade Federal do Espírito Santo, 29043-900 Vitória, ES, Brazil.
| | - Sandhi Maria Barreto
- Faculty of Medicine, Universidade Federal de Minas Gerais, 31270-901 Belo Horizonte, MG, Brazil.
| | - Maria De Jesus Mendes da Fonseca
- National School of Public Health, Oswaldo Cruz Foundation, Rua Leopoldo Bulhões, 1480, Manguinhos, 21041-210 Rio de Janeiro, RJ, Brazil.
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Szwarcwald CL, Montilla DER, Marques AP, Damacena GN, Almeida WDSD, Malta DC. Inequalities in healthy life expectancy by Federated States. Rev Saude Publica 2017; 51:7s. [PMID: 28591354 PMCID: PMC5676373 DOI: 10.1590/s1518-8787.2017051000105] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 10/23/2016] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES To estimate the healthy life expectancy at 60 years by sex and Federated States and to investigate geographical inequalities by socioeconomic status. METHODS Healthy life expectancy was estimated by the Sullivan method, based on the information of the National Survey on Health, 2013. Three criteria were adopted for the definition of “unhealthy state”: self-assessment of bad health, functionality for performing the activities of daily living, and the presence of noncommunicable disease with intense degree of limitation. The indicator of socioeconomic status was built based on the number of goods at household and educational level of the head of household. To analyze the geographical inequalities and socioeconomic level, inequality measures were calculated, such as the ratio, the difference, and the angular coefficient. RESULTS Healthy life expectancy among men ranged from 13.8 (Alagoas) to 20.9 (Espírito Santo) for the self-assessment criterion of bad health. Among women, the corresponding estimates were always higher and ranged from 14.9 (Maranhão) to 22.2 (São Paulo). As to the ratio of inequality by Federated State, the medians were always higher for healthy life expectancy than for life expectancy, regardless of the definition adopted for healthy state. Regarding the differences per Federated State, the healthy life expectancy was seven years higher in one state than in another. By socioeconomic status, differences of three and four years were found, approximately, between the last and first fifth, for men and women, respectively. CONCLUSIONS Despite the association of the mortality indicators with living conditions, the inequalities are even more pronounced when the welfare and the limitations in usual activities are considered, showing the necessity to promote actions and programs to reduce the socio-spatial gradient.
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Affiliation(s)
- Célia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Dália Elena Romero Montilla
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Aline Pinto Marques
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Giseli Nogueira Damacena
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Wanessa da Silva de Almeida
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Fundação Oswaldo Cruz. Rio de Janeiro, RJ, Brasil
| | - Deborah Carvalho Malta
- Departamento de Enfermagem Materno Infantil e Saúde Pública. Escola de Enfermagem. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brasil
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Szwarcwald CL, Souza Júnior PRBD, Marques AP, Almeida WDSD, Montilla DER. Inequalities in healthy life expectancy by Brazilian geographic regions: findings from the National Health Survey, 2013. Int J Equity Health 2016; 15:141. [PMID: 27852270 PMCID: PMC5112675 DOI: 10.1186/s12939-016-0432-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 09/02/2016] [Indexed: 11/15/2022] Open
Abstract
Background The demographic shift and epidemiologic transition in Brazil have drawn attention to ways of measuring population health that complement studies of mortality. In this paper, we investigate regional differences in healthy life expectancy based on information from the National Health Survey (PNS), 2013. Methods In the survey, a three-stage cluster sampling (census tracts, households and individuals) with stratification of the primary sampling units and random selection in all stages was used to select 60,202 Brazilian adults (18 years and over). Healthy life expectancies (HLE) were estimated by Sullivan’s method according to sex, age and geographic region, using poor self-rated health for defining unhealthy status. Logistic regression models were used to investigate socioeconomic and regional inequalities in poor self-rated health, after controlling by sex and age. Results Wide disparities by geographic region were found with the worst indicators in the North and Northeast regions, whether considering educational attainment, material deprivation, or health care utilization. Life expectancy at birth for women and men living in the richest regions was 5 years longer than for those living in the less wealthy regions. Modeling the variation across regions for poor self-rated health, statistically significant effects (p < 0.001) were found for the North and Northeast when compared to the Southeast, even after controlling for age, sex, diagnosis of at least one non-communicable chronic disease, and schooling or socioeconomic class. Marked regional inequalities in HLE were found, with the loss of healthy life much higher among residents of the poorest regions, especially among the elderly. Conclusions By combining data on self-rated health status and mortality in a single indicator, Healthy Life Expectancy, this study demonstrated the excess burden of poor health experienced by populations in the less wealthy regions of Brazil. To mitigate the effects of social exclusion, the development of strategies at the regional level is essential to provide health care to all persons in need, reduce risk exposures, support prevention policies for adoption of healthy behaviors. Such strategies should prioritize population groups that will experience the greatest impact from such interventions.
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Affiliation(s)
- Célia Landmann Szwarcwald
- Institute of Communication and Information Science and Technology in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| | | | - Aline Pinto Marques
- Institute of Communication and Information Science and Technology in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Wanessa da Silva de Almeida
- Institute of Communication and Information Science and Technology in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Dalia Elena Romero Montilla
- Institute of Communication and Information Science and Technology in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Friche AADL, Dias MADS, Reis PBD, Dias CS, Caiaffa WT. Urban upgrading and its impact on health: a "quasi-experimental" mixed-methods study protocol for the BH-Viva Project. CAD SAUDE PUBLICA 2016; 31 Suppl 1:51-64. [PMID: 26648363 DOI: 10.1590/0102-311x00079715] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 09/09/2015] [Indexed: 11/21/2022] Open
Abstract
There is little scientific evidence that urban upgrading helps improve health or reduce inequities. This article presents the design for the BH-Viva Project, a "quasi-experimental", multiphase, mixed-methods study with quantitative and qualitative components, proposing an analytical model for monitoring the effects that interventions in the urban environment can have on residents' health in slums in Belo Horizonte, Minas Gerais State, Brazil. A preliminary analysis revealed intra-urban differences in age-specific mortality when comparing areas with and without interventions; the mortality rate from 2002 to 2012 was stable in the "formal city", increased in slums without interventions, and decreased in slums with interventions. BH-Viva represents an effort at advancing methodological issues, providing learning and theoretical backing for urban health research and research methods, allowing their application and extension to other urban contexts.
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Affiliation(s)
| | | | - Priscila Brandão Dos Reis
- Observatório de Saúde Urbana de Belo Horizonte, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Cláudia Silva Dias
- Observatório de Saúde Urbana de Belo Horizonte, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
| | - Waleska Teixeira Caiaffa
- Observatório de Saúde Urbana de Belo Horizonte, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil
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