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Gomez DVF, de Almeida WDS, de Souza Junior PRB, Lopes MDFC, Luna EJDA, Zimmermann IR, Tavares NUL, Gutierrez MMU, Szwarcwald CL. Prevalence of trachoma in indigenous and non-indigenous areas, Northeastern Brazil, 2019-2021. Rev Panam Salud Publica 2024; 48:e19. [PMID: 38464869 PMCID: PMC10924615 DOI: 10.26633/rpsp.2024.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/08/2024] [Indexed: 03/12/2024] Open
Abstract
Objective To estimate the prevalence of trachoma in indigenous and non-indigenous populations in selected areas of the state of Maranhão, in northeastern Brazil. Methods This was a population-based survey with probabilistic sampling. For the diagnosis of trachoma, external ocular examination was performed using head magnifying loupes, at 2.5X magnification. The prevalence of trachomatous inflammation - follicular (TF) in children aged 1-9 years and the prevalence of trachomatous trichiasis (TT) in the population aged ≥15 years were estimated. Relative frequencies of sociodemographic and environmental characteristics were obtained. Results The study included 7 971 individuals, 3 429 from non-indigenous populations and 4 542 from indigenous populations. The prevalence of TF in non-indigenous and indigenous populations was 0.1% and 2.9%, respectively, and the prevalence of TT among indigenous populations was 0.1%. Conclusions The prevalence of TF and TT in the two evaluation units in the state of Maranhão were within the limits recommended for the elimination of trachoma as a public health problem. However, the prevalence of TF was higher in the indigenous evaluation unit, indicating a greater vulnerability of this population to the disease. The prevalence of TF of below 5.0% implies a reduction in transmission, which may have resulted from improved socioeconomic conditions and/or the implementation of the World Health Organization SAFE strategy.
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Szwarcwald CL, Lopes MDFC, Borges de Souza Junior PR, Vaz Ferreira Gómez D, Luna EJDA, da Silva de Almeida W, Damacena GN, Ribeiro Favacho JDF, Germano de Frias P, Butcher R, Boyd S, Bakhtiari A, Willis R, Jimenez C, Harding-Esch E, Saboyá-Díaz MI, Solomon AW. Population Prevalence of Trachoma in Nine Rural Non-Indigenous Evaluation Units of Brazil. Ophthalmic Epidemiol 2023; 30:561-570. [PMID: 34711133 PMCID: PMC10581672 DOI: 10.1080/09286586.2021.1941127] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 05/20/2021] [Accepted: 06/04/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the contemporary prevalence of trachoma in Brazil's non-indigenous population, surveys of those thought to be at greatest risk of disease were conducted. METHODS Rural census tracts of non-indigenous population from nine mesoregions were selected to compose the survey evaluation units (EUs) by considering previously endemic municipalities at greatest risk of trachoma. In each of the nine EUs, we conducted a population-based prevalence survey. Every resident of selected households aged ≥ 1 year was examined for trachomatous inflammation - follicular (TF) and trachomatous trichiasis (TT). Additionally, data were collected on household-level access to water, sanitation, hygiene (WASH) and education. RESULTS A total of 27,962 individuals were examined across nine EUs. The age-adjusted TF prevalence in 1-9-year-olds was <5% in each EU. The age- and gender-adjusted prevalence of TT unknown to the health system in ≥15-year-olds was <0.2% in eight EUs; in one EU, it was 0.22%. The median number of households surveyed per EU with access to an improved drinking water source within a 30-minute roundtrip of the house was 66%. School attendance was >99% of surveyed children. CONCLUSIONS The prevalence of TF was well below the target for elimination as a public health problem in all EUs. Because EUs surveyed were selected to represent the highest-risk non-indigenous areas of the country, TF prevalence is unlikely to be ≥5% in non-indigenous populations elsewhere. In one EU, the prevalence of TT was above the target threshold for elimination. Further investigation and possibly improvement in TT surgical provision are required in that EU.
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Affiliation(s)
- Célia Landmann Szwarcwald
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Maria de Fátima Costa Lopes
- Coordination of Surveillance of Zoonoses and Vector Transmission Diseases, Department of Immunization and Communicable Diseases, Health Surveillance Secretariat, Ministry of Health, Brasília, Brazil
| | | | - Daniela Vaz Ferreira Gómez
- Coordination of Surveillance of Zoonoses and Vector Transmission Diseases, Department of Immunization and Communicable Diseases, Health Surveillance Secretariat, Ministry of Health, Brasília, Brazil
| | | | - Wanessa da Silva de Almeida
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Giseli Nogueira Damacena
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | - Paulo Germano de Frias
- Board of Education and Research, Study Group on Health Assessment and Management, Professor Fernando Figueira Integral Medicine Institute (IMIP), Recife, Brazil
| | - Robert Butcher
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Sarah Boyd
- International Trachoma Initiative, Task Force for Global Health, Atlanta, Georgia, USA
| | - Ana Bakhtiari
- International Trachoma Initiative, Task Force for Global Health, Atlanta, Georgia, USA
| | - Rebecca Willis
- International Trachoma Initiative, Task Force for Global Health, Atlanta, Georgia, USA
| | | | - Emma Harding-Esch
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Martha Idalí Saboyá-Díaz
- Neglected, Tropical, and Vector-Borne Diseases Unit, Communicable Diseases and Environmental Determinants of Health Department, Pan American Health Organization (PAHO), Washington, DC, USA
| | - Anthony W. Solomon
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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Romero DE, Maia L, Muzy J, Andrade N, Souza Junior PRBD. Factors associated with worsening in the self-rated health status of Brazilian women who lived with dependent elderly people during the first wave of COVID-19. Cien Saude Colet 2023; 28:2051-2064. [PMID: 37436318 DOI: 10.1590/1413-81232023287.13702022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/25/2022] [Indexed: 07/13/2023] Open
Abstract
The objective is to analyze the factors associated with the worsening of the self-rated health (SRH) of Brazilian women who live with elderly people with functional dependence (EFD) during the first wave of COVID-19. ConVid - Behavior Research was used as a data source. For the analysis, the group of women who lived with EFD was compared with those who lived with the elderly without any dependence. Hierarchical prevalence ratio (PR) models were estimated to test the associations between sociodemographic characteristics, changes in income, routine activities and health in the pandemic, with the outcome of worsening SRH. This worsening was more frequent in the group of women living with EFD. After adjusting for hierarchical factors, being black (PR=0.76; 95%CI 0.60-0.96) and having a per capita income lower than minimum wage (PR=0.78; 95%CI 0.64- 0.96) were shown to be protective factors for SRH worsening among EFD co-residents. Indisposition, emergence/worsening of back problems, affected sleep, poor SRH, feeling loneliness and difficulty in carrying out routine activities during the pandemic were positively associated factors. The study demonstrates that living with EFD was associated with a worsening in the health status of Brazilian women during the pandemic, especially among those of higher social status.
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Affiliation(s)
- Dalia Elena Romero
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil.
| | - Leo Maia
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil.
| | - Jessica Muzy
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil.
| | - Nathália Andrade
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil.
| | - Paulo Roberto Borges de Souza Junior
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil.
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Romero DE, Muzy J, Maia LR, Almeida WDSD, Silva DRPD, Malta DC, Souza Junior PRBD. Factors associated with the incidence and worsening of back pain during the first wave of COVID-19 in Brazil. Ciênc saúde coletiva 2023. [DOI: 10.1590/1413-81232023283.13042022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Abstract The article aims to estimate the incidence and worsening of back pain (BP) during the first wave of COVID-19 in Brazil, as well as to investigate demographic, socioeconomic factors and associated changes in living conditions. ConVid - Behavior Research, applied between April and May 2020, was used as data source. The number and distribution of respondents who developed BP and those who had a worsening of the preexisting problem, their 95% confidence intervals and Pearson’s Chi-square test were estimated. The odds ratio of developing BP or worsening a preexisting problem was also estimated using multiple logistic regression models. Pre-existing BP was reported by 33.9% (95%CI 32.5-35.3) of respondents and more than half (54.4%; 95%CI 51.9-56.9) had worsened. The cumulative incidence of BP in the first wave of the pandemic was 40.9% (95%CI 39.2-42.7). Being a woman, the perceived increase in housework and the frequent feeling of sadness or depression were associated with both outcomes. Socioeconomic factors were not associated with any of outcome. The high incidence and worsening of BP during the first wave reveal the need for studies in more recent periods, given the long duration of the pandemic.
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Romero DE, Muzy J, Maia LR, Almeida WDSD, Silva DRPD, Malta DC, Souza Junior PRBD. Factors associated with the incidence and worsening of back pain during the first wave of COVID-19 in Brazil. Cien Saude Colet 2023; 28:771-784. [PMID: 36888861 DOI: 10.1590/1413-81232023283.13042022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 09/15/2022] [Indexed: 03/08/2023] Open
Abstract
The article aims to estimate the incidence and worsening of back pain (BP) during the first wave of COVID-19 in Brazil, as well as to investigate demographic, socioeconomic factors and associated changes in living conditions. ConVid - Behavior Research, applied between April and May 2020, was used as data source. The number and distribution of respondents who developed BP and those who had a worsening of the preexisting problem, their 95% confidence intervals and Pearson's Chi-square test were estimated. The odds ratio of developing BP or worsening a preexisting problem was also estimated using multiple logistic regression models. Pre-existing BP was reported by 33.9% (95%CI 32.5-35.3) of respondents and more than half (54.4%; 95%CI 51.9-56.9) had worsened. The cumulative incidence of BP in the first wave of the pandemic was 40.9% (95%CI 39.2-42.7). Being a woman, the perceived increase in housework and the frequent feeling of sadness or depression were associated with both outcomes. Socioeconomic factors were not associated with any of outcome. The high incidence and worsening of BP during the first wave reveal the need for studies in more recent periods, given the long duration of the pandemic.
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Affiliation(s)
- Dalia Elena Romero
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. 21040-900 Rio de Janeiro RJ Brasil.
| | - Jessica Muzy
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. 21040-900 Rio de Janeiro RJ Brasil.
| | - Leo Ramos Maia
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. 21040-900 Rio de Janeiro RJ Brasil.
| | - Wanessa da Silva de Almeida
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. 21040-900 Rio de Janeiro RJ Brasil.
| | | | | | - Paulo Roberto Borges de Souza Junior
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. 21040-900 Rio de Janeiro RJ Brasil.
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Loyola Filho AID, Firmo JOA, Mambrini JVDM, Peixoto SV, Souza Junior PRBD, Nascimento MMGD. Use of psychotropic drugs by population in an area affected by the tailings dam rupture: Brumadinho Health Project. Rev Bras Epidemiol 2022; 25:e220012. [PMID: 36327417 DOI: 10.1590/1980-549720220012.supl.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/17/2022] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE To describe the consumption of psychotropic drugs in the adult population residing in Brumadinho, Minas Gerais, after the Vale dam collapse, which occurred in 2019. METHODS This is a cross-sectional study, part of the Brumadinho Health Project, developed in 2021, with a representative population-based sample of adults (18 years and over) residing in Brumadinho. A total of 2,805 adults with information on self-reported use of psychotropic drugs (antidepressants and anxiolytics-hypnotics/sedatives) in the last 15 days were included in the analysis. The prevalence of psychotropic drug use was estimated, and the most used psychotropic drugs were identified. Pearson's chi-square test (with Rao-Scott correction) was used to test associations between exposures and use of psychotropic drugs, considering a significance level of p<0.05. RESULTS The use of antidepressants (14.2%) was more common than the use of anxiolytics or hypnotics/sedatives (5.2%), with sertraline and fluoxetine being the most used antidepressants. The use of anxiolytics and hypnotics/sedatives was higher among residents who lived in the area directly affected by the dam's mud, and the use of any psychotropic drug was higher among those who lost a relative/friend in the disaster and assessed that their health worsened after the disaster, and among women. CONCLUSION The results of the study corroborate what was observed in other populations exposed to similar tragedies, regarding the pattern of associations and the of use of psychotropic drugs.
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Affiliation(s)
- Antônio Ignácio de Loyola Filho
- Fundação Oswaldo Cruz, Instituto René Rachou - Belo Horizonte (MG), Brazil
- Universidade Federal de Minas Gerais, School of Nursing - Belo Horizonte (MG), Brazil
| | | | | | - Sérgio Viana Peixoto
- Fundação Oswaldo Cruz, Instituto René Rachou - Belo Horizonte (MG), Brazil
- Universidade Federal de Minas Gerais, School of Nursing - Belo Horizonte (MG), Brazil
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Malta DC, Gomes CS, Silva AGD, Cardoso LSDM, Barros MBDA, Lima MG, Souza Junior PRBD, Szwarcwald CL. Use of health services and adherence to social distancing by adults with Noncommunicable Diseases during the COVID-19 pandemic, Brazil, 2020. Cien Saude Colet 2021; 26:2833-2842. [PMID: 34231696 DOI: 10.1590/1413-81232021267.00602021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 03/22/2021] [Indexed: 11/22/2022] Open
Abstract
The present study investigates the association between the self-reported diagnosis of noncommunicable disease (NCD) and the adherence to social distancing and the use of health services during the COVID-19 pandemic. This was a cross-sectional study with Brazilian adults who participated in the ConVid- Behavior Survey, conducted online between April 24 and May 24, 2020(n = 45.161). This studyconsidered the following NCDs: diabetes, hypertension, respiratory disease, heart disease, and cancer, and evaluated the use of health services and the adherence to social distancing, as well as estimated the prevalences and adjusted prevalence ratio (aPR); 33,9% (95% CI: 32,5-35,3) referred to one or more NCD. Individuals with NCDsshowed a greater adherence to intense social distancing (aPR: 1,07;95% CI: 1,03-1,11), sought out health services more often (aPR:1,24; 95% CI:1,11-1,38), and found greater difficultyin scheduling doctor's appointments (aPR:1.52; 95% CI 1,35-1,71), receiving healthcare treatment (APR:1,50;95% CI:1,22-1,84) and medication (APR:2,17;95% CI:1,77-2,67), and performing examinations (APR:1,78;95% CI:1,50-2,10) and scheduled interventions (APR:1,65;95% CI:1,16-2,34). The presence of NCDs was associated with social distancing, seeking out health care, and difficulty in using health services.
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Affiliation(s)
- Deborah Carvalho Malta
- Departamento de Enfermagem Materno-Infantil e Saúde Pública, Universidade Federal de Minas Gerais. Av. Alfredo Balena 190 5º andar, Escola de Enfermagem, Santa Efigênia. 30130100 Belo Horizonte MG Brasil.
| | - Crizian Saar Gomes
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | - Alanna Gomes da Silva
- Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, Universidade Federal de Minas Gerais. Belo Horizonte MG Brasil
| | | | | | - Margareth Guimarães Lima
- Departamento de Saúde Coletiva, Faculdade de Ciências Médicas, Universidade Estadual de Campinas. Campinas São Paulo Brasil
| | | | - Célia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz. Rio de Janeiro RJ Brasil
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Szklo AS, Iglesias RM, Stoklosa M, Figueiredo VC, Welding K, de Souza Junior PRB, Machado AT, Martins LFL, Nascimento H, Drope J. Cross-validation of four different survey methods used to estimate illicit cigarette consumption in Brazil. Tob Control 2020; 31:73-80. [DOI: 10.1136/tobaccocontrol-2020-056060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/12/2020] [Accepted: 09/23/2020] [Indexed: 11/03/2022]
Abstract
ObjectiveTo cross-validate estimates of the size of the illicit cigarette trade based on the results of four different survey methods.MethodsIn 2018/2019, four non-industry-funded, large-scale studies were conducted in selected Brazilian cities: packs discarded in household garbage/PDG (1 city), packs littered in the streets/PLS (5 cities), a phone survey of tobacco users’ purchase behaviors/VIGITEL (5 cities), and a face-to-face household survey of tobacco users’ purchase behaviors/FTF-household (2 cities). The proportions of illicit cigarettes consumed were based on the price paid by smokers in their last purchase (VIGITEL or FTF-household) and/or direct observation of brand names and health warnings (PDG, PLS or FTF-household).ResultsBased on PLS, the share of packs that avoided taxation ranged from 30.4% (95% CI 25.6% to 35.7%) in Rio de Janeiro to 70.1% (95% CI 64.6% to 75.0%) in Campo Grande; and PDG conducted in Rio de Janeiro found an even lower proportion point estimate of illicit cigarette use (26.8%, 95% CI 25.1% to 28.6%). In FTF-household, the share of illicit cigarette consumption based on the self-reported price ranged from 29.1% (95% CI 22.4% to 35.7%) in Rio de Janeiro to 37.5% (95% CI 31.2% to 43.7%) in São Paulo, while estimates based on pack observation ranged from 29.9% (95% CI 23.3% to 36.5%) in Rio de Janeiro to 40.7% (95% CI 34.3% to 47.0%) in São Paulo. For all cities, VIGITEL presented the lowest levels of illicit consumption, and most illicit brands were produced in Paraguay.ConclusionsSmall differences in the estimated levels of illicit trade across methods were found, except for the phone survey. The cross-validation of estimates from independent studies is important to help effectively implement tobacco excise tax policy in Brazil and other low-income and middle-income countries.
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Andrade J, Borges V, Aparecida de Oliveira Duarte Y, Andrade FD, Alves L, Borges de Souza Junior PR, Lima-Costa MF, Bof de Andrade F. Frailty Syndrome Among Community-Dwelling Older Adults in Brazil. Arch Phys Med Rehabil 2019. [DOI: 10.1016/j.apmr.2019.10.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Macinko J, Andrade FBD, Souza Junior PRBD, Lima-Costa MF. Primary care and healthcare utilization among older Brazilians (ELSI-Brazil). Rev Saude Publica 2018; 52Suppl 2:6s. [PMID: 30379279 PMCID: PMC6254960 DOI: 10.11606/s1518-8787.2018052000595] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 04/01/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To characterize healthcare access and utilization among older Brazilians. METHODS Data are from the baseline wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which is a nationally representative, population-based cohort study of persons aged 50 years and older conducted in 2015/2016 (n = 9,412). The prevalence of barriers to primary care and number and type of doctor visits in the past 12 months are compared by three main sources of healthcare (private, Family Health Strategy, traditional public clinics). Two-part multivariable hurdle analyses assess the relation between healthcare utilization, primary care problems, and source of healthcare, while controlling for healthcare determinants. RESULTS Females comprised 54% of the sample, with a mean age of 63 years. There were no demographic differences by source of healthcare. Nearly 83% had at least one doctor visit in the past 12 months, with higher use among private health plan holders. Private health plan holders most frequently visited specialists, while those using the public system were more likely to visit a general practitioner. Primary care barriers averaged 3.5 out of 12 and were the highest among those using traditional health posts. A greater number of primary care problems was negatively associated with all types of healthcare utilization. CONCLUSIONS By international standards, access to basic healthcare among older Brazilians is relatively high. Nevertheless, different levels of primary care problems between the public and private sectors and resulting utilization patterns suggest the need to continue working to close remaining gaps.
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Affiliation(s)
- James Macinko
- UCLA. Fielding School of Public Health. Departments of Health Policy and Management and Community Health Sciences. Los Angeles, CA, USA
| | - Fabíola Bof de Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | | | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
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Ferreira FR, César CC, Andrade FBD, Souza Junior PRBD, Lima-Costa MF, Proietti FA. Aspects of social participation and neighborhood perception: ELSI-Brazil. Rev Saude Publica 2018; 52Suppl 2:18s. [PMID: 30379291 PMCID: PMC6255139 DOI: 10.11606/s1518-8787.2018052000647] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 05/18/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine the impact of the physical and social surroundings of the neighborhood, which are presented as facilitators or barriers for the social participation of Brazilian older adults. METHODS The study was conducted in a probabilistic representative sample of the Brazilian population aged 50 years and older and who lived in urban areas (n = 7,935). The response variable was social participation, which was defined from two questions about activities performed with other persons: visited friends or relatives in their homes in the last 12 months (yes, no); went out with other persons to public places, such as restaurant, movies, club, park, in the last 12 months (yes, no). The explanatory variables included fear of falling because of defects in sidewalks, concern about the difficulty to get on a bus, subway, or train, difficulty to cross streets, and perception of violence in the neighborhood. Potential confounding variables included age, marital status, education level, self-rated health, living in an asphalted or paved street, time living in the municipality, and socioeconomic position score. Prevalence ratios and respective confidence intervals were estimated using Poisson regression. RESULT Difficulty to cross streets presented an independent association with restricted social participation (PR = 0.95; 95%CI 0.93-0.98) among both women (PR = 0.96; 95%CI 0.92-0.99) and men (PR = 0.94; 95%CI 0.90-0.99). Concern about the difficulty to get on a bus, subway, or train was associated with the outcome only among men (PR = 0.95; 95%CI 0.91-0.99). The fear of falling because of defects in sidewalks and the perception of violence in the neighborhood were not associated with social participation. CONCLUSIONS Urban characteristics that hinder the crossing of streets and accessibility to public transport can be inferred as important barriers for the social participation of Brazilian older adults.
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Affiliation(s)
- Fabiane Ribeiro Ferreira
- Universidade Federal de Minas Gerais. Escola de Educação Física, Fisioterapia e Terapia Ocupacional. Departamento de Fisioterapia. Belo Horizonte, MG, Brasil
| | - Cibele Comini César
- Universidade Federal de Minas Gerais. Faculdade de Ciências Econômicas. Centro de Desenvolvimento e Planejamento Regional. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Belo Horizonte, MG, Brasil
| | - Fabíola Bof de Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | | | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
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12
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Andrade FBD, Antunes JLF, Souza Junior PRBD, Lima-Costa MF, Oliveira CD. Life course socioeconomic inequalities and oral health status in later life: ELSI-Brazil. Rev Saude Publica 2018; 52Suppl 2:7s. [PMID: 30379285 PMCID: PMC6255023 DOI: 10.11606/s1518-8787.2018052000628] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 03/30/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To investigate the association between life course socioeconomic conditions and two oral health outcomes (edentulism and use of dental prostheses among individuals with severe tooth loss) among older Brazilian adults. METHODS This was a cross-sectional study with data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) which includes information on persons aged 50 years or older residing in 70 municipalities across the five great Brazilian regions. Regression models using life history information were used to investigate the relation between childhood (parental education) and adulthood (own education and wealth) socioeconomic circumstances and edentulism and use of dental prostheses. Slope index of inequality and relative index of inequality for edentulism and use of dental prostheses assessed socioeconomic inequalities in both outcomes. RESULTS Approximately 28.8% of the individuals were edentulous and among those with severe tooth loss 80% used dental prostheses. Significant absolute and relative inequalities were found for edentulism and use of dental prostheses. The magnitude of edentulism was higher among individuals with lower levels of socioeconomic position during childhood, irrespective of their current socioeconomic position. Absolute and relative inequalities related to the use of dental prostheses were not related to childhood socioeconomic position. CONCLUSIONS These findings substantiate the association between life course socioeconomic circumstances and oral health in older adulthood, although use of dental prostheses was not related to childhood socioeconomic position. The study also highlights the long-lasting relation between childhood socioeconomic inequalities and oral health through the life course.
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Affiliation(s)
- Fabíola Bof de Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | | | | | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | - Cesar de Oliveira
- University College London, Department of Epidemiology & Public Health. London, UK
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13
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Castro CMSD, Lima-Costa MF, César CC, Neves JAB, Andrade FBD, Souza Junior PRBD, Sampaio RF. Life course and work ability among older adults: ELSI-Brazil. Rev Saude Publica 2018; 52Suppl 2:11s. [PMID: 30379292 PMCID: PMC6255111 DOI: 10.11606/s1518-8787.2018052000648] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 04/18/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To examine factors associated with perception of work ability in a nationally representative sample of Brazilians aged 50 years and over. METHODS We used data from 8,903 participants of the baseline survey of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The dependent variable was self-rated work ability (good or very good versus fair, poor, or very poor). Independent variables included factors that operate at the beginning, middle, and current stage of life. Multivariate analysis was based on prevalence ratios (PR) and 95% confidence intervals (95%CI) estimated by Poisson regression. RESULTS Good work ability was reported by 49% of \ participants (49.4% among men and 48.6% among women). Results of the multivariate analysis showed that, for both men and women, good work ability showed positive and statistically significant associations (p < 0.05) with good health up to 15 years of age (PR = 1.22 and 1.18 , respectively), educational level ≥ 8 years (PR = 1.19 and 1.21, respectively), and current good self-rated health (PR = 1.88 and 1.94, respectively). Negative associations were observed for current age (PR = 0.99 for each increase of one year among men and women), medical diagnosis of depression (PR = 0.70 for men and PR = 0.87 for women), and having one or more at least chronic diseases (PR = 0.88 for men and 0.91 for women). Only for men, positive associations for the age at which they started working (PR = 1.14 and 1.12 for 11–17 and ≥ 18 years, respectively) and living with a spouse (PR = 1.09) were found. CONCLUSIONS Work ability in older ages is built over the life course, particularly by the health conditions in childhood and adolescence, age at which men begin working, educational level, and health conditions in older ages. Policies aimed at increasing longevity in the labor market must take these factors into account.
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Affiliation(s)
| | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | - Cibele Comini César
- Universidade Federal de Minas Gerais. Faculdade de Ciências Econômicas. Centro de Desenvolvimento e Planejamento Regional. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | - Jorge Alexandre Barbosa Neves
- Universidade Federal de Minas Gerais. Faculdade de Ciências Econômicas. Departamento de Sociologia. Belo Horizonte, MG, Brasil
| | - Fabíola Bof de Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | | | - Rosana Ferreira Sampaio
- Universidade Federal de Minas Gerais. Escola de Educação Física, Fisioterapia e Terapia Ocupacional. Programa de Pós-graduação em Ciências da Reabilitação. Belo Horizonte, MG, Brasil
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14
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Nunes BP, Batista SRR, Andrade FBD, Souza Junior PRBD, Lima-Costa MF, Facchini LA. Multimorbidity: The Brazilian Longitudinal Study of Aging (ELSI-Brazil). Rev Saude Publica 2018; 52Suppl 2:10s. [PMID: 30379288 PMCID: PMC6254906 DOI: 10.11606/s1518-8787.2018052000637] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 04/17/2018] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To evaluate the occurrence and factors associated with multimorbidity among Brazilians aged 50 years and over. METHODS This is a cross-sectional study in a nation-based cohort of the non-institutionalized population in Brazil. Data were collected between 2015 and 2016. Multimorbidity was assessed from a list of 19 morbidities, which were categorized into ≥ 2 and ≥ 3 diseases. The analysis included the calculation of frequencies and the most frequent 10 pairs and triplets of combinations of diseases. The crude and adjusted analyses evaluated the demographic, socioeconomic, behavioral, and contextual variables (area of residence, geopolitical region, and coverage of the Family Health Strategy) using Poisson regression. RESULTS From the total of 9,412 individuals, 67.8% (95%CI 65.6–69.9) and 47.1% (95%CI 44.8–49.4) showed ≥ 2 and ≥ 3 diseases, respectively. In the adjusted analysis, women, older persons, and those who did not consume alcohol had increased multimorbidity. There were no associations with race, area of residence, geopolitical region, and coverage of the Family Health Strategy. The 10 pairs (frequencies observed between 11.6% and 23.2%) and the 10 triplets (frequencies observed between 4.9% and 9.5%) of the most frequent diseases mostly included back problems (15 times) and systemic arterial hypertension (11 times). All combinations were statistically higher than expected by chance. CONCLUSIONS The occurrence of multimorbidity was high even among younger individuals (50 to 59 years). Approximately two in three (≥ 2 diseases) and one in two (≥ 3 diseases) individuals aged 50 years and over presented multimorbidity, which represents 26 and 18 million persons in Brazil, respectively. We observed high frequencies of combinations of morbidities.
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Affiliation(s)
- Bruno Pereira Nunes
- Universidade Federal de Pelotas. Faculdade de Enfermagem. Departamento de Enfermagem em Saúde Coletiva. Pelotas, RS, Brasil
| | | | - Fabíola Bof de Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | | | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | - Luiz Augusto Facchini
- Universidade Federal de Pelotas. Faculdade de Medicina. Departamento de Medicina Social. Pelotas, RS, Brasil
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15
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Pimentel WRT, Pagotto V, Stopa SR, Hoffmann MCCL, Andrade FBD, Souza Junior PRBD, Lima-Costa MF, Menezes RLD. Falls among Brazilian older adults living in urban areas: ELSI-Brazil. Rev Saude Publica 2018; 52Suppl 2:12s. [PMID: 30379287 PMCID: PMC6255337 DOI: 10.11606/s1518-8787.2018052000635] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 04/18/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To assess the prevalence and factors associated with falls in a nationally representative sample of older Brazilians residing in urban areas. METHODS Data from 4,174 participants (60 years or older) from the baseline of ELSI-Brazil, conducted between 2015 and 2016, were used. The outcome variable was the reporting of one or more falls in the last 12 months. The exploratory variables were sociodemographic characteristics, factors related to the urban environment, and health conditions. Statistical analysis was performed using Poisson regression. RESULTS The prevalence of falls was 25.1%. Of these, 1.8% resulted in a hip or femur fracture and, among them, 31.8% required surgery for prosthesis placement. Statistically significant associations (p < 0.05) with falls were observed for females [prevalence ratio (PR) = 1.26], age group of 75 years or older (PR = 1.21), fear of falling due to defective sidewalks (PR = 1.47), fear of crossing streets (PR = 1.22), diabetes (PR = 1.17), arthritis or rheumatism (PR = 1.29), and depression (PR = 1.53). No significant associations were found for educational level, marital status, hypertension, and perception of violence in the neighborhood. CONCLUSIONS The factors associated with falls among older adults are multidimensional, comprising individual characteristics and the urban environment, which indicates the need for intra and intersectoral actions to prevent falls in this population.
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Affiliation(s)
- Wendel Rodrigo Teixeira Pimentel
- Universidade de Brasília. Faculdade de Ceilândia. Programa de Pós-graduação em Ciências e Tecnologias em Saúde. Brasília, DF, Brasil.,Ministério da Saúde. Secretaria de Atenção à Saúde. Coordenação de Saúde da Pessoa Idosa. Brasília, DF, Brasil
| | - Valéria Pagotto
- Universidade Federal de Goiás. Faculdade de Enfermagem. Goiânia, GO, Brasil
| | - Sheila Rizzato Stopa
- Universidade de São Paulo. Faculdade de Saúde Pública. Programa de Pós-Graduação em Saúde Pública. São Paulo, SP, Brasil
| | | | - Fabíola Bof de Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | | | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | - Ruth Losada de Menezes
- Universidade de Brasília. Faculdade de Ceilândia. Programa de Pós-graduação em Ciências e Tecnologias em Saúde. Brasília, DF, Brasil
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16
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Andrade EIG, Cherchiglia ML, Souza Junior PRBD, Andrade FBD, Mambrini JVDM, Lima-Costa MF. Factors associated with the receipt of pensions among older adults: ELSI-Brazil. Rev Saude Publica 2018; 52Suppl 2:15s. [PMID: 30379294 PMCID: PMC6262943 DOI: 10.11606/s1518-8787.2018052000665] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 04/30/2018] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To describe the prevalence of receipt of pensions and associated factors in a nationally representative sample of the Brazilian population aged 50 years and over. METHODS We used data from 9,130 participants from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline survey. The outcome variable was receipt of pensions from any source. The exploratory variables were age, gender, residence by region and by urban/rural area, household arrangements, schooling, household assets, perception of income sufficiency, age when started working, number of chronic diseases, and functional limitation. The analyses were based on the Poisson and binary logistic regressions. RESULTS The prevalence of the receipt of pension was 54.3%. In the multivariate analysis, the following factors showed statistically significant (p < 0.05) associations with the outcome: age [Prevalence Ratio (PR) = 2.59 and 3.24 for 60-69 and 70 years], rural residence (PR = 1.23 ), residence in the Northeast, South and Southeast compared to the North (PR ranging from 1.18 to 1.23), living arrangements (PR = 1.07 and 1.15 for living with one person and living alone), perception of income sufficiency (PR = 1.08 and 1.15 for sometimes and always), functional limitation (PR = 1.13) and having 1 and ≥ 2 chronic diseases (PR = 1,09 and 1,17). Negative association was observed for 5-8 years of education. No association between age when the individual started working and the outcome was observed. Younger participants (50-59 years old) with ≥ 2 diseases or functional limitation were 31% and 63% more likely to receive pensions, respectively; the strength of these associations declined with age. CONCLUSIONS The results suggest that health conditions are important determinants of early retirement. Discussions to increase age to the retirement cannot be separated from those on improvements in the health conditions of the Brazilian population.
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Affiliation(s)
- Eli Iola Gurgel Andrade
- Universidade Federal de Minas Gerais. Faculdade de Medicina. Departamento de Medicina Preventiva e Social. Belo Horizonte, MG, Brasil
| | - Mariângela Leal Cherchiglia
- Universidade Federal de Minas Gerais. Faculdade de Medicina. Departamento de Medicina Preventiva e Social. Belo Horizonte, MG, Brasil
| | | | - Fabíola Bof de Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | - Juliana Vaz de Melo Mambrini
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
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Melo-Silva AMD, Mambrini JVDM, Souza Junior PRBD, Andrade FBD, Lima-Costa MF. Hospitalizations among older adults: results from ELSI-Brazil. Rev Saude Publica 2018; 52Suppl 2:3s. [PMID: 30379289 PMCID: PMC6255366 DOI: 10.11606/s1518-8787.2018052000639] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 03/09/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To examine the factors associated with hospital use and their frequency in a nationally representative sample of the Brazilian population aged 50 years or older. METHODS Data from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), conducted in 2015-2016, were used. Predisposing, enabling and need factors for the use of health services were considered. The analyzes were based on the Hurdle regression model and on estimates of population attributable risks. RESULTS Among 9,389 participants, 10.2% had been hospitalized in the previous 12 months. After adjusting for potential confounding variables, statistically significant associations (p < 0.05) were observed for need factors (previous medical diagnosis for chronic diseases and limitation to perform basic activities of daily living) and for enabling factors (living in a rural area and in the North and Midwest regions of the country). The analysis of population attributable risks (PAR) showed a hierarchy of the need factors for the occurrence of hospitalizations, with higher contributions by stroke (PAR = 10.7%) and cardiovascular disease (PAR = 10.0%), followed by cancer (PAR = 8.9%), difficulty to perform basic activities of daily living (PAR = 6.8%), depression (PAR = 5.5%), diabetes (PAR = 4.4% ) and hypertension (PAR = 2.2%). CONCLUSIONS Four of the major diseases associated with hospitalizations (stroke, cardiovascular disease, diabetes and hypertension) are part of the Brazilian list of primary care-sensitive hospitalizations. These results show that there is a window of opportunity to reduce unnecessary hospitalizations among older Brazilian adults through effective primary care actions.
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Affiliation(s)
- Alexandre Moreira de Melo-Silva
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | - Juliana Vaz de Melo Mambrini
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | | | - Fabíola Bof de Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
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Andrade JM, Duarte YADO, Alves LC, Andrade FCD, Souza Junior PRBD, Lima-Costa MF, Andrade FBD. Frailty profile in Brazilian older adults: ELSI-Brazil. Rev Saude Publica 2018; 52Suppl 2:17s. [PMID: 30379282 PMCID: PMC6255048 DOI: 10.11606/s1518-8787.2018052000616] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 05/18/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of frailty and to evaluate the associated factors in the non-institutionalized Brazilian population aged 50 years or older. METHODS The analyses were conducted in 8,556 participants of the baseline survey of the Longitudinal Study of Health of the Brazilian Elderly (ELSI-Brazil) conducted in 2015 and 2016. Frailty was defined based on five characteristics: weight loss, weakness, slowness, exhaustion and low level of physical activity. Participants with three or more characteristics were classified as frail. A Poisson regression model was used to examine the association between frailty and sociodemographic and health factors. RESULTS The prevalence of frailty was 9.0% (95%CI 8.0-10.1) among participants aged 50 years or over. Among the older adults aged 60 or over, the prevalence was 13.5% (95%CI 11.9-15.3) and 16.2% (95%CI 14.3-18.3) among those 65 aged years or over. Factors associated with higher prevalence of frailty were low schooling, residence without a partner, health conditions (poor self-rated health and two or more chronic diseases) and limitation to perform basic activities of daily living. CONCLUSIONS The prevalence of frailty among Brazilians aged 65 years or older is similar to their European counterparts. Poor health conditions, functional limitation and low schooling emerge as the factors most strongly associated with the frailty in this population.
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Affiliation(s)
- Juliana Mara Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | | | - Luciana Correia Alves
- Universidade Estadual de Campinas. Departamento de Demografia do Instituto de Filosofia e Ciências Humanas. Campinas, SP, Brasil
| | | | | | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | - Fabíola Bof de Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
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19
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Andrade FBD, Duarte YADO, Souza Junior PRBD, Torres JL, Lima-Costa MF, Andrade FCD. Inequalities in basic activities of daily living among older adults: ELSI-Brazil, 2015. Rev Saude Publica 2018; 52Suppl 2:14s. [PMID: 30379283 PMCID: PMC6255276 DOI: 10.11606/s1518-8787.2018052000617] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 04/20/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the magnitude of wealth-related inequalities in basic activities of daily living among community-dwelling Brazilian older adults and to determine the contribution of demographic, socioeconomic, and health conditions to the inequality. METHODS We used data from the 2015 Brazilian Longitudinal Study of Aging (ELSI-Brazil) with a nationally representative sample of adults aged 50 years or older. We assessed wealth-related inequalities in basic activities of daily living by the concentration index. Concentration index was decomposed to determine the contribution of demographic, health, and socioeconomic factors to wealth-related inequalities in basic activities of daily living. RESULTS The prevalence of disability in the sample was 15.7% (95%CI 14.9–17.6). The concentration index was -0.145 (95%CI -0.194– -0.097), which indicates that disability is concentrated in the poorest individuals in Brazil. Inequalities in basic activities of daily living disability are primarily explained by socioeconomic status (wealth and own education) not by demographic or health factors. CONCLUSIONS There are avoidable wealth-related inequities for those with a disability in Brazil. The strong contribution of the socioeconomic status highlights the need for new public health policies that promote equity, universality, and integrality, in addition to the expansion of home nursing public services.
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Affiliation(s)
- Fabíola Bof de Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | | | | | - Juliana Lustosa Torres
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
| | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil.,Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
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Loyola Filho AID, Firmo JOA, Mambrini JVDM, Peixoto SV, Souza Junior PRBD, Andrade FBD, Lima-Costa MF, Acúrcio FDA. Cost-related underuse of medications in older adults: ELSI-Brazil. Rev Saude Publica 2018; 52Suppl 2:8s. [PMID: 30379284 PMCID: PMC6255256 DOI: 10.11606/s1518-8787.2018052000622] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 04/11/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To assess the prevalence and factors associated with cost-related underuse of medications in a nationally representative sample of Brazilians aged 50 years and over. METHODS Among the 9,412 participants of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), 6,014 reported using at least one medication on regular basis and were included in the analysis. Underuse of medications was by stopping taking or reducing the number of tablets or the dose of any prescribed medication for financial reasons. The theoretical framework used for the selection of the exploratory variables included predisposing factors, enabling factors, and factors of need. Associations were tested by Poisson regression. RESULTS The prevalence of underuse of medications was 10.6%. After adjustments for relevant covariables, positive and statistically significant associations (p < 0.05) with the outcome were found for females [prevalence ratio (PR) = 1.39], sufficiency of the family income for expenses (PR = 1.74 for sometimes and PR 2.42 for never), frequency with which the physician explains about the disease and treatment (PR = 1.31 for rarely or never), number of medications used (PR = 1.39 for 2-4 and 1.53 for 5 or more), fair (PR = 2.02) and poor or very poor self-rated health (PR = 2.92), and a previous medical diagnosis of depression (PR = 1.69). Negative associations were observed for the age groups of 60-79 years (PR = 0.75) and 80 years and over (PR = 0.43), socioeconomic status of the household (PR = 0.70, 0.79, and 0.60 for the second, third, and fourth quartile, respectively), and private health plan coverage (PR = 0.79). There were no associations between hypertension and self-reported diabetes and underuse of medications. CONCLUSIONS Cost-related underuse of medications is multidimensional and complex, and it covers socio-demographic characteristics, health conditions, and the use of health services. The explanation about the disease and its treatment to the patient and the expansion of the universal access to pharmaceutical care can minimize the risks of underuse.
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Affiliation(s)
- Antônio Ignácio de Loyola Filho
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
- Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Aplicada. Belo Horizonte, MG, Brasil
| | - Josélia Oliveira Araújo Firmo
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | - Juliana Vaz de Melo Mambrini
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | - Sérgio Viana Peixoto
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
- Universidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Aplicada. Belo Horizonte, MG, Brasil
| | | | - Fabíola Bof de Andrade
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz. Instituto René Rachou. Núcleo de Estudos em Saúde Pública e Envelhecimento. Belo Horizonte, MG, Brasil
- Fundação Oswaldo Cruz. Instituto René Rachou. Programa de Pós-Graduação em Saúde Coletiva. Belo Horizonte, MG, Brasil
| | - Francisco de Assis Acúrcio
- Universidade Federal de Minas Gerais. Faculdade de Farmácia. Departamento de Farmácia Social. Belo Horizonte, MG, Brasil
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Theme Filha MM, de Souza Junior PRB, Damacena GN, Szwarcwald CL. Prevalence of chronic non-communicable diseases and association with self-rated health: National Health Survey, 2013. Rev Bras Epidemiol 2017; 18 Suppl 2:83-96. [PMID: 27008605 DOI: 10.1590/1980-5497201500060008] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 07/16/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the profile of 10 chronic noncommunicable diseases investigated in the National Health Survey carried out in Brazil in 2013 and their association with the self-rated health. METHODS A cross-sectional, population-based nationwide study with 60,202 individuals aged 18 years old or more. Sampling process by conglomerate was carried out in three stages of selection: census tract, household, and individual. The prevalence of chronic diseases by age, gender and educational status and the confidence intervals of 95% , the mean age at the first diagnosis and the proportion of limitation of the usual activities were calculated. To test the association with self-rated health, the logistic regression procedure adjusted for gender and age was used. RESULTS The more prevalent diseases were hypertension (21.4%), depression (7.6%), arthritis (6.4%), and diabetes mellitus (6.2%). Individuals diagnosed with stroke reported greater limitations in the daily activities (38.6%). There was a gradient in the prevalence by age and educational level, and all the diseases were more frequent among women. A worse self-rated health was observed among those with a diagnosis of stroke (OR = 3.60; p < 0.001) and those who referred two diseases (OR = 5.53; p < 0.001) or three or more diseases (OR = 10.86; p < 0.001). CONCLUSIONS Because these diseases are associated with modifiable risk factors, the prevention with population focus is the best strategy to reduce the burden of these diseases.
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Affiliation(s)
| | | | - Giseli Nogueira Damacena
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
| | - Celia Landmann Szwarcwald
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil
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Boccolini CS, de Souza Junior PRB. Inequities in Healthcare utilization: results of the Brazilian National Health Survey, 2013. Int J Equity Health 2016; 15:150. [PMID: 27852269 PMCID: PMC5112677 DOI: 10.1186/s12939-016-0444-3] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 09/12/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Brazilian Unified Health System is a public healthcare system that has universal and equitable access among its main principles, but the continental size of the country and the complexity of the public health system complicate the task of providing equal access to all. We aim to investigate the factors associated with inequities in healthcare utilization in Brazil. METHODS We employed data from a nationally representative cross-sectional study (2013 National Health Survey; n = 60,202). The outcome was underutilization of healthcare by adults, defined as lack of utilization of one or more of these services: physician or dentist consultation, and blood glucose or blood pressure screening. A logistic regression model, considering the complex sample, was employed (alpha = 5 %). RESULTS 0.7 % of the sample never visited a physician, 3.3 % never visited a dentist, 3 % never underwent blood pressure screening, 11.5 % never underwent blood glucose screening, and 15 % never utilized at least one of these services. Multivariate models showed a higher likelihood of underutilization of healthcare among individuals of the lowest social class "E" (AOR = 6.31, 95 % CI = 3.76-10.61), younger adults (Adjusted Odds Ratio, or AOR = 4.40, 95 % CI = 3.78-5.12), those with no formal education or incomplete primary education (AOR = 2.93, 95 % CI = 2.30-3.74), males (AOR = 2.16, 95 % CI = 1.99-2.35), and those without private health insurance (AOR = 2.11, 95 % CI = 1.83-2.44). Individuals self-classified as "white" were less likely to report underutilization (AOR = 0.82, 95 % CI = 0.75-0.90). CONCLUSIONS Despite recent expansion of primary healthcare and oral health programs in Brazil, we observed gaps in healthcare utilization among the most vulnerable segments of the population.
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Affiliation(s)
- Cristiano Siqueira Boccolini
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
| | - Paulo Roberto Borges de Souza Junior
- Institute of Scientific and Technological Communication and Information in Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.,Av. Brasil, 4.365 - Pavilhão Haity Moussatché - Manguinhos, Rio de Janeiro, CEP: 21040-900, Brazil
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Teixeira JB, Souza Junior PRBD, Higa J, Theme Filha MM. Mortality from Alzheimer's disease in Brazil, 2000-2009. CAD SAUDE PUBLICA 2015; 31:850-60. [PMID: 25945993 DOI: 10.1590/0102-311x00144713] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 09/29/2014] [Indexed: 01/06/2023] Open
Abstract
Alzheimer's disease is the most prevalent type of dementia in the elderly worldwide. To evaluate the mortality trend from Alzheimer's disease in Brazil, a descriptive study was conducted with the Mortality Information System of the Brazilian Ministry of Health (2000-2009). Age and sex-standardized mortality rates were calculated in Brazil's state capitals, showing the percentage variation by exponential regression adjustment. The state capitals as a whole showed an annual growth in mortality rates in the 60 to 79 year age bracket of 8.4% in women and 7.7% in men. In the 80 and older age group, the increase was 15.5% in women and 14% in men. Meanwhile, the all-cause mortality rate declined in both elderly men and women. The increase in mortality from Alzheimer's disease occurred in the context of chronic diseases as a proxy for increasing prevalence of the disease in the population. The authors suggest healthcare strategies for individuals with chronic non-communicable diseases.
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de Frias PG, Szwarcwald CL, Souza Junior PRBD, Almeida WDSD, Lira PIC. [Correcting vital information: estimating infant mortality, Brazil, 2000-2009]. Rev Saude Publica 2014; 47:1048-58. [PMID: 24626543 PMCID: PMC4206109 DOI: 10.1590/s0034-8910.2013047004839] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 07/30/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To propose a simplified method of correcting vital information and estimating
the coefficient of infant mortality in Brazil. METHODS Vital data in the information systems on mortality and live births were
corrected using correction factors, estimated based on events not reported
to the Brazilian Ministry of Health and obtained by active search. This
simplified method for correcting vital information for the period 2000-2009
for Brazil and its federal units establishes the level of adequacy of
information on deaths and live births by calculating the overall coefficient
of mortality standardized by age and the ratio between reported and expected
live births, respectively, in each Brazilian municipality. By applying
correction factors to the number of deaths and live births reported in each
county, the vital statistics were corrected, making it possible to estimate
the coefficient of infant mortality. RESULTS The highest correction factors were related to infant deaths, reaching values
higher than 7 for municipalities with very precarious mortality information.
For deaths and live births, the correction factors exhibit a decreasing
gradient as indicators of adequacy of the vital information improve. For the
year 2008, the vital information corrected by the simplified method per
state were similar to those obtained in the research of active search. Both
the birth rate and the infant mortality rate decreased in the period in all
Brazilian regions. In the Northeast, the annual rate of decline was 6.0%,
the highest in Brazil (4.7%). CONCLUSIONS The active search of deaths and births allowed correction factors to be
calculated by level of adequacy of mortality information and live births.
The simplified method proposed here allowed vital information to be
corrected per state for the period 2000-2009 and the progress of the
coefficient of infant mortality in Brazil, its regions and states to be
assessed.
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Szwarcwald CL, Escalante JJC, Rabello Neto DDL, Souza Junior PRBD, Victora CG. Estimação da razão de mortalidade materna no Brasil, 2008-2011. CAD SAUDE PUBLICA 2014; 30 Suppl 1:S1-12. [DOI: 10.1590/0102-311x00125313] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Accepted: 10/17/2013] [Indexed: 11/21/2022] Open
Abstract
Neste trabalho, propõe-se uma metodologia de estimação da razão de mortalidade materna (RMM), no Brasil, 2008-2011, por meio das informações do Ministério da Saúde. O método proposto leva em consideração, o sub-registro geral de óbitos, as proporções de investigação de mortes de mulheres em idade fértil, bem como as proporções de óbitos maternos que foram atribuídos, indevidamente, a outras causas antes da investigação. A RMM foi estimada por Unidade de Federação no triênio de 2009-2011. No Brasil, a RMM atinge o valor mínimo em 2011 (60,8/100 mil nascidos vivo) e o máximo em 2009 (73,1/100 mil nascidos vivos), explicado, provavelmente, pela epidemia de influenza A (H1N1). Os maiores valores da RMM foram encontrados no Maranhão e no Piauí, ultrapassando 100/100 mil nascidos vivos, e o menor foi apresentado por Santa Catarina, o único estado com magnitude inferior a 40/100 mil nascidos vivos. Os resultados indicaram valores superiores aos que deveriam ter sido alcançados de acordo com a quinta meta do milênio, mas apontaram para um decréscimo significativo no período de 1990-2011, se as estimativas anteriores da RMM forem consideradas.
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Vasconcellos MTLD, Silva PLDN, Pereira APE, Schilithz AOC, Souza Junior PRBD, Szwarcwald CL. Desenho da amostra Nascer no Brasil: Pesquisa Nacional sobre Parto e Nascimento. CAD SAUDE PUBLICA 2014; 30 Suppl 1:S1-10. [DOI: 10.1590/0102-311x00176013] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 03/24/2014] [Indexed: 11/22/2022] Open
Abstract
Este artigo descreve a amostra da Pesquisa Nacional sobre Parto e Nascimento no Brasil. Os hospitais com 500 ou mais nascidos vivos em 2007 foram estratificados por macrorregião, capital de estado ou não, e tipo, e selecionados com probabilidade proporcional ao número de nascidos-vivos em 2007. Amostragem inversa foi usada para selecionar tantos dias de pesquisa (mínimo de 7) quantos fossem necessários para alcançar 90 entrevistas realizadas com puérperas no hospital. As puérperas foram amostradas com igual probabilidade entre as elegíveis que entraram no hospital no dia. Os pesos amostrais básicos são o inverso do produto das probabilidades de inclusão em cada estágio e foram calibrados para assegurar que estimativas dos totais de nascidos vivos dos estratos correspondessem aos totais de nascidos vivos obtidos no SINASC. Para os dois seguimentos telefônicos (6 e 12 meses depois), a probabilidade de resposta das puérperas foi modelada pelas variáveis disponíveis na pesquisa de base, a fim de corrigir, para a não resposta, os pesos amostrais em cada onda de seguimento.
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Marano D, Gama SGND, Domingues RMSM, Souza Junior PRBD. Prevalence and factors associated with nutritional deviations in women in the pre-pregnancy phase in two municipalities of the State of Rio de Janeiro, Brazil. Rev bras epidemiol 2014; 17:45-58. [DOI: 10.1590/1415-790x201400010005eng] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 04/08/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: To assess the prevalence and potential factors associated with pre-pregnancy nutritional status of women. METHODS: This is a cross-sectional study carried out between December 2007 and November 2008 with 1,535 women in the first trimester of pregnancy and randomly selected in health units of the Brazilian public health system (SUS) in the municipalities of Queimados and Petrópolis in the State of Rio de Janeiro. The diagnosis of nutritional deviations was based on the Body Mass Index, according to the classification of the Institute of Medicine, and the following categories were obtained: underweight, normal weight, overweight and obesity. In the statistical analysis, the multinomial logistic regression model was used and an odds ratio and confidence interval of 95% were estimated. RESULTS: The sample included women between 13 and 45 years. The prevalence of underweight, overweight and obesity were 10, 18 and 11%, respectively. Women living in Queimados, adolescents, women who did not live with a partner and smokers had a higher proportion of low pre-pregnancy weight. There was an association between hypertension, overweight and obesity. Adolescents presented lower chance to overweight and obesity. Living in Queimados reduced the odds of overweight. CONCLUSION: The proportion of pre-pregnancy nutritional deviations was high, and recognizing factors that lead to them is very important for an early identification of women at nutritional risk, with view to interventions to reduce the adverse effects of malnutrition on maternal and child health.
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Frias PGD, Szwarcwald CL, Souza Junior PRBD, Almeida WDSD, Lira PIC. Correcao de informacoes vitais: estimacao da mortalidade infantil, Brasil, 2000-2009. Rev Saude Publica 2013. [DOI: 10.1590/s0034-89102013000901048] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Souza Junior PRBD, Szwarcwald CL, Castilho EAD. Self-rated health by HIV-infected individuals undergoing antiretroviral therapy in Brazil. CAD SAUDE PUBLICA 2011; 27 Suppl 1:S56-66. [PMID: 21503525 DOI: 10.1590/s0102-311x2011001300007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2009] [Accepted: 04/05/2010] [Indexed: 11/21/2022] Open
Abstract
In 2008, a survey was applied to a probabilistically selected sample of 1,245 HIV-infected patients on antiretroviral therapy in Brazil. In this work, the analysis was focused on self-rated health. The analysis was conducted according to sex, age, socioeconomic variables, and clinical and treatment-related patient characteristics. Through stepwise logistic regression procedures, the main predictors of good perception of health status were established. Results showed that 65% self-rated health state as good or excellent, 81% do have no or slight difficulty in following treatment, but 34% men and 47% women reported intense or extreme degree of anxiety/worry feelings. Educational level, work situation, presence of side effects and AIDS-related symptoms were the main predictors of good self-perception of health. Problems related to animus status, involving worry and anxiety about the future are still barriers that must be overcome to improve quality of life of people living with HIV/AIDS.
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Theme Filha MM, Szwarcwald CL, Souza Junior PRBD. [Measurements of reported morbidity and interrelationships with health dimensions]. Rev Saude Publica 2008; 42:73-81. [PMID: 18200343 DOI: 10.1590/s0034-89102008000100010] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2006] [Accepted: 09/11/2007] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To assess the interrelationships between self-rated health, perceptions of long-term illness and diagnoses of chronic diseases. METHODS In the World Health Survey, carried out in Brazil in 2003, 5,000 individuals aged 18 years and over who had been selected from a three-stage stratified sample were interviewed. The original questionnaire was adapted for the Brazilian context. It covered the presence of long-term illness or disability, self-rating of health (general and in several domains) and diagnoses of six chronic diseases (arthritis, angina, asthma, depression, schizophrenia and diabetes mellitus). To compare the relationships between self-rated health, perceptions of long-term illness and the chronic diseases evaluated, the statistical test of homogeneity of proportions and multiple logistic regression models were used. RESULTS Self-rating of health as "not good" and perceptions of having long-term illnesses were significantly more frequent among women, individuals aged 50 years and over and individuals with one or more of the diseases investigated. The interviewees with a diagnosis of diabetes mellitus presented the worst self-rated health: 70.9% reported having a long-term illness and 79.3% considered that their health was "not good". Worse health ratings were found when two or more diseases were present together. The effect of self-rating of health on the perceptions of long-term illness was stronger than was the number of diseases. CONCLUSIONS The three ways of measuring morbidity presented significant interrelationships. Self-rating of health as "not good" had a more important effect on the perceptions of long-term illness, thus suggesting that subjective measurements of health status may be more sensitive for establishing and monitoring individuals' wellbeing.
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